ACTIVITY 4B

GROUP 3

Name Contribution

4.3B evaluation of biomedical literature: II

Macaranas, Aldrien Daryll M.
Hypothesis, objectives and outcome
4.3B evaluation of biomedical literature: I general
Mandia, Mickaellah
information
4.3A evaluation of medical literature: #1
Mangaliag, Lyra Gwyneth

4.3B evaluation of biomedical literature: IV

Mejia, Angeline Karylle C.
methods and discussion, VI conclusions and
significance
4.3A evaluation of medical literature: #3
Millon, May France

Montaniel, Paula May G. 4.3A evaluation of medical literature: #4

Palaganas, Giselle Abigail 4.3B evaluation of biomedical literature: III study

group, IV methods
Pata, John Kyle 4.3A evaluation of medical literature: #2
Name: MEJIA, ANGELINE KARYLLE C. Date: August 11, 2021

Group: 3 Score:

*Answers in bullet style

I. General Information
1. Title of article
Survey of Medication Knowledge and Behaviors Among College Students in Taiwan

2. All authors listed

 Fei-Yuan Hsiao, MS
 Jen-Ai Lee, PhD
 Weng-Foung Huang, PhD
 Shih-Ming Chen, PhD
 Hsiang-Yin Chen, PharmD, MS
3. Institute/s from which article was completed
 School of Pharmacy, Taipei Medical University
 Department of Health and Welfare Policy Management, Institute of Public Health,
 National Yang-Ming University, Taipei, Taiwan
 Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
 Department of Pharmacy, Taipei Medical University Affiliated Wan-Fang Hospital
II. Hypothesis, Objectives, and Outcomes

1. Background data on which authors based their hypothesis and substantiate the need for study
The global rise in prescription drug use further shows the need to research awareness and behavior of
the students. Insufficient awareness of drug use can lead directly to overuse or patient non-
compliance with a medication prescription, leading to serious outcomes. For instance, early self-
discontinuation of antibiotics, a common behavior in Taiwan, often results in microbial resistance
and/or failure in treatment. Misuse of non-prescription medications or herbal products has also been
a major issue for the young population. Inaccurate self-diagnosis, inappropriate medication use, and
not following the indications are some that need to be addressed of. To prevent unhealthy practices
and assess medication knowledge, both medical and non-medical use of prescription drugs by college
students should be evaluated.

2. Hypothesis and/or objectives of the study.

The objectives of this study are:

(1) to measure college students’ knowledge of drug safety;
(2) to evaluate students’ attitudes toward medication consultation;
(3) to assess self-care behaviors with regard to nonprescription medicines, medication consultation
with pharmacists, and appropriate use of medicines among college students in Taiwan.

3. Comment on the objectives

The objectives of this study defined the focus, identified variables to be measured, and it also
established the limits of the study. It was presented briefly and concisely.

4. Primary outcomes to be measured

The primary outcomes to be measured in this study are knowledge on drug safety, attitudes toward
medication consultation, practices towards safe medication use of first-year college students in Taiwan.

5. Independent variable/s
The independent variables in this study are:
 Age
 Gender
 Major of the students
 Type of medication they take
 Dose of medication

III. Study groups/s

1. Subject characteristics/demographics
Of the participants, 3625 (57.8%) were female and 2645 (42.2%) were male. The number of
participants majoring in health science, including medicine, pharmacy, nursing, and other
professionals, was 845 (13.2%), and the number in non-health science majors was 5425 (86.8 %).
There were 1124 (17.9%) participants with family members currently enrolled as medical students,
and 1065 (17%) with family members currently practicing as health care professionals.

2. Any exclusion or inclusion criteria specified

Yes, there is an inclusion criteria specified for the study group. The inclusion criteria in the research
study is the knowledge and behavior of the college students in Taiwan. Also, the demographic or the
subject characteristics is included in the inclusion criteria.

3. Recruitment methods/sampling design

The study participants were sampled by stratified randomization to represent the population of 1489
departments in 139 universities in Taiwan. The sampling ratio was 10% by department. Each
department was categorized for stratification depending on the classification in Taiwan’s education
system. The Departments were stratified into 3 categories according to disciplines. The first category
included departments of literature, business, and law (872 departments); the second category
included departments of science and engineering (383 departments); and the third category included
health science-related departments (234 departments). Ten percent of the departments in each
category were therefore randomized and sampled. After requesting permission from the sampled
departments, the final sample included 83, 39, and 25 departments for category 1, 2, and 3,
respectively, which accounts for 6917 students in 147 departments from 27 universities.

4. Was there any potential for selection bias?

Yes, Because the method they used is stratified randomization. And the aim of the study is to survey
the knowledge, attitudes, and practices towards safe medication use of first-year college students in
Taiwan.

IV. Methods

1. Summarize the study methods in your own words.

In this study, one hundred and forty-seven departments were sampled by stratified randomization in
27 universities. Three sections of the questionnaire were developed, including 10 true/false questions
to measure knowledge.4 questions for attitude in a 5-point scale, and 10 questions for practice in a 5-
point scale. These questions were viewed by thirty college students from diverse majors regarding the
content of items, format, and wording to ensure the readability of the instrument for the first-year
college students.

2. Method/s used to measure dependent variables

In this study they used knowledge, attitude, and practices scores were analyzed by parametric
statistics with a normal distribution for the datasets.

