Post on 18-Jan-2017
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM)
BY MALAYSIAN CONSUMERS
Edited and prepared by:Mohamad Azmi H, Asrul Akmal S, Chua GN
With contributions from:Siti Fauziah A, Lai ST, Norazlin AK, Norazila AG, Abdul Haniff MY, Yap YW, Leow CY, Salmah B, Salmiah MA, Che Pun B, Mohd Dziehan M, Siew LJ
A publication of the Pharmaceutical Services Division and the Clinical Research Centre
Ministry of Health Malaysia
Book.A National Survey On The Use of Medicines_2.12.indd 1 1/20/14 10:33 AM
July 2013© Ministry of Health Malaysia
Published by:Quality Use of MedicinesPharmaceutical Services DivisionMinistry of Health MalaysiaLot 36, Jalan Universiti,46350 Petaling Jaya,Selangor Darul Ehsan,Malaysia.
Tel : (603) 7841 3200Fax : (603) 7968 2222Website : http://www.pharmacy.gov.my
This report is copyrighted. Reproduction and dissemination of this report in part or in whole for research, educational or other non-commercial purposes are authorised without any prior written permission from the copyright holders provided the source is fully acknowledged. Suggested citation is: Pharmaceutical Services Division, Ministry of Health Malaysia. A National Survey on the Use of Medicines (NSUM) by Malaysian Consumers 2012.
This report is also published electronically on the website of the Pharmaceutical Services Division at: http://www.pharmacy.gov.my.
Funding:The National Survey on the Use of Medicines (NSUM) by Malaysian Consumers 2012 is funded by the Operational Budget from Pharmaceutical Services Division, Ministry of Health Malaysia and had been registered at National Medical Research Registry with the given ID No.: NMRR-11-1139-9587.
Book.A National Survey On The Use of Medicines_2.12.indd 2 1/20/14 10:33 AM
CONTENTS PAGEAcknowledgement 5 Executive Summary 6NSUM Project Team 8Data Collectors 9List of Tables (Survey 1) 11List of Tables (Survey 2) 13List of Figures (Survey 2) 13
SURVEY 1: A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
1.0 Introduction 16
2.0 Objectives 17
3.0 Methods 17 3.1 Sample size 18 3.2 Sampling method 18 3.3 Data analysis 18 3.4 Ethical consideration 18
4.0 Results 19 4.1 Demographic data 19 4.2 Pattern of medicines use 20 4.3 Access to medicines 24 4.4 Perception towards medicines labelling 35 4.5 Awareness towards appropriate use of medicines 44 4.6 Assessment towards medication compliance 55 4.7 Assessment of medicines information resources 59 4.8 Awareness on ‘Know Your Medicines’ programme 76
5.0 Discussions 83
6.0 Limitations 86
7.0 Conclusions 86
References 88
Book.A National Survey On The Use of Medicines_2.12.indd 3 1/20/14 10:33 AM
CONTENTS PAGESURVEY 2: EVALUATION OF “KNOW YOUR MEDICINES” PROGRAMME 2012
1.0 Introduction 92
2.0 Objective 93
3.0 Methods 93 3.1 Sample size 94 3.2 Data analysis 94 3.3 Ethical consideration 95
4.0 Results 95 4.1 Part A: Demographic characteristics 95 4.2PartB:Specificcomparisonofresponseatpreandpostprogrammeactivity 96 4.3 Part C: Comparison of knowledge score at pre and post programme activity 99 4.4 Part D: Qualitative response to the programme 100
5.0 Discussions 101
6.0 Limitations 103
7.0 Conclusions 103
References 104
Appendixes 107
Book.A National Survey On The Use of Medicines_2.12.indd 4 1/20/14 10:33 AM
5
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
ACKNOWLEDGEMENT
First and foremost we would like to express our most gratitude to the Director General of Health Malaysia for the permission in publishing this report. Sincere appreciation also to the Ministry of Health Malaysia (MOH) for giving us the opportunity to collaborate in this project and coming up with the second report after five years Quality Use of Medicines-Consumer campaign was launched.
To evaluate the performance of the campaign, two surveys were conducted in year 2012, namely:
Survey 1: A National Survey on the Use of Medicines (NSUM) by Malaysian Consumers 2012
Survey 2: An Evaluation of “Know Your Medicines” Programme 2012 – Pre & Post Survey
Indeed it was a great effort by all the parties involved in these two (2) surveys until this report is published.
We also would like to thank all the data collectors from the various parts of the nation whose enthusiasm, determination and perseverance shown during the training and data collecting sessions which yielded excellent data to be used in this report. Finally, we would like to thank all our colleagues from MOH, Universiti Sains Malaysia (USM) for the excellent intellectual inputs in making this research project a success. We really hope that the output of this report could be utilized by those interested parties in improving consumer use of medicines.
Pharmaceutical Services DivisionMinistry of Health Malaysia
Book.A National Survey On The Use of Medicines_2.12.indd 5 1/20/14 10:33 AM
6
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
EXECUTIVE SUMMARY
Quality Use of Medicines (QUM) is one of the central objectives of Malaysia’s National Medicines Policy. Within the context of QUM framework, it is crucial to get current data from the general population in order to assess their understanding on issues related to rational use of medicines. Also, information from the survey will help the policy makers to evaluate the impact of strategies that had been taken in order to improve quality use of medicines among consumers in this country. Furthermore, the data gain from such survey will be useful for devising future strategies to further enhance quality use of medicines among Malaysian population.
In order to get in-depth data and information on issues related to medicines use among Malaysian consumers, a cross sectional national survey for a period of 3 months (between 14th February - 15th May 2012) were conducted among 3,154 consumers across the country. The study findings showed that:
• Up to 40% of Malaysian consumers were found to be using some form of pharmaceuticals, traditional health compounds and beauty products in their everyday life to manage their health, general well-being and appearance. Of these,
¾ 28.4% were on chronic medications,
¾ 25.2%-37.1% were using vitamins, minerals & supplements,
¾ 9.6%-17.8% were using traditional medicines in the form of herbal beverages, processed and non-processed herbs, and
¾ 12.0% were using beauty products.
• Spending on medicines obtained from private health facilities ranged between null to RM13,807.33 with average of RM82.14 monthly.
• Despite extensive use of pharmaceuticals,
¾ 43.5% did not fully understand the proper use of their medicines
¾ 50.2% were not able to identify the trade or generic name of their medicines
¾ 35.8% were not aware of common side effects of their medicines
¾ 34.7% were not aware of the possible interactions between traditional and modern medicines
The study also found that;
• Doctors were the respondents’ first point of reference when experiencing problems with health, with slightly more than half of them (56.0%) opted to consult a doctor in the government sector.
• The three most common facilities where consumers obtained their medicines are clinics (85.9%), hospitals (75%) and community pharmacies (72.2%).
• Over 80% of respondents perceived medicines labels as adequate and did not report any difficulties in reading the labels.
Book.A National Survey On The Use of Medicines_2.12.indd 6 1/20/14 10:33 AM
7
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
• Although an increasing proportion of consumers were more aware of the safety and regulatory issues of medicines, compliance remained a problem for approximately 70% of the consumers.
• An emerging problem with sharing of medicines can be anticipated with as many as 29.5% of consumers reported to be sharing medications.
• When acquiring medicines information, consumers’ first point of reference was the doctors (51%) and pharmacists (29.3%).
• Majority of consumers (72.5%) preferred additional written information on medicines.
• Majority of consumers (67.3%) stated that they require additional medicines counselling sessions with pharmacists in order to understand and overcome problems pertaining to their medicines.
• Awareness of the national effort to promote quality use of medicines via the ‘Know Your Medicines’ programme among consumers was marginally good but participation remains relatively low.
• Of those who had participated in the ‘Know Your Medicines’ programme, significant improvement was exhibited in their understanding and interpretation on medicines specifically on the use of medicines, type, labelling and registration of medicines, sources of controlled medicines and medicines disposal.
Book.A National Survey On The Use of Medicines_2.12.indd 7 1/20/14 10:34 AM
8
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM PROJECT TEAM
Advisor
Dr. Salmah binti BahriDirector of Pharmacy Practice & DevelopmentPharmaceutical Services DivisionMinistry of Health, Malaysia
Consultants
Assoc. Prof. Dr. Mohamed Azmi bin Ahmad HassaliDeputy Dean,School of Pharmaceutical SciencesUniversiti Sains Malaysia
Assoc. Prof. Dr. Asrul Akmal ShafieDiscipline of Social and Administrative PharmacySchool of Pharmaceutical SciencesUniversiti Sains Malaysia
Ms. Chua Gin NieDiscipline of Social and Administrative PharmacySchool of Pharmaceutical SciencesUniversiti Sains Malaysia
Prof. Dr. Salmiah binti Mohd. AliDeputy Dean (Research and Development)Head of Department & Professor of Pharmacy PracticeMAHSA University
Principal Investigator
Ms. Siti Fauziah binti AbuSenior Principal Assistant DirectorPharmaceutical Services DivisionMinistry of Health, Malaysia
Co-Investigators
Madam Norazlin binti Abd. KadirPharmacist U52Kota Tinggi Hospital, Johor
Madam Norazila binti Abdul GhaniPharmacist U48Sultanah Bahiyah Hospital, Alor Setar
Mr. Abdul Haniff bin Mohamad YahayaPharmacist U48Teluk Intan Hospital, Perak
Madam Yap Yee WoonPharmacist U44Cheras Health Clinic, Kuala Lumpur
Ms. Lai Sook TzePharmacist U44Health Department Federal Territory of Kuala Lumpur & Putrajaya
Mr. Mohd. Dziehan bin MustapaPrincipal Assistant DirectorPharmaceutical Services Division Ministry of Health, Malaysia
Madam Leow Chuan YingPharmacist U44Kampung Pandan Health Clinic, Kuala Lumpur
Secretariat
Madam Che Pun binti BujangDeputy Director of Pharmacy Practice and Development,Pharmaceutical Services DivisionMinistry of Health, Malaysia
Madam Munira binti MuhammadSenior Principal Assistant DirectorPharmaceutical Services DivisionMinistry of Health, Malaysia
Madam Siew Lee JinSenior Assistant DirectorPharmaceutical Services DivisionMinistry of Health, Malaysia
Madam Hazlin binti OthmanSenior Assistant DirectorPharmaceutical Services DivisionMinistry of Health, Malaysia
Book.A National Survey On The Use of Medicines_2.12.indd 8 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
9
DATA COLLECTORSPERLIS
Wan Irnayufzan Hani Wan Ab RahmanPharmacist
Pharmaceutical Services Division, PerlisLim Chian Khie
PharmacistPharmaceutical Services Division, Perlis
Nurul Hidayah MahamudPharmacist
Pharmaceutical Services Division, Perlis
KEDAHGan Seok Mei
PharmacistPharmaceutical Services Division, Kedah
Noraishah Abu BakarPharmacist
District Health Office, Kota SetarNur Azimah Mohd. Rhazi
PharmacistKulim HospitalKhor Chee Hau
PharmacistBaling Hospital
PULAU PINANGNor Mazuen Mohd. Noor
PharmacistPharmaceutical Services Division, P.Pinang
Lee Yoon WeiPharmacist
Seberang Jaya HospitalTiew Poh SinPharmacist
District Health Office, Timur LautJenny Tan Soo Hoon
PharmacistPulau Pinang Hospital
SELANGORNorhayati Musa
PharmacistPharmaceutical Services Division, Selangor
Ng Poh LeePharmacist
Tengku Ampuan Rahimah Hospital
Kwan Wai HongPharmacist
Sekinchan Health ClinicGan Cheng Ling
PharmacistSabak Bernam Hospital
PERAKNurul Izyani Ismail
PharmacistPharmaceutical Services Division, Perak
Norzuraida Abdul WahabPharmacist
Batu Gajah HospitalYap Cheng Hoon
PharmacistTaiping Health Clinic
Kow Pei CheahPharmacist
Slim River HospitalNurul Akma Harun
PharmacistGunung Rapat Health Clinic
KUALA LUMPURMaisara Abdul Rahman
PharmacistPharmaceutical Services Division, WPKL&P
Tan Yee MayPharmacist
Kuala Lumpur Hospital
LABUANChan Chiew Ting
PharmacistPharmaceutical Services Division, Labuan
Gopinatha GaneshPharmacist
Pharmaceutical Services Division, Labuan
MELAKAKhairunnisa Ishak
PharmacistPharmaceutical Services Division, Melaka
Lim Chia WeiPharmacist
Melaka HospitalNadiah Mohd. Mokhtar
PharmacistPadang Sebang Health Clinic
Book.A National Survey On The Use of Medicines_2.12.indd 9 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
10
NEGERI SEMBILANOng See WanPharmacist
Pharmaceutical Services Division, N.SembilanNorlizawati Sariffudin
PharmacistTuanku Jaafar Hospital
O Fui KimPharmacist
Tampin Hospital
JOHORGrace Yung Sze Chia
PharmacistPharmaceutical Services Division, Johor
Norfahmi Mohd. YusofPharmacist
Pharmaceutical Services Division, JohorIzzati Mohd Farok
PharmacistKota Tinggi Hospital
Norashikin Mohd. SamanPharmacist
Chaah Health Clinic
PAHANGTou Pui YeePharmacist
Pharmaceutical Services Division, PahangOmar Othman
PharmacistRaub HospitalJuliza YahyaPharmacist
Bandar Kuantan Health Clinic
SABAHSarawati Mdius
PharmacistPharmaceutical Services Division, Sabah
Musliza ZaidanPharmacist
Duchess of Kent HospitalNurafizah Embok Cheni
PharmacistTawau Hospital
Heng Jin EePharmacist
Keningau Hospital
KELANTANRuzaira Che Razak
PharmacistPharmaceutical Services Division, Kelantan
Lim Ee LainePharmacist
Raja Perempuan Zainab II HospitalAzizah Mohamed
PharmacistJeli Hospital
Shaira Shuwairi Sha-AladinPharmacist
Tanah Merah Hospital
TERENGGANUZunaidah Abdul Rashid
PharmacistPharmaceutical Services Division, Terengganu
Aliana A. RahmanPharmacist
Pharmaceutical Services Division, TerengganuNor Idamarlini Mohamad
PharmacistKemaman Hospital
Tun Maizatul Hafiza Tuan AhmadPharmacist
Hulu Terengganu Hospital
SARAWAKHeriman Mahali
PharmacistMakmal Ubat & Stor Miri
Robin Tan Tiow HengPharmacist
Pharmaceutical Services Division, SarawakIvory Jeanne Ak Bakri
PharmacistSarawak General Hospital
Tang Chen JewPharmacist
Sarikei Health Clinic
Book.A National Survey On The Use of Medicines_2.12.indd 10 1/20/14 10:34 AM
11
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
LIST OF TABLESSURVEY 1: A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN
CONSUMERS 2012
Table 1 Demographic characteristics of respondents
Table 2 Prescription and non-prescription medicines use patterns among consumers
Table 3 General spending on prescription and non-prescription medicines in the last 3 months
Table 4 Factors associated with medicines expenditure in different facilities
Table 5 First action taken by respondents if experiencing any health problems
Table 6 First action taken by respondents if experiencing any health problems according to demographic
Table 7 Consumers’ choice of facilities to obtain medicines
Table 8 (1) Factors associated with consumers’ choice of facilities to obtain medicines
Table 8 (2) Factors associated with consumers’ choice of facilities to obtain medicines
Table 9 Factors affecting medicines-label reading and consumers’ perceived labelling adequacy
Table 10 Association between difficulties in reading medicines labels and demographic characteristics
Table 11 Association between labelling satisfaction and demographic characteristics
Table 12 Association between ability to identify medicines by trade or generic name and demographic characteristics
Table 13 Association between the knowledge on proper use and storage of medicines and demographic characteristics
Table 14 Association between the awareness on the side effects and shelf life of medicines and demographic characteristics
Table 15 Factors affecting the awareness on food-medicines and modern-traditional medicines interactions
Table 16 Response to “Did you know that all modern and traditional medicines should be registered with Ministry of Health?” based on demographic characteristics
Table 17 Factors affecting knowledge on Meditag® availability
Table 18 Response to “Have you ever forgotten to take the prescribed medicines as indicated?” based on demographic characteristics
Book.A National Survey On The Use of Medicines_2.12.indd 11 1/20/14 10:34 AM
12
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Table 19 Response to “Have you ever chosen not to take the prescribed medicines?” based on demographic characteristics
Table 20 Response to “Have you ever shared any medicines with others?” based on demographic characteristics
Table 21 Consumers’ first point of reference on medicines-related issues
Table 22 Response to “Who will be the FIRST person that you consult concerning medicines?” based on demographic characteristics
Table 23Proportion of consumers having difficulties in obtaining medicines information from government doctors/private doctors/government pharmacists/community pharmacists
Table 24 (1)Association of proportion of consumers having difficulties in obtaining medicines information from government doctors/private doctors/government pharmacists/community pharmacists with demographic characteristics
Table 24 (2)Association of proportion of consumers having difficulties in obtaining medicines information from government doctors/private doctors/government pharmacists/community pharmacists with demographic characteristics
Table 25 Frequency of obtaining medicines information from various information sources among Malaysian consumers
Table 26Response to “How often do you obtain medicines information from printed materials, internet and common information channels?” based on demographic characteristics
Table 27Response to “How often do you obtain medicines information from modern healthcare professionals/traditional & complimentary practitioners/friends, family or friends?” based on demographic characteristics
Table 28 Consumers’ response to “Do you need written medicines information?” based on demographic characteristics
Table 29 Responses to “Do you require additional counselling from your pharmacists?” based on demographic characteristics
Table 30 Consumers’ awareness of “Know Your Medicines” programme
Table 31 Consumers’ sources of information about the “Know Your Medicines” programme
Table 32(1) Association between the sources of information about the “Know Your Medicines” programme and area of settlement
Table 32(2) Association between the sources of information about the “Know Your Medicines” programme and area of settlement
Table 33 Attendance for “Know Your Medicines” programme activities
Table 34 Responses to “Have you attended any of the programme’s activities?” based on demographic characteristics
Table 35 Responses to “How satisfied are you with the programme?” based on demographic characteristics
Book.A National Survey On The Use of Medicines_2.12.indd 12 1/20/14 10:34 AM
13
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
LIST OF TABLESSURVEY 2: EVALUATION OF “KNOW YOUR MEDICINES” PROGRAMME 2012
Table 1: Demographic characteristics of respondents
Table 2: Respondents’ knowledge on the Quality Use of Medicines at pre and post intervention
LIST OF FIGURESSURVEY 2: EVALUATION OF “KNOW YOUR MEDICINES” PROGRAMME 2012
Figure 1: Comparison of respondents’ knowledge score at pre and post programme activities
Book.A National Survey On The Use of Medicines_2.12.indd 13 1/20/14 10:34 AM
Book.A National Survey On The Use of Medicines_2.12.indd 14 1/20/14 10:34 AM
SURVEY 1: A NATIONAL SURVEY ON THE USE OF
MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Book.A National Survey On The Use of Medicines_2.12.indd 15 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
16
1.0 INTRODUCTIONSince the existence of mankind, medicines have become essential for reducing mortality and morbidity from various diseases. Within this context the availability of medicines itself will not guarantee that the patients or the healthcare workers will use it appropriately. In order to achieve a holistic process of medication use, many nations are promoting the concept of ‘Quality Use of Medicines’. In a nutshell, ‘Quality Use of Medicines’ can be defined as ‘patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and the lowest cost to them and their community’.1 It is acknowledged that the inappropriate use of medicines can relate to poor or negative health outcomes, increase adverse events and health costs among healthcare consumers around the world.2-6 Research by the California Board of Pharmacy in United States for instance had reported that half of the prescriptions taken each year are used improperly and 96% of patients nationwide fail to ask questions about how to use their medications.7 In the year 2000 alone, more than USD177 billion were estimated for the annual costs of drug-related illness and death in ambulatory care settings.8 Based on the report by Institute of Medicine on ‘Preventing Medication Errors’ in 2006, it was estimated that more than 1.5 million people are injured by medication errors each year incurring a cost of about USD3.5 billion.9
In Malaysia, initial study was conducted to explore issues related to quality use of medicines among consumers by the Pharmaceutical Services Division of Ministry of Health in collaboration with the experts from Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia (USM) revealed that 55.6% of public or consumers did not understand the proper
use of their medicines.10 Maximising health outcomes, reducing adverse events and keeping the health costs within the affordable limits are the initiatives that are being implemented around the world in order to improve the use of medicines. Recognizing that consumer behaviour also influences medication use, introducing consumer strategies to improve the use of medicines is necessary in any country’s attempts to promote rational drug use.11 Within this context, the Malaysian government, through the Ministry of Health (MOH) has developed a comprehensive National Strategy for Quality Use of Medicines-Consumers (QUM-C). A key principle of the strategy is the primacy of consumers in any initiative to promote QUM through effective self-care practices via ‘Know Your Medicines’ programme. Effective self-care involves a complex sequence of tasks, including diagnosing the condition and its cause, selecting proper medicines therapy and monitoring treatment effectiveness. Whereas patients and healthcare providers have always shared these decisions to some extent, the current availability of the medications, which involved both prescriptions and non-prescriptions items allows greater potential in decision making for patients acting with and without direct provider guidance.
In recent years, many European countries have undertaken public education campaigns to encourage rational use of medicines. Few countries such as Australia, United States and Switzerland have published an evaluation of the campaign effectiveness. While some of these campaigns have had limited success, others have been very effective.11-15 For example, repeated sun protection campaigns in Australia was reported to successfully sensitize its targeted audience to be highly aware of the campaign existence over the 3 years.16 It is crucial to learn from the successful campaign elsewhere on
Book.A National Survey On The Use of Medicines_2.12.indd 16 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
17
creating and maintaining awareness. A survey on the use of medicines by consumers in federal territories of Kuala Lumpur & Putrajaya in 2009 stated that there was a 38.2% improvement in understanding and knowledge on medicines use among 70% of consumers. It showed that there was an escalated improvement in consumer’s interpretation and understanding on medicines, in part of trade name (40.4% vs. 80%), knowledge of generic name (27.9% vs. 48.3%), knowledge of side effects (32.7% vs. 51.7%), knowledge on storage (59.4% vs. 73.8%) and discontinuation of medications upon recovery (25.3% vs. 63.6%).17
The ‘Know Your Medicines’ programme strategy was planned in tandem with the aspiration of one of the important components in the Malaysian National Medicines Policy which directly stresses the importance of the QUM concept among consumers of this nation. Thus, in order to understand how effective Malaysian healthcare consumers use their medicines and the impact of the ‘Know Your Medicines’ programme, it is essential to get current data so that the health authorities can plan necessary strategies to enhance consumers’ understanding on the concept of quality use of medicines which is one of the main agenda in the Malaysian National Medicines Policy.18
2.0 OBJECTIVES1. To identify prescription and non-prescription
medicines use pattern among consumers. 2. To explore current knowledge of consumers
on medicines usage.3. To document sources of medicines information
channels commonly used by consumers.4. To evaluate the awareness among
the consumers towards the education programmes on the use of medicines.
3.0 METHODSA cross sectional survey for a period of 3 months (between 14th February – 15th May 2012) was conducted across the country. The questionnaire used in this study had been developed via consultation with all the selected representatives involved with the ‘Malaysian Comprehensive National Project on the Rational Use of Drugs’ and extensive review of available literatures pertaining to consumer surveys on rational use of medicines conducted elsewhere. The developed questionnaire was tested for its content validity by engaging 250 patients from different socioeconomic status and 50 pharmacists practicing in government health centres. The final version of questionnaire consisted of six major domains which includes demographic profile of respondents (7 items), pattern of medicines use (4 items), access to medicines (2 items), patient understanding on medicines (part 1 – 5 items, part 2 – 8 items, part 3 – 3 items), sources of medicines information (5 items) and awareness of ‘Know Your Medicines’ programme (6 items). The final version of the questionnaire was distributed by trained data collectors which had been appointed by the Pharmaceutical Services Department, The Ministry of Health Malaysia.
Inclusion criteria for the potential respondents: • Age 18 years and above. • Non-hospitalized. • Able to read, write and listen (for those who
are illiterate). • Provide verbal consent to participate (ethical
requirement). • Living within 30 kilometres from the chosen
cluster in each state.
Book.A National Survey On The Use of Medicines_2.12.indd 17 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
18
3.1 Sample size
Based on the 95% confidence interval and margin of error of 5%, using a sample size calculator, 377 participants were needed.19
As a national survey with an estimation of 70% participation rate, the estimated sample size required was around 641 individuals. By applying a common design effect of 4 for large sample surveys, the projected sample size of the population that needs to be surveyed was around 2,564.20 For the purpose of this study a total of around 3,000 respondents were surveyed. For each state, at least 200 consumers were approached for participation (100 in rural and 100 in urban area).
3.2 Sampling method
For the purpose of this study, one stage random cluster sampling technique was employed as there is no national sampling frame available.21-23 Using this method, two clusters represented by two public healthcare centres in each state (except Sarawak and Pahang) that delivers healthcare services for most rural and urban population were determined and chosen by using population dataset available from Malaysian Department of Statistics. These public health centres served as a reference point for the administration of the survey. Those who were living within 30 kilometres radius from this reference point were surveyed randomly by the respective assigned data collectors. In each state except Sarawak and Pahang, a total of 100 respondents were surveyed in each clusters (rural and urban). By using this method, a total of 2,400 respondents were surveyed from these 12 states. As Sarawak and Pahang represent the largest and second largest states respectively in Malaysia in terms of its geographical demarcation, additional 2 clusters were
included for sampling purposes and for each cluster 75 respondents were surveyed (rural and urban).This in return gave a total number of 600 respondents surveyed for these two states (300 respondents in each state).
3.3 Data analysis
The analysis of cost data is often complicated by the typically right-skewed distribution due to data clumping at zero. This was also inherent in the present study when estimating the respondents’ medicines expenditure. In order to overcome this problem in the cost analysis, consumers with zero cost were excluded and the rest were log transformed prior to analysis.
All responses received on knowledge and sources of medicines information were cross tabulated and analyzed with Chi-square test, Mann-Whitney test, Kruskal-Wallis test and Spearman correlation test using SPSS software version 18. Missing data were treated as complete case analysis. For all statistical tests performed, the significance level was set a priori at p<0.05.
3.4 Ethical consideration
All the data collectors explained the purpose of the study to their potential respondents prior to administering the survey forms. A verbal consent was obtained from each respondent before the start of the survey. No findings which could identify any individual participant were published. Participation in this research was entirely voluntary.
Book.A National Survey On The Use of Medicines_2.12.indd 18 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
19
4.0 RESULTS4.1 Demographic data
From Table 1, a total of 3,154 respondents from all fifteen states across Malaysia participated in the study. Each state contributed between 6.0-6.3% of the sample respondents except for Pahang and Sarawak which were represented by 295 (9.4%) and 285 (9.0%) participants respectively. The proportion of male participants was 39.9% (n=1,257) while 60.1% was female (n=1,897). Malay participants consisted of 63.9% (n=2,014) of the whole sample while 665 (21.1%) of the participants were Chinese, 197 (6.2%) were Indian and 278 (8.8%) were of other ethnics.
In terms of level of education, 315 (10.0%) of them received primary school level of education, 1,337 (42.4%) received secondary school level of education, and 1,386 (43.9%) received tertiary level of education. A total of 116 (3.7%) of the participants did not receive any formal education. About 33.8% (n=1,067) of the participants were government employees while private sector employees made up of 34.3% (n=1,082) of the participants. Approximately 6.8% (n=215) of participants had retired, 8.9% (n=282) were still studying, and 16.1% (n=508) of them were unemployed. Majority of the participants (n=2,608; 82.7%) lived with their family. Participants were mostly living in urban areas (n=2,291; 72.6%).
Table 1: Demographic characteristics of respondents
Variable n (%)State Johor 200 ( 6.3)
Kedah 200 ( 6.3)Kelantan 189 ( 6.0)Melaka 200 ( 6.3)Negeri Sembilan
200 ( 6.3)
Pahang 295 ( 9.4)Perak 193 ( 6.1)Perlis 200 ( 6.3)Penang 200 ( 6.3)Sabah 200 ( 6.3)Sarawak 285 ( 9.0)Selangor 200 ( 6.3)Terengganu 200 ( 6.3)WP KL 192 ( 6.1)WP Labuan 200 ( 6.3)
Location Urban 2,291 (72.6)Rural 863 (27.4)
Gender Male 1,257 (39.9)
Female 1,897 (60.1)Race Malay 2,014 (63.9)
Chinese 665 (21.1)Indian 197 ( 6.2)Others 278 ( 8.8)
Education level
Primary school
315 (10.0)
Secondary school
1,337 (42.4)
College/university
1,386 (43.9)
No formal education
116 ( 3.7)
Occupation Government 1,067 (33.8)Private/self employed
1,082 (34.3)
Retired 215 ( 6.8)Student 282 ( 8.9)Unemployed 508 (16.1)
Living status Alone 426 (13.5)With family 2,608 (82.7)With non-family
120 ( 3.8)
Book.A National Survey On The Use of Medicines_2.12.indd 19 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
20
4.2 Pattern of medicines use
Table 2 shows the types of medicines used by consumers. Approximately, 28.4% of the respondents reported to be on chronic medicines while 37.1% of the respondents were taking vitamins and 25.2% of the respondents were taking minerals and supplements. The use of non-processed and processed herbs were reported in 9.6% and 11.3% of the respondents respectively. In addition, 17.8% of the respondents were taking herbal beverages and 12% of them were using beauty care products.
Table 2: Prescription and non-prescription medicines use patterns among consumers
Medicines use n (%)
Chronic medicinesYes 896 (28.4)
No 2,255 (71.5)
VitaminsYes 1,170 (37.1)
No 1,978 (62.7)
Minerals and supplements
Yes 795 (25.2)
No 2,352 (74.6)
Non-processed herbsYes 304 ( 9.6)
No 2,844 (90.2)
Processed herbsYes 355 (11.3)
No 2,792 (88.5)
Herbal beveragesYes 560 (17.8)
No 2,589 (82.1)
Beauty care productsYes 378 (12.0)
No 2,768 (87.8)
On average Malaysian spent RM82.14 (SD=RM160.48) on medicines. Malaysian consumers spent the most for their medicines in private hospital (mean=RM241.49, SD=RM320.81), (Table 3). Medicines obtained
from the private pharmacy constitute the second highest spending on medicines (mean=RM135.17, SD=RM190.15). An average of RM128.70 (SD=RM238.10) was spent on medicines obtained from non-pharmacy premises. Spending on medicines obtained from private clinic constitute the lowest expenditure among Malaysian consumers (mean=RM112.45, SD=139.05).
Table 3: General spending on prescription and non-prescription medicines in the last 3 months
Medicines expenditure
Mean (RM)
SD (RM)
Median (RM)
IQR (RM)
Medicines obtained from private clinic(n=776)
112.45 139.05 70.00 70.00
Medicines obtained from private hospital (n=130)
241.49 320.81 100.00 100.00
Medicines obtained from private pharmacy (n=976)
135.17 190.15 70.00 115.00
Medicines obtained from non-pharmacy premises (n=658)
128.70 238.10 50.00 122.00
Table 4 shows the factors associated with the consumers’ medicines expenditure in different
Book.A National Survey On The Use of Medicines_2.12.indd 20 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
21
facilities. Generally, medicines expenditure was significantly associated with respondents’ incomes across all facilities. Additionally, the area of settlement (urban or rural) was found to be significantly associated with consumers’ medicines expenditure in private clinic, private pharmacy and non-pharmacy premises (p<0.001). Consumers living in urban area spent more in private clinic (mean = RM118.85, SD=RM129.91), private pharmacy (mean = RM151.03, SD = RM203.96) and non-pharmacy premises (mean=RM158.40, SD=RM270.76) compared to those in rural area. Meanwhile, the ethnicity and education level of consumers were also found to be significantly associated with medicines expenditure in private clinic, private pharmacy and non-pharmacy premises.
Interestingly, consumers with no formal education were found to spend more for medicines obtained from private hospital (mean = RM165.00, SD = RM120.21, P = 0.180). Consumers’ medicines expenditure in private pharmacy was found to be significantly associated with the area of settlement, gender, age, ethnicity, education level, occupation and monthly income of the consumers. Consumers who were females, of Chinese ethnicity, living with non-family and had a monthly income more than RM4,500.00 recorded the highest medicines expenditure in private pharmacy. For those who have obtained medicines from non-pharmacy premises, retired consumers and those with monthly income of more than RM4,000.00 were found to have spent more P=0.014 and p<0.001 respectively.
Book.A National Survey On The Use of Medicines_2.12.indd 21 1/20/14 10:34 AM
22
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 4:
Fac
tors
ass
ocia
ted
with
med
icin
es e
xpen
ditu
re in
diff
eren
t fac
ilitie
s
Dem
ogra
phic
cha
ract
eris
tics
Med
icin
es e
xpen
ditu
re in
diff
eren
t fac
ilitie
s
Priva
te c
linic
Priva
te h
ospi
tal
Priva
te p
harm
acy
Non-
phar
mac
y pr
emis
e
Mea
n (S
D), R
Mp-
valu
eM
ean
(SD)
, RM
p-va
lue
Mea
n (S
D), R
Mp-
valu
eM
ean
(SD)
, RM
p-va
lue
Area
£
Urba
n11
8.85
(129
.91)
0.00
221
3.02
(272
.85)
0.44
015
1.03
(203
.96)
<0.0
0115
8.40
(270
.76)
<0.0
01*
Rura
l98
.75
(156
.24)
332.
42 (4
33.7
5)86
.25
(127
.64)
58.6
9 (1
03.3
0)Ag
e∞
18-2
412
9.13
(242
.16)
0.17
7
97.6
9 (1
51.4
0)
0.14
4
93.8
8 (1
15.5
7)
0.00
7
75.3
3 (1
22.4
7)
0.09
0
25-3
410
1.92
(106
.59)
92.8
7 (1
36.4
5)13
7.37
(184
.21)
123.
55 (2
11.3
8)35
-44
105.
27 (1
05.2
0)74
.69
(120
.77)
129.
19 (1
83.2
9)13
2.10
(274
.79)
45-5
912
8.48
(125
.50)
104.
20 (1
78.6
4)14
8.63
(256
.43)
173.
71 (2
78.2
2)60
-64
112.
05 (1
49.6
6)12
3.33
(222
.83)
156.
56 (1
82.6
0)13
8.22
(294
.86)
>64
120.
10 (1
31.7
6)80
.71
(93.
20)
126.
79 (1
57.2
0)12
4.74
(163
.37)
Gen
der£
Mal
e11
5.38
(128
.37)
0.37
726
7.35
(391
.37)
0.41
013
0.81
(190
.14)
0.04
910
5.16
(220
.89)
0.01
3*Fe
mal
e11
0.34
(146
.36)
219.
33 (2
45.6
8)13
7.91
(190
.26)
142.
75 (2
46.9
9)Et
hnic
ity∞
Mal
ay10
0.77
(112
.30)
0.01
6
79.4
7 (1
21.4
7)
0.24
3
97.1
8 (1
27.2
9)
<0.0
01
109.
32 (2
04.7
4)
<0.0
01*
Chin
ese
144.
94 (1
96.5
6)12
1.83
(197
.51)
209.
72 (2
56.9
3)19
5.35
(328
.52)
Indi
an12
7.94
(151
.78)
207.
86 (2
40.3
4)18
6.54
(244
.31)
113.
34 (1
99.9
3)Ot
hers
95.3
8 (
93.3
6)79
.41
(136
.62)
70.7
7 (
65.8
2)10
9.97
(175
.80)
Educ
atio
n Le
vel∞
Prim
ary
scho
ol99
.54
(137
.42)
0.00
1
16.4
3 (
37.2
7)
0.18
0
103.
03 (1
31.5
4)
<0.0
01
86.6
3 (1
12.2
7)
<0.0
01*
Seco
ndar
y sc
hool
108.
23 (1
57.8
2)83
.81
(140
.79)
118.
