Social Pharmacy and Pharmacy Administration

Pharmacist Manpower

Alison Anastasi

Background

The Maltese Pharmacist Directory provides a descriptive overview for the demographic and practice characteristics of the pharmacist manpower in Malta.

Objectives

To update and publish a directory, create a website and conduct a manpower analysis.

Design

Two questionnaires were developed: QA1 to collect demographic data and QA2 for the manpower analysis. QA2 was psychometrically evaluated¹. They were sent to all registered pharmacists (n=785) with a stamped self-addressed envelope and follow-up for QA1 was undertaken by telephone contact. A website was created, data was inputted and a questionnaire was developed to evaluate it.

Main outcome measures

Pharmacists’ principal occupation, job satisfaction, and evaluation of website.

Results

Response Rate: 41% (n=304) for QA1 and QA2 by mail, and 100% response for QA1 by telephone contact. 766 pharmacists participated in the study: 60% (n=461) females and 40% (n=305) males [age (years): mean=40, mode=32, range=22-96]. 35% of the pharmacists practise in community pharmacies, 17% in the hospital setting, and 15% are employed in the marketing and sales health practices. In the 1998² study, 38% practised in the community, 15% in hospital and 10% in sales-oriented practices. On comparing the two studies, a significant difference (p<0.05) resulted.

Conclusion

Community Pharmacy Practice is still the major principal occupation, however there seems to be an increasing trend towards the hospital and sales-oriented practices, following a trend identified in the 1999³ study.

References

1. Azzopardi LM. Validation Instruments for Community Pharmacy. Pharmaceutical Care for the Third Millennium. Binghamton: Pharmaceutical Products Press, 2000: 36-37.

2. Mallia-Milanes A. Updating and Evaluating the Directory of Pharmacists [dissertation]. Malta: Pharmacy Department, University of Malta, 1998: 17-18.

3. Serracino Inglott A, Zarb Adami M, Azzopardi LM. FIP Abstract Book. Trends in Principal Occupation of Pharmacists in Malta [abstract]. Netherlands: FIP Publications, 1999: 157.

Socio-economic aspects of the treatment of psoriasis

Vanessa Magro

Background: Psoriasis affects almost 2 % of the European population and may occur at any age, thus affecting quality of life and causing substantial economic impact.¹

Objective: To investigate quality of life (QOL) in patients with psoriasis and measure treatment costs.¹

Design: Three questionnaires were adopted through an anonymous postal survey: a general health questionnaire – Short Form-36 (SF-36), a general skin disease questionnaire – Dermatology Life Quality Index (DLQI) and a disease specific questionnaire – Psoriasis Disability Index (PDI).² Sociodemographic parameters were included. Psoriasis treatment costs¹ including medications, in-patients treatment and out-patients treatment were collected.

Main outcome measures: Patients’ QOL relationship with sociodemographic parameters and direct costs to the health department.

Results: 102 out of 188 patients answered the questionnaires (54%). 45% (n=46) were females and 55% (n=56) were males. Males showed better QOL than females; only statistically significant (p<0.05) with daily activities score of DLQI. QOL was better in patients with mild psoriasis; statistically significant with DLQI and PDI scores (p<0.05). The total yearly cost of psoriasis-specific medications was Lm20,122. PUVA treatment cost Lm1,095 monthly. The out-patients main clinic was mostly attended by psoriasis patients in winter (33.33%) and monthly cost was Lm5,666, while monthly in-patient costs varied from Lm75 to Lm1080.

Conclusion:

Factors including severity of the disease and gender contribute to the impact of psoriasis on QOL. The total cost of psoriasis is significant but varies throughout the year.

References:

1. Belisari A, Finzi AF, Mantovani LG, Italian Association for Studies on Psoriasis. The cost of hospital-related care of patients with psoriasis in Italy based on the AISP study. JEADV 2001; 15:320-24.

