Perspectives of community pharmacists on extended pharmacy services and value-added services in Malaysia: a cross-sectional survey.

OBJECTIVE: This study aimed to investigate patterns of extended pharmacy services (EPS) provided by Malaysian community pharmacists and their willingness to provide value-added services (VAS) in addition to EPS. Additionally, this study examined the barriers to the effective implementation of these two services. METHOD: A cross-sectional survey was conducted using a self-administered questionnaire among community pharmacists in Selangor and Kuala Lumpur. Convenience sampling was done, and descriptive statistics and correlation analysis were performed. RESULTS: Two hundred and thirty-six pharmacists participated. The most rendered EPS were nutritional supplements, hypertension management, and diabetic management, while chronic kidney disease management, smoking cessation, and mental health services were the least rendered. Pharmacists were willing to provide medication waste management and vaccination as VAS but were less inclined towards therapeutic drug monitoring and sterile compounding. Barriers included limited access to medical records of patients, lack of designated counselling areas, and concerns about remuneration. High sales pressure and busy workloads were additional barriers to providing VAS. Continuous professional development (CPD) positively influenced pharmacists' engagement in EPS and VAS. CONCLUSIONS: This study highlights service provision trends and areas for improvement. Addressing identified barriers, such as enhancing access to patient records and establishing designated counselling areas, can improve service delivery. Remuneration models and workload management strategies should be considered to alleviate barriers related to sales pressure and time constraints. Promoting CPD opportunities is crucial for enhancing pharmacist engagement and optimizing EPS and VAS.

Empowering Sustainable Growth and Workforce: Unveiling Challenges and Strategies for Retaining Community Pharmacists in Malaysia.

BACKGROUND: Community pharmacists face challenges in job retention due to compensation, work-life balance, and career growth concerns. With pharmacists' evolving roles in healthcare, retaining them becomes crucial for maintaining quality service. Addressing their needs is vital for a skilled healthcare workforce. This study evaluates job retention among community pharmacists, considering various workforce management domains and demographic characteristics. MATERIALS AND METHODS: A cross-sectional study was employed with a self-administered questionnaire among community pharmacists in Kuala Lumpur and Selangor, Malaysia. Spearman's correlations and ordinal logistic regression analysed job retention relationships with workforce domains and predicted the demographic characteristics. RESULTS: A total of 414 participants attempted the survey, of which 311 completed the study. Strong correlations linked job retention with value, trust, and work-life balance. Female pharmacists had higher retention odds, while younger pharmacists had lower retention odds. Pharmacists with over 10 years of experience showed higher retention odds. DISCUSSION: 'Value and trust' and 'work-life balance' were pivotal for the job retention of community pharmacists. Strategies boosting value, trust, and work-life balance was vital. Gender, age, and experience also predicted job retention. CONCLUSIONS: Cultivating trust, valuing contributions, and providing a work-life balance can enhance job retention and commitment.

Social Determinants Predicting the Community Pharmacists' Workforce Preparedness for, and Response to, the Public Health Emergencies.

OBJECTIVES: To identify the predicting factors that contribute to preparedness for public health emergencies among community pharmacists in India. METHODS: Multistage cluster sampling was done. The geographic breakdown was done based on villages and areas and used as clusters. A simple random method was done in the first stage to select the villages as clusters. From each selected village, a simple random method was done in the second stage to select the areas. From each selected area, all the community pharmacies were selected. The survey questionnaire had 3 sections with 43 items: (A) demographic information, (B) preparedness, (C) response toward infectious diseases. The participants chose "Yes/No", in sections B and C. A score of 1 was given for "Yes", and a score of zero was given for "No". RESULTS: Multiple correlation analyses were conducted between participants' preparedness and response (PR) scores and independent variables. The independent variables such as "More than one Pharmacist working in a pharmacy", "Pharmacists who are trained more than once on disaster management", and encountered more than 1 patient with the infectious disease were positively and significantly correlated with the dependent variable (PR scores). CONCLUSIONS: Community pharmacists were aware of the issues they may face in their community concerning public health emergencies. They believed that the medications available in their pharmacy are sufficient to face any emergency. They could identify the clinical manifestations of public health emergency conditions and provide counselling to the customers toward them. Community pharmacists who were trained more than once in disaster management were the strongest predicting factor.

