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Title: Development of a pharmaceutical care model for the long-term management of asthma in Malaysia
Author: Wong, Pei Se
Awarding Body: University of Strathclyde
Current Institution: University of Strathclyde
Date of Award: 2012
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Asthma is one of the most common chronic diseases affecting adults and children in the world. To date, it is estimated to affect over 300 million of the world population and presents a significant healthcare burden in all countries. In the United State (US) and Europe, asthma control is reported to be achievable by only 5% of asthmatics. Asthma is also one of the top 5 conditions, which impact on healthcare expenditures in the US. Asthma affects 4.6% of the population in Malaysia and has major effects on morbidity, mortality and healthcare costs. The development of a pharmaceutical care model for the long-term management of asthma patients in Malaysia has the goal of increasing patients’ and professionals’ levels of understanding of the pharmacological management of the disease, by developing a framework for the provision of pharmaceutical care. Within that framework, pharmacy services are aimed at promoting the management of prescribed medicines and securing better disease control through decision support and education provided to other health professionals and patients. The overall aim of the current research is to develop a pharmaceutical care model for the long-term management of asthma in Malaysia. This thesis presents the series of research studies undertaken to achieve the aim of study. Chapter 1 of the thesis reviews the intention of the research plan and provides insights into the disease of asthma. The status of the healthcare system in Malaysia and the concept of pharmaceutical care are also discussed. Chapter 2 and Chapter 3 of the thesis discuss the assessment of pharmaceutical needs by means of quality assessment using clinical audit and a direct patient-facing clinical exploratory method. A design and validation processes generated a tool, an Asthma Medication Assessment Tool (MATAST) that can be used not only for quality assessment purpose, but comparison at the international level. The field-testing process of the MAT provides preliminary insights into gaps in asthma clinical management and, potentially, the need for decision support. The direct patient-facing clinical exploratory study uses two methods; semi-structured interviews with individual patients and focus groups of patients to improve understanding of patients’ needs. The outcomes of these studies are a list of gaps of care from clinical audit and patients’ views or perceptions from patients’ interviews which are critically appraised in Chapter 4. Chapter 5 of the thesis discusses a consensus process used to establish a pharmaceutical care model and roles of pharmacists in that model of care. The objective of the consensus process is to establish the activities for in a pharmaceutical care model for asthma management in Malaysia. This study also includes a consensus process of the agreed activities by pharmacists within the pharmaceutical care model. Chapter 6 presents a study to evaluate the self-management ability of patients by means of an educational intervention using an action plan. Asthma self-management is a globally relevant component of care, which is not commonly practised in Malaysia and has never been studied in this country. This study revealed ways of improving the action plan and the patients use of it; the findings provide a framework for asthma self-management interventions in Malaysia. Chapter 7 critically appraises the implications of the findings in the thesis for practice and education as well as future research in the provision of pharmaceutical care in the asthma population.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available