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HOME MEDICATION REVIEW
Ministry of Health Malaysia
Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
The ScenarioThe Scenario
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Our Routine Services
Dispensing Counseling
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
The Issues Patients come to doctor’s appointment with
progressing complication of the disease. Patient has repeated admission to hospital due to
disease progression What happened with medication that we
dispensed?No respond towards the drug? Geriatrics with multiple medication. Most of the patients actually don’t understand how
to take their medication correctly as prescribed.
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
The Role of Pharmacists
Pharmacist is in an ideal position to assist with medication-related problems.Beny J, Bero LA, Bond C. Expending role of outpatient pharmacist: effect on health services utilization, cost and patient outcomes (Cochrane Review). In: The Cochrane Library, Issue 3, 2000. Oxford, UK
The positive impact of pharmacist service on outcome for specific diseases has been demonstrated, such as hypertension, heart failure and anticoagulation therapyBeny J, Bero LA, Bond C. Expending role of outpatient pharmacist: effect on health services utilization, cost and patient outcomes (Cochrane Review). In: The Cochrane Library, Issue 3, 2000. Oxford, UK
Home medication review would allow pharmacist to gain greater insight into patients’ methods of managing their drugsRichard Holland, Elizabeth Lenagham, Ian Harvey, Richard Smith. Does home based medication review keep older people out of hospital? The HOMER randomized controlled trial. BMJ 2005.
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Pilot Project
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
States Involved In Early Stage
Kedah Darul Aman (2004) Selangor Darul Ehsan (2005) Negeri Sembilan Darul Khusus (2006) Melaka Bandaraya Bersejarah (2006)
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
HOME MEDICATION REVIEW
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Main Objective
To improve the outcome of pharmacotherapy by Home
Medication Review conducted by Pharmacist
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Specific Objective To increase patients’ adherence to medication To increase patients’ knowledge on medication (dosing
frequency, indication & administration (DFIT) To identify factors affecting non-compliance To review patient’s method of managing their medication
at home To identify drug related problems To reduce wastage due to over-stocking of medication To improve patient’s Quality of Life
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Counseling at Home
Help From Other Healthcare Provider
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
HOME MEDICATION REVIEWHOME MEDICATION REVIEW
EARLY
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Medication Being Stored At Home
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Unused MedicationCPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
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Result From Improper Storage Of Medication At Home
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CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
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Ministry of Health Malaysia, Pharmaceutical Services Division
Traditional Herbs That Being Consumed By Patient
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Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
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Ministry of Health Malaysia, Pharmaceutical Services Division
Other Findings
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Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Adverse Drug Reaction
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MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Complication of the Disease
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Program Schedule
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Month Activities
1st Month Patient referred to Pharmacist
2nd Month 1st Visit
3rd Month Doctor appointment
4th Month Part supply medication
5th Month Doctor appointment
6th Month 2nd Visit
7th Month Doctor appointment
8th Month Part supply medication
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Patient Selection Patients are being selected by FMS/MO and being reffered
to the pharmacist
Inclusion Criteria : Patients who have problems with medication compliance which
leads to disease complication.
This include: Patients who have more than 1 chronic disease and being
prescribed with 5 or more medication for maintenance therapy.
Geriatric patients with chronic disease with no caregiver to participate/assist in patient medication treatment
Psychiatric patients
Patients who still have poor technique of medical aid device (MDIs, insulin syringes) despite counseling
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Assessment Parameters Medication knowledge Medication compliance Laboratory indices
– Blood Glucose Level (FBS, RBS / 2HPP)– Urine protein– Serum Creatinine– Blood pressure (BP)– Lipid profile (Kolesterol & TG)– BMI (Body Mass Index)
Quality of Life Storage of medication at home. Cost saving (unused medication) Intervention done
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Flow Chart
Refer to Pharmacist
Dispensing & Counseling
Recording
FMS / MO
Pharmacist
Pharmacist
Recruiting Patient
HMR 1/07
HMR 2/07
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Flow ChartRemind Patient :
Phone
Visit Patient’s Home
Record all information HMR 3/07
Assess storage of medication at home Counseling
Unsatisfied
Satisfied
Record findings
Send report to DoctorMemo HMR
Pharmacist
Pharmacist
Pharmacist
Pharmacist
Pharmacist
Pharmacist
Home Visit
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Flow ChartRegistration
Dispensing & Counseling
Recording
Pharmacist
Pharmacist
Appointment with Doctor / part supply medication
HMR 2/07
Screening
Treatment
Pharmacist
Doctor
Triage Nurses
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
HMR Form 1
Tarikh
Nama TelDiagnosis Merokok Pengambilan Alkohol Umur Ya : btg/hari Ya :Berat Tidak TidakTinggi Ubat Bukan PreskripsiBangsa Ya Tidak Ya TidakJantina Catatan : Catatan :PekerjaanTahap PendidikanTidak Sek :
Sek. Ren : Lupa ambil ubat
Sek. Men : Lain-lain, sila nyatakan
Uni/Kolej :Catatan :
SendiriBantuanNyatakan
Tarikh Mula DosTarikh Ubah
DosDos
Tarikh Berhenti
Tarikh Mula Semula
Dos
HMR 1/07
HOME MEDICATION REVIEWBAHAGIAN PERKHIDMATAN FARMASI KEMENTERIAN KESIHATAN MALAYSIA
No Rujukan Pesakit
:::
: :
::
::
Kesan Adverse Ubat
Sejarah Pengubatan :
Ubat
*Isi borang ADR & kepilkan salinanJangkamasa menghidap penyakit
Sebab-sebab Ubat Diberhentikan :Sebab-sebab BerhentiUbat
( ) Ya ( ) Tidak
Mengambil ubat
Pernahkah mendapat kaunseling dari pegaw ai farmasi?
