Navigation

Pharmacy Malaysia

This article describes a new course for pharmacy students called "Pharmacoinformatics, " which combines drug information and pharmacy information systems. It is the first course to integrate the telemedicine and telepharmacy concepts into the curriculum of a Malaysian pharmacy school. One goal of the course is to prevent future pharmacists from suffering from "computer phobia."

This article also describes students' evaluations of the course, which have, in general, been positive. Before taking the course, few students had been aware of the concept of pharmacoinformatics. The evaluation findings will be used as a guide to improve the course and expand it to other pharmacy colleges in Malaysia.

Key Words: Pharmacy; Informatics; Pharmacy curriculum; Pharmacy education; Information technology

INTRODUCTION

ADVANCES IN INFORMATION technology are impacting the role of pharmacists as drug information providers. Vast amounts of drug information are available on the Internet. Quick and easy access to drug information can be obtained from standalone or online computerized drug databases. Such systems provide inexpensive and effective means of disseminating information to patients and to health care professionals.

The use of computers in information management relating to pharmacy services includes access to patient medication histories, generation of cart fill lists, dose calculations, label printing, insurance coverage checking, billing, and inventory controls. Decision support systems have been developed in several areas of drug therapy (1). Such systems allow pharmacists to document interventions and monitor drug therapy. These and other developments in computer and information technology require pharmacists to acquire the knowledge and skills needed to provide a quality service at a minimal cost.

In this environment where information technology is a fundamental aspect in medicine and related disciplines (eg, pharmacy, nursing), most medical, pharmacy, and nursing schools worldwide have incorporated subjects related to informatics into their curriculum. Malaysia is also implementing such subjects, and is currently implementing telemedicine projects nationwide.

In addition, there is a paradigm shift in health care practices: a transformation from industrial age medicine to information age health care. The Malaysian Ministry of Health is moving toward this phenomenon. The government is encouraging the public to acquire at least one personal computer for every household and is promoting computer literacy among the public, especially for young people (ie, students).

At the health institution level, the government is building an infrastructure for information and communication technology in government hospitals. Selected agencies under the supervision of the Ministry of Health are establishing pilot tele-health and teleprimary care projects for selected government hospitals and health clinics at the primary care level; these are expected to be expanded nationwide (2,3).

This paper describes the implementation of a course in pharmacoinformatics for undergraduate pharmacy students at the Universiti Sains Malaysia and students' evaluation of the course. "Pharmacoinformatics" was developed in response to the pharmacy curriculum revisions based upon the growing awareness of the influence of information technologies on pharmacy practice and the drug use process. The course was also intended to prevent pharmacists from suffering from "computer phobia" that has been experienced by mid-career professionals in other sectors of the economy.

COURSE DESCRIPTION

"Pharmacoinformatics" is a two-unit course developed by the clinical pharmacy discipline at the School of Pharmaceutical Sciences during the 6th Malaysian Plan. It was first offered during the 1997-1998 academic year. It is a required course for fourth-year students. The course is divided into five segments:

1. Introduction of drug information services as a component of pharmacy practice: This covers the activities, scope, and role of a pharmacist in the provision of drug information. Comparison is made between drug information services in Malaysia and several other countries/areas such as the United States, Europe, and Australia. Challenges that the drug information practice will face as a result of advancement in information technology and changes in the health care system in Malaysia and worldwide are addressed,

2. A systematic approach to handling drug inquiries and selection of appropriate sources: Features and significance of various drug information sources are discussed. Selected medical and pharmacy journals are used to demonstrate the scope and categories of scientific literature. Students are also taught how to evaluate medical and pharmacy literature. Statistical evaluation of the literature is taught separately in another elective course (ie, pharmacoepidemiology),

3. Various pharmacy-related sources of Web-based information and the importance of the Internet in pharmacy practice: Selected Web sites are reviewed, emphasizing how to analyze information gathered from the Web. In addition, students are required to attend a two-hour orientation on the university library's databases and the Internet. Librarians use a lecture and demonstration approach,

4. Issues on the implementation of telemedicine in Malaysia and the government's initiative in the multimedia super-corridor project to develop computer applications in health care: This covers the development of four projects: teleconsult, continuing medical education, public education, and lifetime health care plan, and

5. The application of pharmacy information systems and how they affect pharmacy services: The role of artificial intelligent components in reorganizing and improving medicine is emphasized. The usefulness of expert systems in decisionmaking processes is reviewed. Applications of such systems in drug use evaluation and drug audit are also discussed.

