Effectiveness of educational intervention on the knowledge, attitudes, and perceptions of community pharmacists regarding colorectal cancer screening in Klang Valley, Malaysia
Main Article Content
Keywords
Colorectal neoplasm, Community pharmacist, health knowledge, educational intervention
Abstract
Background: In Malaysia, a lack of awareness and negative perceptions of cancer screening have contributed to a delay in detecting colorectal cancer. Community pharmacists may play important roles in promoting colorectal cancer screening among the public. Previous research has shown that community pharmacists’ participation in cancer screening is hindered by inadequate knowledge, highlighting the need for educational interventions. Objectives: This study aimed to assess the knowledge, attitudes, and perceptions (KAP) of community pharmacists regarding colorectal cancer screening. Additionally, it sought to evaluate the impact of an online educational intervention designed to improve their KAP. Methods: Fully registered community pharmacists working within the Klang Valley were recruited using convenience and snowball sampling methods. A 3-day online educational intervention was conducted in small intervention groups using a social media application. Post-intervention KAP levels were compared to baseline. Results: The study recruited 303 respondents. The baseline assessment revealed a “satisfactory” level of knowledge (medianpre=72.22%), “good” attitudes (medianpre=80.00%), and “satisfactory” perceptions (medianpre=60.00%). Following the intervention, all three variables showed statistically significant improvements to “good” knowledge (94.44%), “good” attitudes (80.00%), and “good” perceptions (80.00%). Male pharmacists were associated with a higher level of perception towards colorectal cancer screening. Conclusion: The online educational intervention significantly improved community pharmacists’ KAP on colorectal cancer screening. The findings from this study underscore the potential of social media applications as a medium for educating community pharmacists to enhance their practice.
References
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43. Kazi E, Sareshwala S, Ansari Z, Sahota D, Katyal T, Tseng W, Ivey SL. Promoting colorectal cancer screening in South Asian Muslims living in the USA. J Cancer Educ. 2021;36(4):865-873. doi:10.1007/s13187-020-01715-3.
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2. Non-Communicable Disease Section, Ministry of Health Malaysia. National Strategic Plan for Cancer Control Programme 2021–2025. Putrajaya, Malaysia; 2021. Available from: https://www.moh.gov.my
3. Kuipers EJ, Rösch T, Bretthauer M. Colorectal cancer screening—optimizing current strategies and new directions. Nat Rev Clin Oncol. 2013;10(3):130-142. doi:10.1038/nrclinonc.2013.12.
4. Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993;329(27):1977-1981. doi:10.1056/NEJM199312303292701.
5. Jones S, Chen WD, Parmigiani G, Diehl F, Beerenwinkel N, Antal T, et al. Comparative lesion sequencing provides insights into tumor evolution. Proc Natl Acad Sci U S A. 2008;105(11):4283-4288. doi:10.1073/pnas.0712345105.
6. Vicentini M, Zorzi M, Bovo E, Mancuso P, Zappa M, Manneschi G, Mangone L, Giorgi Rossi P. Impact of screening programme using the faecal immunochemical test on stage of colorectal cancer: results from the IMPATTO study. Int J Cancer. 2019;145(1):110-121. doi:10.1002/ijc.32089.
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8. Tamin NSI, Razalli KA, Sallahuddin SN, Chan HK, Hassan MRA. A 5-year evaluation of using stool-based test for opportunistic colorectal cancer screening in primary health institutions across Malaysia. Cancer Epidemiol. 2020;69:101829. doi:10.1016/j.canep.2020.101829.
9. Bujang NN, Lee YJ, Mohd-Zain SA, Aris JH, Md-Yusoff FA, Suli Z, et al. Factors associated with colorectal cancer screening via immunochemical fecal occult blood test in an average-risk population from a multiethnic, middle-income setting. JCO Glob Oncol. 2021;7:333-341. doi:10.1200/GO.20.00460.
10. Sindhu CK, Nijar AK, Leong PY, Li ZQ, Hong CY, Malar L, Lee PY, Kwa SK. Awareness of colorectal cancer among the urban population in the Klang Valley. Malays Fam Physician. 2019;14(3):18-27.
11. Ramanathan K, Schliemann D, Ibrahim Tamin NS, Mohan D, Donnelly M, Su TT. Facilitators and barriers to colorectal cancer screening using the immunochemical faecal occult blood test among an average-risk population in semi-rural Malaysia: a qualitative study. PLoS One. 2022;17(12):e0279489. doi:10.1371/journal.pone.0279489.
12. Vives N, Milà N, Binefa G, Travier N, Farre A, Vidal C, et al. Role of community pharmacies in a population-based colorectal cancer screening program. Prev Med. 2021;145:106420. doi:10.1016/j.ypmed.2021.106420.
13. McGuire TR, Leypoldt M, Narducci WA, Ward K. Accessing rural populations: role of the community pharmacist in a breast and cervical cancer screening programme. J Eval Clin Pract. 2007;13(1):146-149. doi:10.1111/j.1365-2753.2007.00677.x.