22 (1
61.8
7)11
9.32
(258
.38)
Colle
ge/u
nive
rsity
118.
15 (1
25.0
1)10
6.87
(163
.45)
153.
95 (2
15.0
0)14
9.52
(245
.36)
No fo
rmal
edu
catio
n10
6.50
(103
.00)
165.
00 (1
20.2
1)80
.20
( 94
.74)
77.0
8 (1
08.3
1)
Book.A National Survey On The Use of Medicines_2.12.indd 22 1/20/14 10:34 AM
23
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
cha
ract
eris
tics
Med
icin
es e
xpen
ditu
re in
diff
eren
t fac
ilitie
s
Priva
te c
linic
Priva
te h
ospi
tal
Priva
te p
harm
acy
Non-
phar
mac
y pr
emis
e
Mea
n (S
D), R
Mp-
valu
eM
ean
(SD)
, RM
p-va
lue
Mea
n (S
D), R
Mp-
valu
eM
ean
(SD)
, RM
p-va
lue
Occu
patio
n∞
Gove
rnm
ent
118.
10 (1
32.6
6)
0.00
6
105.
49 (1
57.5
4)
0.14
9
123.
41 (1
47.0
0)
0.00
7
149.
23 (2
57.6
8)
0.01
4*Pr
ivate
/sel
f em
ploy
ed11
6.96
(160
.63)
102.
17 (1
69.1
6)16
0.41
(226
.15)
126.
99 (2
29.2
4)Re
tired
110.
29 (1
08.3
2)35
.00
( 44
.08)
126.
90 (1
55.3
1)20
3.57
(423
.54)
Stud
ent
95.6
0 (1
03.6
7)43
.12
( 35
.15)
71.5
2 (6
2.38
)81
.00
( 96
.07)
Unem
ploy
ed94
.91
(119
.91)
108.
00 (1
50.8
3)13
4.16
(237
.59)
83.9
1 (1
34.0
8)Li
ving
Sta
tus∞
Alon
e10
5.60
(142
.29)
0.56
037
.69
( 37
.45)
0.05
211
6.97
(117
.98)
0.40
412
3.11
(163
.33)
0.28
2W
ith fa
mily
113.
20 (1
38.0
1)10
2.83
(160
.76)
134.
79 (1
89.2
9)13
2.26
(250
.29)
With
non
-fam
ily12
2.40
(156
.91)
92.5
0 (
60.1
0)22
5.84
(372
.44)
57.0
0 (
57.4
3)M
onth
ly In
com
e∞
≤RM
500
110.
22 (1
46.4
0)
<0.0
01
25.0
0 (
41.8
3)
0.01
8
76.0
7 (
86.2
7)
<0.0
01
66.0
0 (
70.1
9)
<0.0
01*
RM50
1-RM
1,00
066
.79
( 51
.19)
56.6
7 (
81.4
4)58
.20
( 56
.06)
79.9
8 (1
30.0
1)RM
1,00
1-RM
1,50
096
.27
(121
.54)
90.3
1 (1
43.7
6)66
.67
( 80
.73)
80.2
8 (1
88.0
5)RM
1,50
1-RM
2,00
086
.30
( 87
.79)
45.0
0 (
42.0
3)99
.32
(108
.39)
154.
21 (2
60.5
0)RM
2,00
1-RM
2,50
091
.56
( 82
.80)
76.6
7 (
99.1
5)10
6.79
(120
.43)
91.7
9 (1
52.7
1)RM
2,50
1-RM
3,00
010
1.93
(115
.94)
150.
00 (2
39.7
9)97
.06
(139
.15)
93.3
8 (
98.3
5)RM
3,00
1-RM
3,50
010
1.25
( 7
7.54
)47
.50
( 74
.62)
132.
23 (1
68.0
7)10
2.10
(126
.42)
RM3,
501-
RM4,
000
136.
76 (1
37.7
2)97
.14
(160
.90)
155.
73 (2
41.1
9)10
0.44
( 8
9.90
)RM
4,00
1-RM
4,50
016
6.83
(166
.94)
187.
50 (2
04.5
3)18
4.92
(188
.85)
231.
17 (3
41.5
9)RM
4,50
1-RM
5,00
017
1.67
(363
.53)
25.0
0 (
41.8
3)20
5.61
(323
.77)
188.
14 (3
37.6
0)>
RM5,
000
151.
17 (1
63.1
1)12
7.60
(197
.86)
227.
67 (2
64.9
6)23
9.36
(393
.31)
£ Man
n-W
hitn
ey te
st;
∞ K
rusk
al-W
allis
test
, p<0
.05*
Book.A National Survey On The Use of Medicines_2.12.indd 23 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
24
4.3 Access to medicines
From Table 5, more than half of the respondents (56.0%) claimed that they will consult a government doctor first if they experienced any health problems. There were 27.7% and 11.0% of the respondents who claimed that they will consult a private doctor and self-medicate respectively. Only 4.7% of the respondents claimed that they will consult retail pharmacist if they experience any health problems. Consultation with traditional practitioner was the least favoured by the respondents (0.6%, n=18).
Table 5: First action taken by respondents if experiencing any health problems
If you experiencing any health problems, what is the FIRST action that you’ll take?
n (%)
Consult government doctor 1,766 (56.0)
Consult private doctor 873 (27.7)
Self-medication 346 (11.0)
Consult retail pharmacist 149 ( 4.7)
Consult traditional practitioner 18 ( 0.6)
From Table 6, the consumers’ first point of reference when experiencing any health problems were found to be significantly associated (p<0.001) with participants’ location, age, ethnicity, educational level, occupation and monthly household income.
Book.A National Survey On The Use of Medicines_2.12.indd 24 1/20/14 10:34 AM
25
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 6:
Firs
t act
ion
take
n by
resp
onde
nts
if ex
perie
ncin
g an
y he
alth
pro
blem
s ac
cord
ing
to d
emog
raph
ic
Dem
ogra
phic
cha
ract
eris
tics
Firs
t act
ion
take
n by
resp
onde
nts
if ex
perie
ncin
g an
y he
alth
pro
blem
s
Self-
med
icat
ion
n (%
)
Cons
ult
gove
rnm
ent
doct
orn
(%)
Cons
ult p
rivat
e do
ctor
n (%
)
Cons
ult r
etai
l ph
arm
acis
tn
(%)
Cons
ult
trad
ition
al
prac
titio
ner
n (%
)
p-va
lue
Area
Urba
n27
8 (8
0.3)
1,19
7 (6
7.8)
675
(77.
3)12
2 (8
1.9)
17 (9
4.4)
<0.0
01*
Rura
l68
(19.
7)56
9 (3
2.2)
198
(22.
7)27
(18.
1)1
( 5.
6)Ag
e18
-24
90 (2
6.0)
255
(14.
4)12
5 (1
4.3)
25 (1
6.8)
2 (1
1.1)
<0.0
01*
25-3
413
8 (3
9.9)
464
(26.
3)31
7 (3
6.3)
63 (4
2.3)
2 (1
1.1)
35-4
449
(14.
2)30
4 (1
7.2)
152
(17.
4)19
(12.
8)4
(22.
2)45
-54
34 (
9.8
)32
7 (1
8.5)
140
(16.
0)21
(14.
1)2
(11.
1)55
-64
26 (
7.5
)29
0 (1
6.4)
111
(12.
7)13
( 8
.7)
5 (2
7.8)
>64
9 (
2.6)
126
( 7.
1)28
( 3
.2)
8 (
5.4)
3 (1
6.7)
Gen
der
Mal
e13
1 (3
7.9)
714
(40.
4)33
8 (3
8.7)
68 (4
5.6)
5 (2
7.8)
0.30
9Fe
mal
e21
5 (6
2.1)
1,05
2 (5
9.6)
535
(61.
3)81
(54.
4)13
(72.
2)Et
hnic
ityM
alay
183
(52.
9)1,
287
(72.
9)46
6 (5
3.4)
73 (4
9.0)
4 (2
2.2)
<0.0
01*
Chin
ese
113
(32.
7)18
4 (1
0.4)
297
(34.
0)60
(40.
3)11
(61.
1)In
dian
22 (
6.4
)11
4 (
6.5)
49 (
5.6
)9
( 6.
0)3
(16.
7)Ot
hers
28 (
8.1
)18
1 (1
0.2)
61 (
7.0
)7
( 4.
7)0
( 0.
0)Ed
ucat
ion
leve
lPr
imar
y sc
hool
17 (
4.9
)22
2 (1
2.6)
56 (
6.4
)12
( 8
.1)
7 (3
8.9)
<0.0
01*
Seco
ndar
y sc
hool
107
(30.
9)86
8 (4
9.2)
310
(35.
5)45
(30.
2)7
(38.
9)Co
llege
/uni
vers
ity21
7 (6
2.7)
589
(33.
4)48
9 (5
6.0)
87 (5
8.4)
3 (1
6.7)
No fo
rmal
edu
catio
n5
( 1.
4)87
( 4
.9)
18 (
2.1
)5
( 3.
4)1
( 5.
6)
Book.A National Survey On The Use of Medicines_2.12.indd 25 1/20/14 10:34 AM
26
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
cha
ract
eris
tics
Firs
t act
ion
take
n by
resp
onde
nts
if ex
perie
ncin
g an
y he
alth
pro
blem
s
Self-
med
icat
ion
n (%
)
Cons
ult
gove
rnm
ent
doct
orn
(%)
Cons
ult p
rivat
e do
ctor
n (%
)
Cons
ult r
etai
l ph
arm
acis
tn
(%)
Cons
ult
trad
ition
al
prac
titio
ner
n (%
)
p-va
lue
Occu
patio
nGo
vern
men
t13
2 (3
8.2)
634
(35.
9)26
1 (2
9.9)
40 (2
6.8)
0 (
0.0)
<0.0
01*
Priva
te/s
elf e
mpl
oyed
118
(34.
1)48
1 (2
7.2)
401
(45.
9)73
(49.
0)8
(44.
4)Re
tired
14 (
4.0
)14
6 (
8.3)
49 (
5.6
)5
( 3.
4)1
( 5.
6)St
uden
t52
(15.
0)14
1 (
8.0)
71 (
8.1
)16
(10.
7)2
(11.
1)Un
empl
oyed
30 (
8.7
)36
4 (2
0.6)
91 (1
0.4)
15 (1
0.1)
7 (3
8.9)
Livi
ng s
tatu
sAl
one
57 (1
6.5)
242
(13.
7)10
2 (1
1.7)
21 (1
4.1)
2 (1
1.1)
0.23
6W
ith fa
mily
274
(79.
2)1,
462
(82.
9)73
8 (8
4.5)
118
(79.
2)14
(77.
8)W
ith n
on-fa
mily
15 (
4.3
)60
( 3
.4)
33 (
3.8
)10
( 6
.7)
2 (1
1.1)
Mon
thly
Inco
me
≤RM
500
33 (
9.5
)24
1 (1
3.7)
38 (
4.4
)16
(10.
9)4
(22.
2)
<0.0
01*
RM50
1-RM
1,00
022
( 6
.4)
178
(10.
1)68
( 7
.8)
10 (
6.8
)1
( 5.
6)RM
1,00
1-RM
1,50
035
(10.
1)41
3 (2
3.5)
103
(11.
8)19
(12.
9)0
( 0.
0)RM
1,50
1-RM
2,00
017
( 4
.9)
142
( 8.
1)45
( 5
.2)
7 (
4.8)
1 (
5.6)
RM2,
001-
RM2,
500
33 (
9.5
)24
2 (1
3.8)
116
(13.
3)17
(11.
6)3
(16.
7)RM
2,50
1-RM
3,00
018
( 5
.2)
81 (
4.6
)58
( 6
.6)
7 (
4.8)
3 (1
6.7)
RM3,
001-
RM3,
500
42 (1
2.1)
188
(10.
7)11
9 (1
3.6)
17 (1
1.6)
4 (2
2.2)
RM3,
501-
RM4,
000
26 (
7.5
)46
( 2
.6)
55 (
6.3
)9
( 6.
1)0
( 0.
0)RM
4,00
1-RM
4,50
028
( 8
.1)
81 (
4.6
)64
( 7
.3)
13 (
8.8
)1
( 5.
6)RM
4,50
1-RM
5,00
019
( 5
.5)
33 (
1.9
)42
( 4
.8)
7 (
4.8)
0 (
0.0)
>RM
5,00
073
(21.
1)11
5 (
6.5)
165
(18.
9)25
(17.
0)0
( 0.
0)*S
igni
fican
t at p
<0.0
5
Book.A National Survey On The Use of Medicines_2.12.indd 26 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
27
Table 7 recorded the consumers’ choice of facilities to obtain medicines. It was found that majority of the respondents usually obtained their medicines from clinics (85.9%), hospitals (75.0%) and community pharmacies (72.2%). There remained a small proportion of consumers who claimed to have obtained medicines from grocery shops (11.8%) traditional medicines outlet (7.9%), direct sales facilities (5.0%) and night market (0.7%).
Table 7: Consumers’ choice of facilities to obtain medicines
If you experiencing any health problems, what is the FIRST action that you’ll take?
n (%)
Hospital Chosen 2,364 (75.0)
Not chosen 784 (24.9)
Clinic Chosen 2,709 (85.9)
Not chosen 437 (13.9)
Community pharmacy
Chosen 2,277 (72.2)Not chosen 869 (27.6)
Traditional medicines outlet
Chosen 248 ( 7.9)
Not chosen 2,897 (91.9)
Direct salesChosen 159 ( 5.0)
Not chosen 2,986 (94.7)
Grocery shopChosen 371 (11.8)
Not chosen 2,774 (88.0)
Night marketChosen 23 ( 0.7)
Not chosen 3,120 (98.9)
Others Chosen 17 ( 0.5)
Not chosen 3,128 (99.2)
Table 8 summarized the factors associated with consumers’ choice of facilities to obtain medicines. Consumers’ age, area of settlement, ethnicity, occupation and monthly household income were found to affect their choice to obtain medicines from hospitals. More urban dwellers (77.8%) were found to prefer to obtain their medicines from hospital. Respondents
above 64 years old (79.9%) were also found to prefer obtaining medicines from hospital compared to respondents from other age groups. Respondents of other races (82.9%) also preferred to obtain medicines from hospital more than Malay (77.5%), Chinese (63.3%) and Indian (74.9%) respondents. Hospital was also preferred as a source of medicines by government employees (83.4%) more than respondents working in other areas.
Consumers’ choice to obtain medicines from clinic was associated with their area of settlement. It was found that a higher proportion of consumers living in the rural area (89.9%) claimed to obtain their medicines from clinic compared to those living in the urban area. On the other hand, consumers’ choice to obtain medicines from community pharmacy were found to be influenced by the area of settlement, age, ethnicity, education level, occupation, living status, and monthly income. Respondents who lived in urban area (76.2%), aged between 25 to 34 years (79.3%), of Chinese ethnicity (81.2%) and with tertiary education (81.7%) were found to be more prone to choose community pharmacy as their source of medicines.
As for traditional medicines outlet, the number of respondents who prefer to obtain medicines from this facility was significantly affected by their ethnicity, occupation and monthly income. Majority of Chinese respondents (19.5%) and retirees (10.7%) obtained medicines from traditional medicines outlet. Meanwhile, consumers who are female (5.9%) and of Chinese ethnicity (8.6%) were found to independently influence Malaysian consumers’ preferences to obtain their medicines from direct sales facilities.
Book.A National Survey On The Use of Medicines_2.12.indd 27 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
28
Besides that, consumers’ area of settlement, ethnicity, education level, and monthly income were also found to significantly affect the participants’ choice in obtaining medicines from a grocery shop. Participants from rural area (14.5%), of Malay ethnicity (12.9%), with no formal education (19.0%) and with monthly income less than RM500 (17.5%) claimed to
prefer to obtain medicines from a grocery shop. Monthly income was also found to affect those who have chosen night market as their source of medicines. Consumers with monthly income less than RM500 (3.0%) were found to prefer to obtain their medicines from night market compared to the other respondents who had higher monthly income.
Book.A National Survey On The Use of Medicines_2.12.indd 28 1/20/14 10:34 AM
29
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 8
(1):
Fac
tors
ass
ocia
ted
with
con
sum
ers’
choi
ce o
f fac
ilitie
s to
obt
ain
med
icin
es
Dem
ogra
phic
ch
arac
teris
tics
Cons
umer
s’ c
hoic
e of
faci
litie
s to
obt
ain
med
icin
esH
ospi
tal
Clin
icCo
mm
unity
pha
rmac
yTr
aditi
onal
med
icin
es o
utle
t
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Area
Urba
n1,
778
(77.
8)50
8 (2
2.2)
<0.0
01*
1,93
3 (8
4.7)
350
(15.
3)<0
.001
*
1,73
9 (7
6.2)
544
(23.
8)<0
.001
*
188
(8.2
)2,
094
(91.
7)0.
406
Rura
l58
6 (6
7.9)
276
(32.
0)77
6 (8
9.9)
87(1
0.1)
538
(62.
3)32
5 (3
7.7)
60 (7.0
)80
3 (9
3.0)
Age
18-2
434
9 (7
0.2)
148
(29.
8)
0.04
5*
434
(87.
3)63
(12.
7)
0.16
6
371
(74.
6)12
6 (2
5.4)
<0.0
01*
32 (6.4
)46
5 (9
3.6)
0.08
1
25-3
473
1 (7
4.4)
251
(25.
5)86
1 (8
7.6)
122
(12.
4)78
0 (7
9.3)
203
(20.
7)66 (6.7
)91
6 (9
3.2)
35-4
441
9 (7
9.8)
106
(20.
2)45
0 (8
5.7)
75(1
4.3)
385
(73.
3)14
0 (2
6.7)
37 (7.0
)48
8 (9
3.0)
45-5
938
4 (7
3.3)
140
(26.
7)43
2 (8
2.8)
90(1
7.2)
350
(67.
0)17
2 (3
3.0)
47 (9.0
)47
5 (9
1.0)
60-6
434
2 (7
6.7)
104
(23.
3)38
5 (8
6.5)
60(1
3.5)
281
(63.
1)16
4 (3
6.9)
42 (9.4
)40
3 (9
0.6)
>64
139
(79.
9)35
(20.
1)14
7 (8
4.5)
27(1
5.5)
110
(63.
2)64
(36.
8)24
(13.
8)15
0 (8
6.2)
Gen
der
Mal
e95
3 (7
6.0)
300
(23.
9)0.
281
1,05
7 (8
4.5)
194
(15.
5)0.
033
908
(72.
6)34
3 (2
7.4)
0.83
5
111
(8.9
)1,
140
(91.
1)0.
178
Fem
ale
1,41
1 (7
4.5)
484
(25.
5)1,
652
(87.
2)24
3 (1
2.8)
1,36
9 (7
2.2)
526
(27.
8)13
7(7
.2)
1,75
7 (9
2.7)
Book.A National Survey On The Use of Medicines_2.12.indd 29 1/20/14 10:34 AM
30
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Cons
umer
s’ c
hoic
e of
faci
litie
s to
obt
ain
med
icin
esH
ospi
tal
Clin
icCo
mm
unity
pha
rmac
yTr
aditi
onal
med
icin
es o
utle
t
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Ethn
icity
Mal
ay1,
559
(77.
5)45
2 (2
2.5)
<0.0
01
1,74
1 (8
6.6)
269
(13.
4)
0.51
7
1,40
1 (6
9.7)
609
(30.
3)
<0.0
01*
98 (4.9
)1,
912
(95.
1)
<0.0
01*
Chin
ese
421
(63.
3)24
4 (3
6.7)
567
(85.
3)98
(14.
7)54
0 (8
1.2)
125
(18.
8)13
0 (1
9.5)
534
(80.
3)
Indi
an14
6 (7
4.9)
49(2
5.1)
169
(87.
1)25
(12.
9)13
4 (6
9.1)
60(3
0.9)
12 (6.2
)18
2 (9
3.8)
Othe
rs23
8 (8
2.9)
39(1
4.1)
232
(83.
8)45
(16.
2)20
2 (7
2.9)
75(2
7.1)
8(2
.9)
269
(97.
1)Ed
ucat
ion
Leve
l
Prim
ary
scho
ol22
7 (7
2.3)
87(2
7.7)
0.80
6
265
(84.
4)49
(15.
6)
0.46
0
171
(54.
5)14
3 (4
5.5)
<0.0
01*
32(1
0.2)
282
(89.
8)
0.34
8Se
cond
ary
scho
ol99
9 (7
4.9)
334
(25.
1)1,
136
(85.
4)19
4 (1
4.6)
917
(68.
9)41
3 (3
1.1)
109
(8.2
)1,
221
(91.
8)
Colle
ge/u
nive
rsity
1,05
0 (7
5.8)
335
(24.
2)1,
208
(87.
2)17
8 (1
2.8)
1,13
3 (8
1.7)
253
(18.
3)95 (6.9
)1,
290
(93.
1)
No fo
rmal
edu
catio
n88
(75.
9)28
(24.
1)10
0 (8
6.2)
16(1
3.8)
56(4
8.3)
60(5
1.7)
12(1
0.3)
104
(89.
7)Oc
cupa
tion
Gove
rnm
ent
889
(83.
4)17
6 (1
6.5)
<0.0
01*
912
(85.
6)15
4 (1
4.4)
0.29
3
838
(78.
6)22
8 (2
1.4)
<0.0
01*
53 (5.0
)1,
013
(95.
0)
0.00
3*
Priva
te/s
elf
empl
oyed
726
(67.
2)35
4 (3
2.8)
922
(85.
4)15
7 (1
4.6)
771
(71.
5)30
8 (2
8.5)
101
(9.4
)97
7 (9
0.5)
Retir
ed17
0 (7
9.1)
45(2
0.9)
180
(84.
1)34
(15.
9)14
8 (6
9.2)
66(3
0.8)
23(1
0.7)
191
(89.
3)
Stud
ent
199
(70.
6)83
(29.
4)25
1 (8
9.3)
30(1
0.7)
221
(78.
6)60
(21.
4)21 (7.5
)26
0 (9
2.5)
Unem
ploy
ed38
0 (7
5.1)
126
(24.
9)44
4 (8
7.7)
62(1
2.3)
299
(59.
1)20
7 (4
0.9)
50 (9.9
)45
6 (9
0.1)
Book.A National Survey On The Use of Medicines_2.12.indd 30 1/20/14 10:34 AM
31
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Cons
umer
s’ c
hoic
e of
faci
litie
s to
obt
ain
med
icin
esH
ospi
tal
Clin
icCo
mm
unity
pha
rmac
yTr
aditi
onal
med
icin
es o
utle
t
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Livi
ng S
tatu
s
Alon
e33
7 (7
9.5)
87(2
0.5)
0.11
6
366
(86.
5)57
(13.
5)
0.23
3
320
(75.
7)10
3 (2
4.3)
0.00
8*
25 (5.9
)39
8 (9
4.1)
0.51
6W
ith fa
mily
1,92
9 (7
4.1)
673
(25.
9)2,
244
(86.
3)35
7 (1
3.7)
1,85
8 (7
1.4)
743
(28.
6)21
5(8
.3)
2,38
5 (9
1.7)
With
non
-fam
ily96
(80.
0)24
(20.
0)97
(80.
8)23
(19.
2)99
(82.
5)21
(17.
5)8
(6.7
)11
2 (9
3.3)
Mon
thly
Inco
me
≤RM
500
265
(80.
1)66
(19.
9)
0.04
4*
270
(81.
6)61
(18.
4)
0.05
9
214
(64.
7)11
7 (3
5.3)
<0.0
01*
30 (9.1
)30
1 (9
0.9)
<0.0
01*
RM50
1-RM
1,00
019
8 (7
1.2)
80(2
8.8)
232
(83.
5)46
(16.
5)18
3 (6
5.8)
95(3
4.2)
16 (5.8
)26
2 (9
4.2)
RM1,
001-
RM1,
500
442
(77.
5)12
8 (2
2.5)
485
(85.
4)83
(14.
6)36
7 (6
4.6)
201
(35.
4)23 (4.0
)54
5 (9
6.0)
RM1,
501-
RM2,
000
155
(73.
1)57
(26.
9)18
7 (8
8.2)
25(1
1.8)
131
(61.
8)81
(38.
2)16 (7.5
)19
6 (9
2.5)
RM2,
001-
RM2,
500
316
(76.
9)95
(23.
1)36
2 (8
8.1)
49(1
1.9)
316
(76.
9)95
(23.
1)38 (9.2
)37
3 (9
0.8)
RM2,
501-
RM3,
000
115
(68.
9)52
(31.
1)15
6 (9
3.4)
11 (6.6
)11
5 (6
8.9)
52(3
1.1)
20(1
2.0)
147
(88.
0)
RM3,
001-
RM3,
500
288
(77.
8)81
(21.
9)31
6 (8
5.4)
54(1
4.6)
289
(78.
1)81
(21.
9)40
(10.
8)33
0 (8
9.0)
RM3,
501-
RM4,
000
103
(75.
7)33
(24.
3)11
8 (8
6.8)
18(1
3.2)
106
(77.
9)30
(22.
1)16
(11.
8)11
9 (8
7.5)
RM4,
001-
RM4,
500
145
(77.
5)42
(22.
5)16
1 (8
6.1)
26(1
3.9)
157
(84.
0)30
(16.
0)15 (8.0
)17
2 (9
2.0)
RM4,
501-
RM5,
000
71(6
9.6)
31(3
0.4)
89(8
7.3)
13(1
2.7)
83(8
1.4)
19(1
8.6)
8(7
.8)
94(9
2.2)
>RM
5,00
026
1 (6
9.0)
117
(31.
0)32
9 (8
7.0)
49(1
3.0)
312
(82.
5)66
(17.
5)26 (6.9
)35
2 (9
3.1)
*Sig
nific
ant a
t p<0
.05
Book.A National Survey On The Use of Medicines_2.12.indd 31 1/20/14 10:34 AM
32
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 8
(2):
Fac
tors
ass
ocia
ted
with
con
sum
ers’
choi
ce o
f fac
ilitie
s to
obt
ain
med
icin
es
Dem
ogra
phic
Ch
arac
teris
tics
Cons
umer
s’ c
hoic
e of
faci
litie
s to
obt
ain
med
icin
es
Dire
ct S
ale
Gro
cery
Sho
pNi
ght m
arke
tOt
hers
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Area
Urba
n12
8(5
.6)
2,15
4 (9
4.3)
0.05
8
246
(10.
8)2,
036
(89.
2)0.
013*
21 (0.9
)2,
259
(99.
0)0.
183
14 (0.6
)2,
269
(99.
0)0.
090
Rura
l31 (3.6
)83
2 (9
6.4)
125
(14.
5)73
8 (8
5.5)
2(0
.2)
861
(99.
8)3
(0.3
)85
9 (9
9.5)
Age
18-2
423 (4.6
)47
4 (9
5.4)
0.83
8
71(1
4.3)
426
(85.
7)
0.20
7
2(0
.4)
495
(99.
6)
0.07
9
3(0
.6)
494
(99.
4)
0.43
7
25-3
453 (5.4
)92
9 (9
4.5)
121
(12.
3)86
1 (8
7.6)
3(0
.2)
978
(99.
6)4
(0.4
)97
9 (9
9.5)
35-4
432 (6.1
)49
3 (9
3.9)
51 (9.7
)47
4 (9
0.3)
8(1
.5)
516
(98.
3)4
(0.8
)52
1 (9
8.7)
45-5
425 (4.8
)49
7 (9
5.2)
71(1
3.6)
451
(86.
4)8
(1.5
)51
4 (9
8.5)
4(0
.8)
518
(98.
7)
55-6
421 (4.7
)42
4 (9
5.3)
42 (9.4
)40
3 (9
0.6)
0(0
.0)
445
(100
.0)
2(0
.4)
442
(99.
1)
>64
5(2
.9)
169
(97.
1)15 (8.6
)15
9 (9
1.4)
2(1
.1)
172
(98.
9)0
(0.0
)17
4(1
00.0
)G
ende
r
Mal
e47 (3.8
)1,
204
(96.
2)0.
019*
147
(11.
8)1,
104
(88.
2)0.
717
8(0
.6)
1,24
2 (9
9.3)
0.49
1
8(0
.6)
1,24
3 (9
8.9)
0.16
0Fe
mal
e11
2(5
.9)
1,78
2 (9
4.0)
224
(11.
8)1,
670
(88.
1)15 (0.8
)1,
878
(99.
2)9
(0.5
)1,
885
(99.
4)
Book.A National Survey On The Use of Medicines_2.12.indd 32 1/20/14 10:34 AM
33
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
Ch
arac
teris
tics
Cons
umer
s’ c
hoic
e of
faci
litie
s to
obt
ain
med
icin
es
Dire
ct S
ale
Gro
cery
Sho
pNi
ght m
arke
tOt
hers
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Ethn
icity
Mal
ay82 (4.1
)1,
928
(95.
9)
<0.0
01*
259
(12.
9)1,
751
(87.
1)
0.04
4*
18 (0.9
)1,
990
(99.
1)
0.61
7
12 (0.6
)1,
998
(99.
2)
0.00
2*Ch
ines
e57 (8.6
)60
7 (9
1.3)
58 (8.7
)60
6 (9
1.1)
3(0
.5)
661
(99.
4)3
(0.5
)66
2 (9
9.5)
Indi
an3
(1.5
)19
1 (9
8.5)
19 (9.8
)17
5 (9
0.2)
0(0
.0)
194
(100
.0)
0(0
.0)
194
(98.
5)
Othe
rs17 (6.1
)26
0 (9
3.9)
35(1
2.6)
242
(87.
4)2
(0.7
)27
5 (9
9.3)
2(0
.7)
274
(98.
6)Ed
ucat
ion
Leve
l
Prim
ary
scho
ol7
(2.2
)30
7 (9
7.8)
0.13
6
53(1
6.9)
261
(83.
1)
<0.0
01*
5(1
.6)
309
(98.
4)
0.17
1
2(0
.6)
312
(99.
0)
<0.0
01*
Seco
ndar
y sc
hool
65 (4.9
)1,
265
(95.
1)17
5 (1
3.2)
1,15
5 (8
6.8)
14 (1.1
)1,
315
(98.
9)9
(0.7
)1,
321
(98.
8)
Colle
ge/u
nive
rsity
83 (6.0
)1,
302
(93.
9)12
1(8
.7)
1,26
4 (9
1.2)
3(0
.2)
1,38
1 (9
9.7)
6(0
.4)
1,38
0 (9
9.6)
No F
orm
al
Educ
atio
n4
(3.4
)11
2 (9
6.6)
22(1
9.0)
94(8
1.0)
1(0
.9)
115
(99.
1)0
(0.0
)11
5 (9
9.1)
Occu
patio
n
Gove
rnm
ent
54 (5.1
)1,
012
(94.
9)
0.74
1
82 (7.7
)98
4 (9
2.3)
<0.0
01*
5(0
.5)
1,05
9 (9
9.4)
0.60
0
4(0
.4)
1,06
2 (9
9.5)
0.49
8
Priva
te/s
elf
empl
oyed
61 (5.7
)1,
017
(94.
3)15
4 (1
4.3)
924
(85.
6)9
(0.8
)1,
069
(99.
1)8
(0.7
)1,
071
(99.
0)
Retir
ed11 (5.1
)20
3 (9
4.9)
11 (5.1
)20
3 (9
4.9)
2(0
.9)
212
(99.
1)0
(0.0
)21
4 (9
9.5)
Stud
ent
15 (5.3
)26
6 (9
4.7)
41(1
4.6)
240
(85.
4)0
(0.0
)28
1 (1
00.0
)3
(1.1
)27
8 (9
8.6)
Unem
ploy
ed18 (3.6
)48
8 (9
6.4)
83(1
6.4)
423
(83.
6)7
(1.4
)49
9 (9
8.6)
2(0
.4)
503
(99.
0)
Book.A National Survey On The Use of Medicines_2.12.indd 33 1/20/14 10:34 AM
34
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
Ch
arac
teris
tics
Cons
umer
s’ c
hoic
e of
faci
litie
s to
obt
ain
med
icin
es
Dire
ct S
ale
Gro
cery
Sho
pNi
ght m
arke
tOt
hers
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Chos
enn
(%)
Not
chos
enn
(%)
p-va
lue
Livi
ng S
tatu
s
Alon
e23 (5.4
)40
0 (9
4.6)
0.98
6
44(1
0.4)
379
(89.
6)
0.71
5
1(0
.2)
421
(99.
5)
0.15
2
2(0
.5)
421
(99.
3)
0.99
3W
ith fa
mily
130
(5.0
)2,
470
(95.
0)31
6 (1
2.1)
2,28
4 (8
7.8)
22 (0.8
)2,
577
(99.
1)14 (0.5
)2,
586
(99.
2)
With
non
-fam
ily6
(5.0
)11
4 (9
5.0)
11 (9.2
)10
9 (9
0.8)
0(0
.0)
120
(100
.0)
1(0
.8)
119
(99.
2)M
onth
ly In
com
e
≤RM
500
12 (3.6
)31
9 (9
6.4)
<0.0
01*
58(1
7.5)
273
(82.
5)
<0.0
01*
10 (3.0
)32
1 (9
7.0)
<0.0
01*
5(1
.5)
325
(97.
9)
0.50
2
RM50
1-RM
1,00
010 (3.6
)26
8 (9
6.4)
43(1
5.5)
235
(84.
5)2
(0.7
)27
6 (9
9.3)
2(0
.7)
276
(98.
9)
RM1,
001-
RM1,
500
19 (3.3
)54
9 (9
6.7)
77(1
3.6)
491
(86.
4)3
(0.5
)56
4 (9
9.3)
1(0
.2)
567
(99.
5)
RM1,
501-
RM2,
000
8(3
.8)
204
(96.
2)28
(13.
2)18
4 (8
6.8)
3(1
.4)
209
(98.
6)2
(0.9
)21
0 (9
9.1)
RM2,
001-
RM2,
500
14 (3.4
)39
7 (9
6.6)
42(1
0.2)
369
(89.
8)1
(0.2
)41
0 (9
9.8)
3(0
.7)
408
(99.
3)
RM2,
501-
RM3,
000
13 (7.8
)15
4 (9
2.2)
13 (7.8
)15
4 (9
2.2)
1(0
.6)
166
(99.
4)0
(0.0
)16
7 (1
00.0
)
RM3,
001-
RM3,
500
17 (4.6
)35
3 (9
5.4)
35 (9.5
)33
5 (9
0.5)
3(0
.8)
367
(99.
2)4
(1.1
)36
6 (9
8.7)
RM3,
501-
RM4,
000
10 (7.4
)12
5 (9
1.9)
16(1
1.8)
119
(87.