COURSE GOALS

The general objectives of the course are to provide students with the knowledge and skills necessary to handle drug information and to introduce them to the role of computer-assisted information management in the health care system. In doing this, students are provided with basic drug information skills such as handling drug information requests; the retrieval and use of different drug information sources, including computerized drug databases; and literature evaluation. In addition, they are also exposed to the concept of telemedicine, as well as current and future uses of information systems and decision support in pharmacy-related applications.

At the end of the course, the students are expected to be able to:

1. Identify sources of drug and pharmacy-- related information, and be familiar with the selection process,

2. Evaluate drug and pharmacy-related information for validity and reliability, expertise, and usability,

3. Appreciate the importance of pharmacy information management and how computer technology assists in information handling,

4. Appreciate the importance of updating information in order to provide accurate information to customers or users,

5. Realize today's need to provide information to the public and patients,

6. Understand how information and pharmacy information systems can contribute to pharmacy service in health institutions, and

7. Understand the extent of the contributions that information systems can make in meeting the nation's needs.

Experiential drug information instruction complements this course and is provided through limited training at a drug information center situated at a nearby general hospital; this is a required component of the baccalaureate clerkship.

COURSE FORMAT

The course is taught primarily in a lecture format by four or five clinical pharmacy lecturers. Students are provided with lecture topics and a list of suggested reading materials (Table 1).

Students' performance is evaluated through coursework (40%) and essay final examinations (60%). Students are divided into groups of 15 to 18; each group is assigned to one lecturer. Projects are assigned to each group, allowing students to explore their interests and emphasizing the use of information technologies. Students can use computerized databases and the Internet at the pharmacy school; the Malaysia National Poison Center, which is located in the university; the Penang Hospital; and the main university library to complete their coursework. Students can also use the computer laboratory at the School of Computer Sciences. Previous projects carried out by students included the evaluation of pharmacy-related Internet sites and the establishment of group Web sites.

STUDENTS' EVALUATION

The course was first taught in the second semester of the academic year 1997 to 1998. A formal evaluation was conducted on two groups of students (total 173) during the academic years of 1997 to 1998 and 1998 to 1999.

Questionnaires were distributed to the students after final examinations. The first section covered demographic data. The second section asked students to evaluate the course in general, based on a five-point Likert scale. The third section asked students to evaluate their coursework or project on the same Likert scale. The second and third sections asked open-ended questions to allow students to provide comments and opinions. Students were also allowed to describe the strengths and weaknesses of this course and were asked to provide suggestions to improve the course.

RESULTS

Demographic and General Information

All 83 students from the academic year 1997 to 1998 and all 90 students from the academic year 1998 to 1999 completed the questionnaires. More than two-thirds of the respondents were female (Table 2). Although less than half of the students owned personal computers, the majority of them (97.1%) already had previous experience with a computer. About 30% of the students maintained personal accounts with local Internet service providers.

Students' Opinions on the Course in General

Table 3 presents students general opinions on the course. Almost half of the respondents reported they had not been exposed to subjects dealing with pharmacoinformatics. Eighty-five percent of the students felt that their knowledge of pharmacoinformatics was insufficient before they attended the course.

The majority of students said their knowledge about pharmacoinformatics had increased, and that the course was interesting. About 70% were equivocal about whether the course was relevant to pharmacy. Students were equally divided on whether the course was too imaginative.

Nevertheless, nearly 80% agreed that the course should be maintained. The survey also revealed several areas that need to be addressed in the future, since 42% of the respondents felt that the course was not well conducted. Furthermore, while more than 60% indicated that the course contents were up-to-date, many felt the contents were not sufficient or comprehensive enough.