Emergency Preparedness for the COVID-19 Pandemic: Social Determinants Predicting the Community Pharmacists' Preparedness and Perceived Response in Malaysia.

BACKGROUND: Pandemic preparedness of healthcare providers helps to mitigate future threats such as spread and fatality rates, as well as the management of the disease. Pharmacists are key partners with public health agencies, and the role of community pharmacists is becoming increasingly recognised in this COVID-19 pandemic. The study aimed to explore the emergency preparedness of community pharmacists (CPs) for COVID-19. METHODS: A cross-sectional study was performed among community pharmacists using cluster sampling followed by convenient sampling. A self-administered questionnaire was formulated using references from the previous literature and the WHO preparedness checklist. Descriptive analysis was undertaken for the participants' socio-demographic characteristics. All the data collected were entered into the Statistical Package for Social Sciences version 24 (SPSS V.24), (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.) for analysis. RESULTS: Most of the CPs had five or fewer years of practice experience, and they had all the mandatory information relating to the needs of their communities regarding the disease. The participants knew where to acquire these resources whenever needed. They were able to recognise the signs and symptoms of the disease. Most participants felt that they were confident to provide patient education and carry out their duties during these challenging times. There was a strong position correlation between preparedness and the perceived response of the participants. CONCLUSION: The community pharmacists in Malaysia are prepared enough for COVID-19 pandemic management and perceive that they can respond during any unprecedented situations, such as COVID-19. Community pharmacists were aware of the challenges that they need to face in their community regarding COVID-19.

Management of Medicines Wastage, Returned Medicines and Safe Disposal in Malaysian Community Pharmacies: A Qualitative Study.

Introduction: In supplying medicines to patients and consumers waste can occur in prescribing, dispensing, and leftover stages. Pharmacists in community pharmacies play a crucial role in dispensing and should share information on appropriate medicines disposal with consumers. This qualitative study explored how Malaysian community pharmacists manage medication wastage, returned medicines, and medicines disposal by eliciting their opinions on medicines wastage, the challenges faced, and feasibility of medicine return and safe medicine disposal in the setting of Malaysian community pharmacy. Methods: Telephonic interviews were conducted using a pre-validated interview guide among community pharmacists. Purposive sampling was used to ensure heterogeneity of participants in terms of gender, age, and position in the pharmacy. The interview was conducted until a point where no new information was obtained. Interview data were thematically analyzed. Results: The analysis identified nine themes organized into four domains. The results revealed that pharmacists have positive perceptions of the safe disposal of medicines. Pharmacists mentioned that medicine returns to service in community pharmacies are not common due to a lack of facilities in the management of unwanted, expired, and returned medicines. As such pharmacists have suggested a few ways to minimize medicinal wastage. Conclusions: Respondents aimed to minimize medicines wastage (unused medicines) in order to minimize loss of revenue. Respondents did not usually accept returned medicines due to the operational costs of safe disposal. Disposal of unused medicines was undertaken by centralizing the stocks at an organization facility before being disposed of by outsourced waste management companies.

Determination of pharmacy students' patient safety approach using the theory of planned behaviour: a mixed-method study.