5)0
(0.0
)13
5 (9
9.3)
0(0
.0)
136
(100
.0)
RM4,
001-
RM4,
500
18 (9.6
)16
9 (9
0.4)
16 (8.6
)17
1 (9
1.4)
0(0
.0)
187
(100
.0)
0(0
.0)
187
(100
.0)
RM4,
501-
RM5,
000
6(5
.9)
96(9
4.1)
11(1
0.8)
91(8
9.2)
0(0
.0)
102
(100
.0)
0(0
.0)
102
(100
.0)
>RM
5,00
032 (8.5
)34
6 (9
1.5)
31 (8.2
)34
7 (9
1.8)
0(0
.0)
377
(100
.0)
0(0
.0)
378
(100
.0)
*Sig
nific
ant a
t p<0
.05
Book.A National Survey On The Use of Medicines_2.12.indd 34 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
35
Table 9: Factors affecting medicines-label reading and consumers’ perceived labelling adequacy
Demographic characteristics
Outcome
Labelling adequacy Read label
Yes, n (%) No, n (%) p-value Yes, n (%) No, n (%) p-value
Settlement settingUrban 1,933 (84.7) 350 (15.3)
0.001*2,120 (92.8) 165 ( 7.2)
0.794Rural 769 (89.1) 94 (10.9) 803 (93.0) 60 ( 7.0)Age18-24 412 (82.9) 85 (17.1)
0.001*
452 (90.9) 45 ( 9.1)
<0.01*
25-34 813 (82.8) 169 (17.2) 948 (95.4) 35 ( 3.6)35-44 461 (87.8) 64 (12.2) 500 (95.2) 25 ( 4.8)45-59 466 (83.3) 56 (10.7) 484 (92.5) 39 ( 7.5)60-64 396 (88.8) 50 (11.2) 400 (89.7) 46 (10.3)>64 154 (88.5) 20 (11.5) 139 (79.9) 35 (20.1)GenderMale 1,077 (86.0) 106 (14.0)
0.931,143 (91.2) 110 ( 8.8)
0.004*Female 1,625 (85.8) 268 (14.2) 1,780 (93.9) 115 ( 6.1)EthnicityMalay 1,766 (88.0) 242 (12.0)
<0.01*
1,906 (94.8) 105 ( 5.2)
<0.01*Chinese 519 (78.2) 145 (21.8) 585 (88.0) 80 (12.0)Indian 178 (91.3) 17 ( 8.7) 172 (88.2) 23 (11.8)Others 236 (85.5) 40 (14.5) 259 (93.8) 17 ( 6.2)Education levelPrimary school 277 (88.2) 37 (11.8)
<0.01*
267 (85.0) 47 (15.0)
<0.01*Secondary school 1,182 (88.8) 149 (11.2) 1,238 (92.9) 94 ( 7.1)College/university 1,141 (82.4) 244 (17.6) 1,323 (95.5) 63 ( 4.5)No formal education 102 (87.9) 14 (12.1) 95 (81.9) 21 (18.1)OccupationGovernment 922 (86.6) 143 (13.4)
0.002*
1,033 (96.9) 33 ( 3.1)
<0.01*Private/self employed 902 (83.7) 176 (16.3) 1,001 (92.8) 78 ( 7.2)Retired 195 (81.9) 20 ( 9.3) 192 (89.3) 23 (10.7)Student 231 (81.9) 51 (18.1) 256 (90.8) 26 ( 9.2)Unemployed 451 (89.3) 54 (10.7) 441 (87.2) 65 (12.8)
4.4 Perceptions towards medicines labelling
Table 9 summarized the consumers’ perception towards medicines labelling. Consumers’ perceived labelling adequacy was found to be affected by area of settlement, age, ethnicity,
education level, occupation and monthly household income. Meanwhile, the habit of reading a label prior to using the medicines was found to be associated with consumers’ age, gender, ethnicity, education level, occupation and monthly income.
Book.A National Survey On The Use of Medicines_2.12.indd 35 1/20/14 10:34 AM
36
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Demographic characteristics
Outcome
Labelling adequacy Read label
Yes, n (%) No, n (%) p-value Yes, n (%) No, n (%) p-value
Living statusAlone 353 (83.3) 71 (16.7)
0.251401 (94.6) 23 ( 5.4)
0.315With family 2,240 (86.3) 357 (13.7) 2,406 (92.5) 194 ( 7.5)With non-family 104 (86.7) 16 (13.3) 112 (93.3) 8 ( 6.7)Monthly income≤RM500 288 (87.3) 42 (12.7)
<0.01*
299 (90.3) 32 ( 9.7)
0.003*
RM501-RM1,000 255 (91.7) 23 ( 8.3) 247 (88.8) 31 (11.2)RM1,001-RM1,500 498 (87.5) 71 (12.5) 528 (92.8) 41 ( 7.2)RM1,501-RM2,000 199 (93.9) 13 ( 6.1) 203 (95.8) 9 ( 4.2)RM2,001-RM2,500 353 (85.9) 58 (14.4) 377 (91.7) 34 ( 8.3)RM2,501-RM3,000 143 (85.6) 24 (15.4) 150 (89.8) 17 (10.2)RM3,001-RM3,500 313 (84.6) 57 (15.4) 353 (95.4) 17 ( 4.6)RM3,501-RM4,000 108 (79.4) 28 (20.6) 131 (96.3) 5 ( 3.7)RM4,001-RM4,500 161 (86.1) 26 (13.9) 181 (96.8) 6 ( 3.2)RM4,501-RM5,000 76 (74.5) 26 (13.9) 96 (94.1) 6 ( 5.9)>RM5,000 301 (79.8) 76 (20.2) 353 (93.4) 25 ( 6.6)
*Significant at p<0.05
Generally, majority of the respondents did not find any difficulties in reading medicines label obtained from government or private hospitals and clinics as well as community pharmacies. Further exploration to identify factors that were associated with difficulties in reading medicines label found that consumers’ area of settlement, age, ethnicity, education level and monthly income level are among the factors that affect consumers’ perceived difficulty in reading medicines label obtained from various health institutions. (Table 10). Respondents who
have not had any formal education and those of others ethnicity generally perceived more difficulty in reading medicines label obtained from government facilities. Meanwhile, more respondents who have had at least tertiary education and from urban area, higher income group generally expressed difficulty in reading medicines label obtained from private clinics. Difficulty in reading medicines label obtained from community pharmacies was found to be associated with respondents’ area of settlement.
Book.A National Survey On The Use of Medicines_2.12.indd 36 1/20/14 10:34 AM
37
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 10
: Ass
ocia
tion
betw
een
diffi
culti
es in
read
ing
med
icin
es la
bel a
nd d
emog
raph
ic c
hara
cter
istic
s
Dem
ogra
phic
ch
arac
teris
tics
Outc
ome
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
go
vern
men
t hos
pita
ls/c
linic
s
Diffi
culti
es in
read
ing
med
icin
es la
bel p
rivat
e ho
spita
ls
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
priv
ate
clin
ics
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
co
mm
unity
pha
rmac
ies
Yes
n (%
)No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
e
Sett
lem
ent s
ettin
g
Urba
n30
2 (1
4.8)
1,73
9 (8
5.2)
0.31
5
210
(15.
0)1,
188
(85.
0)0.
257
392
(21.
8)1,
406
(78.
2)<0
.01*
303
(17.
5)1,
426
(82.
5)0.
007*
Rura
l10
8 (1
3.3)
702
(86.
7)43
(12.
6)29
8 (8
7.4)
80(1
4.9)
458
(85.
1)64
(12.
5)44
9 (8
7.5)
Age
18-2
474
(16.
7)36
9 (8
3.3)
0.11
9
54(1
8.2)
243
(81.
8)
0.18
6
90(2
2.8)
305
(77.
2)
0.02
*
66(1
7.4)
313
(82.
6)
0.59
2
25-3
412
4 (1
4.1)
757
(85.
9)92
(14.
9)52
7 (8
5.1)
189
(22.
8)64
0 (7
7.2)
142
(17.
6)66
6 (8
2.4)
35-4
451
(10.
7)42
7 (8
9.3)
35(1
1.3)
275
(88.
7)73
(18.
2)32
9 (8
1.8)
50(1
3.6)
319
(86.
4)
45-5
970
(14.
6)41
0 (8
5.4)
34(1
2.9)
229
(87.
1)53
(15.
1)29
7 (8
4.9)
55(1
6.5)
278
(83.
5)
60-6
468
(16.
3)34
8 (8
3.7)
26(1
3.9)
161
(86.
1)46
(17.
3)22
0 (8
2.7)
38(1
4.9)
217
(85.
1)
>64
23(1
5.1)
129
(84.
9)12
(19.
0)51
(81.
0)21
(22.
6)72
(77.
4)16
(16.
3)82
(83.
7)G
ende
r
Mal
e16
8 (1
4.9)
959
(85.
1)0.
518
103
(14.
7)59
7 (8
5.3)
0.87
2
183
(19.
5)75
6 (8
0.5)
0.47
4
149
(16.
6)74
8 (8
3.4)
0.80
1Fe
mal
e24
2 (1
4.0)
1428
(8
6.0)
150
(14.
4)88
9 (8
5.6)
289
(20.
7)1,
107
(79.
3)21
8 (1
6.2)
1,12
7 (8
3.8)
Book.A National Survey On The Use of Medicines_2.12.indd 37 1/20/14 10:34 AM
38
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Outc
ome
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
go
vern
men
t hos
pita
ls/c
linic
s
Diffi
culti
es in
read
ing
med
icin
es la
bel p
rivat
e ho
spita
ls
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
priv
ate
clin
ics
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
co
mm
unity
pha
rmac
ies
Yes
n (%
)No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
e
Ethn
icity
Mal
ay24
4 (1
2.9)
1,65
1 (8
7.1)
0.01
2*
154
(15.
1)86
4 (8
4.9)
0.15
7
275
(19.
3)1,
147
(80.
7)
0.40
3
221
(16.
2)1,
146
(83.
8)
0.80
9Ch
ines
e90
(17.
8)41
5 (8
2.2)
50(1
1.6)
380
(88.
4)12
2 (2
1.9)
435
(78.
1)87
(16.
2)45
1 (8
3.8)
Indi
an27
(14.
9)15
4 (8
5.1)
14(1
4.6)
82(8
5.4)
33(2
3.9)
105
(76.
1)24
(19.
5)99
(80.
5)
Othe
rs48
(17.
9)22
0 (8
2.1)
35(1
8.1)
158
(81.
9)42
(19.
4)17
5 (8
0.6)
34(1
6.0)
179
(84.
0)Ed
ucat
ion
Leve
l
Prim
ary
scho
ol51
(17.
5)24
0 (8
2.5)
0.03
6*
14(1
3.0)
94(8
7.0)
0.05
1
31(1
9.0)
132
(81.
0)
0.03
2*
19(1
2.7)
131
(87.
3)
0.13
7Se
cond
ary
scho
ol15
8 (1
2.8)
1,07
2 (8
1.2)
90(1
3.1)
595
(86.
9)16
6 (1
7.5)
784
(82.
5)13
7 (1
4.9)
781
(85.
1)
Colle
ge/u
nive
rsity
178
(14.
5)1,
042
(85.
5)13
7 (1
5.2)
766
(84.
8)26
3 (2
2.6)
899
(77.
4)19
9 (1
7.8)
918
(82.
2)No
form
al
educ
atio
n23
(20.
9)87
(79.
1)12
(27.
9)31
(72.
1)12
(20.
0)48
(80.
0)12
(21.
1)45
(78.
9)Oc
cupa
tion
Gove
rnm
ent
131
(12.
6)90
7 (8
7.4)
0.15
0
98(1
4.5)
576
(85.
5)
0.27
7
195
(22.
4)64
7 (8
7.6)
0.17
9
147
(17.
4)69
9 (8
2.6)
0.85
1
Priva
te/s
elf
empl
oyed
142
(15.
9)75
0 (8
4.1)
78(1
2.9)
527
(87.
1)15
6 (1
9.0)
666
(81.
0)12
2 (1
5.7)
654
(84.
3)
Retir
ed27
(13.
3)17
6 (8
6.7)
13(1
3.5)
83(8
6.5)
24(1
8.6)
105
(81.
4)23
(16.
8)11
4 (8
3.2)
Stud
ent
44(1
7.7)
205
(82.
3)32
(19.
6)13
1 (8
0.4)
49(2
1.7)
177
(78.
3)35
(16.
4)17
8 (8
3.6)
Unem
ploy
ed66
(14.
1)40
3 (8
5.9)
32(1
5.9)
169
(84.
1)48
(16.
6)24
1 (8
3.4)
40(1
4.8)
230
(85.
2)
Book.A National Survey On The Use of Medicines_2.12.indd 38 1/20/14 10:34 AM
39
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Outc
ome
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
go
vern
men
t hos
pita
ls/c
linic
s
Diffi
culti
es in
read
ing
med
icin
es la
bel p
rivat
e ho
spita
ls
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
priv
ate
clin
ics
Diffi
culti
es in
read
ing
med
icin
es la
bel f
rom
co
mm
unity
pha
rmac
ies
Yes
n (%
)No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
eYe
sn
(%)
No n (%
)p-
valu
e
Livi
ng s
tatu
s
Alon
e66
(16.
8)32
7 (8
3.2)
0.24
1
34(1
3.6)
216
(86.
4)
0.84
6
65(1
9.8)
263
(80.
2)
0.72
8
53(1
6.3)
273
(83.
7)
0.47
5W
ith fa
mily
332
(14.
1)2,
017
(85.
9)21
0 (1
4.8)
1,21
1 (8
5.2)
392
(20.
4)1,
527
(79.
6)30
3 (1
6.6)
1,52
0 (8
3.4)
With
non
-fam
ily12
(11.
2)95
(88.
8)9
(13.
2)59
(86.
8)15
(17.
0)73
(83.
0)11
(11.
8)82
(88.
2)M
onth
ly in
com
e
≤RM
500
58(1
8.8)
251
(81.
2)
0.18
9
29(1
7.7)
135
(82.
3)
0.21
6
35(1
6.3)
180
(83.
7)
0.00
5*
29(1
4.1)
177
(85.
9)
0.54
9
RM50
1-RM
1,00
045
(17.
6)21
0 (8
2.4)
19(1
7.4)
90(8
2.6)
37(2
3.9)
118
(76.
1)31
(18.
3)13
8 (8
1.7)
RM1,
001-
RM1,
500
81(1
5.0)
459
(85.
0)45
(16.
1)23
4 (8
3.9)
74(1
9.1)
313
(80.
9)58
(15.
4)31
9 (8
4.6)
RM1,
501-
RM2,
000
22(1
1.2)
175
(88.
8)9
(10.
1)80
(89.
9)26
(19.
7)10
6 (8
0.3)
16(1
3.4)
103
(86.
6)
RM2,
001-
RM2,
500
52(1
4.0)
320
(86.
0)26
(11.
1)20
8 (8
8.9)
55(1
7.2)
265
(82.
8)51
(16.
5)25
9 (8
3.5)
RM2,
501-
RM3,
000
21(1
4.4)
125
(85.
6)9
(11.
1)73
(88.
9)24
(18.
3)10
7 (8
1.7)
14(1
3.1)
93(8
6.9)
RM3,
001-
RM3,
500
43(1
2.6)
297
(87.
4)37
(15.
1)20
8 (8
4.9)
57(1
8.3)
255
(81.
7)47
(16.
1)24
5 (8
3.9)
RM3,
501-
RM4,
000
10 (8.8
)10
3 (9
1.2)
7(9
.2)
69(8
0.8)
19(1
7.8)
88(8
2.2)
14(1
3.5)
90(8
6.5)
RM4,
001-
RM4,
500
26(1
5.5)
142
(84.
5)14
(10.
1)12
4 (8
9.9)
27(1
6.9)
133
(83.
1)28
(17.
6)13
1 (8
2.4)
RM4,
501-
RM5,
000
13(1
4.4)
77(8
5.6)
11(1
8.3)
49(8
1.7)
21(2
5.6)
61
(74.
4)12
(14.
6)70
(85.
4)
>RM
5,00
039
(12.
4)27
5 (8
7.6)
44(1
7.1)
213
(82.
9)95
(29.
0)23
3(7
1.0)
65(2
0.9)
246
(79.
1)*S
igni
fican
t at p
<0.0
5
Book.A National Survey On The Use of Medicines_2.12.indd 39 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
40
From Table 11, the participants stated that they were satisfied with the information written on the labels by government hospitals or clinics (81.0%), private hospitals (45.2%), private clinics (56.2%) and community pharmacies (56.1%). This was significantly associated with their area of settlement (p<0.001), age (p<0.001), ethnicity (p<0.001), educational level (p<0.001), monthly income (p<0.001) and occupation (p<0.001).
In the rural area, 85.9% of participants were satisfied with the labelling adequacy by government hospital compared to 79.1% of the participants in the urban area. Eighty-five percents of the participants with secondary education satisfied with the information written on the labels by government hospital and clinic compared to others. Furthermore, Chinese ethnics were the least satisfied (63.1%) with the labels by government hospitals or clinics compared to Indian (85.1%), others (85.2%) and Malay (85.9%).
Book.A National Survey On The Use of Medicines_2.12.indd 40 1/20/14 10:34 AM
41
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 11
: Ass
ocia
tion
betw
een
labe
lling
sat
isfa
ctio
n an
d de
mog
raph
ic c
hara
cter
istic
s
Dem
ogra
phic
ch
arac
teris
tics
Outc
ome
Labe
lling
ade
quac
y by
go
vern
men
t hos
pita
ls/c
linic
sLa
belli
ng a
dequ
acy
by p
rivat
e ho
spita
lsLa
belli
ng a
dequ
acy
by p
rivat
e cl
inic
sLa
belli
ng a
dequ
acy
by
com
mun
ity p
harm
acie
s
Yes
n (%
)No
n
(%)
NA
n (%
)p-
valu
eYe
s n
(%)
No
n (%
)NA
n
(%)
p-va
lue
Yes
n (%
)No
n
(%)
NA
n (%
)p-
valu
eYe
s n
(%)
No
n (%
)NA
n
(%)
p-va
lue
Tota
l=N
2,54
9 (8
1.0)
307
(9.8
)29
0(9
.2)
-1,
418
(45.
2)28
9(9
.2)
1,43
1(4
5.6)
-1,
765
(56.
2)55
9(1
7.8)
814
(25.
9)-
1,76
2(5
6.1)
456
(14.
5)92
0(2
9.3)
Area
Urba
n1,
808
(79.
1)24
2(1
0.0)
233
(10.
2)<0
.001
*
1,15
6(5
0.8)
227
(10.
0)89
2(3
9.2)
<0.0
01*
1,33
9 (5
8.8)
455
(20.
0)48
1(2
1.1)
<0.0
01*
1,34
9 (5
9.3)
372
(16.
3)55
4(2
4.3)
<0.0
01*
Rura
l74
1(8
5.9)
65 (7.5
)57 (6.6
)26
2(3
0.4)
62 (7.2
)53
9(6
2.5)
426
(49.
4)10
4(1
2.1)
333
(38.
6)41
3(4
7.9)
84 (9.7
)36
6(4
2.4)
Age
18-2
437
6(7
5.7)
69(1
3.9)
52(1
0.5)
0.00
1*
235
(47.
3)64
(12.
9)19
8(3
9.8)
<0.0
01*
304
(61.
2)97
(19.
5)96
(19.
3)
<0.0
01*
304
(61.
2)78
(15.
7)11
5(2
3.1)
<0.0
01*
25-3
477
1(7
8.4)
112
(11.
4)98
(10.
0)49
9(5
0.8)
106
(11.
1)37
4(3
8.0)
597
(60.
7)23
0(2
3.4)
155
(15.
8)60
4(6
1.4)
198
(20.
1)18
0(1
8.3)
35-4
444
0(8
3.8)
37 (7.0
)48 (9.1
)25
2(4
8.0)
48 (9.1
)22
5(4
2.9)
311
(59.
2)84
(16.
0)13
0(2
4.8)
294
(56.
0)64
(12.
2)16
7(3
1.8)
45-5
944
4(8
4.9)
38 (7.3
)41 (7.8
)22
0(4
2.5)
33 (6.4
)26
5(5
1.2)
277
(53.
5)69
(13.
3)17
2(3
3.2)
265
(51.
2)62
(12.
0)19
1(3
6.9)
60-6
438
1(8
5.4)
35 (7.8
)30 (6.7
)15
9(3
5.9)
24 (5.4
)26
0(5
8.7)
206
(46.
5)57
(12.
9)18
0(4
0.6)
210
(47.
4)44 (9.9
)18
9(4
2.7)
>64
137
(78.
7)16 (9.2
)21
(12.
1)53
(30.
6)11 (6.4
)10
9(6
3.0)
70(4
0.5)
22(1
2.7)
81(4
6.8)
85(4
9.1)
10 (5.8
)78
(45.
1)G
ende
r
Mal
e1,
006
(80.
3)11
8(9
.4)
127
(10.
1)0.
150
565
(45.
3)11
8(9
.5)
563
(45.
1)0.
624
707
(56.
7)22
6(1
8.1)
313
(25.
1)0.
519
699
(56.
1)19
1(1
5.3)
356
(28.
5)0.
421
Fem
ale
1,54
3(8
1.4)
189
(10.
0)16
3(8
.6)
853
(45.
1)17
1(9
.0)
868
(45.
9)1,
058
(55.
9)33
3(1
7.6)
501
(26.
5)1,
063
(56.
2)26
5(1
4.0)
564
(29.
8)
Book.A National Survey On The Use of Medicines_2.12.indd 41 1/20/14 10:34 AM
42
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Outc
ome
Labe
lling
ade
quac
y by
go
vern
men
t hos
pita
ls/c
linic
sLa
belli
ng a
dequ
acy
by p
rivat
e ho
spita
lsLa
belli
ng a
dequ
acy
by p
rivat
e cl
inic
sLa
belli
ng a
dequ
acy
by
com
mun
ity p
harm
acie
s
Yes
n (%
)No
n
(%)
NA
n (%
)p-
valu
eYe
s n
(%)
No
n (%
)NA
n
(%)
p-va
lue
Yes
n (%
)No
n
(%)
NA
n (%
)p-
valu
eYe
s n
(%)
No
n (%
)NA
n
(%)
p-va
lue
Ethn
icity
Mal
ay1,
728
(85.
9)18
0(8
.9)
104
(5.2
)
<0.0
01*
829
(41.
3)17
2(8
.6)
1,00
6(5
0.1)
<0.0
01*
1,10
9(5
5.3)
310
(15.
4)58
8(2
9.3)
<0.0
01*
1,08
1(5
3.9)
276
(13.
8)65
0(3
2.4)
<0.0
01*
Chin
ese
419
(63.
1)84
(12.
7)15
9(2
3.9)
364
(54.
8)65 (9.8
)23
4(3
5.2)
389
(58.
6)16
9(2
5.5)
105
(15.
8)41
2(6
2.0)
115
(17.
3)13
6(2
0.5)
Indi
an16
6(8
5.1)
17 (8.7
)12 (6.2
)76
(39.
6)19 (9.9
)97
(50.
5)99
(51.
6)37
(19.
3)56
(29.
2)10
2(5
3.1)
24(1
2.5)
66(3
4.4)
Othe
rs23
6(8
5.2)
26 (9.4
)15 (5.4
)14
9(5
4.0)
33(1
2.0)
94(3
4.1)
168
(60.
9)43
(15.
6)65
(23.
6)16
7(6
0.5)
41(1
4.9)
68(2
4.6)
Educ
atio
n le
vel
Prim
ary
scho
ol26
5(8
4.4)
25 (8.0
)24 (7.6
)
<0.0
01*
91(2
9.0)
14 (4.5
)20
9(6
6.6)
<0.0
01*
135
(43.
0)27 (8.6
)15
2(4
8.4)
<0.0
01*
124
(39.
5)24 (7.6
)16
6(5
2.9)
<0.0
01*
Seco
ndar
y sc
hool
1,13
2(8
5.0)
98 (7.4
)10
2(7
.7)
568
(42.
9)96 (7.3
)65
9(4
9.8)
774
(58.
5)16
4(1
2.4)
385
(29.
1)76
3(5
7.7)
147
(11.
1)41
3(3
1.2)
Colle
ge/
unive
rsity
1,06
0(7
6.5)
167
(12.
0)15
7(1
1.3)
730
(52.
7)16
5(1
1.9)
490
(35.
4)81
5(5
8.8)
351
(25.
3)21
9(1
5.8)
833
(60.
1)27
3(1
9.7)
279
(20.
1)No
form
al
educ
atio
n92
(79.
3)17
(14.
7)7
(6.0
)29
(25.
0)14
(12.
1)73
(62.
9)41
(35.
3)17
(14.
7)58
(50.
0)42
(36.
2)12
(10.
3)62
(53.
4)Oc
cupa
tion
Gove
rnm
ent
927
(87.
0)11
9(1
1.2)
20 (1.9
)
<0.0
01*
527
(49.
4)13
4(1
2.6)
405
(38.
0)
<0.0
01*
606
(56.
8)25
5(2
3.9)
205
(19.
2)
<0.0
01*
619
(58.
1)20
9(1
9.6)
238
(22.
3)
<0.0
01*
Priva
te/s
elf
empl
oyed
795
(73.
7)91 (8.4
)19
1(1
7.7)
516
(48.
0)72 (6.7
)48
6(4
5.2)
655
(60.
9)15
9(1
4.8)
260
(24.
2)62
9(5
8.5)
137
(12.
7)30
8(2
8.7)
Retir
ed19
4(9
0.2)
9(4
.2)
12 (5.6
)83
(39.
3)12 (5.7
)11
6(5
5.0)
101
(47.
9)26
(12.
3)84
(39.
8)11
8(5
5.9)
19 (9.0
)74
(35.
1)
Stud
ent
210
(74.
5)40
(14.
2)32
(11.
3)12
8(4
5.6)
35(1
2.5)
118
(42.
0)16
9(6
0.1)
63(2
2.4)
49(1
7.4)
175
(62.
3)43
(15.
3)63
(22.
4)
Unem
ploy
ed42
3(8
3.6)
48 (9.5
)35 (6.9
)16
4(3
2.4)
36 (7.1
)30
6(6
0.5)
234
(46.
2)56
(11.
1)21
6(4
2.7)
221
(43.
7)48 (9.5
)23
7(4
6.8)
Book.A National Survey On The Use of Medicines_2.12.indd 42 1/20/14 10:34 AM
43
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Outc
ome
Labe
lling
ade
quac
y by
go
vern
men
t hos
pita
ls/c
linic
sLa
belli
ng a
dequ
acy
by p
rivat
e ho
spita
lsLa
belli
ng a
dequ
acy
by p
rivat
e cl
inic
sLa
belli
ng a
dequ
acy
by
com
mun
ity p
harm
acie
s
Yes
n (%
)No
n
(%)
NA
n (%
)p-
valu
eYe
s n
(%)
No
n (%
)NA
n
(%)
p-va
lue
Yes
n (%
)No
n
(%)
NA
n (%
)p-
valu
eYe
s n
(%)
No
n (%
)NA
n
(%)
p-va
lue
Livi
ng s
tatu
s
Alon
e33
6(7
9.2)
58(1
3.7)
30 (7.1
)
0.05
3
197
(46.
6)50
(11.
8)17
6(4
1.6)
0.42
3
241
(57.
0)83
(1
9.6)
99(2
3.4)
0.86
0
239
(56.
5)79
(18.
7)10
5(2
4.8)
0.01
6*W
ith fa
mily
2,11
8(8
1.4)
234
(9.0
)24
8(9
.5)
1,16
5(4
4.9)
230
(8.9
)1,
198
(46.
2)1,
457
(56.
2)45
3(1
7.5)
683
(26.
3)1,
453
(56.
0)35
3(1
3.6)
787
(30.
3)W
ith n
on-
fam
ily93
(77.
5)15
(12.
5)12
(10.
0)56
(46.
7)9
(7.5
)55
(45.
8)67
(55.
8)23
(19.
2)30
(25.
0)70
(58.
3)24
(20.
0)26
(21.
7)M
onth
ly In
com
e
≤RM
500
273
(82.
5)36
(10.
9)22 (6.6
)
<0.0
01*
120
(36.
5)37
(11.
2)17
2(5
2.3)
<0.0
01*
162
(49.
2)49
(14.
9)11
8(3
5.9)
<0.0
01*
163
(49.
5)38
(11.
6)12
8(3
8.9)
<0.0
01*
RM50
1-RM
1,00
022
5(8
0.9)
31(1
1.2)
22 (7.9
)89
(32.
0)21 (7.6
)16
8(6
0.4)
124
(44.
6)35
(12.
6)11
9(4
2.8)
137
(49.
3)32
(11.
5)10
9(3
9.2)
RM1,
001-
RM1,
500
491
(86.
3)51 (9.0
)27 (4.7
)23
0(4
0.9)
44 (7.8
)28
9(5
1.3)
311
(55.
2)68
(12.
1)18
4(3
2.7)
304
(54.
0)69
(12.
3)19
0(3
3.7)
RM1,
501-
RM2,
000
181
(85.
4)15 (7.1
)15 (7.1
)77
(36.
3)10 (4.7
)12
5(5
9.0)
108
(50.
9)24
(11.
3)80
(37.
7)95
(44.
8)20 (9.4
)97
(45.
8)RM
2,00
1-RM
2,50
033
9(8
2.5)
32 (7.8
)40 (9.7
)20
0(4
8.7)
27 (6.6
)18
4(4
4.8)
253
(61.
6)61
(14.
8)97
(23.
6)24
7(6
0.1)
58(1
4.1)
106
(25.
8)RM
2,50
1-RM
3,00
012
5(7
4.9)
22(1
3.2)
20(1
2.0)
66(3
9.5)
14 (8.4
)87
(52.
1)10
2(6
1.1)
29(1
7.4)
36(2
1.6)
88(5
2.7)
24(1
4.4)
55(3
2.9)
RM3,
001-
RM3,
500
305
(82.
4)32 (8.6
)33 (8.9
)19
6(5
3.0)
42(1
1.4)
132
(35.
7)24
8(6
7.0)
64(1
7.3)
58(1
5.7)
232
(62.
7)59
(15.
9)79
(21.
4)RM
3,50
1-RM
4,00
010
0(7
3.5)
14(1
0.3)
22(1
6.2)
67(4
9.3)
11 (8.1
)58
(42.
6)78
(57.
4)31
(22.
8)27
(19.
9)82
(60.
3)20
(14.
7)34
(25.
0)RM
4,00
1-RM
4,50
015
1(8
0.7)
17 (9.1
)18 (9.6
)12
5(6
6.8)
15 (8.0
)46
(24.
6)12
4(6
6.3)
39(2
0.9)
23(1
2.3)
132
(70.
6)24
(12.
8)30
(16.
0)RM
4,50
1-RM
5,00
077
(75.
5)13
(12.
7)12
(11.
8)46
(45.
1)13
(12.
7)43
(42.
2)52
(5
1.0)
30(2
9.4)
20(1
9.6)
60(5
8.8)
21(2
0.6)
21(2
0.6)
>RM
5,00
027
7(7
3.3)
42(1
1.1)
59(1
5.6)
199
(52.
6)53
(14.
0)12
6(3
3.3)
200
(52.
2)12
7(3
3.6)
51(1
3.5)
219
(57.
9)89
(23.
5)70
(18.
5)*S
igni
fican
t at p
<0.0
5
Book.A National Survey On The Use of Medicines_2.12.indd 43 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
44
4.5 Awareness towards appropriate use of medicines
Only half of the respondents (49.8%, n=1,567) claimed that they were able to identify medicines by the trade or generic name. This ability was found to be associated with consumers’ area of settlement, age, gender, education level, occupation, living status and monthly income. Consumers from urban area, the age group of 25-34 years, who have received tertiary education, of Indian ethnicity, were government employee, living with non-family members and of higher income group were more able to identify medicines by the trade or generic name (Table 12).
Table 12: Association between ability to identify medicines by trade or generic name and demographic characteristics
Demographic characteristics
Ability to identify medicines by trade or
generic name
Yes n(%)
No n(%) p-value
Settlement setting
Urban 1,242 (54.5)
1,037 (45.5)
<0.01*Rural 325
(37.7)537
(62.3)Age
18-24 279 (56.1)
218 (43.9)
<0.01*
25-34 612 (62.4)
368 (37.6)
35-44 272 (51.8)
253 (48.2)
45-59 217 (41.8)
302 (58.2)
60-64 155 (34.8)
290 (65.2)
>64 32 (18.4)
142 (81.6)
Demographic characteristics
Ability to identify medicines by trade or
generic name
Yes n(%)
No n(%) p-value
Gender
Male 585 (46.8)
685 (53.2)
0.005*Female 982
(51.9)909
(48.1)Ethnicity
Malay 995 (49.5)
1,014 (50.5)
0.146Chinese 317
(47.9)345
(52.1)
Indian 109 (56.2)
85 (43.8)
Others 146 (53.1)
129 (46.9)
Education level
Primary school 59 (18.8)
254 (81.2)
<0.01*Secondary school 599
(45.1)728
(54.9)
College/university 895 (64.6)
490 (35.4)
No formal education 14 (12.1)
102 (87.9)
Occupation
Government 709 (66.5)
357 (33.5)
<0.01*
Private/self employed
462 (42.9)
613 (57.1)
Retired 91 (42.5)
123 (57.5)
Student 160 (56.9)
121 (43.1)
Unemployed 145 (28.8)
359 (71.2)
Living status
Alone 234 (55.2)
190 (44.8)
<0.01*With family 1,251 (48.2)
1,341 (51.8)
With non-family 80 (66.7)
40 (33.3)
Book.A National Survey On The Use of Medicines_2.12.indd 44 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
45
Demographic characteristics
Ability to identify medicines by trade or
generic name
Yes n(%)
No n(%) p-value
Monthly income
≤RM500 109 (33.0)
221 (67.0)
<0.01*
RM501-RM1,000 98 (35.3)
180 (64.7)
RM1,001-RM1,500 229 (40.6)
335 (59.4)
RM1,501-RM2,000 103 (48.6)
109 (51.4)
RM2,001-RM2,500 194 (47.2)
217 (52.8)
RM2,501-RM3,000 81 (48.5)
86 (51.5)
RM3,001-RM3,500 214 (57.8)
156 (42.2)
RM3,501-RM4,000 92 (67.6)
44 (32.4)
RM4,001-RM4,500 119 (63.6)
68 (36.4)
RM4,501-RM5,000 68 (66.7)
34 (33.3)
>RM5,000 256 (67.9)
121 (32.1)
*Significant at p<0.05
It was found that up to 56.6% of the respondents claimed that they really understood the proper use of medicines. The consumers’ understanding were significantly associated with their age (p<0.05), gender (p<0.05), ethnicity (p<0.05), education level (p <0.05), occupation (p<0.05), and also their monthly household income (p<0.05). The study also found that 83.0% of the respondents have good knowledge on proper medicines storage. This is significantly associated with age (p<0.05), ethnicity (p<0.05), education level (p<0.05), occupation (p<0.05) and the consumer’s monthly household income (p<0.05).
Book.A National Survey On The Use of Medicines_2.12.indd 45 1/20/14 10:34 AM
46
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 13
: Ass
ocia
tion
betw
een
the
know
ledg
e on
pro
per u
se a
nd s
tora
ge o
f med
icin
es a
nd d
emog
raph
ic c
hara
cter
istic
s
Dem
ogra
phic
ch
arac
teris
tics
Und
erst
and
the
prop
er u
se o
f med
icin
esKn
owle
dge
on p
rope
r med
icin
es s
tora
ge
Don’
t und
erst
and
n
(%)
Part
ially
un
ders
tand
s n
(%)
Und
erst
and
n (%
)p-
valu
eNo
n
(%)
Yes
n
(%)
p-va
lue
Tota
l=N
109
( 3.
5)1,
257
(39.
9)1,
781
(56.
6)53
4 (1
7.0)
2,61
4 (8
3.0)
Sett
lem
ent s
ettin
g Ur
ban
73 (
3.2
)92
0 (4
0.3)
1,29
1 (5
6.5)
0.37
439
6 (1
7.3)
1,88
9 (8
2.7)
0.82
8Ru
ral
36 (
4.2
)33
7 (3
9.0)
490
(56.
8)13
8 (1
6.0)
725
(84.
0)Ag
e18
-24
22 (
4.4
)21
5 (4
3.3)
260
(52.
3)
<0.0
01*
113
(22.
7)38
4 (7
7.3)
0.00
1*
25-3
415
( 1
.5)
354
(36.
0)61
4 (6
2.5)
171
(17.
4)81
2 (8
2.6)
35-4
417
( 3
.2)
196
(37.
3)31
2 (5
9.4)
66 (1
2.6)
459
(87.
4)45
-59
12 (
2.3
)21
3 (4
0.7)
298
(57.
0)83
(15.
9)44
0 (8
4.1)
60-6
417
( 3
.8)
200
(44.
9)22
8 (5
1.2)
68 (1
5.2)
378
(84.
8)>6
426
(14.
9)79
(45.
4)69
(39.
7)33
(19.
0)14
1 (8
1.0)
Gen
der
Mal
e46
( 3
.7)
551
(44.
0)65
5 (5
2.3)
<0.0
01*
222
(17.
7)1,
031
(82.
3)0.
359
Fem
ale
63 (
3.3
)70
6 (3
7.3)
1,12
6 (5
9.4)
312
(16.