Faktor Ketidakpatuhan Ubat
::
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
HMR Form 2
Tarikh
2. Parameter Dikaji
Dos (D)Selang
masa (F)Indikasi ( I )
Cara P engambilan
(T)Skor Parameter Bacaan
Julat / Bacaan Normal
TarikhFBSRBS (P2)HbA1cUrine AlbSr CrClBPPulseTCTG
Ya (0) Tidak (1) Skor
Tandakan
Kuantiti P erlu diambil (A)
Lebihan Didispen (B)
Baki Didapati (c)
Perbezaan (D=C - B)
(A-D)/A %
Baik (DFIT = 100%)
Baik (>11markah MAS)Tidak (<11markah MAS)Baik (> 80%)Tidak (< 80%)
Nota Peg FarmasiKefahaman DFIT pesakit
Lain-Lain :
3. Kajiselidik Kepatuhan Ubat Pesakit (Medication Adherence Scale 'MAS')* Betul : 1 Salah : 0 [Jumlah (%)]
8)Kesukaran mengingat cara pengambilan ubat (rawatan)
1)Pernahkah anda lupa mengambil ubat anda ?2)Dalam tempoh 2 minggu kebelakangan ini, pernahkah anda terlupa mengambil ubat?3)Pernahkan anda mengurangkan dos anda sendiri tanpa pengetahuan doktor ?4)Pernahkah anda terlupa membawa ubat anda semasa anda pergi bercuti ?
No Ruj Pesakit
HOME MEDICATION REVIEWBAHAGIAN PERKHIDMATAN FARMASI KEMENTERIAN KESIHATAN MALAYSIA
HMR 2/07
Ubat-ubatan
1. Kajiselidik Kefahaman Pesakit *
4. Kajiselidik Kepatuhan Ubat Pesakit (Pill Count)
CatatanUbat-ubatan
(Skor 11-12 Patuh pada rawatan ubat ; Skor 1-10 Tidak patuh pada rawatan ubat) JUMLAH SKOR
c) Kadang-kala (3 markah) cth : tertidur / melengahkan dll d) Selalu (2 markah) cth : nyanyuk / berkaitan penyakit kognitif dll
a) Tidak pernah / jarang sekali (5 markah)
e) Tidak mengambil ubat (1 markah) cth : kerana tidak boleh toleransi kesan samping
b) Ada masa-masa tertentu (4 markah) cth : kenduri / ke rumah anak dll
5)Adakah anda mengambil ubat anda semalam ?6)Pernahkah anda berhenti pengambilan ubat apabila anda rasa anda telah sihat ?7)Pernahkah anda rasa rawatan ini menyusahkan ?