2. Aschroft DM, Griffiths CEM, Li Wan Po A, Williams HC. Quality of life measures in psoriasis: a critical appraisal of their quality. J Clin Pharm Ther 1998; 23:391-398.

Evaluation of First Aid Boxes at places of work

Adrian Camilleri

Background: Pharmacists possess the necessary expertise about first aid items and so they are the ideal candidates to give advice accordingly¹.

Objectives: To assess conformity of the different workplaces regarding the contents of first aid boxes with legal requirements² and to evaluate the proposal of the pharmacist going round doing periodic checking of first aid boxes at places of work.

Design: Study 1. Pharmacists’ questionnaire, hand delivered to 99 community,

hospital/clinical pharmacists. Study 2. Employers’ questionnaire. Seventy-five work places were visited including offices, factories and construction companies. Field observation report was conducted wherever possible. Study 3. Unions’ questionnaire, personally delivered to the representatives of 5 major trade unions.

Main outcome measures: The opinions of pharmacists, union representatives and employers, and the latter’s willingness to pay for the pharmacist’s intervention were assessed through questionnaires containing partially open, closed and Likeart scale questions.

Results: Eighty-six community, hospital/clinical pharmacists (n = 99) answered the questionnaire. Fifty-seven pharmacists (66%) (n=86), 54 (72%) (n=75) employers and 4 (n=5) trade union representatives agreed with the idea of the pharmacist visiting workplaces, doing periodic checking of first aid boxes. Thirty-seven (69%) (n = 54) employers agreed that a fee should be charged for the pharmacist’s intervention. Seventy-three (97%) (n=75) workplaces have a first aid box. Twelve (16%) have the full list of items as stipulated by law².

Conclusion: Pharmacists, as health professionals, should not only check first aid boxes, but also, give advice on first aid items to be kept at workplaces. Employers are willing to pay for the pharmacist’s intervention.

References:

1. Farrugia D. Pharmacist Intervention in First Aid [B.Pharm dissertation]. Msida (Malta): University of Malta.; 2000: xi – xii.

2. Occupational Health and Safety Authority. Work Place (First Aid) Regulations. Valletta (Malta): The Institute; 2002.

EVALUATION OF PHARMACEUTICAL SERVICES IN GOZO GENERAL HOSPITAL.

Georgeann Galea

Background: Hospital pharmaceutical services should effectively meet patients’ needs in accordance with accepted standards of practice and applicable regulations.

Objective: To evaluate pharmaceutical services at GGH and determine improvements which could be implemented.

Design:

1) An interview schedule was developed to determine patient satisfaction with pharmacy services.

2) Two self-administered questionnaires were distributed among pharmacists/pharmacy technicians and nurses to determine their perceptions regarding pharmaceutical services.

3) A study of the financial trend of drug usage in 2000 and 2001 was determined. ‘Drug wastage’ was determined by calculating the cost of expired drugs for the two years.

Main Outcome Measures: Pharmacists’, nurses’ and patients’ perceptions regarding pharmaceutical services. Areas for improvement were identified. Drug stock control was analysed.

Results:

1) Out of 129 interviews, 59.70% (n=77) were satisfied, 34.10%(n=44) were uncertain, and 6.20% (n=8) were dissatisfied with the pharmaceutical services.

2) In questionnaire 1, response rate was 71.40% (n=50). 78% (n=39) were satisfied, 10% (n=5) were uncertain, whereas 12% (n=6) were dissatisfied. Periodic inspection of medication areas was considered the most important service in improving the system.

In questionnaire 2, 20% considered the services very good, 70% considered them good, whereas 10% were uncertain. Discharge medication counselling and drug information service were considered the most important pharmacy services in improving the system.

3) The total drug purchase cost during year 2000 amounted to Lm 440,610.91 whilst that for 2001 was Lm651,763.31. The cost of expired drugs in year 2000 was Lm28,123.68 whereas it amounted to Lm 10,922.44 in 2001.