OBJECTIVES: To investigate pharmacy students' attitudes, subjective norms, perceived behavioural control, intentions and their behaviour towards patient safety using a theory of planned behaviour framework. DESIGN: Mixed-methods research. SETTING: Private university in Malaysia. PARTICIPANTS: Pharmacy undergraduate students participated in the study. There were 18 students participated in the qualitative study and 272 students responded to the survey questionnaire. METHODS: A convergent parallel-mixed method design, involving a quantitative survey and qualitative focus group discussions was used among pharmacy students in a private university in Malaysia. Qualitative data of transcribed verbatim texts were then subjected to a thematic content analysis framework. Multiple correlations were undertaken using the quantitative data to examine how the dependent variable (self-reported knowledge) related to the independent variables (attitudes, behavioural intentions, subjective norms, perceived behavioural control. PRIMARY OUTCOME: Pharmacy students' attitudes, subjective norms, perceived behavioural control, behavioural intentions constructs led to their behaviour towards patient safety. SECONDARY OUTCOME: The quantitative study revealed that there was a moderate positive correlation between students' self-reported knowledge and attitudes (r=0.48, p=0.03). RESULTS: Pharmacy students' attitudes and perceived behavioural control constructs had positive correlations with pharmacy students' self-reported knowledge on patient safety. There was no correlation between students' self-reported knowledge and subjective norms (r=0.27, p=0.23). There was a weak positive correlation between students' self-reported knowledge and perceived behavioural control (r=0.39, p=0.04). There was no correlation between students' self-reported knowledge and behavioural intention (r=0.20, p=0.56). CONCLUSIONS: Theory of planned behaviour constructs such as attitudes, subjective norms, perceived behavioural control and behavioural intentions of pharmacy students, defined their behaviour towards patient safety. Pharmacy students' attitudes and perceived behavioural control constructs were correlated with their self-reported knowledge on patient safety.

Use of Psychotropic "Pro Re Nata" Medications by Patients Attending the Outpatient Clinic in a Hospital: A Qualitative Exploration.

Introduction: Administration of psychotropic pro re nata (PRN) medications is influenced by diverse factors such as legal use of PRN medications, the attitude of patients, personal bias, and stigma toward such medication use. While PRN prescriptions increase the efficiency of care and encourage patients to participate in self-care, the use of psychotropic PRN medications by outpatients has raised concerns about its risks of harm, especially for the outpatients. This study explored the use of psychotropic PRN medications by patients attending the outpatient clinic in a hospital. Methods: Qualitative in-depth interviews were conducted. Purposeful sampling was done to achieve cases with enriched information. Participants were chosen regardless of their ethnicity and were selected using the database and patient records in the clinic. Patients 18 years of age prescribed PRN psychotropic medications attending outpatient clinics in a hospital were included. Vulnerable patients (e.g., pregnant ladies, prisoners, cognitively impaired individual, AIDS/HIV subjects, and terminally ill subjects) were excluded. Results: This study revealed the patients' perspectives and experiences on self-management of psychotropic PRN medications. The themes that emerged were clustered as education and background, knowledge on psychotropic medications, frequency of medication intake, underuse of medication, the overdose of medication, side effects concern, source of information, and personal experience. Conclusions: Patients' understanding of medication, inappropriate medication use, cues to action, and use of alternatives are the factors that affected the self-management of psychotropic PRN medications by the patients.

Impact of Pharmacists' Interventions and Patients' Decision on Health Outcomes in Terms of Medication Adherence and Quality Use of Medicines among Patients Attending Community Pharmacies: A Systematic Review.

Community pharmacists are responsible for providing the appropriate information on the use of medications to patients, which may enhance their medication adherence. The extent of control that patients have on their health care preferences creates many challenges for community pharmacists. This study aimed to determine the impact of pharmacist interventions and patient decisions on health outcomes concerning medication adherence and the quality use of medicines among patients attending community pharmacies. Appropriate studies were identified in a systematic search using the databases of Medline, Scopus, Google Scholar, and PubMed. The search included literature published between 2004 and 2019. The database searches yielded 683 titles, of which 19 studies were included after the full-text analysis with a total of 9313 participants. Metaprop command in Stata software version 14 was used for the analysis. This study was undertaken based on the general principles of the Cochrane Handbook for Systematic Reviews of Interventions and subsequently reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA) extension. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was directly used to rate the quality of evidence (high, moderate, low, or very low). The results revealed the effective interaction between patients and community pharmacists, the importance of pharmacist intervention on medication adherence and quality use of medicine, and the role of community pharmacists in counselling patients. Decision/choice of patients in self-care and self-medication is a factor contributing to health outcomes. Effective interaction of community pharmacists with patients in terms of medication adherence and quality use of medicines provided a better health outcome among patients. The community pharmacists influenced the decision/choice of patients in self-care and self-medications.

Community pharmacists' knowledge, attitudes and practices towards oral healthcare and its management: A systematic review.

