Theses (Master in Pharmacy Practice)

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used for pain, fever, and inflammation. They are readily accessible over-the-counter (OTC) in community pharmacies without a prescription. Due to the ease with which NSAIDs can be acquired, selfmedication with NSAIDs is an increasing concern as it may result in inappropriate use, leading to drug-related problems and potentially serious adverse effects. Objective: The main purpose of this study was to assess the general public’s current level of knowledge, attitude, perception, and practice regarding the use of OTC NSAIDs, to explore their perspective regarding receiving information on NSAIDs, and also to determine the relationship between the knowledge, attitude, perception, and practice. Methods: A cross-sectional study was conducted among the general public in Selangor who had self-medicated with oral OTC NSAIDs. A structured, validated questionnaire was distributed electronically in community pharmacies and via social media platforms. In addition, a hard copy of the questionnaires was provided for non tech-savvy participants. Respondents were recruited through convenience sampling. Incomplete responses were excluded. Data was analysed using Statistical Package for Social Sciences (SPSS). Results: A total of 358 respondents completed the survey. Findings suggest that overall, the general public in Selangor demonstrated good knowledge (70.95%), positive attitude (PRR=67.88%), and good practice (PRR=58.75%) towards OTC NSAIDs use. However, perception of NSAID risks was poor (PRR=35.64%), especially related to risks of selfmedicating and sharing of NSAIDs among friends and family. Age, gender, and education levels were key determinants affecting knowledge levels. Most respondents (89.39%) showed a positive perspective towards receiving information on NSAIDs, with 94.14% agreeing that healthcare professionals (HCPs) should play a direct role in providing such information Statistically significant positive correlations were observed between knowledge-attitude (r=0.218, p<0.001), knowledge-perception (r=0.294, p<0.001), knowledge-practice (r=0.294, p<0.001), attitude-perception (r=0.270, p<0.001), attitude-practice (r=0.585, p<0.001) and perception-practice (r=0.385, p<0.001). Conclusion: There were potential gaps and misconceptions identified in certain areas, particularly regarding the safety aspects of NSAIDs. The study recommends targeted educational interventions to raise awareness and improve overall medication safety. Keywords: NSAIDs, painkillers, community pharmacy, health, wellbeing

Utilisation of Non-Steroidal Anti-Inflammatory Drugs Among the Paediatric Patients of a Private Tertiary Care Hospital Introduction Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are widely prescribed, yet there is a lack of published research investigating their utilisation in the paediatrics population. This study aims to address this gap by examining the prescribing patterns of prescribers at a private tertiary hospital in Malaysia. Additionally, the study explores the actual and potential drug-related problems (DRPs) associated with NSAIDs use, based on all prescriptions collected during the study period. Methods This single-centred, ambi-directional cohort study was conducted at Sunway Medical Centre, Bandar Sunway from January to December 2024. The inclusion criteria included all prescriptions containing at least one NSAIDs, with the patients being less than 18 years old on the date of dispensing. The prescription data and patient progress notes were analysed for the indication for NSAIDs use. In addition to descriptive analysis, chi-squared tests were performed to examine relationships between NSAIDs use, the occurrence of DRPs, and patient demographics. Results There were no statistically significant differences in gender, race, age distribution, allergy status, and medical conditions among the study population with p-values more than 0.05. 93.26% of prescriptions were prescribed by the emergency, paediatrics and orthopaedic departments. Most NSAIDs were indicated for pain or fever relief, with aspirin specifically prescribed for conditions such as Kawasaki Disease or Systemic Lupus Erythematosus. Oral liquid formulations of NSAIDs (55.21%) were the most commonly prescribed due to their dosing convenience, palatability, and suitability for the younger children. Ibuprofen (58.69%) was the most frequently prescribed NSAID, followed by diclofenac (13.03%). As patient age increased, a broader range of NSAID options and formulations, including COX-2 inhibitors, were observed. Aspirin was prescribed mainly for patients under 5 years old, likely due to the prevalence of Kawasaki Disease in this age group. Paracetamol was the most common concomitant medication, consistent with its use for pain or fever relief. No severe adverse events associated with NSAIDs use were identified, indicating appropriate prescribing practices within this population. Dose-related potential DRPs were the most frequent type of DRP observed, occurring more often in patients between 6 to 11 years of age. Conclusion This study has identified the prescribing patterns and potential DRPs associated with NSAIDs use among the paediatric population of a private tertiary hospital. NSAIDs were predominantly prescribed for analgesic and antipyretic purposes. Future research could focus on investigating the knowledge, attitude, and perceptions of NSAIDs use among prescribers and pharmacy personnel. Such studies could provide insights into the practicality and challenges of prescribing medications for this young population. Keywords: Prescription, drug use, medications, prescriber, paediatric, analgesics.