Cadangan Intervensi PengubatanPiawai Kepatuhan Ubat adalah > 80%
Tidak (DFIT < 100%)
Kepatuhan Ubat Pesakit
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
HMR Form 3
Kuantiti Kos
Kuantiti Kuantiti
No Rujukan Pesakit
MASA BERAKHIR LAWATAN OLEH
HMR 3/07BORANG HOME MEDICATION REVIEW
BAHAGIAN PERKHIDMATAN FARMASI KEMENTERIAN KESIHATAN MALAYSIA
Makan Tengahari
Informasi Diet
Minum pagi
Jenis
Makan Malam :
Aktiviti Harian
‘Medication Box’
Overstocking
Minuman
Cahaya (L)Kelembapan
dan Haba (M)
2. INFORMASI DIET DAN AKTIVITI HARIAN
1. CARA SIMPANAN UBAT-UBATANBekas kedap udara/ tertutup
Nama (N)Tarikh
Luput (E)
Simpan jauh daripada
Kanak-kanak ( C )
Nama ubat
Jumlah skor
Bil
Label Ubat
TARIKH LAWATAN MASA MULA
Minum Malam :
Sarapan:
1. Adakah ubat yang anda simpan mempunyai label 'nama ubat' ? 2. Adakah ubat yang anda simpan mempunyai label tarikh luput? 3. Adakah ubat yang anda simpan dijauhkan dari kanak-kanak? 4. Adakah ubat yang anda simpan dijauhkan dari cahaya? 5. Adakah ubat y
Jenis
Minum petang :
Makanan
CATATAN (Jika ada)
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Appointment With Doctor / Part Supply Medication
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
The Interventions Method of proper storage of medication at
home Patient knowledge on medication (dispensing
and follow up counseling) Report any findings of ADR Advice on proper diet and daily activities
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
The Interventions Intervention towards improving
pharmacotherapy– Increase, reduce or maintain the dose– Add, combine or withdrawal of medication
being prescribed– Increase or decrease dosing frequency
(improve patient’s compliance)– Improve technique
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
HOME MEDICATION REVIEWHOME MEDICATION REVIEW
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Storage Of Medication At Home
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Cost Saving Cost saving data based on unused medication at
home (Selangor data : 20 patient)
Patient RM6 322.414 449.87
PKD Petaling 4 33.204 198.402 79.30
20 1083.18PKD Sepang
Total
PKDPKD Kuala LangatPKD Klang
PKD Sabak Bernam
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Outcome of HMR Improvement of treatment outcome. Reduce incident of unscheduled appointment Reduce repeated admission to hospital
emergency dept due to disease progression / complication.
Reduce cost due to wastage of unused medication at home.
Increase patient empowerment to manage their disease at home more effectively.
Improve patient’s Quality Of Life
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Outcome of HMR
Reduce cost on treatment for disease complication in future.
Improve patient’s perception towards the service provided by MOH
Involvement of pharmacist at healthcare centre in Clinical Pharmacy activity
Bring new image of pharmacy services at healthcare center
Recognition & motivation for pharmacy career & development
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Future Plan HMR can be done by all healthcare centers
throughout Malaysia. Put up designated posts of Pharmacist to
conduct HMR dedicatedly. No age limit and covers :
– Psychiatric patients– Patient that being prescribed with narrow
therapeutic index medication (e.g. Epilepsy patients)
– Uncontrolled asthmatic patients
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Future Plan Proper training to conduct HMR
– Clinical pharmacy– Counseling
Standard Operating Procedure. Conduct multi-centre study in order to
evaluate whether the delivery HMR by pharmacist are cost effective in improving treatment outcomes for patients.
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Ministry of Health Malaysia, Pharmaceutical Services Division
Acknowledgement
Dr Lian Lu Ming (Ex-Deputy State Director Of Health Selangor)Pn Zawiyah Mat Johor (Ex-Assistant Deputy Director Of Health Selangor: Pharmaceuticalcare)
Dr Salmah Bahari (Deputy State Director Of Health Melaka)Hjh Hazimah Othman (Deputy State Director of Health Negeri Sembilan)
Dr Ramli Abd Ghani (Ex-Deputy Director Of Health Kedah)Dr Mohamed Azmi Hassali (Lecturer-School of pharmaceutical sciences USM)
Prof Madya Dr Rosnani Hashim (Head of Pharmacy Dept, UKM)Cik Sameerah Bt Shaikh Abdul Rahman (Deputy Assistant Director Of Pharmacy KKM)
Pn Norharlina Sulaiman (Assistant Director Pharmaceutical Care Service Division Selangor)Nor Azlina Sariam(Pharmacist PKD Klang)
Norhanizah Hashim(Pharmacist PKD Petaling)Farahwahida Mohd Kassim (Pharmacist PKD Petaling)
Kobu Thiruvanackan(Ex-Pharmacist PKD Sabak Bernam)Srima Elina Shamsuri(Ex-Pharmacist PKD Sepang)
Zaitulhusna Md Safee(Ex-Pharmacist PKD Hulu Langat)Pn Azwana Supian (Pharmacist PKD Seremban)
Ministry of Health Malaysia, Pharmaceutical Services Division
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007
Thank You
Prepared by:
Mohd Dziehan Mustapa Pharmacist U41
Pharmaceutical Services DivisionHealth Department Of Selangor
(PKD Kuala Langat)
CPA-MPS CONFERENCE 2007
MEDICATION REVIEW SYMPOSIUM 4th August 2007