BACKGROUND: Community pharmacists play a significant part in providing oral healthcare advice as there are significant connections between oral healthcare and body system healthcare. OBJECTIVE: To systematically review the literature regarding the knowledge, attitudes and practice of community pharmacists in managing oral healthcare problems. METHODS: A systematic review was conducted through Scopus, PubMed and Google Scholar databases. Studies regarding knowledge, attitudes and practice of management of dental care by community pharmacists between 1990 and 2019 were included. RESULTS: Forest plot was performed to access knowledge, attitudes and practice of community pharmacist on oral healthcare. The results showed there were 44% of community pharmacists have a lack of knowledge on oral healthcare to provide an appropriate recommendation to patients with dental problems. Eighty-eight per cent of community pharmacists were willing to improve their knowledge of oral healthcare. There were 86% of them recognised that their role was significant in oral health. However, there were 59% of community pharmacists who had poor attitude in providing oral health information. CONCLUSIONS: Community pharmacists were lacking knowledge on oral health mainly because of paucity in providing appropriate training courses. This has led to poor practices towards oral healthcare as they were unable to provide suitable products recommendations to the patients. This has led the community pharmacists into lack of attitudes in providing oral health information. However, most of the community pharmacists were conscious of their role in the oral healthcare system and were willing to improve their knowledge of oral healthcare.

Social Determinants Predicting the Knowledge, Attitudes, and Practices of Women Toward Zika Virus Infection.

Objective: To investigate the factors predicting knowledge, attitude, and practices (KAP) toward Zika virus infection among women population in Cebu City, Philippines. Study Design: A cross-sectional survey was conducted from March 2018 to May 2018. Ethical practices were followed. A total of 702 women was approached and finally 516 completed the survey. Methods: Descriptive analysis was undertaken for the participants' characteristics. Kolmogorov-Smirnov test was applied to declare the nature of data distribution. To determine the role of socio-demographic characteristics on KAP, differences in socio-demographic status were compared with the KAP scores using the one-way analysis of variance or Kruskal-Wallis test with p < 0.05 as significant. Logistic regression analysis was used to determine the predictors of each KAP domain (good and poor). Results: There was a significant positive correlation between level of education and KAP scores. Also, there was a significant positive correlation between employment and KAP scores. Knowledge score was a significant predictor of practice score (b = 1.261, p = 0.024), and attitude score was also a significant predictor of practice score (b = 0.183, p = 0.039). However, knowledge score was not a significant predictor of attitude score (b = 0.316, p = 0.247). Conclusions: The present findings provided an overall view of KAP on Zika virus infection among females in Philippines and the socio-demographic factors that affected their KAP. Women with postgraduate education and being in higher profession were the predictors influencing the KAP scores of this female population. Women with postgraduate education was the strongest predictor.

The Effect of Demographic and Social Factors on the Decision-Making of Community Pharmacists in Ethical Dilemmas.

OBJECTIVE: The objective of the study is to investigate the effect of demographic and social factors on the decision-making of community pharmacists when confronted with ethical dilemmas during their professional practice. METHODS: This was a questionnaire-based, cross-sectional study. A total of 1057 community pharmacists were approached. The final participants were 742. Independent-sample t-test and one-way analysis of variance were used to analyze the factors (age, gender, work experience, education qualification, number of pharmacists per pharmacy, and pharmacy location). FINDINGS: Older pharmacists, experienced pharmacists, and urban pharmacists have less ethical dilemma compared to the younger pharmacists, less work experience pharmacists, and rural pharmacists, respectively. CONCLUSION: Individual factors such as age, gender, work experience, and educational level and organizational factors such as the number of pharmacists in a pharmacy and location of pharmacy may influence the ethical dilemma of community pharmacists.

Zika Outbreak Emergency Preparedness and Response of Malaysian Private Healthcare Professionals: Are They Ready?