5)1,
583
(83.
5)Et
hnic
ityM
alay
57 (
2.8
)72
8 (3
6.2)
1,22
6 (6
1.0)
<0.0
01*
312
(15.
5)1,
700
(84.
5)
0.00
1*Ch
ines
e36
( 5
.4)
332
(50.
0)29
6 (4
4.6)
138
(20.
8)52
6 (7
9.2)
Indi
an11
( 5
.6)
77 (3
9.5)
107
(54.
9)24
(12.
3)17
1 (8
7.7)
Othe
rs5
( 1.
8)12
0 (4
3.3)
152
(54.
9)60
(21.
7)21
7 (7
8.3)
Educ
atio
n le
vel
Prim
ary
scho
ol23
( 7
.3)
152
(48.
4)13
9 (4
4.3)
<0.0
01*
52 (1
6.6)
262
(83.
4)
0.00
6*Se
cond
ary
scho
ol46
( 3
.5)
545
(40.
9)74
0 (5
5.6)
204
(15.
3)1,
128
(84.
7)Co
llege
/uni
vers
ity24
( 1
.7)
503
(36.
3)85
9 (6
2.0)
246
(17.
7)1,
140
(82.
3)No
form
al e
duca
tion
16 (1
3.8)
57 (4
9.1)
43 (3
7.1)
32 (2
7.6)
84 (7
2.4)
Book.A National Survey On The Use of Medicines_2.12.indd 46 1/20/14 10:34 AM
47
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Und
erst
and
the
prop
er u
se o
f med
icin
esKn
owle
dge
on p
rope
r med
icin
es s
tora
ge
Don’
t und
erst
and
n
(%)
Part
ially
un
ders
tand
s n
(%)
Und
erst
and
n (%
)p-
valu
eNo
n
(%)
Yes
n
(%)
p-va
lue
Occu
patio
n Go
vern
men
t14
( 1
.3)
332
(31.
1)72
0 (6
7.5)
<0.0
01*
157
(14.
7)90
9 (8
5.3)
<0.0
01*
Priva
te/s
elf e
mpl
oyed
41 (
3.8
)48
7 (4
5.1)
551
(51.
1)19
3 (1
7.9)
886
(82.
1)Re
tired
12 (
5.6
)89
(41.
6)11
3 (5
2.8)
22 (1
0.2)
193
(89.
8)St
uden
t8
( 2.
8)13
1 (4
6.5)
143
(50.
7)72
(25.
5)21
0 (7
4.5)
Unem
ploy
ed34
( 6
.7)
218
(43.
1)25
4 (5
0.2)
90 (1
7.8)
416
(82.
2)Li
ving
sta
tus
Alon
e13
( 3
.1)
154
(36.
4)25
6 (6
0.5)
0.07
779
(18.
6)34
5 (8
1.4)
0.62
0W
ith fa
mily
96 (
3.7
)10
56 (4
0.6)
1450
(55.
7)43
5 (1
6.7)
2167
(83.
3)W
ith n
on-fa
mily
0 (
0.0)
46 (3
8.3)
74 (6
1.7)
20 (1
6.7)
100
(83.
3)M
onth
ly h
ouse
hold
inco
me
<RM
500
24 (
7.3
)14
4 (4
3.5)
163
(49.
2)
<0.0
01*
80 (2
4.2)
251
(75.
8)
0.02
8*
RM50
1-RM
1,00
015
( 5
.4)
113
(40.
6)15
0 (5
4.0)
54 (1
9.4)
224
(80.
6)RM
1,00
1-RM
1,50
021
( 3
.7)
252
(44.
3)29
6 (5
2.0)
96 (1
6.9)
473
(83.
1)RM
1,50
1-RM
2,00
08
( 3.
8)83
(39.
2)12
1(57
.1)
30 (1
4.2)
182
(85.
8)RM
2,00
1-RM
2,50
016
( 3
.9)
163
(39.
7)23
2 (5
6.4)
63 (1
5.3)
348
(84.
7)RM
2,50
1-RM
3,00
06
( 3.
6)72
(43.
1)89
(53.
3)32
(19.
2)13
5 (8
0.8)
RM3,
001-
RM3,
500
5 (
1.4)
137
(37.
0)22
8 (6
1.6)
55 (1
7.5)
315
(85.
1)RM
3,50
1-RM
4,00
02
( 1.
5)47
(34.
6)87
(64.
0)17
(12.
5)11
9 (8
7.5)
RM4,
001-
RM4,
500
0 (
0.0)
79 (4
2.2)
108
(57.
8)31
(16.
6)15
6 (8
3.4)
RM4,
501-
RM5,
000
4 (
3.9)
40 (3
9.2)
58 (5
6.9)
16 (1
5.7)
86 (8
4.3)
>RM
5,00
08
( 2.
1)12
2 (3
2.3)
248
(65.
6)57
(15.
1)32
1 (8
4.9)
* Si
gnifi
cant
at p
<0.0
5
Book.A National Survey On The Use of Medicines_2.12.indd 47 1/20/14 10:34 AM
48
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Majority of the respondents were generally aware of the side effects of medicines (64.2%, n=2,017). Respondents from urban area, of a younger age group, higher education and income level were found to have better awareness of medicines side effect (Table 14). Meanwhile, up
to 90% (n=2,826) of respondents were aware of medicines’ expiry dates. This was found to be associated with the consumers’ area of settlement, age, occupation, education and income level (Table 14).
Table 14: Association between the awareness on the side effects and shelf life of medicines and demographic characteristics
Demographic characteristics
Aware of medicines’ side effects Aware medicines’ expiry dates
Yes, n (%) No, n (%) p-value Yes, n (%) No, n (%) p-value
Area of settlement
Urban 1,524 (66.7) 760 (33.3)<0.001*
2,096 (91.7) 188 ( 8.2)<0.001*
Rural 493 (57.1) 370 (42.9) 730 (84.6) 133 (15.4)
Age
18-24 329 (66.2) 167 (33.6)
<0.001*
442 (88.9) 55 (11.1)
<0.001*
25-34 717 (72.9) 266 (27.1) 924 (93.9) 59 ( 6.0)
35-44 352 (67.0) 173 (33.0) 484 (92.2) 41 ( 7.8)
45-59 319 (61.0) 204 (39.0) 464 (88.7) 58 (11.1)
60-64 236 (52.9) 210 (47.1) 382 (85.7) 64 (14.3)
>64 64 (36.8) 110 (63.2) 130 (74.7) 44 (25.3)
Gender
Male 738 (58.9) 515 (41.1)<0.001*
1,106 (88.3) 147 (11.7)0.050
Female 1,279 (67.5) 615 (32.5) 1,720 (90.8) 174 ( 9.2)
Ethnicity
Malay 1,299 (64.6) 713 (35.4)
0.056
1,794 (89.2) 217 (10.8)
0.512Chinese 397 (59.8) 266 (40.1) 608 (91.6) 56 ( 8.4)
Indian 131 (67.2) 64 (32.8) 171 (87.7) 24 (12.3)
Others 190 (68.6) 87 (31.4) 253 (91.3) 24 ( 8.7)
Education level
Primary school 139 (44.3) 175 (55.7)
<0.001*
244 (77.7) 70 (22.3)
<0.001*Secondary school 828 (62.2) 504 (37.8) 1,219 (91.5) 113 ( 8.5)
College/university 999 (72.1) 386 (27.8) 1,287 (92.9) 98 ( 7.1)
No formal education 51 (44.0) 65 (56.0) 76 (65.5) 40 (34.5)
Book.A National Survey On The Use of Medicines_2.12.indd 48 1/20/14 10:34 AM
49
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Demographic characteristics
Aware of medicines’ side effects Aware medicines’ expiry dates
Yes, n (%) No, n (%) p-value Yes, n (%) No, n (%) p-value
Occupation
Government 807 (75.7) 259 (24.3)
<0.001*
1,010 (94.7) 55 ( 5.2)
<0.001*
Private/self employed 651 (60.3) 427 (39.6) 960 (89.0) 119 (11.0)
Retired 108 (50.2) 107 (49.8) 191 (88.8) 24 (11.2)
Student 184 (65.2) 98 (34.8) 254 (90.1) 28 ( 9.9)
Unemployed 267 (52.8) 239 (47.2) 411 (81.2) 95 (18.8)
Living status
Alone 290 (68.4) 134 (31.6)
0.125
386 (91.0) 38 ( 9.0)
0.567With family 1,640 (63.0) 961 (37.0) 2,326 (89.4) 275 (10.6)
With non-family 85 (70.8) 35 (29.2) 112 (93.3) 8 ( 6.7)
Monthly household income
<RM500 187 (56.5) 144 (43.5)
<0.001*
266 (80.4) 65 (19.6)
<0.001*
RM501-RM1,000 152 (54.7) 126 (45.3) 228 (82.0) 50 (18.0)
RM1,001-RM1,500 339 (59.6) 229 (40.2) 508 (89.3) 61 (10.7)
RM1,501-RM2,000 136 (64.2) 76 (35.8) 192 (90.6) 20 ( 9.4)
RM2,001-RM2,500 256 (62.2) 155 (37.7) 369 (89.8) 42 (10.2)
RM2,501-RM3,000 92 (55.1) 75 (44.9) 153 (91.6) 14 ( 8.4)
RM3,001-RM3,500 246 (66.5) 124 (33.5) 345 (93.2) 24 ( 6.5)
RM3,501-RM4,000 100 (73.5) 36 (26.5) 131 (96.3) 5 ( 3.7)
RM4,001-RM4,500 140 (74.9) 47 (25.1) 178 (95.2) 9 ( 4.8)
RM4,501-RM5,000 72 (70.6) 30 (29.4) 92 (90.2) 10 ( 9.8)
>RM5,000 295 (78.0) 83 (22.0) 359 (95.0) 19 ( 5.0)
*Significant at p<0.05
Book.A National Survey On The Use of Medicines_2.12.indd 49 1/20/14 10:34 AM
50
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Table 15: Factors affecting the awareness on food-medicines and modern-traditional medicines interactions
Demographic characteristics
Awareness of interactions between modern medicines and food
Awareness of interactions between modern and traditional medicines
Yes, n (%) No, n (%) p-value Yes, n (%) No, n (%) p-value
Total=N 2,151 (68.3) 996 (31.6) - 2,056 (65.3) 1,092 (34.7) -
Age
18-24 331 (66.6) 166 (33.4)
<0.001*
316 (63.6) 181 (36.4)
0.012*
25-34 719 (73.1) 264 (26.9) 652 (66.3) 331 (33.7)
35-44 380 (72.4) 145 (27.6) 361 (68.8) 164 (31.2)
45-54 346 (66.2) 176 (33.7) 343 (65.6) 180 (34.4)
55-64 280 (62.8) 166 (37.2) 291 (65.2) 155 (34.8)
>64 95 (54.6) 79 (45.4) 93 (53.4) 81 (46.6)
Gender
Male 797 (63.6) 456 (36.4)<0.001*
761 (60.7) 492 (39.3)<0.001*
Female 1,354 (71.5) 540 (28.5) 1,295 (68.3) 600 (31.7)
Ethnicity
Malay 1,417 (70.4) 594 (29.5)
0.012*
1,304 (64.8) 708 (35.2)
<0.001*Chinese 417 (62.8) 247 (37.2) 473 (71.2) 191 (28.8)
Indian 124 (63.6) 71 (36.4) 123 (63.1) 72 (36.9)
Others 193 (69.7) 84 (30.3) 156 (56.3) 121 (43.7)
Education level
Primary school 184 (58.6) 130 (41.4)
<0.001*
183 (58.3) 131 (41.7)
<0.001*Secondary school 916 (68.8) 415 (31.2) 853 (64.0) 479 (36.0)
College/university 996 (71.9) 390 (28.1) 973 (70.2) 413 (29.8)
No formal education 55 (47.4) 61 (52.6) 47 (40.5) 69 (59.5)
Occupation
Government 793 (74.4) 272 (25.5)
<0.001*
745 (69.9) 321 (30.1)
0.003*
Private/self employed 715 (66.3) 364 (33.7) 682 (63.2) 397 (36.8)
Retired 142 (66.0) 73 (34.0) 141 (65.6) 74 (34.4)
Student 183 (64.9) 99 (35.1) 178 (63.1) 104 (36.9)
Unemployed 318 (62.8) 188 (37.2) 310 (61.3) 196 (38.7)
Living status
Alone 294 (69.3) 130 (30.7)
0.640
275 (64.9) 149 (35.1)
0.328With family 1,766 (67.9) 835 (32.1) 1,694 (65.1) 908 (34.9)
With non-family 89 (74.2) 31 (25.8) 86 (71.7) 34 (28.3)
Book.A National Survey On The Use of Medicines_2.12.indd 50 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
51
Demographic characteristics
Awareness of interactions between modern medicines and food
Awareness of interactions between modern and traditional medicines
Yes, n (%) No, n (%) p-value Yes, n (%) No, n (%) p-value
Monthly income
≤RM500 220 (66.5) 111 (33.5)
0.043
192 (58.0) 139 (42.0)
<0.001*
RM501-RM1,000 194 (69.8) 84 (30.4) 183 (65.8) 95 (34.2)
RM1,001-RM1,500 378 (66.4) 191 (33.6) 333 (58.5) 236 (41.5)
RM1,501-RM2,000 138 (65.1) 74 (34.9) 138 (65.1) 74 (34.9)
RM2,001-RM2,500 262 (63.7) 148 (36.0) 267 (65.0) 144 (35.0)
RM2,501-RM3,000 99 (59.3) 68 (40.7) 98 (58.7) 69 (41.3)
RM3,001-RM3,500 269 (72.7) 101 (27.3) 250 (67.6) 120 (32.4)
RM3,501-RM4,000 96 (70.6) 40 (29.4) 106 (77.9) 30 (22.1)
RM4,001-RM4,500 131 (70.1) 56 (29.9) 130 (69.5) 57 (30.5)
RM4,501-RM5,000 75 (73.5) 27 (26.5) 79 (77.5) 23 (22.5)
>RM5,000 283 (74.9) 95 (25.1) 278 (73.5) 100 (6.5)
*Significant at p<0.05
Majority of the respondents were aware of the potential interactions between food with modern medicines (68.3%) and traditional with modern medicines (65.3%). This awareness was significantly associated with respondents’ age, gender, ethnicity, education level, occupation and monthly income (Table 15).
Up to 76.4% of the participants were aware of the requirement for registration with the Ministry
of Health Malaysia for all modern and traditional medicines prior to marketing. Consumers who were females (77.9%), from the age group of 25 to 34 years old (85.4%), with tertiary education (82.0%), government employee (90.8%), who lived alone (83.3%), and with monthly income between RM1,501 to RM2,000 (86.7%) were more aware of this medicines’ registration requirement (Table 16).
Table 16: Response to “Did you know that all modern and traditional medicines should be registered with Ministry of Health?” based on demographic characteristics
Demographic characteristics
Outcome“Did you know that all modern and traditional medicines should
be registered with Ministry of Health?”Yes, n(%) No, n(%) p-value
Total=N 2,403 (76.4) 744 (23.6)
Age18-24 367 (74.0) 129 (26.0)
<0.001*
25-34 840 (85.4) 144 (14.6)
35-44 434 (82.5) 92 (17.5)
45-59 380 (72.8) 142 (27.2)
60-64 300 (67.4) 145 (32.6)
>64 82 (47.1) 92 (52.9)
Book.A National Survey On The Use of Medicines_2.12.indd 51 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
52
Demographic characteristics
Outcome“Did you know that all modern and traditional medicines should
be registered with Ministry of Health?”Yes, n(%) No, n(%) p-value
GenderMale 929 (74.0) 326 (26.0)
0.012Female 1,474 (77.9) 418 (22.1)
EthnicityMalay 1,593 (79.3) 417 (20.7)
<0.001*Chinese 439 (66.0) 226 (34.0)
Indian 138 (70.4) 58 (29.6)
Others 233 (84.4) 43 (15.6)
Education levelPrimary school 185 (59.1) 128 (40.9)
<0.001*Secondary school 1,037 (77.9) 295 (22.1)
College/university 1,136 (82.0) 250 (18.0)
No formal education 45 (38.8) 71 (61.2)
OccupationGovernment 968 (90.8) 98 ( 9.2)
<0.001*
Private/self employed 794 (73.5) 286 (26.5)
Retired 147 (68.4) 68 (31.6)
Student 196 (69.5) 86 (30.5)
Unemployed 298 (59.1) 206 (40.9)
Living statusAlone 353 (83.3) 71 (16.7)
0.001With family 1,953 (75.1) 649 (24.9)
With non-family 96 (80.7) 23 (19.3)
Monthly income≤RM500 211 (63.6) 121 (36.4)
<0.001*
RM501-RM1,000 208 (75.1) 69 (24.9)
RM1,001-RM1,500 420 (73.9) 148 (26.1)
RM1,501-RM2,000 183 (86.7) 28 (13.3)
RM2,001-RM2,500 302 (73.5) 109 (26.5)
RM2,501-RM3,000 122 (73.1) 45 (26.9)
RM3,001-RM3,500 306 (82.5) 65 (17.5)
RM3,501-RM4,000 112 (82.4) 24 (17.6)
RM4,001-RM4,500 145 (77.5) 42 (22.5)
RM4,501-RM5,000 79 (77.5) 23 (22.5)
>RM5,000 309 (81.7) 69 (18.3)
Book.A National Survey On The Use of Medicines_2.12.indd 52 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
53
Only 38.7% of the participants were aware of Meditag® availability. This knowledge was found to be influenced by the participants’ age (p<0.05), gender (p<0.05), ethnicity (p<0.05), education level (p<0.05), occupation (p<0.05), living status (p<0.05) and monthly income household (p<0.05) (Table 17). Participants of
age between 25 to 34 years (52.3%), females (40.0%), who were of Malay ethnicity (41.6%), who have tertiary education (48.6%), who were government-employed (59.6%), lived with non-family (48.3%) and have a monthly income within the range of RM4,501 to RM5,000 (52.0%) were more aware of the Meditag® availability.
Table 17: Factors affecting knowledge on Meditag® availability
Demographic characteristics
Outcome
Knowledge of Meditag availability
Yes, n(%) No, n(%) p-value
Age
18-24 176 (35.8) 190 (38.7)
<0.001*
25-34 509 (52.3) 325 (33.4)
35-44 223 (43.0) 209 (40.3)
45-59 162 (31.5) 216 (41.9)
60-64 112 (25.7) 188 (43.2)
>64 21 (12.1) 63 (36.2)
Gender
Male 454 (36.8) 469 (38.0)0.034*
Female 749 (40.0) 722 (38.5)
Ethnicity
Malay 827 (41.6) 763 (38.4)
<0.001*Chinese 194 (29.5) 243 (36.9)
Indian 69 (37.1) 64 (34.4)
Others 113 (40.9) 121 (43.8)
Education level
Primary school 48 (15.4) 138 (44.2)
<0.001*Secondary school 484 (36.8) 551 (41.9)
College/ university 66 (48.6) 464 (33.9)
No formal education 7 (6.2) 38 (33.6)
Occupation
Government 631 (59.6) 332 (31.4)
<0.001*
Private/self employed 330 (31.0) 462 (43.4)
Retired 57 (27.3) 88 (42.1)
Student 85 (30.7) 109 (39.4)
Unemployed 100 (20.0) 200 (40.1)
Book.A National Survey On The Use of Medicines_2.12.indd 53 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
54
Demographic characteristics
Outcome
Knowledge of Meditag availability
Yes, n(%) No, n(%) p-value
Living status
Alone 185 (44.0) 166 (39.5)
0.001*With family 962 (37.4) 984 (38.3)
With non-family 56 (48.3) 40 (34.5)
Monthly income
≤RM500 80 (24.3) 131 (39.8)
<0.001*
RM501-RM1,000 79 (28.7) 128 (46.5)
RM1,001-RM1,500 197 (35.2) 221 (39.5)
RM1,501-RM2,000 81 (38.6) 102 (48.6)
RM2,001-RM2,500 151 (37.5) 153 (38.0)
RM2,501-RM3,000 52 (31.7) 70 (42.7)
RM3,001-RM3,500 180 (49.0) 124 (33.8)
RM3,501-RM4,000 70 (51.9) 42 (31.1)
RM4,001-RM4,500 81 (43.5) 63 (33.9)
RM4,501-RM5,000 53 (52.0) 26 (25.5)
>RM5,000 177 (47.6) 129 (34.7)
*Significant at p<0.05
Book.A National Survey On The Use of Medicines_2.12.indd 54 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
55
4.6 Assessment towards medication compliance
Up to 69.1% (n=2,170) of the respondents admitted to ever missed taking their medication as prescribed. This study found that the respondents’ age, ethnicity, education level, occupation, and monthly income were significantly (p<0.05) associated with consumers’ compliance to prescribed medications (Table 18). Majority of
the Chinese respondents (75.5%) reported to have ever forgotten to take prescribed medicines as indicated. In addition, respondents who had received to primary level of education (61.0%) were more likely to remember to take prescribed medicines as indicated. On the other hand, respondents aged 64 and above (73.4%) were more likely to forget to take prescribed medicines as indicated.
Table 18: Response to “Have you ever forgotten to take the prescribed medicines as indicated?” based on demographic characteristics
Demographic characteristicsEver forgotten to take the prescribed medicines as indicated?
Yes, n (%) No, n (%) p-value
Age
18-24 362 (73.1) 133 (26.9)
0.010*
25-34 698 (70.9) 286 (39.1)
35-44 338 (64.3) 188 (35.7)
45-54 349 (67.0) 172 (33.0)
55-64 296 (66.4) 150 (33.6)
>64 127 (73.4) 46 (26.6)
Gender
Male 844 (67.5) 407 (32.5)0.135
Female 1,326 (70.0) 568 (30.0)
Ethnicity
Malay 1,329 (66.2) 680 (33.8)
<0.001*Chinese 501 (75.5) 163 (24.5)
Indian 132 (67.3) 64 (32.7)
Others 208 (75.4) 68 (24.6)
Education level
Primary school 191 (61.0) 122 (39.0)
<0.001*Secondary school 871 (65.4) 460 (34.6)
College/university 1,024 (73.9) 362 (26.1)
No formal education 84 (73.0) 31 (27.0)
Occupation
Government 754 (70.7) 312 (29.3)
0.022*
Private/self employed 741 (68.7) 337 (31.3)
Retired 139 (64.7) 76 (35.3)
Student 209 (74.4) 72 (25.6)
Unemployed 327 (64.8) 178 (35.2)
Book.A National Survey On The Use of Medicines_2.12.indd 55 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
56
Demographic characteristicsEver forgotten to take the prescribed medicines as indicated?
Yes, n (%) No, n (%) p-value
Living status
Alone 296 (69.8) 128 (30.2)
0.761With family 1,787 (68.7) 813 (31.3)
With non-family 85 (71.4) 34 (28.6)
Monthly income
≤RM500 233 (70.2) 99 (29.8)
0.002*
RM501-RM1,000 167 (60.5) 109 (39.5)
RM1,001-RM1,500 372 (65.6) 195 (34.4)
RM1,501-RM2,000 137 (64.9) 74 (35.1)
RM2,001-RM2,500 282 (68.6) 129 (31.4)
RM2,501-RM3,000 116 (69.5) 51 (30.5)
RM3,001-RM3,500 269 (72.5) 102 (27.5)
RM3,501-RM4,000 102 (75.0) 34 (25.0)
RM4,001-RM4,500 128 (68.4) 59 (31.6)
RM4,501-RM5,000 77 (75.5) 25 (24.5)
>RM5,000 285 (75.4) 93 (24.6)
*Significant at p<0.05
Less than half of the respondents (n=1,319, 42%) admitted to have consciously chosen not to take the prescribed medicines. Respondents who are from the age group of 25-34 years, of
Chinese ethnicity, with tertiary education, living alone and from higher income group were more likely to choose not to take the prescribed medications (Table 19).
Table 19: Response to “Have you ever chosen not to take the prescribed medicines?” based on demographic characteristics
Demographic characteristicsEver choose not to take prescribed medicines?
Yes, n (%) No, n (%) p-value
Age18-24 238(48.0) 258 (52.0)
<0.001*
25-34 478 (48.6) 505 (51.4)
35-44 211 (40.1) 315 (59.9)
45-54 184 (35.3) 337 (64.7)
55-64 146 (32.7) 300 (67.3)
GenderMale 503 (40.2) 749 (59.8)
0.106Female 816 (43.1) 1,078 (56.9)
Book.A National Survey On The Use of Medicines_2.12.indd 56 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
57
Demographic characteristicsEver choose not to take prescribed medicines?
Yes, n (%) No, n (%) p-value
EthnicityMalay 769 (38.3) 1,241 (61.7)
<0.001*Chinese 353 (53.2) 311 (46.8)
Indian 81 (41.3) 115 (58.7)
Others 116 (42.0) 160 (58.0)
Education LevelPrimary school 89 (28.4) 224 (71.6)
<0.001*Secondary school 505 (37.9) 826 (62.1)
College/university 685 (49.4) 701 (50.6)
No formal education 40 (34.5) 76 (65.5)
OccupationGovernment 474 (44.5) 592 (55.5)
<0.001*
Private/self employed 481 (44.6) 597 (55.4)
Retired 79 (36.7) 136 (63.3)
Student 120 (42.6) 162 (57.4)
Unemployed 165 (32.7) 340 (67.3)
Living status
Alone 205 (48.3) 219 (51.7)
0.011*With family 1,060 (40.8) 1,541 (59.2)
With non-family 53 (44.5) 66 (55.5)
Monthly income≤RM500 121 (36.4) 211 (63.6)
<0.001*
RM501-RM1,000 102 (36.8) 175 (63.2)
RM1,001-RM1,500 219 (38.6) 349 (61.4)
RM1,501-RM2,000 76 (36.0) 135 (64.0)
RM2,001-RM2,500 172 (41.8) 239 (58.2)
RM2,501-RM3,000 78 (46.7) 89 (53.3)
RM3,001-RM3,500 139 (37.6) 231 (62.4)
RM3,501-RM4,000 64 (47.1) 72 (52.9)
RM4,001-RM4,500 91 (48.7) 96 (51.3)
RM4,501-RM5,000 53 (52.0) 49 (48.0)
>RM5,000 198 (52.4) 180 (47.6)
*Significant at p<0.05
Book.A National Survey On The Use of Medicines_2.12.indd 57 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
58
Sharing of medications was a common practice among consumers (29.5%, n=928) (Table 20). Respondents who lived with non-family members were more likely to share medications than those living alone or with family members (p=0.004).
Additionally, those from the age group between 18-24 years (43.8%), are students (42.5%) and have tertiary education (38.6%) were found to be more likely to share medications than the others.
Table 20: Response to “Have you ever shared any medicines with others?” based on demographic characteristics
Demographic characteristicsEver shared medicines with others?
Yes, n (%) No, n (%) p-value
Area
Urban 731 (32.0) 1,553 (68.0)<0.001*
Rural 197 (22.8) 666 (77.2)
Age
18-24 217 (43.8) 278 (56.2)
<0.001*
25-34 353 (35.9) 631 (64.1)
35-44 141 (26.8) 385 (73.2)
45-54 112 (21.5) 410 (78.5)
55-64 75 (16.8) 371 (83.2)
>64 30 (17.2) 144 (82.8)
Gender
Male 375 (29.9) 879 (70.1)
Female 553 (29.2) 1,340 (70.8)
Ethnicity
Malay 579 (28.8) 1,430 (71.2)
0.001*Chinese 222 (33.4) 443 (66.6)
Indian 37 (18.9) 159 (81.1)
Others 90 (32.5) 187 (67.5)
Education level
Primary school 48 (15.3) 265 (84.6)
<0.001*Secondary school 319 (23.9) 1,014 (76.1)
College/university 535 (38.6) 850 (61.4)
No formal education 26 (22.4) 90 (77.6)
Occupation
Government 338 (31.7) 728 (68.3)
<0.001*
Private/self employed 332 (30.8) 747 (69.2)
Retired 44 (20.5) 171 (79.5)
Student 120 (42.5) 162 (57.4)
Unemployed 94 (18.6) 411 (81.3)
Book.A National Survey On The Use of Medicines_2.12.indd 58 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
59
Demographic characteristicsEver shared medicines with others?
Yes, n (%) No, n (%) p-value
Living status
Alone 141 (33.3) 283 (66.7)
0.004*With family 738 (28.4) 1,864 (71.6)
With non-family 48 (40.3) 71 (59.6)
Monthly income
≤RM500 90 (27.1) 242 (72.9)
<0.001*
RM501-RM1,000 68 (24.6) 208 (75.4)
RM1,001-RM1,500 154 (27.1) 415 (72.9)
RM1,501-RM2,000 44 (20.9) 167 (79.1)
RM2,001-RM2,500 110 (26.8) 301 (73.2)
RM2,501-RM3,000 65 (38.9) 102 (61.1)
RM3,001-RM3,500 120 (32.3) 251 (67.7)
RM3,501-RM4,000 41 (30.1) 95 (69.9)
RM4,001-RM4,500 57 (30.5) 130 (69.5)
RM4,501-RM5,000 41 (40.2) 61 (59.8)
>RM5,000 135 (35.7) 243 (64.3)
*Significant at p<0.05
4.7 Assessment of medicines information resources
Slightly more than half of the participants (n=1,602, 51.0%) claimed that they will consult the doctor as their first point of referral when they have any concerns about medicines while 921 (29.3%) participants claimed that they will consult the pharmacists (Table 21). A small proportion of the participants claimed that they will consult the nurses (2.5%), medical assistants (1.4%), friends (2.4%) and family members (11.2%).
Table 22 showed the association between consumers’ choice of reference and their demographic characteristics. Consumers’ first point of reference was found to be associated with their age (p<0.001). Most participants from
the age group of 45-54 years were more likely to consult the doctors than the other healthcare professionals regarding medicines-related concern. Similarly, male and others consumers were also more likely to consult a doctor when faced with medication problem. There was also a statistically significant association between consumers’ education and income level with their first point of consult (p<0.001). Participants with primary education and those earning between RM1,001-RM1,500 monthly tend to consult doctors for further information when they have medication problem. Those who are unemployed (p<0.001) and living with family (p<0.01) were also more likely to consult the doctors when faced with medication problem.
Book.A National Survey On The Use of Medicines_2.12.indd 59 1/20/14 10:34 AM
60
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Table 21: Consumers’ first point of reference on medicines-related issues
First person to consult concerning medicines n (%)Doctor 1,602 (51.0)
Pharmacist 921 (29.3)
Family member 353 (11.2)
Nurse 76 ( 2.5)
Friends/neighbours 74 ( 2.4)
Medical assistant 44 ( 1.4)
Table 22: Response to “Who will be the FIRST person that you consult concerning medicines?” based on demographic characteristics
Demographic characteristics
First person to consult concerning medicines
Doctorn (%)
Pharmacistn (%)
Nursen (%)
Medical assistant
n (%)
Friends/ neighbours
n (%)
Family membern (%)
p-value
Age
18-24 235 (47.7) 119 (24.1) 14 (2.8) 10 (2.0) 17 (3.4) 92 (18.7)
<0.001*
25-34 428 (44.5) 370 (37.6) 17 (1.7) 14 (1.4) 26 (2.6) 94 ( 9.6)
35-44 297 (56.6) 130 (24.8) 20 (3.8) 10 (1.9) 10 (1.9) 41 ( 7.8)
45-54 304 (58.3) 137 (26.3) 12 (2.3) 5 (1.0) 8 (1.5) 46 ( 8.8)
55-64 234 (52.5) 127 (28.5) 10 (2.2) 5 (1.1) 7 (1.6) 52 (11.7)
>64 94 (54.0) 38 (21.8) 3 (1.7) 0 (0.0) 6 (3.4) 28 (16.1)
Gender
Male 645 (51.6) 357 (28.5) 17 (1.4) 22 (1.8) 37 (3.0) 140 (11.2)0.025*
Female 957 (50.6) 564 (29.8) 59 (3.1) 22 (1.2) 37 (2.0) 213 (11.3)
Ethnicity
Malay 1,071 (53.3) 560 (27.8) 55 (2.7) 30 (1.5) 43 (2.1) 201 (10.0)
<0.001*Chinese 281 (42.6) 232 (35.2) 7 (1.1) 5 (0.8) 14 (2.1) 105 (15.9)
Indian 102 (52.0) 64 (32.7) 6 (3.1) 3 (1.5) 3 (1.5) 15 ( 7.7)
Others 148 (53.4) 65 (23.5) 8 (2.9) 6 (2.2) 14 (5.1) 32 (11.6)
Education level
Primary school 189 (60.4) 55 (17.6) 9 (2.9) 3 (1.0) 7 (2.2) 42 (13.4)
<0.001*Secondary school 722 (54.2) 332 (24.9) 51 (3.8) 26 (2.0) 31 (2.3) 138 (10.4)
College/university 623 (45.1) 516 (37.3) 14 (1.0) 13 (0.9) 32 (2.3) 155 (11.2)
No formal education 68 (58.6) 18 (15.5) 2 (1.7) 2 (1.7) 4 (3.4) 18 (15.5)
Book.A National Survey On The Use of Medicines_2.12.indd 60 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
61
Demographic characteristics
First person to consult concerning medicines
Doctorn (%)
Pharmacistn (%)
Nursen (%)
Medical assistant
n (%)
Friends/ neighbours
n (%)
Family membern (%)
p-value
Occupation
Government 490 (46.0) 422 (39.6) 20 (1.9) 15 (1.4) 24 (2.3) 68 ( 6.4)
<0.001*
Private/ self employed 581 (53.9) 279 (25.9) 27 (2.5) 13 (1.2) 28 (2.6) 119 (11.0)
Retired 113 (52.6) 66 (30.7) 3 (1.4) 1 (0.5) 5 (2.3) 25 (11.6)
Student 137 (48.8) 58 (20.6) 6 (2.1) 5 (1.8) 10 (3.6) 61 (21.7)
Unemployed 281 (55.6) 96 (19.0) 20 (4.0) 10 (2.0) 7 (1.4) 80 (15.8)
Living status
Alone 210 (49.5) 149 (35.1) 9 (2.1) 6 (1.4) 14 (3.3) 25 ( 5.9)
0.002*With family 1,338 (51.5) 731 (28.1) 63 (2.4) 34 (1.3) 52 (2.0) 321 (12.4)
With non-family 53 (44.5) 40 (33.6) 4 (3.4) 4 (3.4) 8 (6.7) 7 ( 5.9)
Monthly income
≤RM500 183 (55.1) 67 (20.2) 6 (1.8) 2 (0.6) 13 (3.9) 51 (15.4)
<0.001*
RM501-RM1,000 136 (49.1) 60 (21.7) 17 (6.1) 3 (1.1) 11 (4.0) 39 (14.1)
RM1,001-RM1,500 332 (58.3) 124 (21.8) 22 (3.9) 18 (3.2) 15 (2.6) 55 ( 9.7)
RM1,501-RM2,000 114 (54.0) 55 (26.1) 8 (3.8) 5 (2.4) 3 (1.4) 19 ( 9.0)
RM2,001-RM2,500 227 (55.4) 116 (28.3) 7 (1.7) 6 (1.5) 9 (2.2) 34 ( 8.3)
RM2,501-RM3,000 92 (55.4) 39 (23.5) 1 (0.6) 5 (3.0) 2 (1.2) 22 (13.3)
RM3,001-RM3,500 187 (50.7) 122 (33.1) 8 (2.2) 4 (1.1) 7 (1.9) 35 ( 9.5)
RM3,501-RM4,000 64 (47.1) 59 (43.4) 1 (0.7) 0 (0.0) 2 (1.5) 9 ( 6.6)
RM4,001-RM4,500 87 (46.8) 80 (43.0) 0 (0.0) 0 (0.0) 4 (2.2) 13 ( 7.0)
RM4,501-RM5,000 35 (34.3) 46 (45.1) 2 (2.0) 0 (0.0) 0 (0.0) 16 (15.7)
>RM5,000 141 (37.3) 152 (40.2) 4 (1.1) 1 (0.3) 8 (2.1) 58 (15.3)
*Significant at p<0.05
From Table 23, most of the participants (67.5%) felt that it was easy for them to obtain medicines information from the government doctors and 19.1% of them felt that it was hard while the rest did not give any answer (13.4%). 52.5% of the respondents thought it was easy to obtain medicines information from a private doctor, 16.8% thought it was hard and the rest (30.7%) had no answer. 68.7% of the respondents thought
it was easy to obtain medicines information from government pharmacist, 368 (11.7%) of them find it hard and 614 (19.6%) had no answer. Lastly, 1,755 (56.0%) of the respondents felt that obtaining medicines information from community pharmacist was easy, 379 (12.1%) of them find it hard while the rest (31.9%) did not give any answer.