Conclusion: Potential areas for improvement exist, since the focus of pharmacy service has expanded beyond the dispensing of medications to the provision of pharmaceutical care.¹

Reference:

1. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical Care Practice. New York, NY: McGraw-Hill Co; 1998.

Information and Communication Systems

Compiling and Evaluating a drug reference handbook.

Anita Bellizzi.

Background:

The main reference handbook used by local healthcare professionals is the British National Formulary (BNF).

Objective:

To compile an addendum to the BNF in order to provide information on products available in the local retail setting that are not listed in the BNF.

Design:

The information contained in the addendum was obtained from manufacturer’s product inserts and drug reference books. The data included drug names, proprietary names, doses, manufacturer’s name, local agent and price, and other products available with the same proprietary name. Drug monographs were included when drug information was not found in the BNF. A list of local drug agent addresses, extra pages for notes, extra space in the index were also included. The page numbering system, the font size, addendum size and binding style are different from those of the BNF. The addendum compiled has a presentation style adapted from the BNF with the kind permission of the Joint Formulary Committee. The addendum was distributed to nine healthcare professionals: pharmacists, doctors and undergraduate students for evaluation.

Main outcome measures:

Evaluation of presentation, contents, use and costing of compiled addendum.

Results:

The majority preferred a pocket-size format with fonts as those presented in the addendum. There was no specific pattern regarding binding preference. All found inclusion of extra note pages and extra sections useful. Healthcare professionals with over fifteen years of practice prefer a colour-coded addendum and would buy publication every 3 years. Pharmacy students and pharmacists with fewer years of practice would buy addendum every year. Price preferred was between Lm2 and Lm5.

Conclusion:

It was felt that the addendum provided the information, which was not found in the BNF, which information was not yet compiled in any publication.

A Newsletter for a Community Pharmacy in a Tourist Area

Karen Galea

Background: Tourists and Maltese residents travelling abroad could benefit from information given by community pharmacists in the form of a newsletter.

Objective: To issue and evaluate newsletters aimed for community pharmacy clients especially tourists.

Design: Eight newsletters were designed consisting of four, A4 size pages. A questionnaire was developed in order to receive the feedback from the readers¹. The newsletters were distributed in five tourist localities: Sliema, Qawra, Bugibba, St. Paul’s Bay, and Mellieha. Fifty copies of each newsletter were distributed to the 21 pharmacies. The newsletters were offered free of charge to clients visiting the pharmacy. Data was analysed using the Biomedical Data Package software.

Main outcome measures: Response to a questionnaire included in the newsletters on the usefulness, reliability and efficiency of the newsletters.

Results: The number of newsletters, including questionnaires, distributed was 8400; 48% (3800) were taken by patients visiting the pharmacies, with a 12.9% (489) response rate to the questionnaire: 64% (311) females and 36% (178) males; 68% (334) tourists and 32% (155) Maltese. Respondents to the questionnaire found the newsletters: informative 99.6% (487); interesting 99.1% (485); easy-to-read font size 98.2% (480); attractive layout 92.2% (452); preference for colour 37% (181); useful illustrations 65.4% (320) and adequate length 76.5% (374); 60.9% (298) of the tourists found the newsletter useful, 63.8% (312) would like to see a similar newsletter in their country and 97.3% (476) suggested that the newsletter should be published on a regular basis.

Conclusion: The results show that the newsletters were informative and interesting. It can also be concluded that continuation of publication of the newsletter in the future should be considered.

References: 1. Rossi B. The production and evaluation of a pharmacy department newsletter (dissertation). Msida (Malta): University of Malta,; 2002

Setting up a curriculum for undergraduate courses for medical representatives

Sarah Curmi

Background: International companies and institutes provide training to the medical representatives.1 A code of ethics is set up by national organisations like the Association of British Pharmaceutical Industry (ABPI), that regulate drug promotion.

Objective: To set up a curriculum to educate pharmacy students to provide the healthcare professions with accurate, balanced information in an ethical way.