Student's Evaluation of Coursework

More than half of the students agreed that they learned a lot about the Internet through coursework (Table 4). Perhaps these were the students (55%) who did not own their own computers. Overall findings indicated that students were satisfied with the coursework and that they found it interesting and stimulating. Nevertheless, the majority of students agreed that the facilities and computers available at the school are not sufficient. They were satisfied with the time allocated and the guidance provided in carrying out their projects.

DISCUSSION

The role of the pharmacist as a drug information specialist is no longer confined to responding to drug information requests, but rather continues to expand to include other responsibilities. Areas with rapidly developing new technology include information technology, medication development technology, and equipment technology (4). Drug information pharmacists are expected to be involved in evaluating, selecting, and implementing these new technologies within their institutions. We developed a new course to provide students with the basic training they needed to meet the drug information demands of health professionals and the public, while at the same time exposing them to some of the applications of information technology related to pharmacy practice.

The findings of our students' evaluation of this new course are interesting. The evaluation showed few students were aware of pharmacoinformatics. Perhaps that is why most of them found this course interesting and felt their knowledge on pharmacoinformatics increased. Nevertheless, many were not sure about the relevance of this course to pharmacy practice. These findings show that even in their final year at the pharmacy school, students are still not aware of the rapidly changing effects information technology has had on pharmacy practice around the world. It is also possible that students choose to ignore such changes because innovations in information technology and health care may have not been implemented locally.

Overall, these findings should enable faculty to determine ways to increase awareness of the usefulness of such technology in pharmacy practice. One way is to introduce more examples of professional and patient-education computer software (5). This method, however, will place an additional financial burden on the School of Pharmacy because of software costs. Professional software such as the Drugdex and Iowa Drug Information Services" are already available at the school of pharmacy, the Malaysia National Poison Center, and the Penang Hospital. Most students have limited exposure to these software programs unless they are involved in small research projects taken as an elective course.

The survey shows that some students felt that the course was not well conducted and its contents were not sufficient or comprehensive. Since the evaluation was conducted during the first two years of the course, this finding should allow the faculty to reorganize the course content with an emphasis on organization, comprehensiveness, and relevance to pharmacy practice.

Many students found that the projects or assignments were interesting and have helped them learn more about the Internet. These projects or assignments were computer-based; students agreed that school- or university-- based computer facilities were not adequate. Although almost half of the students had their own personal computers, not all were able to access the Internet. As a result they had to rely upon university-based computer laboratories or Internet cafes. Computer access is becoming increasingly important but hardware and software are expensive. The school of pharmacy should address this problem if it is to create a culture of information technology-literate pharmacy students.

CONCLUSION

We have attempted to combine drug information and pharmacy information management in one course. Students built the necessary skills through a didactic program combined with experiential drug information clerkships. In general, student response had been positive. Several measures have been identified to improve this course.

REFERENCES

1. Dasta JF, Greer ML, Speedie SM. Computers in healthcare: overview and bibliography. Ann Pharmacother. 1992;26(1):109-117.

2. Ramiya S. IT in health. Malaysian Medical Tribune. July 2000;103;12/2000.

3. Vegil S. IT in healthcare. Malaysian Medical Tribune. October 2000;109; 18/2000.

4. Vanscoy GJ, Gajewski LK, Tyler LS, et al. The future of medication information practice: a consensus. Ann Pharmacother. 1996;30(7/8 ):876-881.

5. Miller LG, Jungnickel PW, Scott DM. Pharmaceutical care in rural community pharmacy clerkships: emphasis on developing computer skills to enhance patient education. Am J Pharm Edu. 1996;60(3):249-256.

AB FATAH AB RAHMAN, PHARMD, MOHAMED IZHAM MOHAMED IBRAHIM, PHD, MOHD BAIDI BAHARI, PHARMD, AND MOHAMAD HANIKI NIK MOHAMED, PHARMD

Lecturers, Clinical & Administrative Pharmacy Department, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia

RAHMAT AWANG, PHARMD

Director, National Poison Centre, Universiti Sains Malaysia, Penang, Malaysia

Reprint address: Mohamed Izham Mohamed Ibrahim, PhD, Lecturer, Clinical & Administrative Pharmacy Department, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia (e-mail: mizham@usm.my).

Copyright Drug Information Association Oct-Dec 2002
Provided by ProQuest Information and Learning Company. All rights Reserved