Zika virus has been declared as a public health emergency of international concern. The Center for Disease Control and Prevention has issued guidelines reminding healthcare workers about the importance of taking steps to prevent the spread of Zika virus, how to test and isolate patients suspected of carrying the Zika virus, and how to protect themselves from infection. Therefore, it is of utmost importance for healthcare professionals to be fully aware of Zika virus preparedness, and response measures should an outbreak occur in Malaysia in order to quickly and efficiently contain the outbreak, ensure the safety of individual or healthcare personnel safety, as well as to prevent further spreading of the disease. This research aims to show how prepared Malaysian healthcare professionals are against Zika virus and how well can they respond during an outbreak. In total, 504 healthcare professionals (128 general practitioners, 215 community pharmacists, 161 nurses) from private health clinics were the target population of the four states of Malaysia where Zika cases suspected. The sample size of each category was calculated by using a formula for estimating the population proportion. An additional 10% of the calculated sample size was added to compensate the non-response rate. The Center For Disease Control and Prevention and World Health Organisation provided a checklist to assess how prepared healthcare professionals are for an Zika outbreak. This checklist was modified to a questionnaire in order to assess health care professionals' preparedness and response to the Zika outbreak. Community pharmacists are still lacking in their preparedness and perceived response to the Zika outbreak compared to the general practitioners in the private sector. Hence community pharmacists should attend training given by the Ministry of Health Malaysia as a continuing education, which may help them to respond during a Zika outbreak.

Quality of Life and Caregivers' Burden of Parkinson's Disease.

AIM: This study focused on the impact of the clinical features on the quality of life (QoL) of Parkinson's disease (PD) patients and of their caregivers. METHODS: This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale; the Hoehn and Yahr stage and the Schwab and England Activities of Daily Living Scale were used to assess the severity and the ability of PD patients respectively. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. RESULTS: At least one of the clinical features affected PD patients' QoL, and at least one of the QoL domains affected the caregivers' burden. Clinical features "saliva and drooling" and "dyskinesia" explained 29% of variance in QoL of PD patients. The QoL domains "stigma," along with "emotional well-being" explained 48.6% of variance in caregivers' burden. CONCLUSIONS: The clinical features "saliva and drooling" and "dyskinesia" impacted the QoL of PD patients, and the QoL domains "stigma" and "emotional well-being" of PD patients impacted their caregivers' burden.

Knowledge about Human Papillomavirus and Cervical Cancer: Predictors of HPV Vaccination among Dental Students

Background: The objective of this study is to determine the influence of dental students' knowledge and attitude regarding human papillomavirus infection of cervical cancer on willingness to pay for vaccination. Basic research design: A convenience sampling method was used. The minimal sample size of 136 was calculated using the Raosoft calculator with a 5 % margin of error and 95% confidence level. Participants: The study population were all final year dental students from the School of Dentistry. Methods: A self-administered questionnaire was used to measure knowledge levels and attitudes regarding human papillomavirus vaccination. Contingent valuation was conducted for willingness to pay for vaccination. Main outcome measures: The Center for Disease Control and Prevention has stated that human papillomavirus are associated with oropharynx cancer and the American Dental Association insist on expanding public awareness of the oncogenic potential of some HPV infections. Thus, as future dental practitioners, dental students should be aware of human papillomavirus and their links with cancer and the benefits of vaccination. Results: Knowledge on HPV and cervical cancer did not impact on attitudes towards vaccines. However, significant correlation existed between knowledge and willingness to pay for vaccination. Conclusions: Dental students' knowledge on HPV and cervical cancer has no influence on their attitude towards HPV vaccines. However, their willingness to pay for HPV vaccination is influenced by their knowledge of cervical cancer and HPV vaccination.

Pharmacy students' anxiety towards research during their undergraduate degree; How to reduce it?

OBJECTIVE: To measure pharmacy students' anxiety towards research and how academic support, academic effort, attitude and self-efficacy influence their research anxiety. METHODS: A cross-sectional study was conducted with undergraduate final year students of pharmacy using a convenient sampling method. A validated self-administered questionnaire was used. RESULTS: Response rate for this study was 85.9% (128 students from a population of 149). The participants agreed that they read literature to understand research, but did not attend research-related coursework. Most participants (91.4%) felt that they were under stress while doing research. Almost all participants (97.6%) felt that they were doing very badly during their data analysis or they may fail their research projects. The majority of participants agreed that help from the lecturers' and friends in research give emotional support for their research activities. CONCLUSION: Academic support for pharmacy students, along with their additional academic effort will improve the students' self-efficacy and reduce research anxiety.