Design: Questionnaires were developed and distributed to 153 pharmacists, 256 doctors (both in government run health centres and in private clinics), 15 employers of pharmaceutical companies, 86 medical representatives and to 122 students. Data was analysed using SPSS package. Literature review was consulted to understand the principles involved in curriculum design and to set out time plan and objectives.2

Main outcome measures: Rating of subjects like communication skills, selling skills and product knowledge through questionnaires.

Results: Ninety-six (n=99) pharmacists, 104 (n=106) doctors, 8 (n=8) employers and 32 (n=32) medical representatives rated communication skills as ‘very important'. All pharmacists (99), 104 (n=106) doctors, 5 (n=8) employers and 26 (n=32) medical representatives agreed that product knowledge is ‘very important’ in a curriculum. Eight employers (n=8) and 24 (n=32) medical representatives said that selling skills are ‘very important’. This contrasts with the opinion of doctors and pharmacists where only 15 (n=106) and 27 (n=99) respectively said that selling skills are ‘very important’. Forty (n=76) students said that they would pursue such credits if included in their undergraduate pharmacy curriculum. Literature review showed that role-playing should be an integral part of the curriculum.

Conclusions: The curriculum should emphasize ethics and communication skills. Special attention should be given to selling skills and product knowledge.

References:

1. Portelli K. The marketing of medicinals with special reference to advertising and medicinal presentation [dissertation]. Msida (Malta): University of Malta.; 1992

2. Sciberras G. A diploma in marketing: curriculum perspectives [dissertation]. Msida (Malta): University of Malta.; 1997.

Structure Activity Relationship in the Pharmacy Curriculum

By: Alexandra Micallef

Background: With the progress of technology especially computers in all fields education technology, seeks to enhance learning for students with problems in grasping fundamental concepts.

Objective:

To evaluate whether, the presentation of information to students, via computer aided visualization tools enhanced their ability to grasp fundamental concepts, as opposed to when information was presented in a traditional format.

Design:

A library of 3D molecules was constructed using the Smiles¹and the Corina² sites available on the Internet. Pharmacy Students from first, third and fourth years participated in the study. This study was divided into 2 parts pre-test and post-test. The students were assigned two questionnaires in the pretest phase, to evaluate the extent to which respondents had grasped the basic tenets presented in the credit and to evaluate the extent of computer knowledge that this cohort had as well as their general attitudes towards them. In the post-test stage, the same questionnaire was given to the same cohort. Here however the questionnaires were supplemented with the presentation of the 3D molecules in question.

Main outcome measures:

Comparison between the post-test and pretest scores of assigned questionnaires.

Results:

20 first year students participated in the study. A majority of the students (94%) agreed that the study was relevant to material taught in the lecture while 73% of the respondents agreed that the study reinforced important concepts. The students scored better in the post-test (+3%) as compared to the pretest, however this difference was not statistically significant. In study 2 results show a statistical significance with students showing an improved score of (+63%).

conclusion:

The results suggest that the use of 3D molecular modelling tools could help students to enhance their understanding of important concepts delivered in lectures.

References:

1.Smiles software.

http://www.daylight.com/dayhtml/smiles/index.html

2. Corina software available at:

http://www2.ccc.uni-erlangen.de/services/index.html

Qualtiy Care Programmes

Validation of Hospital Pharmacy Setting

Ian Ellul

Background: Quantitative appraisal systems are developed and essential to monitor the services of a hospital pharmacy.

Objective: To develop and evaluate an internal validation tool in order to assess the standards of the setting of a hospital pharmacy.

Design: The tool is a set of standards developed through literature review^(1,2,3). Each standard has an assigned score. Of importance was a similar validation tool developed for community pharmacy⁽¹⁾. The tool involved 30 sections grouped in 8 domains. A Definition booklet was also produced explaining the tool. The maximum score was 350 marks and the minimum validation grade was 150 marks.