Book.A National Survey On The Use of Medicines_2.12.indd 61 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
62
Table 23: Proportion of consumers having difficulties in obtaining medicines information from government doctors/private doctors/government pharmacists/community pharmacists
Variable Yes, n (%) No, n (%) No Answer, n (%)
Easy to obtain medicines information from government doctors 2,120 (67.5) 601 (19.1) 421 (13.4)
Easy to obtain medicines information from private doctors 1,649 (52.5) 526 (16.8) 964 (30.7)
Easy to obtain medicines information from government pharmacists 2,154 (68.7) 368 (11.7) 614 (19.6)
Easy to obtain medicines information from community pharmacists 1,755 (56.0) 379 (12.1) 1,000 (31.9)
From Table 24, this study found that difficulty in obtaining medicines information from government doctors was significantly associated with age (p<0.05), ethnicity (p<0.05), education level (p<0.05), occupation (p<0.05), living status (p<0.05) and monthly income (p<0.05). It is also observed that the difficulty in obtaining medicines information from private doctors was significantly associated with age
(p<0.05), gender (p<0.05), ethnicity (p<0.05), education level (p<0.05), occupation (p<0.05), and monthly income. Other than that, this study found that both difficulty in obtaining information from government pharmacist and community pharmacist, are significantly associated with age (p<0.05), ethnicity (p<0.05), education level (p<0.05), occupation (p<0.05), and monthly income (p<0.05).
Table 24 (1): Association of proportion of consumers having difficulties in obtaining medicines information from government doctors/private doctors/government pharmacists/community pharmacists with demographic characteristics
Demographic characteristics
Difficulty in obtaining medicines information
Government doctors Private doctors
Yes No p-value Yes No p-value
Age
18-24 299 125
<0.001*
209 90
<0.001*
25-34 624 221 560 209
35-44 371 80 306 66
45-54 364 91 231 90
55-64 333 64 214 53
Gender
Male 821 2520.224
671 2310.005*
Female 1,299 349 978 295
Ethnicity
Malay 1,495 321
<0.001*
999 302
<0.001*Chinese 301 178 408 125
Indian 140 33 100 31
Others 184 69 142 68
Book.A National Survey On The Use of Medicines_2.12.indd 62 1/20/14 10:34 AM
63
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Demographic characteristics
Difficulty in obtaining medicines information
Government doctors Private doctors
Yes No p-value Yes No p-value
Education level
Primary school 247 31
<0.001*
125 26
<0.001*Secondary school 960 208 698 186
College/university 822 348 786 296
No formal education 91 14 40 18
Occupation
Government 765 237
<0.001*
573 230
<0.001*
Private/self employed 648 199 608 164
Retired 152 36 100 25
Student 165 76 147 55
Unemployed 390 53 221 52
Living status
Alone 287 89
0.009*
234 77
0.186With family 1,768 475 1,360 424
With non-family 63 37 55 25
Monthly income
≤RM500 245 48
<0.001*
150 51
<0.001*
RM501-RM1,000 196 50 131 40
RM1,001-RM1,500 425 84 267 78
RM1,501-RM2,000 157 35 96 27
RM2,001-RM2,500 291 73 216 82
RM2,501-RM3,000 111 27 93 20
RM3,001-RM3,500 249 80 216 75
RM3,501-RM4,000 71 34 75 27
RM4,001-RM4,500 123 42 132 24
RM4,501-RM5,000 53 20 56 16
>RM5,000 192 108 213 85
*Significant at p<0.05
Book.A National Survey On The Use of Medicines_2.12.indd 63 1/20/14 10:34 AM
64
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Table 24 (2): Association of proportion of consumers having difficulties in obtaining medicines information from government doctors/private doctors/government pharmacists/community pharmacists with demographic characteristics
Demographic characteristics
Difficulty in obtaining medicines information
Government pharmacists Community pharmacists
Yes No p-value Yes No p-value
Age
18-24 325 73
0.002*
290 73
<0.001*
25-34 697 127 624 141
35-44 363 58 296 48
45-54 343 61 245 66
55-64 316 36 221 42
Gender
Male 835 1630.190
695 1610.629
Female 1,319 205 1,060 218
Ethnicity
Malay 1,473 177
<0.001*
1,046 232
<0.001*Chinese 373 113 471 65
Indian 128 22 102 18
Others 180 56 136 64
Education level
Primary school 202 22
<0.001*
117 25
<0.001*Secondary school 941 135 696 159
College/university 939 195 903 183
No formal education 72 16 39 12
Occupation
Government 805 140
<0.001*
632 159
<0.001*
Private/self employed 679 122 627 121
Retired 146 18 111 20
Student 182 45 165 43
Unemployed 342 43 220 36
Living status
Alone 284 59
0.649
235 65
0.163With family 1,791 291 1,456 294
With non-family 78 18 64 20
Book.A National Survey On The Use of Medicines_2.12.indd 64 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
65
Demographic characteristics
Difficulty in obtaining medicines information
Government pharmacists Community pharmacists
Yes No p-value Yes No p-value
Monthly income
≤RM500 208 33
0.002*
154 36
<0.001*
RM501-RM1,000 190 34 135 37
RM1,001-RM1,500 390 61 264 77
RM1,501-RM2,000 155 20 87 19
RM2,001-RM2,500 301 50 247 53
RM2,501-RM3,000 113 19 94 12
RM3,001-RM3,500 245 60 219 52
RM3,501-RM4,000 82 17 87 16
RM4,001-RM4,500 145 17 142 19
RM4,501-RM5,000 68 6 73 4
>RM5,000 252 51 250 53
*Significant at p<0.05
Table 25 summarized the frequency of obtaining medicines information from various information sources among Malaysian consumers. Most of the consumers stated that they seldom obtained medicines information from printed materials (46.7%) and TV or radio (49.6%) while only 28.2% claimed that they often obtained medicines information from the internet. Modern healthcare professionals remained the most
common source of medicines information for about 47.4% of consumers. Interestingly, only 5.1% of the respondents claimed that they often sought medicines information from traditional and complimentary practitioners. Friends, family and neighbours remained a viable source of medicines information for some of the respondents 44.8% (n=1,404).
Table 25: Frequency of obtaining medicines information from various information sources among Malaysian consumers
Information source Frequency n (%)
Printed materials (magazines, newspaper)
Never 826 (26.3)
Seldom 1,474 (46.7)
Often 724 (23.0)
Internet
Never 1,060 (33.8)
Seldom 1,049 (33.5)
Often 883 (28.2)
Common information and entertainment channels (TV or radio)
Never 817 (26.0)
Seldom 1,557 (49.6)
Often 651 (20.8)
Book.A National Survey On The Use of Medicines_2.12.indd 65 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
66
Information source Frequency n (%)
Modern healthcare professionals (doctors, pharmacists, nurses)
Never 427 (13.6)
Seldom 1,183 (47.7)
Often 1,487 (47.4)
Traditional and complimentary practitioners(shaman, sinseh)
Never 1,737 (55.4)
Seldom 976 (31.1)
Often 161 ( 5.1)
Friends, family and neighbours
Never 705 (22.5)
Seldom 1,404 (44.8)
Often 860 (27.4)
From Table 26 and 27, frequency in obtaining medicines information from printed materials was significantly related to consumers’ living area (p<0.001), age (p<0.001), gender (P=0.017), ethnicity (p<0.001), education level (p<0.001), occupation (p<0.001) and monthly household income (p<0.001). Meanwhile, frequency in obtaining medicines information from the internet was found to be significantly related to consumers’ living area (p<0.001), age (p<0.001), gender (p<0.001), ethnicity (p<0.001), education level (p<0.001), occupation (p<0.001), living status (p<0.001) and monthly household income (p<0.001).
Frequency in obtaining medicines information from common information channels (TV, radio) was significantly related to age (p<0.001), ethnicity (p<0.001), education level (p<0.001), consumers’ occupation (p<0.001) and monthly household income (p<0.001). Frequency in
obtaining medicines information from modern healthcare professionals was significantly related to consumers’ living area (p<0.001), age (p<0.001), ethnicity (P=0.002), education level (p<0.001), occupation (p<0.001) and monthly household income (p<0.001) (Table 27). Frequency in obtaining medicines information from traditional practitioners was significantly related to consumers’ living area (p<0.001), age (P=0.019), ethnicity (p<0.001), education level (p<0.001), occupation (p<0.001) and monthly household income (p<0.001). Frequency in obtaining medicines information from friends, family or neighbours was significantly related to consumers’ living area (p<0.001), age (p<0.001), gender (p<0.001), ethnicity (p<0.001), education level (p<0.001), occupation (p<0.001) and monthly household income (p<0.001).
Book.A National Survey On The Use of Medicines_2.12.indd 66 1/20/14 10:34 AM
67
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 26
: Res
pons
e to
“How
ofte
n do
you
obt
ain
med
icin
es in
form
atio
n fro
m p
rinte
d m
ater
ials
, int
erne
t and
com
mon
info
rmat
ion
chan
nels
?”
base
d on
dem
ogra
phic
cha
ract
eris
tics
Dem
ogra
phic
ch
arac
teris
tics
Obta
inin
g m
edic
ines
info
rmat
ion
from
vario
us s
ourc
es
Prin
ted
mat
eria
lsIn
tern
etCo
mm
on in
form
atio
n ch
anne
l
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Area
Urba
n55
6 (2
4.4)
1,10
7 (4
8.6)
558
(24.
5)<0
.001
*71
2 (3
1.3)
836
(36.
8)65
7 (2
8.9)
<0.0
01*
460
(20.
2)1,
152
(50.
7)58
3 (2
5.6)
0.31
0Ru
ral
168
(19.
5)36
7 (4
2.5)
268
(31.
1)17
1 (1
9.8)
213
(24.
7)40
3 (4
6.7)
191
(22.
1)40
5 (4
6.9)
234
(27.
1)
Age
18-2
410
4 (2
1.0)
269
(54.
2)10
7 (2
1.6)
<0.0
01*
205
(41.
4)19
1 (3
8.6)
88 (1
7.8)
<0.0
01*
106
(21.
4)26
0 (5
2.4)
111
(22.
4)
<0.0
01*
25-3
425
6 (2
6.0)
522
(53.
0)18
9 (1
9.2)
400
(40.
7)37
5 (3
8.2)
184
(18.
7)21
2 (2
1.6)
507
(51.
6)22
3 (2
2.7)
35-4
414
4 (2
7.4)
253
(48.
1)12
1 (2
3.0)
127
(24.
1)21
2 (4
0.3)
168
(31.
9)13
3 (2
5.3)
257
(48.
9)12
8 (2
4.3)
45-5
410
7 (2
0.7)
229
(44.
2)15
0 (2
9.0)
88 (1
7.1)
162
(31.
4)22
9 (4
4.4)
102
(19.
8)27
0 (5
2.3)
126
(24.
4)
55-6
483
(18.
7)15
6 (3
5.1)
172
(38.
7)57
(12.
9)90
(20.
3)25
5 (5
7.6)
73 (1
6.5)
203
(45.
8)15
0 (3
3.9)
>64
30 (1
7.2)
45 (2
5.9)
87 (5
0.0)
6 (3
.4)
19 (1
0.9)
136
(78.
2)25
(14.
4)60
(34.
5)79
(45.
4)
Gen
der
Mal
e25
5 (2
0.4)
588
(47.
0)36
1 (2
8.8)
0.01
7*30
0 (2
4.1)
419
(33.
6)46
8 (3
7.5)
<0.0
01*
228
(18.
3)63
2 (5
0.7)
347
(27.
8)0.
062
Fem
ale
469
(24.
8)88
6 (4
6.9)
465
(24.
6)58
3 (3
0.9)
630
(33.
4)59
2 (3
1.3)
423
(22.
4)92
5 (4
8.9)
470
(24.
9)
Ethn
icity
Mal
ay42
6 (2
1.2)
935
(46.
6)56
7 (2
8.2)
<0.0
01*
525
(26.
2)67
0 (3
3.4)
701
(35.
0)
<0.0
01*
435
(21.
7)99
6 (4
9.7)
515
(25.
7)
<0.0
01*
Chin
ese
175
(26.
4)31
2 (4
7.0)
151
(22.
7)22
4 (3
3.8)
221
(33.
3)19
6 (2
9.6)
119
(17.
9)32
4 (4
8.9)
177
(26.
7)
Indi
an61
(31.
3)82
(42.
1)39
(20.
0)59
(30.
4)60
(30.
9)60
(30.
9)39
(20.
1)96
(49.
5)48
(24.
7)
Othe
rs62
(22.
5)14
5 (5
2.5)
69 (2
5.0)
75 (2
7.2)
98 (3
5.5)
103
(37.
3)58
(21.
0)14
1 (5
0.7)
77 (2
7.9)
Book.A National Survey On The Use of Medicines_2.12.indd 67 1/20/14 10:34 AM
68
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Obta
inin
g m
edic
ines
info
rmat
ion
from
vario
us s
ourc
es
Prin
ted
mat
eria
lsIn
tern
etCo
mm
on in
form
atio
n ch
anne
l
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Educ
atio
n le
vel
Prim
ary
scho
ol37
(11.
9)90
(28.
8)15
2 (4
8.7)
<0.0
01*
14 (4
.5)
42 (1
3.5)
219
(70.
4)
<0.0
01*
43 (1
3.8)
135
(43.
4)11
6 (3
7.3)
<0.0
01*
Seco
ndar
y sc
hool
276
(20.
8)62
9 (4
7.3)
374
(28.
1)22
8 (1
7.2)
465
(35.
1)55
8 (4
2.1)
304
(22.
9)63
3 (4
7.8)
351
(26.
5)
Colle
ge/
unive
rsity
400
(28.
9)72
6 (5
2.4)
235
(17.
0)63
4 (4
5.8)
529
(38.
2)19
9 (1
4.4)
289
(20.
9)74
9 (5
4.1)
293
(21.
2)
No fo
rmal
ed
ucat
ion
11 (
9.5
)29
(25.
0)65
(56.
0)7
( 6.
0)13
(11.
2)84
(72.
4)15
(12.
9)40
(34.
5)57
(49.
1)
Occu
patio
n
Gove
rnm
ent
318
(29.
8)54
9 (4
1.5)
180
(16.
9)
<0.0
01*
414
(38.
9)43
7 (4
1.1)
192
(18.
0)
<0.0
01*
240
(22.
6)58
6 (5
5.1)
210
(19.
7)
<0.0
01*
Priva
te/s
elf
empl
oyed
216
(20.
0)53
4 (4
9.5)
288
(26.
7)28
6 (2
6.6)
348
(32.
3)38
9 (
6.2)
217
(20.
2)52
0 (4
8.3)
294
(27.
3)
Retir
ed56
(26.
2)62
(29.
0)81
(37.
9)30
(14.
2)41
(19.
3)12
2 (5
7.5)
38 (1
7.9)
88 (4
1.5)
74 (3
4.9)
Stud
ent
60 (2
1.4)
158
(56.
2)55
(19.
6)11
2 (4
0.0)
127
(45.
4)37
(13.
2)60
(21.
4)15
0 (5
3.4)
59 (2
1.0)
Unem
ploy
ed74
(14.
7)17
1 (3
3.7)
222
(44.
0)41
( 8
.1)
96 (1
9.0)
320
(63.
5)96
(19.
0)21
3 (4
2.3)
180
(35.
7)
Livi
ng s
tatu
s
Alon
e10
4 (2
5.5)
205
(48.
3)10
8 (2
5.5)
0.31
6
172
(40.
7)10
3 (2
4.3)
141
(33.
3)
<0.0
01*
97 (2
2.9)
207
(48.
9)10
6 (2
5.1)
0.45
4W
ith fa
mily
588
(22.
6)1,
209
(46.
5)69
0 (2
6.6)
656
(25.
3)86
5 (3
3.4)
935
(36.
1)53
0 (2
0.4)
1,29
7 (5
0.0)
674
(26.
0)
With
non
-fa
mily
31 (2
6.1)
59 (4
9.6)
28 (2
3.5)
54 (4
5.4)
42 (3
5.3)
22 (1
8.5)
24 (2
0.2)
51 (4
2.9)
37 (3
1.1)
Book.A National Survey On The Use of Medicines_2.12.indd 68 1/20/14 10:34 AM
69
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Obta
inin
g m
edic
ines
info
rmat
ion
from
vario
us s
ourc
es
Prin
ted
mat
eria
lsIn
tern
etCo
mm
on in
form
atio
n ch
anne
l
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Mon
thly
inco
me
≤RM
500
51 (1
5.4)
127
(38.
3)14
9 (4
4.9)
<0.0
01*
61 (1
8.5)
83 (2
5.2)
181
(54.
8)
<0.0
01*
70 (2
1.1)
121
(36.
6)13
4 (4
0.5)
<0.0
01*
RM50
1-RM
1,00
040
(14.
4)11
2 (4
0.4)
111
(40.
1)39
(14.
1)67
(24.
2)15
5 (5
6.0)
64 (2
3.1)
113
(40.
8)90
(32.
5)
RM1,
001-
RM1,
500
106
(18.
8)25
4 (4
5.0)
168
(29.
7)98
(17.
4)17
4 (3
0.9)
244
(43.
3)11
5 (2
0.4)
274
(48.
7)15
3 (2
7.2)
RM1,
501-
RM2,
000
45 (2
1.3)
101
(49.
7)49
(23.
2)38
(18.
0)90
(42.
7)60
(28.
4)51
(24.
2)10
0 (4
7.4)
44 (2
0.9)
RM2,
001-
RM2,
500
95 (2
3.1)
198
(48.
2)99
(24.
1)10
7 (2
6.1)
151
(36.
8)13
6 (3
3.2)
83 (2
0.2)
211
(51.
5)10
1 (2
4.6)
RM2,
501-
RM3,
000
40 (2
4.0)
81 (4
8.5)
35 (2
1.0)
47 (2
8.1)
63 (3
7.7)
42 (2
5.1)
34 (2
0.4)
95 (5
6.9)
27 (1
6.2)
RM3,
001-
RM3,
500
98 (2
6.4)
190
(51.
2)77
(20.
8)13
5 (3
6.4)
146
(39.
4)79
(21.
3)86
(23.
2)21
0 (5
6.6)
71 (1
9.1)
RM3,
501-
RM4,
000
48 (3
5.3)
66 (4
8.5)
18 (1
3.2)
66 (4
8.5)
39 (2
8.7)
29 (2
1.3)
24 (1
7.6)
74 (5
4.4)
28 (2
0.6)
RM4,
001-
RM4,
500
47 (2
5.1)
105
(56.
1)35
(18.
7)71
(38.
0)64
(34.
2)49
(26.
2)47
(25.
1)93
(49.
7)42
(22.
5)
RM4,
501-
RM5,
000
30 (2
9.4)
51 (5
0.0)
18 (1
7.6)
41 (4
0.2)
36 (3
5.3)
22 (2
1.6)
17 (1
6.7)
56 (5
4.9)
26 (2
5.5)
>RM
5,00
012
3 (3
2.5)
185
(48.
9)66
(17.
5)18
0 (4
7.7)
132
(35.
0)62
(16.
4)60
(15.
9)20
5 (5
4.4)
101
(26.
8)
*Sig
nific
ant a
t p<0
.05
Book.A National Survey On The Use of Medicines_2.12.indd 69 1/20/14 10:34 AM
70
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 27
: Res
pons
e to
“How
ofte
n do
you
obt
ain
med
icin
es in
form
atio
n fro
m m
oder
n he
alth
care
pro
fess
iona
ls/t
radi
tiona
l & c
ompl
imen
tary
pr
actit
ione
rs/f
riend
s, fa
mily
or f
riend
s?” b
ased
on
dem
ogra
phic
cha
ract
eris
tics
Dem
ogra
phic
ch
arac
teris
tics
Obta
inin
g m
edic
ines
info
rmat
ion
from
vario
us s
ourc
es
Mod
ern
heal
thca
re p
rofe
ssio
nals
Tradi
tiona
l pra
ctiti
oner
sFr
iend
s/fa
mily
/nei
ghbo
urs
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Area
Urba
n 1,
123
(49.
4)86
3 (3
8.0)
260
(11.
4)<0
.001
*14
3 (6
.3)
763
(33.
6)1,
216
(53.
5)<0
.001
*69
3 (3
0.5)
1,06
2 (4
6.7)
424
(18.
7)<0
.001
*Ru
ral
364
(42.
2)32
0 (3
7.1)
167
(19.
4)18
(2.1
)21
3 (2
4.7)
521
(60.
4)16
7 (1
9.4)
342
(39.
6)28
1 (3
2.6)
Age
18-2
421
3 (4
2.9)
209
(42.
1)67
(13.
5)
<0.0
01*
24 (4
.8)
151
(30.
5)28
6 (5
7.8)
0.01
9*
172
(34.
7)23
0 (4
6.4)
79 (1
5.9)
<0.0
01*
25-3
449
7 (5
0.6)
382
(38.
9)91
(9.3
)42
(4.3
)34
5 (3
5.1)
516
(52.
5)27
3 (2
7.8)
492
(50.
1)17
2 (1
7.5)
35-4
424
2 (4
6.0)
191
(36.
3)87
(16.
5)35
(6.7
)16
8 (3
1.9)
289
(54.
9)13
1 (2
4.9)
240
(45.
6)13
3 (2
5.3)
45-5
423
5 (4
5.7)
198
(38.
5)74
(14.
4)27
(5.2
)14
8 (2
8.7)
292
(56.
7)12
6 (2
4.4)
218
(42.
2)13
8 (2
6.7)
55-6
422
1 (4
9.9)
146
(33.
0)74
(16.
7)20
(4.5
)11
8 (2
6.7)
253
(57.
2)10
2 (2
3.1)
167
(37.
8)13
3 (3
0.1)
>64
79 (4
5.4)
57 (3
2.8)
34 (1
9.5)
13 (7
.5)
46 (2
6.4)
101
(58.
0)56
(32.
2)57
(32.
8)50
(28.
7)
Gen
der
Mal
e56
2 (4
5.1)
476
(38.
2)19
2 (1
5.4)
0.06
261
(4.9
)39
2 (3
1.5)
693
(55.
6)0.
919
321
(25.
7)54
7 (4
3.9)
317
(25.
4)0.
013*
Fem
ale
925
(48.
9)70
7 (3
7.4)
235
(12.
4)10
0 (5
.3)
584
(30.
9)1,
044
(55.
3)53
9 (2
8.5)
857
(45.
4)38
8 (2
0.5)
Ethn
icity
Mal
ay92
8 (4
6.3)
745
(37.
2)30
3 (1
5.1)
0.00
2*
84 (4
.2)
590
(29.
5)1,
161
(58.
0)
<0.0
01*
499
(24.
9)88
4 (4
4.1)
502
(25.
0)
<0.0
01*
Chin
ese
334
(50.
4)26
0 (3
9.2)
63 (
9.5
)59
(8.9
)24
1 (3
6.3)
295
(44.
5)23
8 (3
5.9)
301
(45.
4)89
(13.
4)
Indi
an10
3 (5
3.4)
64 (3
3.2)
21 (1
0.9)
7 (3
.6)
57 (2
9.7)
104
(54.
2)46
(23.
8)90
(46.
6)44
(22.
8)
Othe
rs12
2 (4
4.2)
114
(41.
3)40
(14.
5)11
(4.0
)88
(31.
9)17
7 (6
4.1)
77 (2
7.9)
129
(46.
7)70
(25.
4)
Educ
atio
n le
vel
Book.A National Survey On The Use of Medicines_2.12.indd 70 1/20/14 10:34 AM
71
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Obta
inin
g m
edic
ines
info
rmat
ion
from
vario
us s
ourc
es
Mod
ern
heal
thca
re p
rofe
ssio
nals
Tradi
tiona
l pra
ctiti
oner
sFr
iend
s/fa
mily
/nei
ghbo
urs
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Prim
ary
scho
ol11
2 (3
6.0)
122
(39.
2)71
(22.
8)
<0.0
01*
12 (3
.9)
75 (2
4.1)
187
(60.
1)
<0.0
01*
69 (2
2.2)
112
(36.
0)98
(31.
5)
<0.0
01*
Seco
ndar
y sc
hool
587
(44.
4)51
9 (3
9.2)
199
(15.
0)76
(5.7
)39
0 (2
9.5)
749
(56.
7)32
4 (2
4.5)
576
(43.
5)34
7 (2
6.2)
Colle
ge/
unive
rsity
747
(53.
9)50
8 (3
6.7)
118
( 8.
5)60
(4.3
)49
3 (3
5.6)
730
(52.
7)43
9 (3
1.7)
686
(49.
5)21
4 (1
5.5)
No fo
rmal
ed
ucat
ion
41 (3
5.3)
34 (2
9.3)
39 (3
3.6)
13 (1
1.2)
18 (1
5.5)
71 (6
1.2)
28 (2
4.1)
30 (2
5.9)
46 (3
9.7)
Occu
patio
n
Gove
rnm
ent
574
(53.
9)37
8 (3
5.5)
101
(9.5
)
<0.0
01*
41 (
3.9
)38
4 (3
6.1)
573
(53.
9)
<0.0
01*
273
(25.
7)54
7 (5
1.4)
210
(19.
7)
<0.0
01*
Priva
te/s
elf
empl
oyed
486
(45.
3)42
2 (3
9.3)
151
(14.
1)64
( 6
.0)
302
(28.
1)60
5 (5
6.3)
287
(26.
7)47
8 (4
4.4)
249
(23.
1)
Retir
ed11
3 (5
3.3)
68 (3
2.1)
29 (1
3.7)
12 (
5.7
)57
(27.
0)12
2 (5
7.8)
61 (2
8.9)
71 (3
3.6)
64 (3
0.3)
Stud
ent
118
(42.
0)12
1 (4
3.1)
38 (1
3.5)
13 (1
4.6)
99 (3
5.4)
152
(54.
3)10
9 (3
8.8)
121
(43.
1)40
(14.
2)
Unem
ploy
ed19
6 (3
8.9)
194
(38.
5)10
8 (2
1.4)
31 (
6.2
)13
4 (2
6.6)
285
(56.
5)13
0 (2
5.8)
187
(37.
1)14
2 (2
8.2)
Livi
ng s
tatu
s
Alon
e21
1 (4
9.9)
154
(36.
4)52
(12.
3)
0.23
1
26 (
6.1
)13
1 (3
1.0)
237
(56.
0)
0.24
7
116
(27.
4)19
9 (4
7.0)
88 (2
0.8)
0.27
7W
ith fa
mily
1,20
5 (4
6.5)
991
(38.
2)36
4 (1
4.0)
130
( 5.
0)81
2 (3
1.4)
1,42
2 (5
4.9)
705
(27.
2)1,
143
(44.
1)60
0 (2
3.1)
With
non
-fa
mily
69 (5
8.0)
38 (3
1.9)
11 (
9.2
)5
( 4.
2)32
(26.
9)77
(64.
7)38
(31.
9)61
(51.
3)17
(14.
3)
Book.A National Survey On The Use of Medicines_2.12.indd 71 1/20/14 10:34 AM
72
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dem
ogra
phic
ch
arac
teris
tics
Obta
inin
g m
edic
ines
info
rmat
ion
from
vario
us s
ourc
es
Mod
ern
heal
thca
re p
rofe
ssio
nals
Tradi
tiona
l pra
ctiti
oner
sFr
iend
s/fa
mily
/nei
ghbo
urs
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Ofte
n, n
(%)
Seld
om, n
(%)
Neve
r, n
(%)
p-va
lue
Mon
thly
inco
me
≤RM
500
127
(38.
5)10
9 (3
3.0)
92 (2
7.9)
<0.0
01*
23 (7
.0)
85 (2
5.8)
213
(64.
5)
<0.0
01*
110
(33.
3)10
4 (3
1.5)
111
(33.
6)
<0.0
01*
RM50
1-RM
1,00
011
1 (4
0.1)
96 (3
4.7)
64 (2
3.1)
11 (4
.0)
64 (2
3.2)
182
(65.
9)65
(23.
5)10
9 (3
9.4)
89 (3
2.1)
RM10
01-
RM15
0023
6 (4
1.9)
231
(41.
0)86
(15.
3)23
(4.1
)16
9 (3
0.1)
311
(55.
3)13
7 (2
4.3)
230
(40.
9)15
1 (2
6.8)
RM1,
501-
RM2,
000
100
(47.
6)88
(41.
9)18
( 8
.6)
8 (3
.8)
60 (2
8.4)
110
(52.
1)48
(22.
7)99
(46.
9)40
(19.
0)
RM20
01-
RM2,
500
181
(44.
1)18
4 (4
4.9)
41 (1
0.0)
21 (5
.1)
130
(31.
7)22
3 (5
4.4)
102
(24.
9)19
4 (4
7.3)
90 (2
2.0)
RM2,
501-
RM3,
000
78 (4
6.7)
63 (3
7.7)
22 (1
3.2)
6 (3
.6)
57 (3
4.1)
84 (5
0.3)
43 (2
5.7)
86 (5
1.5)
26 (1
5.6)
RM3,
001-
RM3,
500
187
(50.
4)14
2 (3
8.3)
40 (1
0.8)
18 (4
.9)
144
(38.
8)18
3 (4
9.3)
93 (2
5.1)
186
(50.
1)73
(19.
7)
RM3,
501-
RM4,
000
83 (6
1.0)
37 (2
7.2)
14 (1
0.3)
9 (6
.6)
48 (3
5.3)
64 (4
7.1)
51 (3
7.5)
59 (4
3.4)
20 (1
4.7)
RM4,
001-
RM4,
500
109
(58.
3)60
(32.
1)16
( 8
.6)
13 (7
.0)
68 (3
6.4)
89 (4
7.6)
57 (3
0.5)
98 (5
2.4)
25 (1
3.4)
RM4,
501-
RM5,
000
54 (5
2.9)
38 (3
7.3)
8 (
7.8)
5 (4
.9)
35 (3
4.3)
55 (5
3.9)
33 (3
2.4)
45 (4
4.1)
21 (2
0.6)
>RM
5,00
022
1 (5
8.6)
130
(34.
5)26
( 6
.9)
24 (6
.4)
111
(29.
4)22
3 (5
9.2)
119
(31.
6)19
1 (5
0.7)
59 (1
5.6)
*Sig
nific
ant a
t p<0
.05
Book.A National Survey On The Use of Medicines_2.12.indd 72 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
73
Almost three quarters of the respondents (72.5%) felt that they need written medicines information and this was significantly associated with their age (p<0.05), ethnicity (p<0.05), education level (p<0.05) and occupation
(p<0.05) (Table 28). The findings suggested that most respondents from the age of 35-44 years old, with secondary education, who were government employees, required additional written medicines information.
Table 28: Consumers’ response to “Do you need written medicines information?” based on demographic characteristics
Demographic characteristicsNeed written medicines information?
Yes, n (%) No, n (%) p-value
Total 2,286 (72.5) 858 (27.2) -
Age
18-24 360 (72.5) 136 (27.5)
0.001*
25-34 714 (72.7) 269 (27.3)
35-44 414 (78.7) 112 (21.3)
45-54 378 (72.6) 142 (27.6)
55-64 313 (70.2) 133 (29.8)
>64 107 (61.8) 66 (38.2)
Gender
Male 901 (72.0) 351 (28.0)0.462
Female 1,382 (73.0) 901 (27.0)
Ethnicity
Malay 1,471 (73.2) 539 (26.8)
<0.001*Chinese 454 (68.5) 209 (31.5)
Indian 124 (63.3) 72 (36.7)
Others 237 (86.2) 38 (13.8)
Education level
Primary school 213 (68.1) 100 (31.9)
0.037*Secondary school 991 (74.5) 340 (25.5)
College/university 1,006 (72.7) 378 (27.3)
No formal education 76 (65.5) 40 (34.5)
Occupation
Government 823 (76.3) 243 (23.7)
<0.001*
Private/self employed 755 (70.0) 323 (30.0)
Retired 137 (64.0) 77 (36.0)
Student 201 (71.3) 81 (28.7)
Unemployed 370 (73.4) 134 (26.6)
Book.A National Survey On The Use of Medicines_2.12.indd 73 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
74
Demographic characteristicsNeed written medicines information?
Yes, n (%) No, n (%) p-value
Living status
Alone 299 (70.5) 125 (29.5)
0.548With family 1,899 (73.1) 700 (26.9)
With non-family 86 (72.3) 33 (27.7)
Monthly income
≤RM500 244 (73.5) 88 (26.5)
0.542
RM501-RM1,000 194 (70.0) 83 (30.0)
RM1,001-RM1,500 413 (72.8) 154 (27.2)
RM1,501-RM2,000 155 (73.5) 56 (26.5)
RM2,001-RM2,500 287 (69.8) 124 (30.2)
RM2,501-RM3,000 113 (67.7) 54 (32.3)
RM3,001-RM3,500 279 (75.6) 90 (24.4)
RM3,501-RM4,000 95 (69.9) 41 (30.1)
RM4,001-RM4,500 141 (75.4) 46 (24.6)
RM4,501-RM5,000 78 (76.5) 24 (23.5)
>RM5000 280 (74.1) 98 (25.9)
*Significant at p<0.05
Up to 67.3% of respondents reported that they require additional counselling from their pharmacists (Table 29). This need was significantly associated with gender (p<0.05), ethnicity (p<0.05), and occupation (p<0.05). This study found that the proportion of female respondents (69.4%) requiring additional counselling from their pharmacists was higher
than the male respondents (64.7%). Consumer of others ethnicity (86.2%) was also found to require additional counselling from pharmacists compared with Malay, Chinese and Indian. In addition, majority of those working in the government sector (72.1%) also claimed that they require additional counselling from their pharmacists.
Book.A National Survey On The Use of Medicines_2.12.indd 74 1/20/14 10:34 AM
75
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Table 29: Responses to “Do you require additional counselling from your pharmacists?” based on demographic characteristics
Demographic characteristics
Outcome
Require additional counselling from pharmacists?
Yes, n (%) No, n (%) p-value
Total 2,123 (67.3) 1,021 (32.4)
Age
18-24 315 (63.5) 181 (36.5)
0.154
25-34 690 (70.1) 294 (29.9)
35-44 359 (68.3) 167 (31.7)
45-54 347 (66.9) 172 (33.1)
55-64 292 (65.5) 154 (34.5)
>64 120 (69.4) 53 (30.6)
Gender
Male 810 (64.7) 441 (35.3)0.007*
Female 1,313 (69.4) 580 (30.6)
Ethnicity
Malay 1,372 (68.3) 638 (31.7)
<0.001*Chinese 422 (63.7) 241 (36.3)
Indian 115 (59.0) 80 (41.0)
Others 214 (77.5) 62 (22.5)
Education level
Primary school 198 (63.3) 115 (36.7)
0.374Secondary school 906 (68.1) 424 (31.9)
College/university 938 (67.7) 447 (32.3)
No formal education 81 (69.8) 35 (30.2)
Occupation
Government 769 (72.1) 297 (27.9)
<0.001*
Private/self employed 687 (63.7) 391 (36.3)
Retired 121 (56.5) 93 (43.5)
Student 183 (65.1) 98 (34.9)
Unemployed 363 (71.9) 142 (28.1)
Living status
Alone 285 (67.2) 139 (32.8)
0.988With family 1,756 (67.6) 843 (32.4)
With non-family 80 (67.2) 39 (32.8)
Book.A National Survey On The Use of Medicines_2.12.indd 75 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
76
Demographic characteristics
Outcome
Require additional counselling from pharmacists?