14. Bowel Cancer UK. Bowel cancer facts: About bowel cancer. 2023. Available from: https://www.bowelcanceruk.org.uk/about-bowel-cancer/bowel-cancer/
15. Bowel Cancer Australia. BowelScreen Australia. 2023. Available from: https://www.bowelcanceraustralia.org/bowelscreen
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17. Program Perkhidmatan Farmasi, Ministry of Health Malaysia. Farmasi komuniti di Malaysia: Tableau public. 2020. Available from: https://public.tableau.com
18. Tsuyuki RT, Beahm NP, Okada H, Al Hamarneh YN. Pharmacists as accessible primary health care providers: review of the evidence. Can Pharm J. 2018;151(1):4-5. doi:10.1177/1715163517745517.
19. Raosoft Inc. Sample Size Calculator. 2004. Available from: http://www.raosoft.com/samplesize.html
20. Ministry of Health Malaysia. Clinical Practice Guidelines: Management of Colorectal Carcinoma. MaHTAS; 2017.
21. Kerrison RS, Robinson A, Skrobanski H, Kayal G, Kaushal A, Ide-Walters C, et al. Demographic and psychological predictors of community pharmacists’ cancer-related conversations with patients. BMC Health Serv Res. 2022;22(1):268. doi:10.1186/s12913-022-07587-1.
22. World Health Organization. Colorectal cancer fact sheet. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer
23. Centers for Disease Control and Prevention. Colorectal (Colon) Cancer Screening. 2023. Available from: https://www.cdc.gov/cancer/colorectal/basic_info/screening/
24. Alshammari M, Al-Maktoum S, Alsharidah A, Siddique A, Anaam M, Alsahali S, et al. Knowledge, attitude and practice of colorectal cancer among community pharmacists in the Qassim region of Saudi Arabia. Pharmacy. 2024;12(2):42. doi:10.3390/pharmacy12020042.
25. Schliemann D, Paramasivam D, Dahlui M, Cardwell CR, Somasundaram S, Ibrahim Tamin NS, et al. Change in public awareness of colorectal cancer symptoms following the Be Cancer Alert Campaign in Malaysia. BMC Cancer. 2020;20:252. doi:10.1186/s12885-020-06742-3.
26. Dancey CP, Reidy J. Statistics Without Maths for Psychology. 8th ed. London: Pearson; 2020.
27. Mensah KB, Mensah ABB, Yamoah P, Attakorah J, Bangalee V, Oosthuizen F. Knowledge assessment and barriers to cancer screening among Ghanaian community pharmacists. J Oncol Pharm Pract. 2022;28(1):64-73. doi:10.1177/1078155220983413.
28. Alqudah MAY, Al-Samman RM, Mukattash TL, Abu-Farha RK. Knowledge and attitudes of pharmacists towards colorectal cancer health education in Jordan. Int J Clin Pract. 2021;75(5):e13986. doi:10.1111/ijcp.13986.
29. Odebunmi OO, Wangen M, Waters AR, Ferrari RM, Marciniak MW, Rohweder C, et al. Colorectal cancer screening knowledge among community pharmacists: a national survey. J Am Pharm Assoc. 2024. doi:10.1016/j.japh.2024.102130.
30. Uygun A, Caliskan ND, Tezcan S. Community pharmacists’ knowledge on cancer and screening methods. J Oncol Pharm Pract. 2023;29(2):386-392. doi:10.1177/10781552211073822.
31. Mensah KB, Boamah Mensah AB, Wiafe E, Padayachee N, Aduse Poku AY, Dwobeng Amo B, et al. Impact of brief educational intervention on knowledge of cancer among community pharmacists. J Oncol Pharm Pract. 2022;28(8):1771-1780.
32. Rehman HT, Jawaid H, Tahir A, Imtiaz M, Zulfiqar T, Aziz T. Breast cancer knowledge among health professionals: a pre-post intervention study. J Family Med Prim Care. 2022;11(9):5649-5655. doi:10.4103/jfmpc.jfmpc_1226_22.
33. Gadd N, Lee S, Sharman MJ, Obamiro K. Educational interventions to improve bowel cancer awareness and screening. Prev Med Rep. 2024;39:102653. doi:10.1016/j.pmedr.2024.102653.
34. Friedemann-Sánchez G, Griffin JM, Partin MR. Gender differences in colorectal cancer screening barriers and information needs. Health Expect. 2007;10(2):148-160. doi:10.1111/j.1369-7625.2006.00430.x.
35. Ooi CY, Hanafi NS, Liew SM. Knowledge and practice of colorectal cancer screening among primary care physicians in Malaysia. Singapore Med J. 2019;60(11):596-604. doi:10.11622/smedj.2019011.