Psychometric evaluation was carried out. Applicability and practicality testing was carried out by applying the tool at Zammit Clapp hospital (ZCH) pharmacy by two raters. To assess face and content validity, ten health care professionals at ZCH were asked to review the tool. Inter-rater reliability testing was carried out by applying the tool at the hospital pharmacy by the investigator and another rater. Statistical analysis was performed using Microsoft Excel 2000 and Biomedical Data package (BMDP) software version 7.

Main outcome measures: Applicability and practicality, face and content validity, inter-rater reliability.

Results: Applicability and practicality was good. The average time to apply the tool was 30 minutes. Face and content validity was found to be strong. The correlation coefficient for the overall score was high (0.961).

Conclusions: The validation tool can be used to evaluate practical public and private hospital pharmacy settings.

References:

1. Azzopardi LM. Validation instruments for community pharmacy. USA: Pharmaceutical

Products Press, 2000: 26, 155.

2. Royal Pharmaceutical Society of Great Britain. Medicines, Ethics & Practice - A guide for

pharmacists, 26^thed. Great Britain: The Foundation, 2002.

3. Brown TR. Handbook of Institutional pharmacy Practice, 3^rd ed. USA: American

Society of Hospital Pharmacy, 1992.

Supervisor: Dr. LM. Azzopardi

Signature: __________________

Validation of Equipment in a Hospital Pharmacy Setting

Bertram Debono

Background: Validation tools, which are quantitative measurement systems, are used to monitor the quality of services provided by the pharmacists.¹

Objective: To develop and validate a tool intended to monitor the standards of hospital pharmacy equipment and which measures the quality of services provided by the pharmacist.

Design: Development and psychometric evaluation of a validation tool comprising standards of equipment based on a quantitative measurement system. Evaluation was carried out at Zammit Clapp Hospital where four pharmacists, three nurses, three medical doctors, two consultants and four pharmacy students participated in the study.

Outcome measures: Applicability and practicality of the tool, face and content validity, and inter-rater reliability.

Results: The raters reported that the statements of the tools were properly constructed and could be followed with ease. The average time (20 min) taken to perform the scoring exercise was acceptable. The panel members examined the statements and agreed on most of the statements, however some minor changes were made on the language clarity and the scores pre-assigned to each statement. A major change was made to one of the sections. Correlation between scores resulting from the application of the tool was high indicating consistency of scoring by the different raters. (Kappa value = 0.89)

Conclusions: From the applicability and practicality testing, it was shown that the validation tool could be easily applied in the practical setting. The agreement among the panel members suggests that the tool possesses a high content validity and measures what is supposed to measure. The inter-rater reliability test indicated that the validation tool is reliable. The tool can now be applied to any hospital pharmacy to monitor and maintain the correct standards of equipment. This would mean higher quality services offered by the pharmacists.

References:

1. Azzopardi L.M, Validation Instruments for Community Pharmacy. Binghamton (NY): Pharmaceutical Products Press, 2000; 55-101.

External Validation of Hospital Clinical Pharmacists Intervention

Noemi Galea

Background

Validation is a proactive, inclusive programme, designed to demonstrate that performance is acceptable^[1].

Objective

§ to justify and evaluate the significance of the hospital clinical pharmacist intervention

§ to test and implement validation tools that will measure the impact of such an intervention on patient care and other health care professionals.

Design

Validation instruments developed by Azzopardi^[2]were adapted in order to develop tools for the hospital setting. As a result, two external validation tools were developed: (i) the Health Professionals Tool was distributed among all non-pharmacist health professionals offering their services at Zammit Clapp Hospital (ZCH), and (ii) the Patients Services Tool was used during interviews with patients on discharge.

Main outcome measures

Quantitative measurement of the significance of the clinical pharmacist intervention as perceived by patients and non-pharmacist health professionals; maximum score for each tool was 100.

Results

Sixty patients were interviewed (males=19 (32%), females=41 (68%)). Fifty-one (95%) health professionals returned the completed validation tool. Scores ranged from 44-98 and 74-100 for health professionals and patients respectively. The patients’ average score (94) was equal to that obtained for the community setting^[2]. The average score obtained for the health professionals (88) was much higher than that obtained from the community setting (69)^[2]. Age and professional background implied a higher score for health professionals (p<0.05).

Conclusions

The external validation process provided a quantitative and scientific exercise to highlight the contribution of hospital clinical pharmacists in patient care.

References

[1] Southgate L, Pringle M. Revalidation in the United Kingdom: general principles based on experience in general practice. BMJ 1999; 319: 1180-1183

[2] Azzopardi LM. Validation Instruments for Community Pharmacy Pharmaceutical Care for the Third Millennium. Binghamton: Pharmaceutical Products Press, 2000: 105-107

Signature: _______________________

Medicine Regulations

Abstract Paper

Title: Issues concerning Cosmetic Products

Name of Student: Deborah Caruana

Background: In Malta Cosmetic products are regulated by the European Union regulations¹. Issues which are controversial in the European Countries are also being discussed by the Maltese authorities.

Objective: To study and evaluate various issues which concern cosmetic products, such as the issue of borderline products and the issue of animal testing which right now is undergoing a lot of debates.

Design: An open-ended questionnaire was designed. It was distributed to pharmacies (n=20) and beauticians (n=12) randomly. Another 100 questionnaires were given out to the general public.

Main outcome measures: The perception of cosmetic importance and use in today’s society.

Results: 50% of the pharmacists’, 42% of the beauticians and 28% of the public know what a cosmetic is. The majority of the pharmacists and beauticians agree with the importance of cosmetics. 5% of the public (males) do not. Ninety percent of the pharmacists, 75% of the beauticians and 54% of the public are aware of cosmetic testing² done for safety purposes. With regards to animal testing, 40%pharmacists, 75% beauticians and 56% of the public are against it. The majority of the respondents think that the beautician is the expert on cosmetic products. A woman uses more cosmetics than a man does daily. The use of these products increases with age in women and it decreases in men.

Conclusions: More information on cosmetic products is needed for everyone.

References:

1. European Commission. The rules governing cosmetic products in the European Union. Volume 1 1999: 1 – 66.

2. The Scientific Committee on Cosmetic Products and Non-Food Products intended for consumers. Notes of Guidance for testing of cosmetic ingredients for their safety evaluation. 24^th October 2000: 1 – 84

Supervisor ______________________

The Dissemination of Information in Pharmacovigilance

Renata Cutajar

Background: Regulatory systems dictating the safety of pharmaceutical products are necessary to protect the consumer, however, they will always depend upon the support and co-operation of all health-care professionals, which is achieved by effective communication amongst all involved.

Objectives : To analyse the attitudes and awareness towards Adverse Drug Reaction (ADR) reporting, to determine the most effective means of delivering information and to compare these results, with the situation in other European countries.

Design :

Study 1 & 2 : Two questionnaires were distributed, the first, to 110 pharmacists (14 hospital pharmacists, 92 community pharmacists and 4 medical representatives) the second to 50 doctors in the clinics of eight selected pharmacies. Both questionnaires were made available online.

Study 3 : An e-mail was sent to 20 European medicine control agencies. The e-mail guided them to an online site containing a set of questions regarding the awareness of pharmacovigilance and ADR reporting in their country.

Main outcome measures : Open-ended questionnaire ; interview.

Results : Seventy four (67.3%) pharmacists; 15 (30%) doctors answered the questionnaire. Fourteen (18.9%); 2 (13%) knew the correct definition of an ADR, 29 (39.9%); 6 (40%) are familiar with spontaneous ADR reporting schemes and 23 (31.1%); 5 (33%) know which ADRs should be reported. Fourty seven (63.5%); 11 (73%) would contribute to ADR reporting if the scheme is introduced in Malta, and 66 (89.19%); 8 (53%) would be interested in attending talks related to the subject. The most likely read information is by post 42 (56.76%); 6 (40%), e-mail 3 (4.05%); 4 (27%) and both 28 (37.84%); 5 (33%).

Conclusion : The results provide a preliminary description of the health professionals’ present level of knowledge of ADR reporting, and identify the most effective means of dissemination of information.

Pharmacoeconomics

Title: Keywords in Pharmacoeconomics

Author: Ives Bilocca

Background: To acquire a comprehensive knowledge of keywords in Pharmacoeconomics through research.

Objective: To expand the Glossary of Keywords in Pharmacoeconomics (1), while evaluating pharmacists’ knowledge of such keywords and efficacy of the updated Glossary using a crossword-type questionnaire.

Design: A literature search from books, pharmaceutical journals, articles, the internet to find other keywords used in pharmacoeconomic studies and those not specific, but also used, in the field; these were added to the Glossary.

The criss-cross puzzle questionnaires were distributed to 253 pharmacists; 107 collected. The same questionnaire was re-distributed to 30 of these pharmacists after they read the updated Glossary. The ‘paired t-test’ was used to prove the statistical significance of the results (2).

Main outcome measures: Determination of pharmacists’ knowledge of keywords in Pharmacoeconomics, according to how many, and which, questions they answered correctly and their graduation year. Determination of efficacy of the updated Glossary, according to how many correct questions the pharmacists answered in the re-distributed questionnaire.

Results: Out of 16 questions, most pharmacists (22) answered 4 questions correctly. Recently graduated pharmacists have a better knowledge of the keywords than less recently graduated pharmacists do. On re-distribution of the questionnaire, pharmacists answered more correctly, with a statistical significance of p<0.05.

Conclusions: Pharmacists have a very basic knowledge of keywords in Pharmacoeconomics, knowing only common keywords. Providing information, through the updated Glossary, improved their knowledge since they answered more questions correctly. Past graduate pharmacists have a low knowledge of such keywords and education with information is required for such pharmacists.

References:

1. Zarb Adami M. Keywords in Pharmacoeconomics. 1999: 6-26.

2. Azzopardi L.M. Validation Instruments for Community Pharmacy: Pharmaceutical Care for the Third Millennium. New York: Pharmaceutical Products Press. 2000: 149-244.

The Perception of the Maltese Public Regarding the Government Giving Free Medication.

Author: Buttigieg Christiana.

Project Supervisor: Zarb-Adami Maurice.

Background: The Government supplies free medicines to hospital and institutionalised-inpatients, Schedule-II and Schedule-V patients through the Government National Health Insurance Service ¹.

Objective: To interview a sufficient number of the public to give a statistically useful insight into the public’s perception of this service.

Design: Respondents were randomly chosen around Malta and Gozo. The study was carried out by personally assisting the filling of questionnaires. The designed questionnaire only included closed questions having a determined range of answers on a Likert scale². Required data was easier to extract. Data was analyzed using the SPSS package³.

Main outcome measures: Establishing information regarding the service being used, the pharmacoeconomic aspect, the quality of the medication, satisfaction with the service provided and the relationship with government pharmacists, future recommendations and improvement to the service.

Results: The tool resulted reproducible and consistent. Confirmed by the test-retest method (Kappa values close to 1.00³). Out of those interviewed, 74% used this service regularly, 56% were Yellow Card holders. 69% realized the cost of the medicines collected. Service (52%) and efficiency (54%) were satisfactory. 77% complained of waiting long. 63% felt there was no patient-pharmacist relationship. 76.5%-88.9% strongly agreed that improvement is necessary. Over 90% agreed to collect medicines from community pharmacies.

Conclusion: A high percentage of the Maltese public makes use of this service. An increasing percentage prefers collecting medicines from their pharmacist (decentralization) to receive better service and on a personal level.

References:

1. Debattista A, Editor. Government Pharmaceutical Services in Malta. 2002. Available at:

URL: http://www.health.gov.mt/health_services/gps.htm. Accessed September, 2002.

2. Wimmer RD, Dominick JR. Mass Media Research: An Introduction. 6^th ed. USA: Wadsworth; 1999.