Yes, n (%) No, n (%) p-value
Monthly income
≤RM500 229 (69.0) 103 (31.0)
0.153
RM501-RM1,000 175 (63.2) 102 (36.8)
RM1,001-RM1,500 390 (68.9) 176 (31.1)
RM1,501-RM2,000 156 (73.9) 55 (26.1)
RM2,001-RM2,500 268 (65.2) 143 (34.8)
RM2,501-RM3,000 100 (59.9) 67 (40.1)
RM3,001-RM3,500 253 (68.4) 117 (31.6)
RM3,501-RM4,000 95 (69.9) 41 (30.1)
RM4,001-RM4,500 128 (68.4) 59 (31.6)
RM4,501-RM5,000 74 (72.5) 28 (27.5)
>RM5,000 252 (66.7) 126 (33.3)
*Significant at p<0.05
4.8 Awareness on ‘Know Your Medicines’ programme
Almost half of the respondents (47.5%, n=1,493) claimed that they were aware of the “Know Your Medicines” programme. This awareness was found to be significantly associated with the respondents’ ethnicity, gender, education level,
occupation, living status and monthly income (Table 30). Respondents from the age group of 25-34 years, with tertiary education, who worked in the government sector, living alone and earning between RM3,001-RM3,500 monthly were more aware of the national programme.
Table 30: Consumers’ awareness on “Know Your Medicines” programme
Demographic characteristics
Outcome
Aware of “Know Your Medicines” programme
Yes, n (%) No, n (%) p-value
Age
18-24 228 (46.0) 268 (54.0)
<0.001*
25-34 563 (57.2) 421 (42.8)
35-44 276 (52.5) 250 (47.5)
45-54 233 (44.7) 288 (55.3)
55-64 159 (35.7) 286 (64.3)
GenderMale 525 (41.9) 728 (58.1)
<0.001*Female 968 (51.1) 425 (48.9)
Ethnicity
Malay 1,059 (52.7) 951 (47.3)
<0.001*Chinese 199 (30.0) 465 (70.0)
Indian 80 (40.8) 116 (59.2)
Others 155 (56.2) 121 (43.8)
Book.A National Survey On The Use of Medicines_2.12.indd 76 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
77
Demographic characteristics
Outcome
Aware of “Know Your Medicines” programme
Yes, n (%) No, n (%) p-value
Education level
Primary school 70 (22.4) 243 (77.6)
<0.001*Secondary school 666 (50.0) 665 (50.0)
College/university 736 (53.1) 650 (46.9)
No formal education 21 (18.1) 95 (81.9)
Occupation
Government 747 (70.1) 319 (29.9)
<0.001*
Private/self employed 390 (36.1) 689 (63.9)
Retired 76 (35.5) 138 (64.5)
Student 119 (42.2) 163 (57.8)
Unemployed 161 (31.9) 344 (68.1)
Living status
Alone 243 (57.3) 181 (42.7)
<0.001*With family 1,183 (45.5) 1,418 (54.5)
With non-family 66 (47.5) 53 (44.5)
Monthly income
≤RM500 137 (41.3) 195 (58.7)
<0.001*
RM501-RM1,000 102 (36.8) 175 (63.2)
RM1,001-RM1,500 264 (46.6) 303 (53.4)
RM1,501-RM2,000 101 (47.9) 110 (52.1)
RM2,001-RM2,500 196 (47.7) 215 (52.3)
RM2,501-RM3,000 65 (38.9) 102 (61.1)
RM3,001-RM3,500 211 (56.9) 160 (43.1)
RM3,501-RM4,000 74 (54.4) 62 (45.6)
RM4,001-RM4,500 98 (52.4) 89 (47.6)
RM4,501-RM5,000 47 (46.1) 55 (53.9)
>RM5,000 193 (51.1) 185 (48.9)* Significant at p<0.05
Table 31 summarized the consumers’ sources of information about the “Know Your Medicines” programme. Most of the respondents obtained their information of the programme from
brochure (75.9%) followed by common information channel (52.4%) and road banner (48.7%).
Table 31: Consumers’ sources of information about the “Know Your Medicines” programme
Sources of Information about programme Yes, n (%) No, n (%)
Common information channel 733 (52.4) 666 (47.6)Family/friends/neighbour 593 (43.5) 771 (56.5)Road banner 670 (48.7) 705 (51.3)Internet 472 (34.9) 881 (65.1)Brochure 1,081 (75.9) 343 (24.1)Others 155 (17.0) 758 (83.0)
Book.A National Survey On The Use of Medicines_2.12.indd 77 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
78
Table 32 summarized the association between sources of information about the “Know Your Medicines” programme and area of settlement (urban or rural). The types of information
sources (family/friends/neighbour/internet and others) were significantly associated with where consumers’ were residing.
Table 32(1): Association between the sources of information about the “Know Your Medicines” programme and area of settlement
Demographic characteristics
Sources of information about “Know Your Medicines” programme
Common information channel Family/friends/neighbour Road banner
Yes n(%)
No n(%) p-value Yes
n(%)No
n(%) p-value Yes n(%)
No n(%) p-value
Settlement Setting
Urban 574 (53.5)
498 (46.5)
0.1
480 (46.0)
564 (54.0)
0.001*
523 (49.9)
525 (50.1)
0.1Rural 159
(48.6)168
(51.4)113
(35.3)207
(64.7)147
(45.0)180
(55.0)
*Significant at p<0.05
Table 32(2): Association between the sources of information about the “Know Your Medicines” programme and area of settlement
Demographic characteristics
Sources of information about “Know Your Medicines” programme
Internet Brochure Others
Yes n(%)
No n(%) p-value Yes
n(%)No
n(%) p-value Yes n(%)
No n(%) p-value
Settlement Setting
Urban 385 (37.0)
655 (63.0)
0.003*
829 (75.8)
265 (24.2)
0.9
137 (19.9)
552 (80.1)
<0.001*Rural 87
(27.8)226
(72.2)252
(76.4)78
(23.6)155
(17.0)206
(92.0)
*Significant at p<0.05
Approximately 61.6% of the respondents have attended the “Know Your Medicines” programme’s activities (Table 33). The attendance was
significantly influenced by the respondents’ age (p<0.05), gender (p<0.05), ethnicity (p<0.05), and occupation (p<0.05) (Table 34).
Book.A National Survey On The Use of Medicines_2.12.indd 78 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
79
Table 33: Attendance for “Know Your Medicines” programme activities
Variables n (%)
Attendance to programme’s activitiesYes 919 (61.6)No 574 (38.4)
Types of programme activitiesTalk 518 (56.4)Exhibition 760 (82.7)Road show 81 ( 8.8)
Level of satisfaction
Very satisfied 312 (34.1)Satisfied 551 (60.2)Neither 47 ( 5.1)Not satisfied 4 ( 0.4)Very not satisfied 1 ( 0.1)
Programme beneficial?Yes 917 (99.7)No 3 ( 0.3)
Table 34: Responses to “Have you attended any of the programme’s activities?” based on demographic characteristics
Demographic characteristics
Attended programme activities?
Yes, n (%) No, n (%) p-value
Age
18-24 134 (58.5) 95 (41.5)
0.007*
25-34 376 (65.5) 198 (34.5)
35-44 174 (62.1) 106 (37.9)
45-59 134 (57.3) 100 (42.7)
60-64 89 (54.9) 73 (45.1)
>64 12 (38.7) 19 (61.3)
Gender
Male 308 (57.2) 230 (42.8)0.04*
Female 611 (62.9) 361 (37.1)
Ethnicity
Malay 644 (59.9) 432 (40.1)
0.001*Chinese 108 (54.0) 92 (46.0)
Indian 54 (66.7) 27 (33.3)
Others 113 (73.9) 40 (26.1)
Education level
Primary school 38 (55.1) 31 (44.9)
0.7Secondary school 407 (60.1) 270 (39.9)
College/university 462 (62.1) 282 (37.9)
No formal education 12 (60.0) 8 (40.0)
Book.A National Survey On The Use of Medicines_2.12.indd 79 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
80
Demographic characteristics
Attended programme activities?
Yes, n (%) No, n (%) p-value
Occupation
Government 517 (68.3) 240 (31.7)
<0.001*
Private/self employed 205 (52.2) 188 (47.8)
Retired 35 (45.5) 42 (54.5)
Student 74 (60.2) 49 (39.8)
Unemployed 88 (55.0) 72 (45.0)
Living status
Alone 157 (62.5) 94 (37.5)
0.3With family 716 (60.1) 475 (39.9)
With non-family 46 (68.7) 21 (31.3)
Monthly income
≤RM500 81 (57.4) 60 (42.6)
0.4
RM501-RM1,000 48 (46.6) 55 (53.4)
RM1,001-RM1,500 159 (60.0) 106 (40.0)
RM1,501-RM2,000 68 (66.0) 35 (34.0)
RM2,001-RM2,500 120 (60.9) 77 (39.1)
RM2,501–RM3,000 34 (52.3) 31 (47.7)
RM3,001-RM3,500 144 (67.9) 68 (32.1)
RM3,501–RM4,000 50 (65.8) 26 (34.2)
RM4,001-RM4,500 63 (63.6) 36 (36.4)
RM4,501–RM5,000 28 (57.1) 21 (42.9)
>RM5,000 121 (62.4) 73 (37.6)
*Significant at p<0.05
Among those who have attended the “Know Your Medicines” programme activities, 94.3% of the respondents were between very satisfied to satisfied with the programme activities (Table 33). From Table 35, satisfaction with the
programme was found to be associated with the participants’ educational level (p=0.01). Majority of the respondent felt that the programme was beneficial (99.7%) (Table 33).
Book.A National Survey On The Use of Medicines_2.12.indd 80 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
81
Tabl
e 35
: Res
pons
es to
“How
sat
isfie
d ar
e yo
u wi
th th
e pr
ogra
mm
e?” b
ased
on
dem
ogra
phic
cha
ract
eris
tics
Dem
ogra
phic
ch
arac
teris
tics
“How
sat
isfie
d ar
e yo
u w
ith th
e pr
ogra
mm
e?”
Very
not
sat
isfie
d, n
(%
)No
t sat
isfie
d, n
(%
)Ne
utra
l, n
(%)
Satis
fied,
n (
%)
Very
sat
isfie
d, n
(%
)p-
valu
e
Age
18-2
40
(0.0
)1
(0.7
)12
(8.4
) 88
(61.
5)42
(29.
4)
0.5
25-3
41
(0.3
)2
(0.5
)25
(6.5
)23
4 (6
1.3)
120
(31.
4)
35-4
40
(0.0
)0
(0.0
)6
(3.3
)10
6 (5
7.9)
71 (3
8.8)
45-5
40
(0.0
)1
(0.7
)5
(3.5
)77
(53.
8)60
(42.
0)
55-6
40
(0.0
)0
(0.0
)5
(5.3
)62
(66.
0)27
(28.
7)
>64
0 (0
.0)
0 (0
.0)
0 (0
.0)
10 (7
6.9)
3 (2
3.1)
Gend
er
Mal
e1
(0.3
) 3
(0.9
)20
(6.0
)20
0 (6
0.1)
109
(32.
7)0.
3Fe
mal
e0
(0.0
)1
(0.2
)33
(5.3
)37
7 (6
0.3)
214
(34.
2)
Ethn
icity
Mal
ay1
(0.1
)3
(0.4
)37
(5.5
)40
0 (5
9.1)
23
6 (3
4.9)
0.4
Chin
ese
0 (0
.0)
0 (0
.0)
10 (8
.7)
78 (6
7.8)
27 (2
3.5)
Indi
an0
(0.0
)1
(1.8
) 2
(3.6
)32
(57.
1)21
(37.
5)
Othe
rs0
(0.0
)0
(0.0
)4
(3.6
)67
(11.
6)39
(12.
1)
Educ
atio
n le
vel
Prim
ary s
choo
l0
(0.0
)1
(2.7
)1
(2.7
)20
(54.
1)15
(40.
5)
0.01
*Se
cond
ary s
choo
l0
(0.0
)0
(0.0
)15
(3.5
)25
0 (5
9.0)
159
(37.
5)
Colle
ge/u
nive
rsity
1 (0
.2)
3 (0
.6)
37 (7
.6)
302
(62.
4)14
1 (2
9.1)
No fo
rmal
edu
catio
n0
(0.0
)0
(0.0
)0
(0.0
)5
(38.
5)8
(61.
5)
Book.A National Survey On The Use of Medicines_2.12.indd 81 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
82
Dem
ogra
phic
ch
arac
teris
tics
“How
sat
isfie
d ar
e yo
u w
ith th
e pr
ogra
mm
e?”
Very
not
sat
isfie
d, n
(%
)No
t sat
isfie
d, n
(%
)Ne
utra
l, n
(%)
Satis
fied,
n (
%)
Very
sat
isfie
d, n
(%
)p-
valu
e
Occu
patio
n
Gove
rnm
ent
1 (0
.2)
2 (0
.4)
29 (
5.4
)32
5 (6
0.7)
178
(33.
3)
0.9
Priva
te/s
elf e
mpl
oyed
0 (0
.0)
1 (0
.5)
8 (
3.7)
130
(60.
5)
76 (3
5.3)
Retir
ed0
(0.0
)0
(0.0
)2
( 5.
1)27
(69.
2)10
(25.
6)
Stud
ent
0 (0
.0)
0 (0
.0)
8 (
9.8)
48 (5
8.5)
26 (3
1.7)
Unem
ploy
ed0
(0.0
)1
(1.1
)6
( 6.
9)47
(54.
0)33
(37.
9)
Livin
g st
atus
Alon
e0
(0.0
) 0
(0.0
)17
(10.
1)
98 (5
8.3)
53 (3
1.5)
0.3
With
fam
ily1
(0.1
)4
(0.5
)34
( 4
.6)
450
(60.
6)25
3 (3
4.1)
With
non
-fam
ily0
(0.0
)0
(0.0
)2
( 4.
2)29
(60.
4)17
(35.
4)
Mon
thly
inco
me
≤RM
500
0 (0
.0)
0 (0
.0)
5 (
5.8)
40 (4
6.5)
41 (
5.8
)
0.06
RM50
1-RM
1,00
00
(0.0
)1
(1.9
)0
( 0.
0)28
(51.
9)25
(46.
3)
RM1,
001-
RM1,
500
0 (0
.0)
1 (0
.6)
9 (
5.3)
101
(59.
8)58
(34.
3)
RM1,
501-
RM2,
000
0 (0
.0)
0 (0
.0)
3 (
4.4)
48 (7
0.6)
17 (2
5.0)
RM2,
001-
RM2,
500
0 (0
.0)
1 (0
.8)
7 (
5.8)
73 (6
0.8)
39 (3
2.5)
RM2,
501–
RM3,
000
0 (0
.0)
0 (0
.0)
1 (
2.8)
24 (6
6.7)
11 (3
0.6)
RM3,
001-
RM3,
500
0 (0
.0)
0 (0
.0)
9 (
6.0)
89 (5
9.7)
51
(34.
2)
RM3,
501–
RM4,
000
1 (1
.9)
1 (1
.9)
5 (
9.6)
34
(65.
4)11
(21.
2)
RM4,
001-
RM4,
500
0 (0
.0)
0 (0
.0)
1 (
1.6)
41 (6
4.1)
22 (3
4.4)
RM4,
501–
RM5,
000
0 (0
.0)
0 (0
.0)
4 (1
3.8)
18 (6
2.1)
7 (2
4.1)
>RM
5,00
00
(0.0
)0
(0.0
)9
( 7.
1)79
(62.
7)38
(30.
2)
*Sig
nific
ant a
t p<0
.05
Book.A National Survey On The Use of Medicines_2.12.indd 82 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
83
5.0 DISCUSSIONSMedicines use and expenditure among Malaysian consumers
28.4% of the respondents in this survey reported to be on chronic medicines while up to about a quarter of the respondents were taking minerals and supplements. This finding could be explained in part by the increasing prevalence of chronic illnesses in Malaysia which was reported to be at 15.5% in 2006.24 Among the non-communicable diseases found across the country, hypertension was reported to be of the highest prevalence followed by diabetes mellitus, asthma and other cardiovascular diseases. Such disease patterns found in Malaysia resembled closely to that of developed countries.25,26 The burden of chronic disease will eventually lead to a higher demand for health services and ultimately contribute to a growing economic costs.27
The use of traditional medicines in the form of processed and non-processed herbs and herbal beverages was found in 9.6%-17.8% of the survey respondents. Meanwhile, up to 12% of them claimed to consume beauty care products. This shows that consumers in Malaysia are widely using pharmaceuticals not only to maintain their health but also to enhance their vitality and appearance. The growing pharmaceutical market for self-enhancement and beauty in the country is primarily to cater for the consumers’ demand for well-being. This periodic mapping of pharmaceuticals use among consumers in Malaysia is indeed an important effort to explore issues on quality use of medicines and make plans for future interventions and policies.
In recent years, public out-of-pocket healthcare expenditure in Malaysia has increased steadily.28
This is closely reflected by the findings in this survey where Malaysian consumers recorded
an average spending of RM82.14 monthly on medicines alone obtained from various healthcare facilities. The private sector health expenditure in Malaysia is funded primarily by publics’ out-of-pocket expenditure where payment is made at the point of accessing health services. Therefore, it is not unusual to find that majority of the survey respondents spent the most for their medicines obtained from private hospitals, community pharmacies and non-pharmacy premises which makes up the extensive network of the private healthcare sector.
The private healthcare sector mainly caters for the urban population or those who can afford to pay. Hence, consumers living in urban area were found to record a higher expenditure in private facilities. Meanwhile, the public healthcare system in Malaysia which is made up of a network of general hospitals, district hospitals and health clinics established under the MOH is a more popular avenue for the poor to seek treatment. Earlier study found that those from the lower education and income groups were the main users of services provided by government health facilities whereas the private health facilities were mostly visited by those from higher income group.24 This was consistent with the findings in this survey as reflected by the expenditure on medicines in private facilities.
The implication of a high out-of-pocket expenditure in health by the public is that such payment does not allow for pooling of risks and leads to a high probability of catastrophic payments that can result in poverty for the household. Thus, as part of the National Medicine Policy agenda to promote quality use of medicines, it is envisioned that current policies and interventions that are already in place will help to promote rational use of and judicious spending on medicines among consumers.
Book.A National Survey On The Use of Medicines_2.12.indd 83 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
84
Knowledge of medicines use
Despite the extensive pharmaceutical use among the survey respondents, more than half of them (56.6%) claimed that they understand the proper use of medicines and were unable to identify their own medicines by the trade or generic name. However, most of the Malaysian consumers were aware of the side effect, possible food-drug and drug-drug interactions, medicines’ shelf life and storage condition.
As expected, lower education level, unemployment, consumer with multiple prescription items and elderly have more problems in identifying medicines name than other groups. They were aware of the availability of generic medicines; however, the term ‘generic’ was not commonly used by them.29 Interestingly, this study also found that more respondents of Chinese ethnicity had problems in medicines identification compared to the other ethnics groups.
Self-assessed use of medicines
It is widely acknowledged that patients seldom comply with the instructions on the use of medication or treatment. Prior reviews have estimated the extent of patient default at 20% to 82%.30 This survey highlighted the same results; a high proportion of consumers reported that they had ever forgotten to take their medication at some point in their lives.
In general, medication compliance is affected by a multitude of factors.31 From this survey, it was found that self-reported compliance can be expected from those with lower education. It was also found that compliance decreases with increasing age. This is not uncommon; as the patient‘s cognitive ability decreases with advancing age, compliance is generally affected.31
Consumers who lack of awareness of their disease, do not fully understand treatment plan or perceive any benefits from taking medicines as prescribed are expected to be less compliant thereby consciously choosing not to take their medications even when it is indicated.31 In this survey, there was a higher proportion of Chinese respondent who reported to have chosen not take prescribed medicines. Similarly, those who were more educated and affluent were less likely to abide passively to the prescribed instructions. These groups of consumers may already have pre-formed beliefs about medicines that are embedded and conditioned by the local culture and customs.
The negative implication of sharing medicines is tantamount to using medicines without prescription. While self-medication is benign and might be beneficial up to a certain extent, sharing of medications without professional supervision will expose patients at an increased risk of harm arising from medication error.32 In this survey, sharing of medications was found to be notably more prevalent in respondents living in the urban area, of younger age group, living with non-family members, tertiary education and higher income level. The condition and consumers’ characteristics facilitating sharing of medicines among Malaysians are similar to those found in international literatures.32,33
One of the limitations in this survey is that assessment of compliance was based on patient self-report and thus may not reflect the actual medication taking behaviour.
Sources of information
Majority of the respondents still prefer to consult the doctors as their reference point on issues concerning medicines. This could be explained in part by the evolution of healthcare profession
Book.A National Survey On The Use of Medicines_2.12.indd 84 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
85
in Malaysia which is largely dominated by the doctors. However, when asked about the ease of obtaining information on medicines, approximately 70% felt that it is easier to obtain information from government pharmacists and doctors compared to community pharmacists (56.0%) or private doctors (52.5%). The ease or difficulty in obtaining medicines information from these healthcare providers were significantly associated with age (p<0.05), ethnicity (p<0.05), education level (p<0.05), occupation (p<0.05) and monthly income (p<0.05) of respondents.
With the advent of technologies, information on medicines not only circulates through formal and informal network, but also via mass media and the internet. Up to a quarter of the respondents frequently obtained medicines information from the internet and mass media (e.g. TV and radio). While little can be done to control and constrain the information available in the World Wide Web and mass media, there is an urgent need to educate consumers about the credibility and reliability of information obtained from sources other than the mainstream healthcare providers. Realizing that the internet is now a popular avenue to obtain information, the Pharmaceutical Services Division has developed an online portal for consumers to submit medicines enquiries and complaints of pharmaceuticals as part of the national “Know Your Medicines” programme.
There remained some proportion of consumers who sought consultation and medicines information from traditional and complimentary (TCM) practitioners. Malaysia has a diverse pool of traditional medicines practices as the country is made up of multi-ethnic groups that carry with them different cultures, theories, beliefs and experiences. At the time of this survey, efforts to evaluate, regulate and standardize traditional
medicines products, practices and practitioners by the Ministry of Health Malaysia are underway. Herbal treatments are the most popular form of traditional medicines, and are highly profitable in the local as well as international market place. Thus, it is imperative that the consumers are kept informed of the policies and legislation governing TCMs to ensure that they access only safe and effective products and services.
Almost three quarters of the respondents need additional written medicines information and this was associated with their age, ethnicity, education level and occupation. Such information seeking behaviour among consumers in Malaysia should be harnessed as an opportunity to get them to be more involved in their own healthcare. Although many pharmaceutical companies now provide patient information leaflet as a product package insert, majority of these materials are not available in Malay language. There is a need for future research to assess the impact of written information leaflets on consumers’ medicines knowledge and satisfaction with information received.
Majority of the respondents reported that they require additional counselling from their pharmacists. This is reflective of the expansion of pharmacists’ role in patient care in the healthcare system in Malaysia. The increase in the number of pharmacists in both public and private workforce has translated into the provision of more pharmaceutical care services such as medication management therapy. Malaysian consumers now view pharmacists as an important player in the healthcare system.
Know Your Medicines programme
The “Know Your Medicines” programme is a national project jointly organized by the Ministry of Health (MOH) and the Consumers Association
Book.A National Survey On The Use of Medicines_2.12.indd 85 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
86
of Malaysia (FOMCA) aiming to improve quality use of medicines among consumers in the country. The programme, launched in 2007, and is conducted by pharmacists from both public and private sectors and includes activities such as workshops and exhibitions on medicines for the public.
Five years into the programme, up to half of the consumers participated in this survey were aware of the programme’s existence. Out of these, 61.6% reported to have participated in the programme activities. In this survey, female respondents tend to be more aware of the program than male respondents. This was consistent with findings from Bell et al where more female respondents were found to be aware of the Direct-to-Consumer (DTC) medicines advertising programme.34 It is thought that women consumers would have more predilections for such public health programme than the men.
The awareness of the programme was also found to be associated with respondents’ education level; consumers who were less educated were least aware of the programme and this was consistent with findings by Barry et al.35 In order to ensure that the programme is far reaching to every level of the society, content of the programme activities must be designed appropriately according to the target audience to ensure its relevance.
Government employees were also more aware of the programme compared to other respondents. Since “Know Your Medicines” programme is a government initiated effort, the promotion of the programme may have been more widespread within the government workforce. In addition, consumers from the Chinese ethnic group were the least aware of the programme. This could be explained in part by the relatively smaller number of Chinese employee within the government workforce.
Regarding the sources of information, those who were staying in urban settings tend to obtain information on the programme from internet. This could be due to better internet connectivity in the urban area compared to the rural outskirts. In addition, government infrastructures as well as majority of the hospitals and health centre are also located in the urban setting. Majority of the respondents who had participated in the programme activities were satisfied with the programme and felt that it was beneficial for them.
6.0 LIMITATIONSThe evaluation of consumers’ awareness, knowledge and understanding of quality use of medicines were based on a self-reported assessment and hence actual consumer behaviour cannot be verified. Public’s out-of-pocket expenditure on medicines was an estimation that was based on consumer recall due to the lack of secondary data on medicines billing in private healthcare sector.
7.0 CONCLUSIONSThe use of pharmaceuticals is very prevalent among consumers in Malaysia and this account for part of consumers’ out-of-pocket expenditure for health. More than 80% of consumers felt that medicines labelling is adequate and did not expressed any difficulty in reading the labels of medicines obtain from various health facilities in Malaysia. Despite that, it can be estimated that up to half of the consumers in Malaysia are still not able to identify medicines by their trade or generic name. However, more consumers these days are aware of the safety and regulatory issues surrounding pharmaceuticals marketed in Malaysia. The information seeking behaviour
Book.A National Survey On The Use of Medicines_2.12.indd 86 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
87
of consumers in Malaysia has evolved over the years with more consumers consulting the mainstream healthcare providers such as doctors and pharmacists as well as accessing information through the use of technologies such as internets. Although generally consumers’ awareness of the national “Know Your Medicines” programme is widespread, participation uptake is still relatively low. Overall, it can be observed that Malaysian consumers’ medicines taking and information seeking behaviour has evolved over time as captured by the National Survey on the Use of Medicines in 2008 and 2012. This periodic mapping of pharmaceuticals use among consumers in Malaysia is indeed an important effort to explore issues on quality use of medicines and make plans for future interventions and policies.
Book.A National Survey On The Use of Medicines_2.12.indd 87 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
88
REFERENCES1. World Health Organization. How to develop and implement a national drug policy. 2nd edition ed.
Geneva: WHO Press; 2001.
2. Hardon A, Hodgkin, C., Fresle, D. How to investigate the use of medicines by consumers. Switzerland: World Health Organization and University of Amsterdam 2004.
3. Grand AL, Hogerzeil, H.V., Haaijer-Ruskamp, F.M. Intervation research in rational use of drugs: a review. Health Policy and Planning. 1999;14(2):89-109.
4. Homedes N, Ugalde A. Review article: Patient’s compliance with medical treatments in the third world. What do we know? Health Policy and Planning. 1993;8(4):291-314.
5. Hardon AP. The use of modern pharmaceuticals in a Filipino village: Doctors’ prescription and self medication. Social Science & Medicine. 1987;25(3):277-292.
6. Del Rio MC, Prada C, Alvarez FJ. The use of medication by the Spanish population. Pharmacoepidemiology and Drug Safety. 1997;6:41-48.
7. Hempel J. California Pilot Program Creates Rx Fact Sheets, Ads to Inform Consumers. California 2004.
8. Ernst FR, Grizzle, A.J. Drug related morbidity and mortality: updating the cost of illness model. J Am Pharm Assoc. 2001;41:192-199.
9. Aspden P, Wolcott, J.A., Bootman, J.L., Cronenwett, L.R. Preventing medication errors: quality chasm series. Washington, DC: The national academies press; 2007.
10. Bahri S, Othman, N. H.,Ahmad Hassali, M.A., Shafie, A.A., Mohamed Ibrahim, M.I. A national Survey on the use of medicines (NSUM) by Malaysian consumers 2008. first ed: Pharmaceutical Services Division, Ministry of Health; 2008.
11. Kirkpatrick CMJ, Roughead EE, Monteith GR, Tett SE. Consumer involvement in quality use of medicines (QUM) projects-lessons from Australia. BMC Health Services Research 2005. 2005;5(75):1-7.
12. Donnelly N, Orr N, Baird H. Impacts of the 2007 NPS National Awareness Campaign: Findings from surveys of consumers. National Medicine Symposium. National Convention Centre, Canberra, Australia: National Prescribing Service Limited; 2008.
13. Lefebvre RC, Peterson GS, McGraw SA, et al. Community intervention to lower blood cholesterol: the “Know Your Cholesterol” campaign in Pawtucket, Rhode Island. Health Educ Q. 1986;13(2):117-129.
14. Lu Y, Hernandez, P., Abegunde, D., Edejer, T. The World Medicines Situation 2011-Medicine Expenditures. 3rd ed. Geneva: World Health Organization; 2011.
Book.A National Survey On The Use of Medicines_2.12.indd 88 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
89
15. Wutzke SE, Artist, M.A., Kehoe, L.A., Flercher, M., Mackson, J.M., Weekes, L.M. Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia. Health Promotion International, 2006;22(1):53-64.
16. Smith BJ, Ferguson, C., McKenzie, J., Bauman, A., Vita, P. Impacts from repeated mass media campaigns to promote sun protection in Australia. Health Promotion International. 2006;17(1):51-60.
17. Bahri S, Lai ST, Yap YW, Ching MW, Ahmad Khidzar N, Kua J. A survey on the use of medicines by consumers in Federal Territories of Kuala Lumpur and Putrajaya. International Conferences on Improving Use of Medicines 2008.
18. National Medicines Policy of Malaysia. Ministry of Health; Malaysia 2003.
19. Sample size calculator. 2004; http://www.raosoft.com/samplesize.html.
20. Kish L. Methods of design effects. Journal of Official Statistics. 1995;11(55-77).
21. Kelley K, Clark, B., Brown, V., Sitzia, J. Good practice in the conduct and reporting of survey research. International Journal for Quality in Health Care. 2003;15(3):261-266.
22. Vallée J, Souris, M., Fournet, F., Bochaton, A., Mobillion, V., Peyronnie, K.,Salem, G. Sampling in health geography: reconciling geographical objectives and probabilistic methods. An example of a health survey in Vientiane (Lao PDR). Emerging Themes in Epidemiology. 2007;4(6):1-8.
23. Chan L, Hart, G.L., Goodman, D.C. Geographic Access to Health Care for Rural Medicare Beneficiaries. J Rural Health. 2006;22(2):140-146.
24. Amal NM, Paramesarvathy R, Tee GH, Gurpreet K, Karuthan C. Prevalence of Chronic Illness and Health Seeking Behaviour in Malaysian Population: Results from the Third National Health Morbidity Survey (NHMS III) 2006. Med J Malaysia. March 2011 2011;66(1):36-41.
25. World Health Organization. The World Health Report 2003 – Shaping the Future. Geneva, Switzerland 2003.
26. Wilper AP, Woolhandler, S., Lasser, K.E., et al. A national study of chronic disease prevalence and access to care in uninsured U.S. adults. Ann Intern Med. 2008;149(1706).
27. Yach D, Corinna, H., Gould, C.L., et al. The Global Burden of Chronic Diseases - Overcoming impediments to prevention and control. JAMA. 2004;291:2616-2622.
28. Chee HL, Barraclaugh S, eds. Healthcare in Malaysia. The Dynamics of Provision, Financing and Access. New York: Routledge; 2007.
29. Hassali MA, Kong, D.C.M., Stewart, K. Generic medicines: perceptions of consumers in Melbourne, Australia. The International Journal of Pharmacy Practice,. 2005;13:257-264.
Book.A National Survey On The Use of Medicines_2.12.indd 89 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
90
30. Cramer J, Mattson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed?: A novel assessment technique. The Journal of the American Medical Association. 1989;261(22):3273-3277.
31. Osterberg L. Adherence to Medication. New England Journal of Medicine. 2005;353:487-497.
32. Goldsworthy RC, Schwartz NC, Mayhon CB. Beyond abuse and exposure: Framing the impact of prescription-medication sharing. American Journal of Public Health. 2008;98(6):1115-1121.
33. Ellis J, Mullan J. Prescription medication borrowing and sharing-risk factors and management Aust. Fam. Physician. 2009;38(10):816-819.
34. Bell RA, Kravitz RL, Wilkes MS. Direct-to-Consumer Prescription Drug Advertising and the Public. Journal of General Internal Medicine. 1999;14(11):651-657.
35. Barry MM, Doherty A, Hope A, Sixsmith J, Kelleher CC. A community needs assessment for rural mental health promotion. Health Education Research. 2000;15(3):293-304.
Book.A National Survey On The Use of Medicines_2.12.indd 90 1/20/14 10:34 AM
SURVEY 2: EVALUATION OF
“KNOW YOUR MEDICINES” PROGRAMME 2012
PRE & POST SURVEY
Book.A National Survey On The Use of Medicines_2.12.indd 91 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
92
ABSTRACTBackground:Quality Use of Medicines (QUM) is one of the central objectives of Malaysia’s National Medicines Policy. Within the context of QUM framework, it is vital to empower consumers with the right awareness and knowledge on issues pertaining to medicines. The "Know Your Medicines" programme was a national project jointly organized by the Ministry of Health (MOH) and the Consumers Association of Malaysia (FOMCA) to improve quality use of medicines among consumers in the country. After five years of the national programme, policy makers now seek to evaluate the impact of strategies that had been taken thus far. The data gain from such survey will be very useful to inform and devise future strategies to enhance quality use of medicines in population.
Objectives:To evaluate the effectiveness of ‘Know Your Medicines’ programme activities on consumers’ knowledge on quality use of medicines.
Methods:A cross-sectional pre-post design survey was conducted among selected participants who attended the ‘Know Your Medicines’ programme between September 2011 to May 2012. The questionnaire used in this survey had been developed via consultation with all the selected representatives involved with the “Malaysian Comprehensive National Project on the Rational Use of Drugs”. The data was statistically analysed using SPSS version 18.
Results:Participants of the ‘Know Your Medicines’ programme exhibited significant improvement in their understanding and interpretation on medicines specifically on the use of medicines (83.4% vs. 90.4%), type, labelling and registration
of medicines (89.5% vs. 95.3%), sources of controlled medicines (82.0% vs. 88.3%) and medicines disposal (68.1% vs. 83.7%). Factors such as age, gender and education affected significantly on respondents’ knowledge on type, labelling and registration medicines, knowledge on quality of medicines and knowledge on disposing expired or damage medicines (p<0.05) in both pre and post- survey.
Conclusion:Overall, respondents have better understanding and knowledge on the quality use of medicines following the ‘Know Your Medicines’ programme activities.
1.0 INTRODUCTIONMedicines are an essential part of healthcare in terms of reducing mortality and morbidity from various diseases. As a general concept, ‘rational use’ of drugs is defined as patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and the lowest cost to them and their community.1 It is acknowledged that inappropriate use of medicines can lead to poor or negative health outcomes, increase adverse events and health costs among healthcare consumers around the world.2-6 Research by the California Board of Pharmacy in the United States found that half of the prescriptions taken each year are used improperly. To make matter worse, about 96% of patients nationwide failed to ask questions about how to use their medications.7 In the year 2000, more than $177 billion were estimated for the annual costs of medicines-related illness and death in ambulatory care settings in the United States.8 Based on the report by Institute of Medicine on ‘Preventing Medication Errors’ in 2006 it is estimated that more than 1.5 million people are injured by medication errors each year incurring a cost of $3.5 billion.9
Book.A National Survey On The Use of Medicines_2.12.indd 92 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
93
In Malaysia, the first study done by the MOH in collaboration with the experts from Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia (USM) in 2008 revealed that 55.6% of public or consumers did not understand the proper use of their medicines.10 Maximising health outcomes, reducing adverse events and keeping the health costs within the affordable limits are the initiatives that are being implemented around the world in order to improve the use of medicines. Recognizing that consumer behaviour also influences medication use, introducing consumer strategies to improve the use of medicines is necessary in any country’s attempts to promote rational drug use.11 Within this context, the Malaysian government, through the Ministry of Health (MOH) has developed a comprehensive National Strategy for Quality Use of Medicines-Consumers (QUM-C). A key principle of the strategy is the primacy of consumers in any initiative to promote QUM through effective self-care practices via ‘Know Your Medicines’ programme. Effective self-care involves a complex sequence of tasks, including diagnosing the condition and its cause, selecting proper medicines therapy and monitoring treatment effectiveness. Whereas patients and healthcare providers have always shared these decisions to some extent, the current availability of the medications, which involved both prescriptions and non-prescriptions items allows greater potential range of decision making for patients acting with and without direct provider guidance.