36. San-Juan-Rodriguez A, Newman TV, Hernandez I, Swart ECS, Klein-Fedyshin M, Shrank WH, Parekh N. Impact of community pharmacist-provided preventive services on outcomes: umbrella review. Prev Med. 2018;115:145-155. doi:10.1016/j.ypmed.2018.08.029.
37. Fitch Solutions. Americas Agribusiness Insight. 2021.
38. Ministry of Health Malaysia. National Diabetes Registry Report 2020. Putrajaya; 2021.
39. Baxter K, Courage C, Caine K. Surveys. In: Understanding Your Users. Morgan Kaufmann; 2015.
40. Urbanek M, Hanna C, Eckmann L, Carr M, Schadler A, Kebodeaux C. Pharmacists’ perceptions of providing colorectal cancer screening in community practice. J Am Pharm Assoc. 2024. doi:10.1016/j.japh.2024.102111.
41. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for designing behaviour change interventions. Implement Sci. 2011;6:42. doi:10.1186/1748-5908-6-42.
42. Beshir SA, Hanipah MA. Knowledge, perception and practice of breast cancer promotion among community pharmacists in Malaysia. Asian Pac J Cancer Prev. 2012;13(9):4427-4430. doi:10.7314/apjcp.2012.13.9.4427.
43. Kazi E, Sareshwala S, Ansari Z, Sahota D, Katyal T, Tseng W, Ivey SL. Promoting colorectal cancer screening in South Asian Muslims living in the USA. J Cancer Educ. 2021;36(4):865-873. doi:10.1007/s13187-020-01715-3.
44. Algahtani A. Evaluating the effectiveness of the e-learning experience in some universities in Saudi Arabia from male students’ perceptions. Durham University; 2011.
45. Githens RP. Older adults and e-learning: opportunities and barriers. Q Rev Distance Educ. 2007;8(4):329-338.
46. Department of Statistics Malaysia. MyCensus 2020: Population well-being (Social Relations). Putrajaya; 2023.
47. Puspitasari IM, Garnisa IT, Sinuraya RK, Witriani W. Perceptions, knowledge, and attitude toward mental health disorders among students in an Indonesian university. Psychol Res Behav Manag. 2020;13:845-854. doi:10.2147/PRBM.S274337.
48. Sendall MC, Ostermann L, Brown C, McCosker L. Health promotion of bowel and breast cancer screening in community pharmacies: pharmacists’ perceptions. Pharm Pract. 2018;16(4):1275. doi:10.18549/PharmPract.2018.04.1275.
49. Ministry of Health Malaysia. National Strategic Plan for Colorectal Cancer (NSPCRC) 2021–2025. Putrajaya; 2021.
50. Ruggli M, Stebler D, Gasteiger M, Trottmann M, Hochuli P, Telser H, Vaucher F. Experience with a colorectal cancer campaign in Swiss pharmacies. Int J Clin Pharm. 2019;41(5):1359-1364. doi:10.1007/s11096-019-00899-z.
51. Singapore Cancer Society. Colorectal Cancer Campaign. 2016.
52. Egbewande OM, Abdulwasiu MA, Yusuf RO, Durojaye AB, Ashimiyu-Abdulsalam ZI. Roles of community pharmacists in cancer management. Innov Pharm. 2022;13(3). doi:10.24926/iip.v13i3.4946.
53. Mancini S, Ravaioli A, Falcini F, Giuliani O, Corradini R, De Girolamo G, et al. Strategies for delivery of faecal occult blood test kits and participation to colorectal cancer screening. Eur J Cancer Care. 2018;27(1). doi:10.1111/ecc.12631.
54. Von Karsa L, Patnick J, Segnan N, Atkin W, Halloran S, Lansdorp-Vogelaar I, et al. European guidelines for quality assurance in colorectal cancer screening. Endoscopy. 2013;45(1):51-59. doi:10.1055/s-0032-1325997.
55. Moser P. Managing baseline variability in experimental studies with control groups. Handbook of Experimental Pharmacology. 2020.
56. Althubaiti A. Information bias in health research: definition, pitfalls and adjustment methods. J Multidiscip Healthc. 2016;9:211-217. doi:10.2147/JMDH.S104807.
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Effectiveness of educational intervention on the knowledge, attitudes, and perceptions of community pharmacists regarding colorectal cancer screening in Klang Valley, Malaysia. Pharm Pract (Granada) [Internet]. 2026 Mar. 12 [cited 2026 Mar. 26];24(1):1-15. Available from: https://pharmacypractice.org/index.php/pp/article/view/3406
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How to Cite
1.
Effectiveness of educational intervention on the knowledge, attitudes, and perceptions of community pharmacists regarding colorectal cancer screening in Klang Valley, Malaysia. Pharm Pract (Granada) [Internet]. 2026 Mar. 12 [cited 2026 Mar. 26];24(1):1-15. Available from: https://pharmacypractice.org/index.php/pp/article/view/3406