3. Is there a strategy of comparisons in the study’s purpose?

Yes, there is a strategy of comparison.

4. Did the researchers control how patients are allocated to the comparison groups?
Yes, researchers did a great job to their patients.

5. Identify the study design. Is the design appropriate in the attainment of the study objectives?
In this study, they used cross-sectional study and is appropriate since the study take place at a single
point in time. It does not involve manipulating variables and allows researchers to look at numerous
characteristics at once specifically in age, income, gender, and etc. It can, as well they provide
information about what is happening in a current population.

6. Statistical tests/procedures applied in the analysis

The results were done parametric statistics with a normal distribution for the datasets. Procedures
applied were stratified randomization during the choosing of students/ participants.

V. Results and Discussions

1. What types of data (i.e. nominal, ordinal, interval, or ratio) were presented?
Ordinal data

2. Are the statistical tests conducted appropriately for the type of data presented? support your
answer.
 T test is not appropriate, ANOVA can be appropriate if it is Kruskal-Wallis H test and also chi
square is appropriate to be used for the type of data presented.
 T-tests are not appropriate to use with ordinal data because ordinal data has no central
tendency, it also has no normal distribution. The values of ordinal data are evenly distributed,
not grouped around a mid-point.
 The Kruskal-Wallis H test (sometimes also called the "one-way ANOVA on ranks") is a rank-
based nonparametric test that can be used to determine if there are statistically significant
differences between two or more groups of an independent variable on a continuous or
ordinal dependent variable.
 Chi square test can only be used for categorical data. It is used to determine whether there is
a statistically significant difference between the expected frequencies and the observed
frequencies in one or more categories of a contingency table.
3. Were descriptive and inferential statistical analysis conducted? Were these appropriate for the
data?
Descriptive statistics used to calculate ordinal data are: Simple counts (e.g. number of men and
women in a sample), Percentages (e.g. percentage of men and women in a sample, % saying "good" or
"bad") and Proportions (e.g. proportion of men and women in a sample). Therefore, appropriate to be
used. The inferential statistics is appropriate because it allows one to make predictions from that
data.

4. What do the major results mean?

 The mean score on the knowledge portion of the questionnaire was 6.6- 6 2.3. this means that
the knowledge on medication from both non-health science major and health science major
are less satisfactory even though the health science major had a better score.
 The students attitudes toward (12.6+/-6 2.2) and trusted (3.6+/- 6 1.0) pharmacists’
Consultation was positive. This means that the students from both groups believe that the
pharmacist are the best profession to handle medication consultation.
 The students total score on drug safety practice was 34.06(4.09) out of 50. This means that
the level of knowledge on drug safety practice is low and that pharmacist need to improve on
their method or way of providing drug Information and also the need for medication
 education.
5. Interpret the result: “Further analysis of the health-science related groups was performed to
identify the level of trust felt toward the profession of pharmacy. A significant difference
p<0.001 was identified between scores of medical (3.5 ± 1.0), Pharmacy (4.0 ± 1.0), and nursing
students (3.7 ± 1.0)”

This means that the score from medical group in the level of trust they have towards the profession of
pharmacy is less than one in a thousand chance of being wrong. the same goes for Pharmacy group
and nurse group and also there is a difference in the level of trust toward the Pharmacy profession
from the medical and nursing group compared to the pharmacy group.

6. What were the sources of biases identified in the study? Where there other biases?
Confirmation bias, recall bias, observation bias, acquiescence bias. There were no other bias.

VI. Conclusion and Significance

1. Summarize the authors’ conclusion using your own words.

The study showed that college students in Taiwan have positive attitudes toward the necessity of
medication consultation, but lack appropriate knowledge, attitudes, and practices related to the safe
use of medications. Further study is expected to address the practices and improve the medication
knowledge on the individuals of Taiwan.

2. Based on the findings of the study, do you agree with the conclusion? Support your answer.
We agree with the conclusions that interventions to improve drug knowledge and safe medication
practices should be made immediately by pharmacist to improve the safety of medication use in
Taiwan. Because as stated in the survey results, inspite the positive attitudes toward consulting with
pharmacists, the participants actually proceeded with their incorrect medication practices.

3. Do these conclusions seem valid to you? Support your answers. If not, how would your
conclusions from this differ from those of the authors?
The conclusion seemed valid because it was concluded based on the data gathered by the
researchers.

4. Strengths of the study.

A structured, self-administered questionnaire was designed by a group of faculty members and
graduate students in the School of Pharmacy, Taipei Medical University. A separate panel including
faculty members from the pharmacy school and experts in pharmacoeconomics or statistics evaluated
the content for validity. In addition, 30 pharmacists examined the survey instrument for face validity.
Thirty college students from diverse majors were invited to review the content of items, format, and
wording to ensure the readability of the instrument for the first-year college students. The test-and-
retest reliability was also determined using a Spearman correlation coefficient of 0.719.

5. Limitations of the study.

The sample selected for this study was categorized for stratification depending on the classification in
Taiwan’s education system. The majority of the participants were non-health science majors. The
details of each item in the True or False questions were based on findings from a pilot research
survey, which indicated lack of appropriate information about the said medications in Taiwan. The
data indicating inappropriate drug use practices further strengthens the need for medication
education. Future study is needed to correct the behaviors and improve the medication knowledge of
the people of Taiwan.