In recent years, many European countries have undertaken public education campaigns to encourage rational use of medicines. Few countries such as Australia, United States and Switzerland have published an evaluation of the campaign effectiveness. While some of these campaigns have had limited success, others have been very effective.11-15 We have the most to learn from the effective campaign such as the sun protection
campaigns in Australia reported by Smith et al.16 In which targeted audience had high awareness of the campaign that is sustained over the 3 years. A survey on the use of medicines by consumers in federal territories of Kuala Lumpur & Putrajaya in 2009 stated that there was a 38.2% improvement in understanding and knowledge on medicines use among 70% of consumers. It showed that there was an escalated improvement in consumer’s interpretation and understanding on medicines, such as identification by trade name (40.4% vs. 80%) and generic name (27.9% vs. 48.3%), knowledge of medicines side effects (32.7% vs. 51.7%) and storage (59.4% vs. 73.8%) as well as on the issue of discontinuation of medications upon recovery (25.3% vs. 63.6%).17
The ‘Know Your Medicines’ programme strategy was planned in tandem with the aspiration of one of the important components in the Malaysian National Medicines Policy to promote the importance of the QUM concept among consumers in the country. Thus, in order to help health authorities in planning necessary strategies to enhance consumers understanding on the concept of quality use of medicines, it is essential to evaluate the effectiveness of the ‘Know Your Medicines’ programme that is currently in place.18
2.0 OBJECTIVETo evaluate the knowledge acquired on quality use of medicines following ‘Know Your Medicines’ programme.
3.0 METHODSA pre-post design survey was conducted among selected participants who met the selection criteria and had attended pharmacist-initiated intervention during the ‘Know Your Medicines’ programme from September 2011 to May 2012. A pre-intervention self-administered
Book.A National Survey On The Use of Medicines_2.12.indd 93 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
94
questionnaire was delivered to selected participants during the programme registration. A post-test which consisted of the same questions as the pre-intervention was delivered to the same participants at the end of the programme. The questionnaire employed in this survey was developed via consultation with all the selected representatives involved with the “Malaysian Comprehensive National Project on the Rational Use of Drugs” and review from the educational talks materials.
A true answer was scored as ‘1’ while false answer as ‘0’. Total score was calculated based on number-right scoring method.19 The total score was further corrected for guessing using formula scoring via the following equation:20
FS=R–W/(C-1)
In which,
FS = ‘corrected’ or formula scoreR = number of items answered rightW = number of items answered wrongC = number of choices per item
(same for all items)
The interpretation of the score was based on interquartile as outlined below:
PERCENTILE INTERPRETATION25 Poor knowledge
50-75 Moderate knowledge>75 Excellent knowledge
3.1 Sample size
For each state, at least 200 programme participants were approached for participation. The projected sample size of respondents were based on 55.6% of total population that did not understand the proper used of their medicines.10 Based on the 95% confidence interval and margin
of error of 5%, using sample size calculator, 385 participants are needed.21 As a national survey with an estimation of 50% participation rate (the survey will be administered by individual data collectors in each state), the estimated sample size was around 462. By applying a common design effect of 4 for large sample surveys, the actual sample size of population that needs to be surveyed was around 1,848.22
For the purpose of this study a total of 2,800 respondents were surveyed.
Inclusion criteria:
- Age 18 years and above.
- Able to comprehend and complete the questionnaire.
- Provide verbal consent to participate (ethical requirement).
Exclusion criteria:
- Educational talk to health care personnel (example CME, CPE etc.)
- Participants who had attended ‘Know Your Medicines’ programme.
3.2 Data analysis
The encoded responses were entered into Microsoft Excel. All the data received from this survey was analysed using PASW Statistics 18, Release Version 18.0.0 (SPSS Inc, 2008). In the case of double digit, error in repeating when coding was corrected from 11 to 1 and from 22 to 2. Appropriate descriptive and inferential statistics were applied for data analysis. McNemar test was employed to analyse the responses across items in the questionnaire at pre and post intervention. Additionally, Wilcoxon-Signed Rank Test was employed to analyse the difference in the knowledge score at pre and post intervention. Analysis of the open-ended responses on
Book.A National Survey On The Use of Medicines_2.12.indd 94 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
95
participants’ comments of the programme (Part D) employed qualitative thematic analysis. For all statistical tests performed, the significance level was set at p<0.05.
3.3 Ethical consideration
All the data collectors explained the purpose of the study to their potential respondents prior to administering the survey forms. A verbal consent was obtained from each respondent before the start of the survey. No findings which could identify any individual participant were published. Participation in this research was entirely voluntary.
4.0 RESULTSThere were 2,651 returned questionnaires obtained from the 15 states in Malaysia during the ‘Know Your Medicines’ programme.
4.1 Part A: Demographic characteristics
Table 1 summarized the demographic characteristics of participants of the ‘Know Your Medicines’ programme. Majority of the respondents were from Pahang (11.8%, n=312) and Penang (8.1%, n= 216). Most of the respondents lived in urban areas (74.8%, n=1,982). Female respondents (67.3%, n=1,785) and those of Malay ethnicity (75.3%) constitute the majority of participants. Programme participants were mostly represented by those from the age group of 25-34 years old (29.8%). Out of a total of 2,651 respondents, 2,205 respondents (83.3%) were living with their family. Slightly more than half of the respondents were government employees (53.2%, n=1,410). Majority of the respondents (47.0%) had up to secondary education.
Table 1: Demographic characteristics of respondents
Demographic characteristics n (%)
State
Johor 174 ( 6.6)
Kedah 200 ( 7.5)
Kelantan 188 ( 7.1)
Melaka 140 ( 5.3)
Negeri sembilan 190 ( 7.2)
Pahang 312 (11.8)
Perak 200 ( 7.5)
Perlis 170 ( 6.4)
Penang 216 ( 8.1)
Sabah 200 ( 7.5)
Sarawak 191 ( 7.2)
Selangor 84 ( 3.2)
Terengganu 140 ( 5.3)
WP Kuala Lumpur & HKL 132 ( 5.0)
WP Labuan 114 ( 4.3)
Area
Urban 1,982 (74.8)
Rural 669 (25.2)
Gender
Male 866 (32.7)
Female 1,785 (67.3)
Races
Malay 1,995 (75.3)
Chinese 257 ( 9.7)
Indian 155 ( 5.9)
Others 242 ( 9.1)
Age
18-24 682 (25.7)
25-34 790 (29.8)
35-44 400 (15.1)
45-54 390 (14.7)
55-64 312 (11.8)
>65 77 ( 2.9)
Book.A National Survey On The Use of Medicines_2.12.indd 95 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
96
Demographic characteristics n (%)
Living status
Alone 337 (12.7)
With family 2,205 (83.3)
With non family 105 ( 4.0)
Occupation
Government 1,410 (53.2)
Private or self employment 275 (10.4)
Retired 139 ( 5.2)
Students 556 (21.0)
Unemployed 271 (10.2)
Education
Primary school 180 ( 6.8)
Secondary school 1,243 (47.0)
College/university 1,180 (44.6)
No formal education 39 ( 1.5)
4.2 Part B: Specific comparison of response at pre & post programme activity
Overall, there was a significant improvement in the respondents’ knowledge on quality use of medicines at pre and post intervention for each item across all dimensions in the questionnaire (Table 2). The proportion of participants who were able to correctly identify medicines as substances to treat, prevent and control disease increased from 80.1%-93.0% at baseline to 83.4%-96.8% post-intervention (p<0.001). Similarly, the proportion of participants who correctly identified a generic and brand or trade name of the medicines increased from 74.3% and 78.9% to 92.6% and 92.4% respectively following the programme activities (p<0.001). More respondents were aware of the need to read medicines label prior to use at the end of the programme. Knowledge on the registration requirement for medicines marketed in Malaysia
also improved from 94.6% at pre intervention to 97.8% at post intervention (p<0.001). There was also significant improvement noted in participants’ knowledge on the concept of 5R, namely right patient, right medicines, right dose, right route and right time (p<0.001).
As part of the programme’s agenda to empower consumers in Malaysia, participants were enlightened on the issues relating to consumers’ rights. The improvement in the awareness of consumers’ right in Malaysia was successfully captured at the end of the programme as demonstrated by an increase in the proportion of respondents who were able to correctly identify their rights as consumers (p<0.001). In addition, the proportion of respondents who could correctly identify the correct sources for controlled medicines also increased following programme activities (p<0.001). With regards to medicines storage and disposal, significantly more consumers were able to identify the correct medicines storage places and disposal method at the end of the programme activities (p<0.001).
Book.A National Survey On The Use of Medicines_2.12.indd 96 1/20/14 10:34 AM
97
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Tabl
e 2:
Res
pond
ents
’ kno
wled
ge o
n th
e qu
ality
use
of m
edic
ines
at p
re a
nd p
ost i
nter
vent
ion
Dim
ensi
onSt
atem
ent
Pre
Post
p-va
lue
Corr
ect a
nsw
er,
n (%
)W
rong
ans
wer
, n
(%)
Corr
ect a
nsw
er,
n (%
)W
rong
ans
wer
, n
(%)
Know
ledg
e on
wha
t are
m
edic
ines
?
Subs
tanc
es u
sed
to tr
eat d
isea
ses
2,46
8 (9
3.1)
183
( 6.
9)2,
567
(96.
8)84
( 3
.2)
<0.0
01*
Subs
tanc
es u
sed
to p
reve
nt d
isea
ses
2,12
4 (8
0.1)
527
(19.
9)2,
410
(90.
9)24
1 (
9.1)
<0.0
01*
Subs
tanc
es u
sed
to c
ontro
l dis
ease
s2,
362
(89.
1)28
9 (1
0.9)
2,21
0 (8
3.4)
441
(16.
6)<0
.001
*
Know
ledg
e on
type
s,
labe
lling
and
re
gist
ratio
n of
m
edic
ines
Gene
ric n
ame
of th
e m
edic
ines
1,97
0 (7
4.3)
681
(25.
7)2,
454
(92.
6)19
7 (
7.4)
<0.0
01*
Bran
d or
trad
e na
me
of th
e m
edic
ines
2,09
1 (7
8.9)
560
(21.
1)2,
450
(92.
4)20
1 (
7.6)
<0.0
01*
You
shou
ld re
ad th
e la
bel b
efor
e ta
king
any
m
edic
ines
2,53
5 (9
5.6)
116
( 4.
4)2,
605
(98.
3)46
( 1
.7)
<0.0
01*
All m
edic
ines
sho
uld
be re
gist
ered
with
the
Mal
aysi
an M
inis
try o
f Hea
lth2,
507
(94.
6)14
4 (
5.4)
2,59
3 (9
7.8)
58 (
2.2
)<0
.001
*
Know
ledg
e on
qu
ality
use
of
med
icin
es
Righ
t med
icin
es2,
565
(96.
8)86
( 3
.2)
2,62
2 (9
8.9)
29 (
1.1
)<0
.001
*
Righ
t dos
e2,
545
(96.
0)10
6 (
4.0)
2,60
0 (9
8.1)
51 (
1.9
)<0
.001
*
Righ
t adm
inis
tratio
n tim
e2,
542
(95.
9)10
9 (
4.1)
2,60
1 (9
8.1)
50 (
1.9
)<0
.001
*
Know
ledg
e on
righ
t as
med
icin
es
cons
umer
Righ
ts to
kno
w th
e na
me
of th
e m
edic
ines
2,51
6 (9
4.9)
135
( 5.
1)2,
595
(97.
9)56
( 2
.1)
<0.0
01*
Righ
ts to
obt
ain
info
rmat
ion
on th
e in
dica
tion
of th
e m
edic
ines
2,55
0 (9
6.2)
101
( 3.
8)2,
600
(98.
1)51
( 1
.9)
<0.0
01*
Righ
ts to
obt
ain
the
info
rmat
ion
on h
ow to
take
the
med
icin
es2,
554
(96.
3)97
( 3
.7)
2,60
0 (9
8.1)
51 (
1.9
)<0
.001
*
Righ
ts to
obt
ain
corre
ctly
labe
lled
med
icin
es2,
536
(95.
7)11
5 (
4.3)
2,58
9 (9
7.7)
62 (
2.3
)<0
.001
*
Righ
ts to
obt
ain
the
info
rmat
ion
on s
afet
y an
d in
tera
ctio
n of
med
icin
es s
uppl
ied
2,49
0 (9
3.9)
161
( 6.
1)2,
570
(96.
9)81
( 3
.1)
<0.0
01*
Know
ledg
e on
con
trol
led
med
icin
es
Med
icin
es w
hich
can
be
obta
ined
from
med
ical
do
ctor
s2,
475
(93.
4)17
6 (
6.6)
2,58
6 (9
7.5)
65 (
2.5
)<0
.001
*
Med
icin
es w
hich
can
be
obta
ined
from
pha
rmac
ists
1,99
4 (7
5.2)
657
(24.
8)2,
230
(84.
1)42
1 (1
5.9)
<0.0
01*
Med
icin
es w
hich
can
be
obta
ined
from
trad
ition
al
med
icin
e pr
actit
ione
r2,
050
(77.
3)60
1 (2
2.7)
2,20
9 (8
3.3)
442
(16.
7)<0
.001
*
Book.A National Survey On The Use of Medicines_2.12.indd 97 1/20/14 10:34 AM
98
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Dim
ensi
onSt
atem
ent
Pre
Post
p-va
lue
Corr
ect a
nsw
er,
n (%
)W
rong
ans
wer
, n
(%)
Corr
ect a
nsw
er,
n (%
)W
rong
ans
wer
, n
(%)
Know
ledg
e on
obt
aini
ng
cont
rolle
d m
edic
ines
A go
vern
men
t clin
ic/h
ospi
tal
2,60
9 (9
8.4)
42 (
1.6
)2,
625
(99.
0)26
( 1
.0)
<0.0
01*
Priva
te c
linic
/hos
pita
l2,
308
(87.
1)34
3 (1
2.9)
2,46
3 (9
2.9)
188
( 7.
1)<0
.001
*
Com
mun
ity p
harm
acy
1,88
0 (7
0.9)
771
(29.
1)2,
138
(80.
6)51
3 (1
9.4)
<0.0
01*
Tradi
tiona
l med
icin
es o
utle
t/ch
ines
e m
edic
ines
hal
l2,
193
(82.
7)45
8 (1
7.3)
2,32
8 (8
7.8)
323
(12.
2)<0
.001
*
Groc
ery
shop
2,39
8 (9
0.5)
253
( 9.
5)2,
478
(93.
5)17
3 (
6.5)
<0.0
01*
Nigh
t mar
ket
2,45
1 (9
2.5)
200
( 7.
5)2,
523
(95.
2)12
8 (
4.8)
<0.0
01*
Inte
rnet
2,36
9 (8
9.4)
282
(10.
6)2,
438
(92.
0)21
3 (
8.0)
<0.0
01*
Know
ledg
e on
med
icin
es
stor
age
In th
e ba
thro
om2,
432
(91.
7)21
9 (
8.3)
2,47
1 (9
3.2)
180
( 6.
8)<0
.001
*
Away
from
sun
light
and
hea
t2,
407
(90.
8)24
4 (
9.2)
2,40
3 (9
0.6)
248
( 9.
4)<0
.001
*
In p
lace
s re
acha
ble
to c
hild
ren
2,43
5 (9
1.9)
216
( 8.
1)2,
477
(93.
4)17
4 (
6.6)
<0.0
01*
In th
e ca
r2,
341
(88.
3)31
0 (1
1.7)
2,48
3 (9
3.7)
168
( 6.
3)<0
.001
*
Know
ledg
e on
dis
posi
ng
expi
red/
da
mag
ed
med
icin
es
Thro
w in
to th
e ru
bbis
h bi
n1,
458
(55.
0)1,
193
(45.
0)2,
055
(77.
5)59
6 (2
2.5)
<0.0
01*
Flus
h do
wn th
e to
ilet
20,4
59 (7
7.1)
606
(22.
9)2,
272
(85.
7)37
9 (1
4.3)
<0.0
01*
Burn
1,99
8 (7
5.4)
653
(24.
6)2,
334
(88.
0)31
7 (1
2.0)
<0.0
01*
Bury
1,50
1 (5
6.6)
1,15
0 (4
3.4)
2,00
2 (7
5.5)
649
(24.
5)<0
.001
*
Retu
rn to
the
near
est p
harm
acy,
clin
ic o
r hos
pita
l2,
031
(76.
6)62
0 (2
3.4)
2,43
8 (9
2.0)
213
( 8.
0)<0
.001
*
*Sig
nific
ant a
t p<0
.05
Book.A National Survey On The Use of Medicines_2.12.indd 98 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
99
4.3 Part C: Comparison of knowledge score at pre & post programme activity
Figure 1 showed distribution of respondents’ knowledge score before and after attending the “Know Your Medicines” programme activities. Overall, there was a significant improvement in the knowledge score across all 8 domains of the quality use of medicines questionnaire.
Respondents’ knowledge on what are medicines improved significantly from 83.4% at pre intervention to 90.4% at post intervention
(p<0.001). In addition, knowledge on type, labelling and registration medicines also has improved significantly from 85.9% to 95.3% (p<0.001). Respondents’ knowledge score on quality of medicines increased by 2.2% following intervention while their knowledge on the rights as a consumer increased from 95.4% to 97.7%. A significant improvement in score was also observed in respondents’ knowledge on controlled medicines and its sources. As for respondents’ knowledge on medicines storage and disposal, a 2% and 15.6% increased respectively were captured at the end of the programme activities.
Figure 1: Comparison of respondents’ knowledge score at pre & post programme activities
120
100
80
60
40
20
0Knowledgeon what aremedicines
Knowledgeon type,
labelling andregistrationmedicines
Knowledgeon quality
of medicines
Knowledgeon right asmedicinesconsumer
Knowledgeon controlled
medicines
Knowledgeon obtaining
controlledmedicines
Knowledgeon medicines
storage
Knowledgeon medicines
disposal
Pre Post
Book.A National Survey On The Use of Medicines_2.12.indd 99 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
100
4.4 Part D: Qualitative response to the programme
In the questionnaires distributed, an open-ended question was posed to respondents to gather comments and suggestions from the respondents on ways to improve the next programme or campaign. Responses to the open-ended question were analysed thematically. Themes were identified from reading and re-reading responses. All the responses were grouped under themes and each theme was examined. Responses were categorised, counted and described. A total of 12.6% (n=322) of the respondents provided the responses. The following themes and break down of responses were identified from the content analysis.
· Theme 1: Pharmacist should be more prepared – 62
responses
· Theme 2: Attitude of Pharmacist - 76 responses
· Theme 3: Management in pharmacist’s talk - 52
responses
· Theme 4: Programme - 80 responses
· Theme 5: Places for the programme - 52 responses
Theme 1:Pharmacist should be more prepared
A few respondents commented that the pharmacist should be well-prepared when handling the talk and programme. They also commented that programme materials were not enough to supplement the presentation. The pharmacists should have a slide for presentation
during the talk so that the audience can see clearly what they were talking about. In addition, in order to spread the knowledge on the quality use of medicines, some of the participants suggested the use of media such as radio and television as the better means of promoting the programme.
Theme 2:Attitude of pharmacist
Generally, comments under this theme can be divided into 2 categories of respondents. The first category reflected a good level of satisfaction with the attitude of the pharmacist as a presenter. On the flip side, some of the respondents felt that, in order to improve the ‘Know Your Medicines’ programme in future, the pharmacists must be friendlier with the audience in order to build better rapport with the audience. In addition, some of the respondents thought that the pharmacists should have more patience when carrying out programme activities.
Theme 3:Management in pharmacist’s talk
A few respondents said that the example of medicines especially generic medicines should be shown clearly to them during the talk and the programme. Participants also suggested that more talks pertaining to medicines should be regularly held in near future and the notes and brochures should be supplemented with the talks.
Theme 4:Continuous programme
Most of the respondents expressed their support for the programme and suggest that the programme must be held continuously so that the communities could develop awareness and knowledge on the quality use of medicines.
Book.A National Survey On The Use of Medicines_2.12.indd 100 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
101
The frequency of programme activities in the village and other area should be increased. It was also suggested that unused or expired medications can be returned or disposed during the programme.
Theme 5:Places for the programme
Participants gave some suggestions on the appropriate venue to hold the programme activities namely in schools, within villages, residential areas and FELDA communities. It was thought that it would be beneficial to expose the younger generations on the issues of medicines at an earlier age. Meanwhile, conducting programme activities within a community setting offers convenience for its residence to attend the programme.
5.0 DISCUSSIONSFollowing respondents participation in the programme activities, it was found that a good proportion of them have an improved understanding and knowledge on the use of medicines as not only to treat but also to prevent and control disease. Indeed, the increasing use of medicines to prevent illness will have a long-term positive impact on public health.23
Respondents in this survey also indicated an improvement in their ability to identify generic and trade names of medicines. The newly acquired knowledge can assist consumers in making choices about medicines marketed in Malaysia. When healthcare providers prescribe medicines using its generic name, consumers will be presented with more choices of pharmaceutically equivalents and cheaper alternatives thereby satisfying consumers’ right to choices.
The use of generic medicines safeguard access to essential medicines and improve
compliance, especially for those affected by economic reasons.24 Earlier, a cross-sectional survey among the general public in the state of Penang, Malaysia found that respondents were more familiar with trade names instead of generic names.25 Respondents had improved understanding and knowledge of branded and generic names after the ‘Know Your Medicines’ programme would mean that more consumers will be willing to discuss generic medicines with their healthcare providers after the programme. This could in turn facilitate the uptake of generic medicines in the country.
Part of the programme content emphasizes the importance of proper medicines use among consumers namely being able to identify the right medicines, dose and schedule of administration. Much of this information can be found on the medicines label as required by the law under the Malaysian Poison Act 1952.26 When presented with the medicines label, consumers need to be able to read and act upon the instruction given accordingly. Earlier work by Gupta and colleagues found that patients may not necessarily read or understand the instructions properly.27 Inadequate labelling along with poor health literacy and understanding of medicines use could all potentially lead to medications error.28 In addition, in order to make informed choices about medical treatment options, consumers need knowledge about the benefits and the risks of medicines. While a lot of pressure has been applied to healthcare professionals to provide adequate medicines information to consumers, the ‘Know Your Medicines’ programme also emphasizes on educating the consumers in upholding their rights in obtaining information on medicines use and safety. Passive consumer behaviour is generally observed in the Asian cultures; consumers who did not have knowledge about how or when to take their medicines may not voice their concern or ask for information.29
Book.A National Survey On The Use of Medicines_2.12.indd 101 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
102
Hence, it is anticipated that when consumers are aware of and assert their rights, medicines use and safety awareness can be improved.
The dispensing of controlled medicines has to be done by the licensed pharmacist or a licensed physician.26 Educating the consumers on the proper medicines distribution channel and the legislative requirement surrounding marketed pharmaceutical in Malaysia will ensure that Malaysian consumers will gain access only to safe and effective products and services. In this aspect, the ‘Know Your Medicines’ programme has shown to have successfully imparted this knowledge to its participants. The proportions of consumers who could correctly identify the correct sources of controlled medicines and registration requirement of pharmaceutical products have improved significantly at the end of the programme.
Proper storage of medicines may be defined as the safekeeping of medicines in suitable area to ensure the stability, safety and effectiveness of medication. Safety and convenience are two most common concerns when storing a medication.30 Many consumers are unaware that extreme heat, moisture, air and humidity can potentially lead to drugs degradation. An appropriate medicines storage conditions must include adequate space with proper ventilation-lighting, temperature controls and refrigeration as well as being out of reach of children. Ideally, the medicines box or locked cabinet is the recommended storage place for most of the medicines at home.31 At the end of the programme, majority of the respondents could correctly identify the appropriate medicines storage place.
Good medicines management includes also an appropriate disposal method. Improper medicines disposal may pose serious threat to public health and environment.32 Therefore guidelines on safe disposal of unwanted medicines are required and an organized
method of collecting unused medication needs to be introduced.32 While different forms of pharmaceuticals have distinct disposal options, many consumers preferred method of disposal include discarding medicines in the waste bin or flushing it down the toilet.30,31&33 In Malaysia, consumers are encouraged to return any unused or expired medicines to a nearby pharmacy via a “Drug Take-Back” programme. Overall, a significant improvement can be seen in the knowledge and understanding on quality use of medicines among consumers indicating the effectiveness of the ‘Know Your Medicines’ programme. With the increasing use of pharmaceuticals in the everyday life of Malaysian consumers, the ‘Know Your Medicines’ programme is a great avenue for the public to obtain medicines related information.
For the purpose of future improvement, feedback on what aspect of the programme can be improved was gathered from the participants in the form of an open ended question. As pharmacists from the Ministry of Health were central to the execution of the programme, much of the suggestions from the consumers had focused on the role of pharmacists. A good communication skill is vital in pharmacy practice as it involves helping people and society to make the best use of pharmaceuticals products and services.34 Hence, the delivery of medicines and health related information to the public need not only be accurate but also in simple and understandable terms so as not to confuse them with the medical jargons. Consumers also highlighted the need for pharmacists to have a friendly disposition. It was perceived as important for the public to feel comfortable when interacting with the pharmacists. Stemming from the above suggestions, it is imperative to have a module on good communication skills when training potential pharmacists to deliver such public health programme.
Book.A National Survey On The Use of Medicines_2.12.indd 102 1/20/14 10:34 AM
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
103
Participants of the programme also noted that there were insufficient programme materials to complement the activities and facilitate their understanding in the issue of quality use of medicines. Within this context, The National Drugs Campaign by the Australian Government to reduce youths’ motivation to use illicit drugs is a good example to emulate. The development of each phase of the campaign and resources were informed by the formative research team which has conducted prior qualitative and quantitative research to explore youth attitudes towards and behaviour in relation to illicit drugs, key drivers and barriers to trial and identified effective channels to communicate with youths. Using the information as captured in the National Survey on Use of Medicine 2008, more relevant campaign resources can be developed based on the needs of Malaysian consumers.
Consumers also claimed that the advertisement of the ‘Know Your Medicines’ programme was not widespread enough. Instead of making the programme a government-led initiative, the coverage of the programme could be enlarged by engaging participation of non-governmental organizations, private doctors, community pharmacists and local community leaders in villages such as FELDA settlements. All in all, the response from the public regarding this programme was rather encouraging. Many have called for the programme to be held more regularly.
6.0 LIMITATIONSThis study has several limitations. As a convenient sampling method was utilized in this study during distribution of questionnaire, there are possibilities for selection bias. Random members of the public that the researchers met were approached to fill up the questionnaires. The results may not be representative to the entire population of the country of Malaysia. The results obtained in this questionnaire survey were based on self-reported information which very much depends on the honesty and recall ability of the respondents, as well as their understanding of the questionnaire.
7.0 CONCLUSIONSOverall, respondents have better understanding and knowledge on the quality use of medicines following participation in the ‘Know Your Medicines’ programme activities. Emerging trends from the periodic mapping of pharmaceutical use as provided by the National Survey on the Use of Medicines should be used to inform the programme's development and implementation.
Book.A National Survey On The Use of Medicines_2.12.indd 103 1/20/14 10:34 AM
104
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
REFERENCES1. World Health Organization. How to develop and implement a national drug policy. 2nd edition ed.
Geneva: WHO Press; 2001.
2. Hardon A, Hodgkin, C., Fresle, D. How to investigate the use of medicines by consumers. Switzerland: World Health Organization and University of Amsterdam 2004.
3. Grand AL, Hogerzeil, H.V., Haaijer-Ruskamp, F.M. Intervation research in rational use of drugs: a review. Health Policy and Planning. 1999;14(2):89-109.
4. Homedes N, Ugalde A. Review article: Patient's compliance with medical treatments in the third world. What do we know? Health Policy and Planning. 1993;8(4):291-314.
5. Hardon AP. The use of modern pharmaceuticals in a Filipino village: Doctors' prescription and self medication. Social Science & Medicine. 1987;25(3):277-292.
6. Del Rio MC, Prada C, Alvarez FJ. The use of medication by the Spanish population. Pharmacoepidemiology and Drug Safety. 1997;6:41-48.
7. Hempel J. California Pilot Program Creates Rx Fact Sheets, Ads to Inform Consumers. California 2004.
8. Ernst FR, Grizzle, A.J. Drug related morbidity and mortality: updating the cost of illness model. J Am Pharm Assoc. 2001;41:192-199.
9. Aspden P, Wolcott, J.A., Bootman, J.L., Cronenwett, L.R. Preventing medication errors: quality chasm series. Washington, DC: The national academies press; 2007.
10. Bahri S, Othman, N. H.,Ahmad Hassali, M.A., Shafie, A.A., Mohamed Ibrahim, M.I. A national Survey on the use of medicines (NSUM) by Malaysian consumers 2008. first ed: Pharmaceutical Services Division, Ministry of Health; 2008.
11. Kirkpatrick CMJ, Roughead EE, Monteith GR, Tett SE. Consumer involvement in quality use of medicines (QUM) projects-lessons from Australia. BMC Health Services Research 2005. 2005;5(75):1-7.
12. Donnelly N, Orr N, Baird H. Impacts of the 2007 NPS National Awareness Campaign: Findings from surveys of consumers. National Medicine Symposium. National Convention Centre, Canberra, Australia: National Prescribing Service Limited; 2008.
13. Lefebvre RC, Peterson GS, McGraw SA, et al. Community intervention to lower blood cholesterol: The "Know Your Cholesterol" campaign in Pawtucket, Rhode Island. Health Educ Q. 1986;13(2):117-129.
14. Lu Y, Hernandez, P., Abegunde, D., Edejer, T. THE WORLD MEDICINES SITUATION 2011-MEDICINE EXPENDITURES. 3rd ed. Geneva: World Health Organization; 2011.
Book.A National Survey On The Use of Medicines_2.12.indd 104 1/20/14 10:34 AM
105
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
15. Wutzke SE, Artist, M.A., Kehoe, L.A., Flercher, M., Mackson, J.M., Weekes, L.M. Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia. Health Promotion International,. 2006;22(1):53-64.
16. Smith BJ, Ferguson, C., McKenzie, J., Bauman, A., Vita, P. Impacts from repeated mass media campaigns to promote sun protection in Australia. Health Promotion International. 2006;17(1):51-60.
17. Bahri S, Lai ST, Yap YW, Ching MW, Ahmad Khidzar N, Kua J. A survey on the use of medicines by consumers in Federal Territories of Kuala Lumpur and Putrajaya. International Conferences on Improving Use of Medicines 2008.
18. (Malaysia) MOH. National Medicines Policy of Malaysia. 2nd ed 2003.
19. Frary RB. Comparative Review: Partial-credit scoring methods for multiple choice tests. Applied Measurement in Education. 1989;2(1):79-96.
20. Rowley GL, Traub, R.E. Formula Scoring, Number-right Scoring, and Test-taking Strategy. Journal of Educational Measurement. March 1977 1977;14(1):15-22.
21. Sample size calculator. 2004; http://www.raosoft.com/samplesize.html.
22. Kish L. Methods of design effects. Journal of Official Statistics. 1995;11(55-77).
23. Morgan TK, Williamson, M., Pirotta, M., Stewart, K., Myers, S.P., Barnes, J. A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older. The Medical Journal of Australia. 2012;196(1):50-53.
24. Kesselheim AS, Stedman, M.R., Bubrick, E.J., Gagne, J.J., Misono, A.S., Lee, J.L., Brookhart,M.A., Avorn, J., Shrank, W.H. . Seizure Outcomes Following Use of Generic vs. Brand-Name Antiepileptic Drugs: A Systematic Review and Meta-Analysis. Drugs. 26 March 2010 2010;70(5):605-621.
25. Oh A.L. H, M.A., Al-Haddad, M.S., Syed Sulaiman, S.A., Shafie, A.A., Awaisu, A. Public knowledge and attitudes towards antibiotic usage: A cross-sectional study among the general public in the state of Penang, Malaysia. J Infect Dev Ctries. 28 May 2011 2011;28(5):338-347.
26. Malaysian Poisons Regulations. Vol Regulation 12 (1), subregulation (ba) and (c).1952.
27. Gupta MC, Verma, S. DRUG USE AT THE LEVEL OF PRIMARY HEALTH CENTRES – A CRITICAL APPRAISAL. Health Administrator.19(1):8-12.
28. Jassim A. In-home Drug Storage and Self-medication with Antimicrobial Drugs in Basrah, Iraq. Oman Medical Journal. 2010;25(2):1-9.
29. Abdo-Rabbo A, Al-Ansari, M., Gunn, B.,Suleiman, B. MEDICINE USE IN OMAN: PUBLIC KNOWLEDGE, ATTITUDE AND PRACTICE (KAP). SQU Med J. 2009;9(2):124-131.
Book.A National Survey On The Use of Medicines_2.12.indd 105 1/20/14 10:34 AM
106
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
30. Amod F, Chetty, K.,Essa,A.S.,Hlela, L.,Maharaj, C., Oosthuizen, F. A Pilot Study to Determine Public Trends in Storage and Disposal of Medicines. SA Pharmaceutical Journal. 2008;75(7):7-10.
31. Abdo-Rabbo A, Al-Ansari, M., Gunn, B.C., Suleiman, B.J. The Use of Medicines in Oman Public Knowledge, Attitudes and Practices. SQU Med J. 2009;9(2):124-131.
32. FDA US. Safe Disposal of Medicines. 2012; http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/default.htm. Accessed 6 December 2012.
33. Persson M, Sabelström, E., Gunnarsson, B. Handling of unused prescription drugs — knowledge, behaviour and attitude among Swedish people. Environment International. 2009;35(5).
34. Fresle DA, Wolfheim, C. Public Education in Rational Drug Use: a Global Survey. Geneva: World Health Organization; 1997.
Book.A National Survey On The Use of Medicines_2.12.indd 106 1/20/14 10:34 AM
107
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
APPENDIXESAppendix 1: Questionnaire on Survey 1 National Survey on the Use of Medicines by Malaysian Consumers
-‐-‐ State Area Identification No
MINISTRY OF HEALTH MALAYSIA NATIONAL SURVEY ON THE USE OF MEDICINES BY MALAYSIAN CONSUMERS
Protocol No.: 9587
Date of Interview: _____/____/____ (dd/mm/yy) Questionnaire Completed Incomplete Time of Interview: ______________ (am/pm) Status
Pengenalan: Bahagian Perkhidmatan Farmasi, Kementerian Kesihatan Malaysia sedang menjalankan kajian bertajuk National Survey on the Use of Medicines by Malaysian Consumers. Keputusan kajian ini akan membolehkan pihak berkuasa kesihatan untuk merancang strategi yang dikehendaki dalam meningkatkan pemahaman pengguna terhadap konsep penggunaan ubat secara rasional. Panduan mengisi borang:
1. Borang ini terdiri daripada 6 seksyen: i. Seksyen 1: Data demografik
ii. Seksyen 2: Corak penggunaan ubat iii. Seksyen 3: Keperolehan ubat iv. Seksyen 4: Penilaian persepsi dan kesedaran pesakit terhadap penggunaan ubat-‐ubatan v. Seksyen 5: Penilaian sumber maklumat ubat-‐ubatan
vi. Seksyen 6: Kesedaran terhadap kempen ‘Kenali Ubat Anda’
2. Semua pengumpul data diminta untuk mewawancara responden secara individu dan mencatat semua jawapan yang diberikan oleh responden.
