a national survey on the use of medicines (nsum) by malaysian ...

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.


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


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


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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


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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.


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• 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.


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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



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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



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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


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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


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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


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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


SURVEY 1: A NATIONAL SURVEY ON THE USE OF

MEDICINES (NSUM) BY MALAYSIAN CONSUMERS 2012



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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



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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.



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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.



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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%).


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)



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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



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.


22


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)


23


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*



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.


25


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)


26


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



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.



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.


29


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)


30


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)


31


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


32


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)


33


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)


34


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



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.


36



Outcome

Labelling adequacy Read label


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.


37


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)


38


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)


39


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



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%).


41


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)


42


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)


43


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



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


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)



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)



45



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)


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).


46


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)


47


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


48


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


Aware of medicines’ side effects Aware medicines’ expiry dates


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)


49



Aware of medicines’ side effects Aware medicines’ expiry dates


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)



50


Table 15: Factors affecting the awareness on food-medicines and modern-traditional medicines interactions


Awareness of interactions between modern medicines and food

Awareness of interactions between modern and traditional medicines


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)



51


Awareness of interactions between modern medicines and food

Awareness of interactions between modern and traditional medicines


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)


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


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)



52


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)



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


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)


Occupation

Government 631 (59.6) 332 (31.4)

<0.001*


Retired 57 (27.3) 88 (42.1)

Student 85 (30.7) 109 (39.4)

Unemployed 100 (20.0) 200 (40.1)



54


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)




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)




Occupation

Government 754 (70.7) 312 (29.3)

0.022*


Retired 139 (64.7) 76 (35.3)

Student 209 (74.4) 72 (25.6)

Unemployed 327 (64.8) 178 (35.2)



56

Demographic characteristicsEver forgotten to take the prescribed medicines as indicated?


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)


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?


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)



57

Demographic characteristicsEver choose not to take prescribed medicines?


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)


College/university 685 (49.4) 701 (50.6)


OccupationGovernment 474 (44.5) 592 (55.5)

<0.001*


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)




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?


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)



Occupation

Government 338 (31.7) 728 (68.3)

<0.001*


Retired 44 (20.5) 171 (79.5)

Student 120 (42.5) 162 (57.4)

Unemployed 94 (18.6) 411 (81.3)



59

Demographic characteristicsEver shared medicines with others?


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)


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.


60


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


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)



61


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)


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.



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


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


63




Government doctors Private doctors


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



64


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



Government pharmacists Community pharmacists


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



65



Government pharmacists Community pharmacists


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


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)



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).


67


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)


68


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)


69


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


70


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


71


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)


72


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



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?


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)



Occupation

Government 823 (76.3) 243 (23.7)

<0.001*


Retired 137 (64.0) 77 (36.0)

Student 201 (71.3) 81 (28.7)

Unemployed 370 (73.4) 134 (26.6)



74

Demographic characteristicsNeed written medicines information?


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)


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.


75


Table 29: Responses to “Do you require additional counselling from your pharmacists?” based on demographic characteristics


Outcome

Require additional counselling from pharmacists?


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)



Occupation

Government 769 (72.1) 297 (27.9)

<0.001*


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)



76


Outcome

Require additional counselling from pharmacists?


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)


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


Outcome

Aware of “Know Your Medicines” programme


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)



77


Outcome

Aware of “Know Your Medicines” programme


Education level

Primary school 70 (22.4) 243 (77.6)




Occupation

Government 747 (70.1) 319 (29.9)

<0.001*


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)



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


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)


Table 32(2): Association between the sources of information about the “Know Your Medicines” programme and area of settlement


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)


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).



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


Attended programme activities?


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)





80


Attended programme activities?


Occupation

Government 517 (68.3) 240 (31.7)

<0.001*


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)


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).



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

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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.



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



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



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



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.



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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.



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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.



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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.


SURVEY 2: EVALUATION OF

“KNOW YOUR MEDICINES” PROGRAMME 2012

PRE & POST SURVEY



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



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



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



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.


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)



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).


97


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

*


98


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



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



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.



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



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.



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.


104


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.

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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.

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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.

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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


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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


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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


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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


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


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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


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?


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

*TB/NA-‐Tidak berkenaan/ Not Applicable

4.1.4 a b c d


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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





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?


4.2.4 Adakah anda sedar bahawa semua ubat mempunyai tarikh luput?

Are you aware that all medicines have expiry date?


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?


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?


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


112



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


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?





4.1.5 a

b

c

d


113



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’


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 __________________








6.2

a

b

c

d

e

f


114



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


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?



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


115


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


116


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


117


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


118


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


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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


120


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


a national survey on the use of medicines (nsum) by malaysian ...

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