Attitudes and Readiness of Students of Healthcare Professions towards Interprofessional Learning.

OBJECTIVES: To evaluate the attitudes and readiness of students of healthcare professions towards interprofessional learning. METHODOLOGY: A cross-sectional study design was used. Two different scales were used to measure the readiness for and perception of interprofessional learning; these were the 'Readiness for Interprofessional Learning Scale' and the 'Interdisciplinary Education Perception Scale'. A convenience sampling method was employed. The sample was drawn from undergraduate students enrolled in years 1 to 5 of medical, dental, pharmacy and health sciences programme. Descriptive and inferential statistics were used to analyse the data. RESULTS: The overall response rate was 83%. The students mentioned that shared learning with other healthcare professional students will increase their ability to understand clinical problems. The students also mentioned that such shared learning will help them to communicate better with patients and other professionals. The students preferred to work with individuals from their own profession. Participants from medical, dental, pharmacy, and health sciences had a difference in opinion about 'negative professional identity', a domain of the Readiness for Interprofessional Learning Scale. Based on the different year of study of the students, 'team work and collaboration', 'negative professional identity' and 'roles and responsibility' were the Interdisciplinary Education Perception Scale domains where students had a difference in opinion. CONCLUSIONS: Attitudes and readiness towards interprofessional learning showed significant differences among students of various healthcare professions; these differences also depended on the students' year of study. Interprofessional learning should be incorporated in the curriculum of all healthcare professional programs, which may foster students to become competent healthcare providers and understand each profession's role.

Cervical Cancer Prevention in Malaysia: Knowledge and Attitude of Undergraduate Pharmacy Students Towards Human Papillomavirus Infection, Screening and Vaccination in Malaysia.

This study was conducted to evaluate knowledge of undergraduate pharmacy students about human papillomavirus infection and their attitude towards its prevention. A cross-sectional survey was conducted in 270 undergraduate pharmacy students using a validated questionnaire to assess knowledge about human papillomavirus infection and cervical cancer and their attitudes towards human papillomavirus vaccines. Eighty-one percent of the respondents knew that human papillomavirus is a cause of cervical cancer, and 87.8 % knew that this infection is preventable. The gender of the respondents showed the strongest correlations with human papillomavirus knowledge. There were no significant correlations between the ethnic group of the respondents and their human papillomavirus-related knowledge. Higher perceptions of risk were associated with relationship status, and respondents who were in a relationship showed greater interest in vaccinating themselves; relationship status emerged as a unique predictor. The results indicated a moderately high level of knowledge and positive attitude towards human papillomavirus vaccination with few disagreements. The results of this study will help to develop and plan appropriate education campaigns for pharmacy students that aim to reduce human papillomavirus infection and, consequently, the incidence of and mortality caused by cervical cancer in Malaysia.

Pharmacy students' knowledge and perceptions about adverse drug reactions reporting and pharmacovigilance.

Pharmacy students' knowledge about adverse drug reaction reporting can impact their attitude towards patient care and issues on patient safety. The aim of this study was to investigate the knowledge and perception of pharmacy students about adverse drug reaction reporting and pharmacovigilance and to study their willingness to report. A cross-sectional study using a validated questionnaire was conducted among the university students. The demographic details of the respondents were studied. The number of female respondents was comparatively higher than the male respondents. There were no significant differences by gender regarding the knowledge on adverse drug reaction reporting and pharmacovigilance except with the knowledge of post-marketing surveillance for which male students appeared to be more knowledgeable than female students. The results showed that the pharmacy students had sufficient knowledge and there are significant differences in perception among the students on adverse drug reaction reporting.

Evaluation of patient safety culture among Malaysian retail pharmacists: results of a self-reported survey.

BACKGROUND: Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use. OBJECTIVE: To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia. METHODS: A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted. RESULTS: The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of "staff training and skills" were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup. CONCLUSION: The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety.