Consensus among healthcare stakeholders on a collaborative medication therapy management model for chronic diseases in Malaysia; A Delphi study

Naeem Mubarak, Ernieda Md Hatah, Mohd Aznan Md Aris, Asrul Akmal Shafie, Che Suraya Zin

Research output: Contribution to journalArticle

Abstract

Background The general problem is lack of inter-professional collaboration and the way private primary care responds to manage chronic diseases in Malaysia. Absence of prescription review, inadequate patient education, the highest percentage of prescribing errors and half of the chronic disease patients are nonadherent. Medicines are the most common and life long used interventions in chronic diseases. Hence, the need to manage medicine in chronic diseases becomes obligatory. As both general practitioner and community pharmacist can dispense medications, this has resulted in a business rivalry. There is a need to build consensus among various healthcare stakeholders for a collaborative medication therapy management model (CMTM) where community pharmacist has an active role in chronic care. Method This study utilized modified e-Delphi method to build consensus. A validated e-Delphi survey was administered to a purposive sample of 29 experts. Consensus was pre-defined to be the point where >85% of the experts fall in either agree or strongly agree category for each statement. The inter-expert agreement was computed in both rounds using Intra-class correlation coefficient and Kendall’s W. Delphi operates in an iterative fashion till there comes stability in responses. At the end of each round, experts were provided aggregate response, their own response and choice to change their response in the light of aggregate response. Results Response rate was 70.73% and 100% in 1 st and 2 nd round, respectively. Consensus was achieved on 119/132 statements which mainly referred to the need, structural and regulatory aspects of CMTM model in Malaysia. However, there were some flashpoints on dispensing separation and means to finance this model. Stability in response of experts was achieved after 2 nd round; hence, no next round was executed. Conclusion Overall, the study findings witnessed the expert panel’s support for the CMTM model. Study helped to sketch CMTM model and facilitated development of some recommendations to the authorities which may help to formulate a policy to bring CPs under a working relationship with GPs. Hence, this study should be taken as a call for redefining of the roles of CPs and GPs in Malaysia.

Original languageEnglish
Article numbere0216563
JournalPLoS ONE
Volume14
Issue number5
DOIs
Publication statusPublished - 1 May 2019

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Medication Therapy Management
Delphi Technique
Malaysia
chronic diseases
stakeholders
health services
drug therapy
Chronic Disease
Delivery of Health Care
therapeutics
Pharmacists
Patient Education
General Practitioners
Medicine
Prescriptions
Primary Health Care
medicine
patient education
general practitioners
finance

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Consensus among healthcare stakeholders on a collaborative medication therapy management model for chronic diseases in Malaysia; A Delphi study. / Mubarak, Naeem; Md Hatah, Ernieda; Md Aris, Mohd Aznan; Shafie, Asrul Akmal; Zin, Che Suraya.

In: PLoS ONE, Vol. 14, No. 5, e0216563, 01.05.2019.

Research output: Contribution to journalArticle

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