Introduction: Pharmaceutical Services Division, Malaysia Ministry of Health is currently undertaking a research project title National Survey on the Use of Medicines by Malaysian Consumers. The study outcomes would allow health authorities to plan necessary strategies to enhance consumers in understanding the concept of rational use of drugs. Guidelines to fill up the form:
1. This form consists of 6 sections: i. Section 1:Demographic Data ii. Section 2:Pattern of Medicine Use iii. Section 3:Access to Medicine iv. Section 4: Evaluation of patients perceptions and awareness on use of medicines v. Section 5: Assessment of medicine information resources vi. Section 6:Awareness on Know Your Medicines Campaign
2. All data collector is required to individually interview the respondent and record all the answers given by the respondent.
Sila tandakan [] pada kotak yang berkaitan dan/atau tulis jawapan pada ruang yang disediakan. Please tick [] the appropriate box and/or write down the answer(s) at the space provided.
SEKSYEN 1: DATA DEMOGRAFIK SECTION 1: DEMOGRAPHIC DATA
Kegunaan rasmi sahaja Official use
only
1.1 Umur Age
1 18-‐24 2 25-‐34 3 35-‐44
4 45-‐54 5 55-‐ 64 6 ≥ 65
1.1
1.2 Jantina
Gender 1 Lelaki 2 Perempuan Male Female
1.2
1.3
Bangsa Ethnic Group
1 Melayu 2 Cina 3 India 4 Lain-‐lain Malay Chinese Indian Others
1.3
Book.A National Survey On The Use of Medicines_2.12.indd 107 1/20/14 10:34 AM
108
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM Questionnaire Muka Surat/Page 2 of 8
1.4 Tahap pendidikan Education Level
1 Sekolah rendah 2 Sekolah menengah Primary school Secondary school 3 Kolej/Universiti 4 Tiada pendidikan rasmi College/University No formal education
1.4
1.5 Pekerjaan Occupation
1 Kerajaan 2 Swasta /Bekerja sendiri Government Private /Self-‐employment
3 Pesara 4 Pelajar 5 Tidak bekerja Retired Student Unemployed
1.5
1.6 Cara tinggal
Living status 1 Sendiri 2 Keluarga 3 Bukan ahli keluarga Alone With family With non-‐family
1.6
1.7 Pendapatan bulanan isi rumah Monthly household income
1 RM500 & ke bawah/ below 2 RM501-‐1,000
3 RM1,001-‐RM1,500 4 RM1,501-‐RM2,000
5 RM2,001-‐RM2,500 6 RM2,501-‐RM3,000 7 RM3,001-‐RM3,500 8 RM3,501-‐RM4,000 9 RM4,001-‐RM4,500 10 RM4,501-‐RM5,000 11 >RM5,000
1.7
SEKSYEN 2: CORAK PENGGUNAAN UBAT SECTION 2: PATTERN OF MEDICINE USE
Kegunaan rasmi sahaja Official use
only
2.1 Adakah ketika ini, anda mengambil sebarang ubat untuk penyakit kronik seperti kencing manis, darah tinggi atau penyakit jantung?
Are you currently taking any medicine for chronic diseases, e.g. diabetes, hypertension or heart disease?
1 Ya/ Yes 2 Tidak/ No (Sila ke soalan 2.2/ Proceed to question 2.2)
(i) Jika ya, sudah berapa lama anda mengambil ubat tersebut? If yes, how long have you been taking the medicine?
bulan/ month(s) (Sila ke soalan 2.2/ Proceed to question 2.2)
2.1
Book.A National Survey On The Use of Medicines_2.12.indd 108 1/20/14 10:34 AM
109
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM Questionnaire Muka Surat/Page 3 of 8
2.2
Adakah ketika ini, anda mengambil persediaan seperti berikut: Are you currently taking the following preparations : a. Vitamin (cth. Vitamin C, E, B12) Vitamins (e.g. Vitamin C, E, B12) b. Garam-‐galian (cth. Kalsium, zink, magnesium) dan suplemen
(cth. Glucosamine, fiber) Minerals (e.g. Calcium, zinc, magnesium) and supplements
(e.g. Glucosamine, fiber) c. Herba tidak diproses (cth. Daun misai kucing, akar ginseng) Non-‐processed herbs (e.g.Misai kucing’s leaves, ginseng’s
root)
d. Herba diproses (cth. Kapsul ginseng, kapsul Kacip Fatimah) Processed herbs (e.g.Ginseng’s capsule, Kacip Fatimah’s
capsule)
e. Minuman Herba (cth. Minuman botol atau tin teh detox, teh Misai Kucing, kopi Tongkat Ali)
Herbal beverages (e.g. Canned or tin detox tea drinks, Misai Kucing tea drinks, Tongkat Ali coffee drinks)
f. Produk rawatan kecantikan berasaskan sumber herba, suplemen, bahan kimia atau haiwan (cth. kolagen, pati sarang burung, placenta, suntikan vitamin, botox) Beauty care products derived from herbs, supplements, chemicals or animals (e.g. collagen, birds nest extract, placenta, vitamin injection, botox)
1 Ya/ Yes
1 Ya/ Yes
1 Ya/ Yes
1 Ya/ Yes
1 Ya/ Yes
1 Ya/ Yes
2 Tidak/No
2 Tidak/No
2 Tidak/No
2 Tidak/No
2 Tidak/No
2 Tidak/No
2.2 a b c d e f
2.3
Berapakah anggaran jumlah wang yang anda belanjakan bagi perkara-‐perkara berikut sama ada untuk diri sendiri atau keluarga dalam 3 bulan yang lepas? Jika tiada, sila isi RM0 (kosong) dalam ruang yang disediakan.
What is the estimation of your expenditure on the following items for either yourself or family in the last 3 months? If none, please put RM0 (zero) in the space provided.
a) Ubat yang diperoleh dari klinik swasta Medicines obtained from private clinic
b) Ubat yang diperoleh dari hospital swasta
Medicines obtained from private hospital c) Ubat yang diperoleh dari farmasi swasta Medicines obtained from private pharmacy d) Ubat yang diperoleh dari bukan premis farmasi (Kedai runcit, jualan lansung dll) Medicines obtained from non-‐pharmacy Premise (Grocery shop, direct selling etc.)
2.3 a b c d
SEKSYEN 3: KEPEROLEHAN UBAT SECTION 3: ACCESS TO MEDICINE
Kegunaan rasmi sahaja Official use
only
3.1
Sekiranya anda mengalami masalah kesihatan, apakah tindakan pertama yang anda ambil? (Sila pilih SATU jawapan sahaja)
If you experiencing any health problems, what is the FIRST action that you’ll take? (Choose ONE option only)
1 Berjumpa doktor kerajaan Consult government doctor 2 Berjumpa doktor swasta Consult Private doctor 3 Berjumpa ahli farmasi di Kedai Farmasi Consult Pharmacist at Pharmacy Outlet 4 Berjumpa pengamal tradisional Consult traditional practitioner
5 Rawatan sendiri Self-‐medication
3.1
Book.A National Survey On The Use of Medicines_2.12.indd 109 1/20/14 10:34 AM
110
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM Questionnaire Muka Surat/Page 4 of 8
3.2
Di manakah selalunya anda mendapatkan ubat? (Sila pilih sehingga TIGA lokasi/premis yang anda selalu kunjungi)
Where do you usually obtain your medicines? (Choose up to THREE of the locations/premises that you often visit)
1 Hospital/ Hospital 2 Klinik/ Clinic 3 Farmasi komuniti/ community pharmacy 4 Outlet perubatan tradisional Traditional medicines outlet 5 Jualan langsung / Direct sales 6 Kedai runcit/ Grocery shop 7 Pasar malam/ Night market 8 Lain-‐lain, sila nyatakan/ Others, please specify ______________________________
3.2 a b c
SEKSYEN 4: PENILAIAN PERSEPSI DAN KESEDARAN PESAKIT TERHADAP PENGGUNAAN UBAT-‐UBATAN SECTION 4: EVALUATION OF PATIENTS PERCEPTIONS AND AWARENESS ON THE USE OF MEDICINES
Kegunaan rasmi sahaja Official use
only
BAHAGIAN 1: PERSEPSI TERHADAP LABEL UBAT/ PART 1: PERCEPTIONS TOWARDS MEDICINE LABELLING
4.1.1
Setiap kali anda dibekalkan ubat, adakah anda diberikan maklumat yang mencukupi pada label ubat anda? (Label ubat mempunyai nama pesakit, nama dan kekuatan ubat, dos, frekuensi, cara pengambilan ubat, nama pembekal/ premis dan tarikh pembekalan)
Every time you are supplied with medicines, are you given adequate information on your medicine labels? (Medicines label includes patient’s name, drug’s name & strength, dosing, frequency, method of administration, supplier/ premise name and supplied date)
1 Ya/ Yes 2 Tidak/ No 4.1.1
4.1.2
Sebelum anda mengambil ubat, adakah anda membaca maklumat pada label ubat anda?
Before taking your medicines, do you read the information on your medicine labels?
1 Ya/ Yes 2 Tidak/ No 4.1.2
4.1.3
Adakah anda menghadapi kesukaran membaca label ubat yang dibekalkan dari:
Do you have trouble reading labels for medicines supplied from the following:
a. Hospital atau klinik kerajaan/ Government hospital/clinic
b. Hospital swasta/ Private hospital
c. Klinik swasta/ Private clinics
d. Farmasi komuniti/ Community pharmacy
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA 1 Ya/ Yes 2 Tidak/ No 9 TB/NA
*TB/NA-‐Tidak berkenaan/ Not Applicable
4.1.4 a b c d
Book.A National Survey On The Use of Medicines_2.12.indd 110 1/20/14 10:34 AM
111
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM Questionnaire Muka Surat/Page 5 of 8
4.1.4
Adakah anda berpuas hati dengan maklumat yang ditulis pada label yang dibekalkan oleh:
Are you satisfied with the information written on the labels given by:
a. Hospital atau klinik kerajaan/ Government hospital or clinic
b. Hospital swasta/ Private hospital
c. Klinik swasta/ Private clinics
d. Farmasi komuniti/ Community pharmacy
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA 1 Ya/ Yes 2 Tidak/ No 9 TB/NA
*TB/NA-‐Tidak berkenaan/ Not Applicable
4.1.5 a b c d
BAHAGIAN 2: KESEDARAN TERHADAP PENGGUNAAN UBAT/ PART 2: AWARENESS TOWARDS APPROPRIATE USE OF MEDICINES
4.2.1 Bolehkah anda membezakan nama ubat sama ada ianya nama bahan
aktif atau nama dagangan? (cth. Panadol® dan paracetamol)
Can you differentiate between the active ingredient and brand name of a particular medicine? (e.g. Panadol® and paracetamol)
1 Ya/ Yes
2 Tidak/ No
4.2.1
4.2.2 Adakah anda faham bagaimana cara menggunakan ubat dari segi dos,
frekuensi, teknik, pemantauan kesan sampingan dan interaksi bagi ubat-‐ubatan yang anda peroleh?
Do you understand the proper use of your medicines in term of dose, frequency, method of administration, side effect monitoring and interaction?
1 Faham sepenuhnya/ Understand 2 Kurang faham/ Partially understand 3 Tidak faham langsung/ Not understand
4.2.2
4.2.3 Adakah anda sedar akan kesan sampingan ubat anda?
Are you aware of the side effects of your medicines?
1 Ya/ Yes 2 Tidak/ No 4.2.3
4.2.4 Adakah anda sedar bahawa semua ubat mempunyai tarikh luput?
Are you aware that all medicines have expiry date?
1 Ya/ Yes 2 Tidak/ No 4.2.4
4.2.5
Adakah anda sedar bahawa terdapat ubat/makanan yang tidak boleh diambil bersama?
Are you aware that there are medicines/ food that should not been taken together?
1 Ya/ Yes 2 Tidak/ No 4.2.5
4.2.6 Adakah anda sedar bahawa terdapat ubat moden dan tradisional yang
tidak boleh diambil bersama?
Are you aware that there are some of modern and traditional medicines should not to be taken together?
1 Ya/ Yes 2 Tidak/ No 4.2.6
4.2.7 Adakah anda tahu cara penyimpanan ubat yang betul?
Do you know the correct way of medicines storage?
1 Ya/ Yes 2 Tidak/ No
4.2.7
Book.A National Survey On The Use of Medicines_2.12.indd 111 1/20/14 10:34 AM
112
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM Questionnaire Muka Surat/Page 6 of 8
4.2.8 Adakah anda tahu bahawa semua ubat perlu didaftar dengan Kementerian Kesihatan Malaysia?
Do you know that all medicines have to be registered with Ministry Of Health, Malaysia?
1 Ya/ Yes 2 Tidak/ No (Sila ke soalan 4.3.1/ Proceed to question 4.3.1)
(i) Jika Ya, adakah anda tahu ketersediaan hologram Meditag untuk memeriksa ketulenan sesuatu produk?
If yes, do you know the availability of Meditag hologram to check the genuineness of the products?
1 Ya/ Yes 2 Tidak/ No
4.2.8 4.2.8(i)
BAHAGIAN 3: PENILAIAN KEPATUHAN PESAKIT TERHADAP UBAT-‐UBATAN/ PART 3: ASSESSMENT TOWARDS MEDICATION COMPLIANCE
4.3.1 Pernahkah anda lupa untuk mengambil ubat seperti diarahkan?
Have you ever forgotten to take a prescribed medicine as indicated? 1 Ya/ Yes 2 Tidak/ No
4.3.1
4.3.2
Pernahkah anda memilih untuk tidak mengambil ubat yang dipreskrib?
Have you ever chosen not to take a prescribed medicine? 1 Ya/ Yes 2 Tidak/ No 4.3.2
4.3.3 Pernahkah anda berkongsi ubat dengan orang lain?
Have you ever shared any medicine with others? 1 Ya/ Yes 2 Tidak/ No
4.3.3
SEKSYEN 5: PENILAIAN SUMBER MAKLUMAT UBAT-‐UBATAN SECTION 5: ASSESSMENT OF MEDICINE INFORMATION RESOURCES
Kegunaan rasmi sahaja Official use
only
5.1
Sekiranya terdapat kemusykilan tentang ubat, siapakah orang PERTAMA yang anda rujuk?
If you have any concerns about medicines, who will be the FIRST person that you consult?
1 Doktor/ Doctor 2 Ahli farmasi/ Pharmacist 3 Jururawat/ Nurse 4 Pemb. Perubatan/ Medical Assistant 5 Rakan atau jiran/ Friends or neighbor 6 Ahli keluarga/ Family member 9 Tidak Berkenaan/ Not Applicable
3.1
5.2
Adakah mudah untuk mendapatkan maklumat ubat daripada:
Is it easy to obtain medicine information from:
a. Doktor kerajaan?/ Government doctor?
b. Doktor swasta?/ Private doctor?
c. Ahli Farmasi kerajaan?/ Government pharmacist?
d. Ahli farmasi komuniti?/ Community pharmacist?
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA 1 Ya/ Yes 2 Tidak/ No 9 TB/NA
*TB/NA-‐Tidak berkenaan/ Not Applicable
4.1.5 a
b
c
d
Book.A National Survey On The Use of Medicines_2.12.indd 112 1/20/14 10:34 AM
113
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM Questionnaire Muka Surat/Page 7 of 8
5.3 Nyatakan kekerapan anda mendapatkan maklumat ubat
dari sumber berikut:
How often do you obtain medicines information from:
a. Media cetak (majalah, suratkhabar)/ Printed materials (magazines, newspapers)
b. Internet/ Internet c. Siaran informasi dan hiburan (TV, radio)/ Common
information and entertainment channels (TV, radio) d. Pengamal perubatan moden (doktor, ahli farmasi,
jururawat)/Modern healthcare professionals (doctors, pharmacists, nurses)
e. Pengamal perubatan tradisional dan komplementari (bomoh, sinseh) /Traditional and complimentary practitioners (shaman, sinseh)
f. Rakan, ahli keluarga dan jiran/ Friends, family and neighbours
1Selalu 2 Jarang 9 Tidak pernah Often Seldom Never 1Selalu 2 Jarang 9 Tidak pernah Often Seldom Never 1Selalu 2 Jarang 9 Tidak pernah Often Seldom Never 1Selalu 2 Jarang 9 Tidak pernah Often Seldom Never 1Selalu 2 Jarang 9 Tidak pernah Often Seldom Never 1Selalu 2 Jarang 9 Tidak pernah Often Seldom Never
5.3 a b c d e
5.4 Adakah anda memerlukan maklumat ubat secara bertulis?
Do you need written medicine information? 1 Ya/ Yes 2 Tidak/ No
5.4
5.5 Dengan pengetahuan ubat anda yang sedia ada, adakah anda memerlukan kaunseling tambahan daripada ahli farmasi?
With your current knowledge on medicines, do you require additional counseling from your pharmacist?
1 Ya/ Yes 2 Tidak/ No 5.5
SEKSYEN 6: KESEDARAN TERHADAP KEMPEN ‘KENALI UBAT ANDA’ SECTION 6: AWARENESS ON ‘KNOW YOUR MEDICINE CAMPAIGN’
Kegunaan rasmi sahaja Official use
only
6.1 Adakah anda sedar tentang ‘Kempen Kenali Ubat Anda’ yang dianjurkan oleh Kementerian Kesihatan Malaysia?
Are you aware of ‘Know Your Medicine Campaign ‘organized by Ministry Of Health (MOH)?
1 Ya/ Yes
i. Jika Ya, sila ke soalan seterusnya
If Yes, please proceed to the next questions
2 Tidak/ No
Jika Tidak, sesi.tamat
If No, end of session
6.1
6.2 Di manakah anda mendapatkan maklumat berkenaan kempen tersebut? Where do you get the information about the campaign? a. Iklan dari siaran informasi dan hiburan (TV, radio dll) /
Advertisement from common information and entertainment channels (TV, radio etc.)
b. Ahli keluarga/ Saudara/ Rakan/ Jiran Family/Relatives/Friends/ Neighbours c. Sepanduk dan papan iklan jalanan Road banner and billboard d. Internet Internet e. Risalah dan maklumat dari fasiliti kesihatan Brochure and information from health facilities f. Lain-‐lain, sila nyatakan ________________ Others, please specify __________________
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
*TB/NA-‐Tidak berkenaan/ Not Applicable
6.2
a
b
c
d
e
f
Book.A National Survey On The Use of Medicines_2.12.indd 113 1/20/14 10:34 AM
114
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
NSUM Questionnaire Muka Surat/Page 8 of 8
6.3
Pernahkah anda menghadiri sebarang aktiviti kempen?
Have you attended any of the campaign’s activities?
1 Ya/Yes 2Tidak/No 9 TB/NA
Jika Tidak, sesi tamat/ If No, end of session Jika Ya, apakah bentuk aktiviti yang dihadiri? If Yes, what kind of activity(ies) you have attended? a. Ceramah/ Talk 1 b. Pameran/ Exhibition 1 c. Jerayawara/ Roadshow 1
6.3 6.3a 6.3b 6.3c
6.4 Bagaimana tahap kepuasan anda terhadap kempen ini?
How satisfied are you with the campaign?
1 Sangat berpuas hati/Very Satisfied 2 Berpuas hati/ Satisfied 3 Sama ada berpuas hati mahupun Tidak berpuas hati/ Neither 4Tidak berpuas hati/Not Satisfied 5 Sangat tidak berpuas hati/Very Not Satisfied
9 TB/NA
*TB/NA-‐Tidak berkenaan/ Not Applicable
6.4
6.5
Sebagai pengguna ubat, adakah anda fikir kempen ini bermanfaat kepada anda?
As a consumer of medicines, do you think the campaign is beneficial to you?
1 Ya/ Yes 2 Tidak/ No 9 TB/NA
*TB/NA-‐Tidak berkenaan/ Not Applicable
6.5
KEBENARAN DARI PESAKIT Saya telah diterangkan dengan jelas tentang kajian ini dan telah diberi peluang untuk menanyakan sebarang soalan. Saya memahami dan menerima semua jawapan yang telah diberikan. CONSENT BY PARTICIPANT I have been clearly explained about this study and was given the opportunity to ask any questions. I understand and accept all the answers given. ______________________ ___________ Tandatangan Peserta Kajian Tarikh Signature of Study Participant Date
Temubual Tamat End of Interview: Masa tamat temubual:
Time at end of interview pg/ptg am/pm
Book.A National Survey On The Use of Medicines_2.12.indd 114 1/20/14 10:34 AM
115
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Appendix 2: Questionnaire on Survey 2 (Pre-Study) Quality Use of Medicine – Consumer Campaign Effectiveness Study (Pre)
1
‘KENALI UBAT ANDA’
ANJURAN BAHAGIAN PERKHIDMATAN FARMASI
KEMENTERIAN KESIHATAN MALAYSIA KAJIAN KEBERKESANAN KEMPEN PENGGUNAAN UBAT BERKUALITI-PENGGUNA
QUALITY USE OF MEDICINE – CONSUMER CAMPAIGN EFFECTIVENESS STUDY NAMA PROGRAM/AKTIVITI / PROGRAMME NAME / ACTIVITY : TARIKH / DATE : TEMPAT / VENUE :
A. Data Demografik / Demographic Data
B. Maklumat Am /General Information
Pernahkah anda mengikuti kempen sebegini sebelum ini ? Have you ever attended such campaign before?
Ya / Yes Tidak / No
Jika YA, sila nyatakan program yang pernah diikuti / If YES, please state the programme that you attended:
Pameran / Exhibition
Lain-lain / Others : (sila nyatakan / pleasa state)
Ceramah / Talk ----------------------------------------------------
C. Pengetahuan berkenaan penggunaan ubat / Knowledge on medicine use
(Sila jawab semua soalan dibawah / Please answer all the following questions)
Bil./ No Soalan / Question Jawapan / Answer
Kegunaan Urusetia
For Official Use 1 Ubat ialah / Medicine is a?
a. Bahan yang digunakan untuk merawat penyakit / Substance used to treat diseases
Betul / Right
Salah / Wrong
B
S
b. Bahan yang digunakan untuk mencegah penyakit / Substance used to prevent diseases
Betul / Right
Salah / Wrong
c. Bahan yang digunakan untuk mengawal penyakit / Substance used to control diseases
Betul / Right
Salah / Wrong
Nama / Name No kad pengenalan/ IC
Umur / Age
18 - 24 45 - 54 25 - 34 55 - 64 35 - 44 ≥ 65
Jantina / Gender
Lelaki / Male
Perempuan / Female
Bangsa / Ethnic group
Melayu / Malay
India / Indian
Cina / Chinese
Lain-lain / Others
Pekerjaan / Occupation
Badan kerajaan / Government
Pesara / Retired
Badan swasta / Bekerja sendiri
Pelajar / Student
Private/ Self-employed
Tidak bekerja / Unemployed
Cara Tinggal / Living status
Berseorangan / Alone
Bersama keluarga / With family
Bersama bukan keluarga/ With non-family
Tahap pendidikan / Education level
Sekolah rendah /Primary
Sekolah menengah / Secondary
Kolej/Universiti / University / College
Tiada pendidikan formal / No formal education
KEGUNAAN URUSETIA FOR OFFICIAL USE
Nombor Siri / Serial Number
Pengiraan skor (Score) B S J Pre (sebelum program)
Pre programme
PRE
Book.A National Survey On The Use of Medicines_2.12.indd 115 1/20/14 10:34 AM
116
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
2
2 Adakah anda tahu / Do you know? a. Nama generik ubat / Generic name of a medicine
Contoh / Example : - Paracetamol
Ya / Yes
Tidak / No
B
S
b. Nama dagang atau jenama ubat / Brand or Trade name of a medicine Contoh / Example : - Panadol®
Ya / Yes
Tidak / No
c. Anda perlu membaca label ubat sebelum mengambil sebarang ubat ? You should read the label before taking any medicine?
Ya / Yes
Tidak / No
d. Setiap ubat perlu didaftar dengan Kementerian Kesihatan Malaysia? All medicines should be registered with the Malaysian Ministry of Health?
Ya / Yes
Tidak / No
3 Apakah penggunaan ubat secara berkualiti / What is quality use of medicine?
a. Ubat yang BETUL / RIGHT medicine
Ya / Yes
Tidak / No
B
S
b. Dos yang BETUL / RIGHT dose
Ya / Yes
Tidak / No
c. Masa pengambilan yang BETUL / RIGHT administration time
Ya / Yes
Tidak / No
4 Apakah hak anda sebagai pengguna ubat-ubatan / What are your rights as a medicine consumer?
a. Hak untuk mengetahui nama ubat / Rights to know the name of the medicine
Ya / Yes
Tidak / No
B
S
b. Hak untuk mendapat maklumat tentang kegunaan ubat / Rights to obtain information on the indication of the medicine
Ya / Yes
Tidak / No
c. Hak untuk mendapat maklumat tentang cara pengambilan ubat / Rights to obtain the information on how to take the medicine
Ya / Yes
Tidak / No
d. Hak untuk mendapat ubat yang dilabel dengan betul / Rights to obtain correctly labeled medicine
Ya / Yes
Tidak / No
e. Hak untuk mendapat maklumat tentang keselamatan ubat dan interaksi ubat yang dibekalkan / Rights to obtain the information on safety and interaction of medicine supplied.
Ya / Yes
Tidak / No
5 Apakah itu UBAT TERKAWAL / What is a CONTROLLED MEDICINE?
a. Ubat yang boleh diperolehi daripada doktor perubatan / A medicine which can be obtained from medical doctors
Betul / Right
Salah / Wrong
B
S
b. Ubat yang boleh diperolehi daripada ahli farmasi / A medicine which can be obtained from pharmacists
Betul / Right
Salah / Wrong
c. Ubat yang boleh diperolehi daripada pengamal perubatan tradisional / A medicine which can be obtained from traditional medicine practitioners
Betul / Right
Salah / Wrong
6 Di manakah sepatutnya anda memperolehi UBAT TERKAWAL ? / Where you should obtain CONTROLLED MEDICINE?
a. Klinik / Hospital kerajaan / Government clinic / hospital
Ya / Yes
Tidak / No
B
S
b. Klinik / Hospital swasta / Private clinic / hospital
Ya / Yes
Tidak / No
c. Farmasi komuniti / Community pharmacy
Ya / Yes
Tidak / No
Book.A National Survey On The Use of Medicines_2.12.indd 116 1/20/14 10:34 AM
117
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
3
d. Toko ubat / Kedai sinseh / Traditional medicine outlet / Chinese medicine hall
Ya / Yes
Tidak / No
e. Kedai runcit / Grocery shop
Ya / Yes
Tidak / No
f. Pasar malam/ Night market
Ya / Yes
Tidak / No
g. Internet / Internet
Ya / Yes
Tidak / No
7 Di manakah ubat sepatutnya disimpan / Where should you store your medicine?
a. Di dalam bilik air / In the bathroom
Ya / Yes
Tidak / No
B
S
b. Di tempat yang jauh dari cahaya matahari dan haba / Away from sunlight and heat
Ya / Yes
Tidak / No
c. Di tempat yang mudah diambil oleh kanak-kanak / In places reachable to children
Ya / Yes
Tidak / No
d. Disimpan dalam kereta / In the car
Ya / Yes
Tidak / No
8 Bagaimanakah cara pelupusan ubat yang telah rosak atau melepasi tarikh luput? / How do you dispose damaged or expired medicine?
a. Buang dalam tong sampah / Throw into the rubbish bin
Ya / Yes
Tidak / No
B
S
b. Buang dalam tandas / Flush down the toilet
Ya / Yes
Tidak / No
c. Bakar / Burn
Ya / Yes
Tidak / No
d. Tanam / Bury
Ya / Yes
Tidak / No
e. Diserahkan ke kedai farmasi, klinik atau hospital yang berdekatan / Return to the nearest pharmacy, clinic or hospital
Ya / Yes
Tidak / No
Terima kasih kerana meluangkan masa untuk menjawab soalan ini Thank you for your time in answering the questions
Book.A National Survey On The Use of Medicines_2.12.indd 117 1/20/14 10:34 AM
118
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
Appendix 3: Questionnaire on Survey 2 (Post-study) Quality Use of Medicine – Consumer Campaign Effectiveness Study (Post)
1
‘KENALI UBAT ANDA’
ANJURAN BAHAGIAN PERKHIDMATAN FARMASI
KEMENTERIAN KESIHATAN MALAYSIA KAJIAN KEBERKESANAN KEMPEN PENGGUNAAN UBAT BERKUALITI-PENGGUNA
QUALITY USE OF MEDICINE – CONSUMER CAMPAIGN EFFECTIVENESS STUDY NAMA PROGRAM/AKTIVITI / PROGRAMME NAME / ACTIVITY : TARIKH / DATE : TEMPAT / VENUE :
A. Data Demografik / Demographic Data
B. Pengetahuan berkenaan penggunaan ubat / Knowledge on medicine use (Sila jawab semua soalan dibawah / Please answer all the following questions)
Bil./ No Soalan / Question Jawapan / Answer
Kegunaan Urusetia
For Official Use 1 Ubat ialah / Medicine is a?
a. Bahan yang digunakan untuk merawat penyakit / Substance used to treat diseases
Betul / Right
Salah / Wrong
B
S
b. Bahan yang digunakan untuk mencegah penyakit / Substance used to prevent diseases
Betul / Right
Salah / Wrong
c. Bahan yang digunakan untuk mengawal penyakit / Substance used to control diseases
Betul / Right
Salah / Wrong
2 Adakah anda tahu / Do you know? a. Nama generik ubat / Generic name of a medicine
Contoh / Example : - Paracetamol
Ya / Yes
Tidak / No
B
S
b. Nama dagang atau jenama ubat / Brand or Trade name of a medicine Contoh / Example : - Panadol®
Ya / Yes
Tidak / No
Nama / Name No kad pengenalan/ IC
Umur / Age
18 - 24 45 - 54
25 - 34 55 - 64 35 - 44 > 64
Jantina / Gender
Lelaki / Male
Perempuan / Female
Bangsa / Ethnic group
Melayu / Malay
India / Indian
Cina / Chinese
Lain-lain / Others
Pekerjaan / Occupation
Badan kerajaan / Government
Pesara / Retired
Badan swasta / Bekerja sendiri
Pelajar / Student
Private/ Self-employed
Tidak bekerja / Unemployed
Cara Tinggal / Living status
Berseorangan / Alone
Bersama keluarga / With family
Bersama bukan keluarga/ With non-family
Tahap pendidikan / Education level
Sekolah rendah /Primary
Sekolah menengah / Secondary
Kolej/Universiti / University / College
Tiada pendidikan formal / No formal education
KEGUNAAN URUSETIA FOR OFFICIAL USE
Nombor Siri / Serial Number
Pengiraan skor (Score) B S J Pre (sebelum program)
Pre programme
Post (selepas program) Post programme
POST
Book.A National Survey On The Use of Medicines_2.12.indd 118 1/20/14 10:34 AM
119
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
2
c. Anda perlu membaca label ubat sebelum mengambil sebarang ubat ? You should read the label before taking any medicine?
Ya / Yes
Tidak / No
d. Setiap ubat perlu didaftar dengan Kementerian Kesihatan Malaysia? All medicines should be registered with the Malaysian Ministry of Health?
Ya / Yes
Tidak / No
3 Apakah penggunaan ubat secara berkualiti / What is quality use of medicine?
a. Ubat yang BETUL / RIGHT medicine
Ya / Yes
Tidak / No
B
S
b. Dos yang BETUL / RIGHT dose
Ya / Yes
Tidak / No
c. Masa pengambilan yang BETUL / RIGHT administration time
Ya / Yes
Tidak / No
4 Apakah hak anda sebagai pengguna ubat-ubatan / What are your rights as a medicine consumer?
a. Hak untuk mengetahui nama ubat / Rights to know the name of the medicine
Ya / Yes
Tidak / No
B
S
b. Hak untuk mendapat maklumat tentang kegunaan ubat / Rights to obtain information on the indication of the medicine
Ya / Yes
Tidak / No
c. Hak untuk mendapat maklumat tentang cara pengambilan ubat / Rights to obtain the information on how to take the medicine
Ya / Yes
Tidak / No
d. Hak untuk mendapat ubat yang dilabel dengan betul / Rights to obtain correctly labeled medicine
Ya / Yes
Tidak / No
e. Hak untuk mendapat maklumat tentang keselamatan ubat dan interaksi ubat yang dibekalkan / Rights to obtain the information on safety and interaction of medicine supplied.
Ya / Yes
Tidak / No
5 Apakah itu UBAT TERKAWAL / What is a CONTROLLED MEDICINE?
a. Ubat yang boleh diperolehi daripada doktor perubatan / A medicine which can be obtained from medical doctors
Betul / Right
Salah / Wrong
B
S
b. Ubat yang boleh diperolehi daripada ahli farmasi / A medicine which can be obtained from pharmacists
Betul / Right
Salah / Wrong
c. Ubat yang boleh diperolehi daripada pengamal perubatan tradisional / A medicine which can be obtained from traditional medicine practitioners
Betul / Right
Salah / Wrong
6 Di manakah sepatutnya anda memperolehi UBAT TERKAWAL ? / Where you should obtain CONTROLLED MEDICINE?
a. Klinik / Hospital kerajaan / Government clinic / hospital
Ya / Yes
Tidak / No
B
S
b. Klinik / Hospital swasta / Private clinic / hospital
Ya / Yes
Tidak / No
c. Farmasi komuniti / Community pharmacy
Ya / Yes
Tidak / No
d. Toko ubat / Kedai sinseh / Traditional medicine outlet / Chinese medicine hall
Ya / Yes
Tidak / No
e. Kedai runcit / Grocery shop
Ya / Yes
Tidak / No
f. Pasar malam/ Night market
Ya / Yes
Tidak / No
Book.A National Survey On The Use of Medicines_2.12.indd 119 1/20/14 10:34 AM
120
A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012
3
g. Internet / Internet
Ya / Yes
Tidak / No
7 Di manakah ubat sepatutnya disimpan / Where should you store your medicine?
a. Di dalam bilik air / In the bathroom
Ya / Yes
Tidak / No
B
S
b. Di tempat yang jauh dari cahaya matahari dan haba / Away from sunlight and heat
Ya / Yes
Tidak / No
c. Di tempat yang mudah diambil oleh kanak-kanak / In places reachable to children
Ya / Yes
Tidak / No
d. Disimpan dalam kereta / In the car
Ya / Yes
Tidak / No
8 Bagaimanakah cara pelupusan ubat yang telah rosak atau melepasi tarikh luput? / How do you dispose damaged or expired medicine?
a. Buang dalam tong sampah / Throw into the rubbish bin
Ya / Yes
Tidak / No
B
S
b. Buang dalam tandas / Flush down the toilet
Ya / Yes
Tidak / No
c. Bakar / Burn
Ya / Yes
Tidak / No
d. Tanam / Bury
Ya / Yes
Tidak / No
e. Diserahkan ke kedai farmasi, klinik atau hospital yang berdekatan / Return to the nearest pharmacy, clinic or hospital
Ya / Yes
Tidak / No
C. Ulasan / Cadangan memperbaiki kempen (Sila nyatakan)
Comments / Suggestions to improve the campaign (please specify)
………………………………………………………………………………………………………………….................... ……………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………
Adakah anda berminat untuk mendapatkan maklumat lanjut berkenaan kempen penggunaan ubat berkualiti? Are you interested in getting more information about the campaign-quality use of medicines?
Jika ya, sila isi maklumat di bawah: / If yes, please fill in the information below:
Alamat emel/ Email address: _______________________________________________
Atau/ Or
Layari laman web kami di www.knowyourmedicine.gov.my Surf our website at www.knowyourmedicines.gov.my
Terima kasih kerana meluangkan masa untuk menjawab soalan ini Thank you for your time in answering the questions
Book.A National Survey On The Use of Medicines_2.12.indd 120 1/20/14 10:34 AM