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Fulltext Examining behavioural coping strategies as mediators between work-family conflict and psychological distress

Aazami S, Shamsuddin K, Akmal S

ScientificWorldJournal, 2015;2015:343075.
PMID: 25695097 DOI: 10.1155/2015/343075

We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual's needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict.
Fulltext Work-family conflict and sleep disturbance: the Malaysian working women study

Aazami S, Mozafari M, Shamsuddin K, Akmal S

Ind Health, 2016;54(1):50-7.
PMID: 26423332 DOI: 10.2486/indhealth.2015-0086

This study aimed at assessing effect of the four dimensions of work-family conflicts (strain and time-based work interference into family and family interference into work) on sleep disturbance in Malaysian working women. This cross-sectional study was conducted among 325 Malaysian married working women. Multiple-stage simple random sampling method was used to recruit women from public service departments of Malaysia. Self-administrated questionnaires were used to measure the study variables and data were analyzed using SPSS version 21. We found that high level of the four dimensions of work-family conflicts significantly increase sleep disturbance. Our analyses also revealed an age-dependent effect of the work-family conflict on sleep disturbance. Women in their 20 to 30 yr old suffer from sleep disturbance due to high level of time-based and strain-based work-interference into family. However, the quality of sleep among women aged 30-39 were affected by strain-based family-interference into work. Finally, women older than 40 yr had significantly disturbed sleep due to strain-based work-interference into family as well as time-based family interference into work. Our findings showed that sleep quality of working women might be disturbed by experiencing high level of work-family conflict. However, the effects of inter-role conflicts on sleep varied among different age groups.
Fulltext Malay version of the family satisfaction scale: validity and reliability among Malaysian working women

Aazami S, Shamsuddin K, Akmal S

Int J Public Health Res, 2015;5(2):606-612.
MyJurnal

Introduction Family satisfaction is referred to the extent in which family members feel happy and fulfilled with each other. However, there has been lack of evidences on the family satisfaction scale within the Malaysian context. Therefore, the aim of this study was to assess validity of the Malay version of the Olson’s Family Satisfaction Scale. This is to allow Malaysian researchers to bring family satisfaction in line with the different field of studies.
Methods This study was conducted among 567 Malaysian working women. Data were collected using self-administrated questionnaires. This study conducted exploratory and confirmatory factor analysis, convergent validity and internal consistency using Cronbach’s alpha.
Results The findings of this study support the uni-dimensionality of the Malay version of the family satisfaction scale. The 10 items of the scale account for 68.1% of the total variance and the un-rotated factor loadings ranged from 0.76 to 0.87. Confirmatory factor analysis was run and supported the structure of family satisfaction scale. The results of confirmatory factor analysis using AMOS 21 in the current study reported the following indices: RMSEA= 0.06, CFI= 0.94, NFI= 0.94, TLI= 0.93. The convergent validity (average variance extracted= 0.65) and the internal consistency (Cronbach’s alpha= 0.94) of this construct were adequately supported.
Conclusions The findings support the factor structure, convergent validity and the internal consistency of the examined construct. Therefore, Malay version of the family satisfaction scale is a valid and reliable instrument among Malaysian working women.
Fulltext The Relationship Between Job Satisfaction and Psychological/Physical Health among Malaysian Working Women

Aazami S, Shamsuddin K, Akmal S, Azami G

Malays J Med Sci, 2015 Jul-Aug;22(4):40-6.
PMID: 26715907 MyJurnal

The workplace environment has a great influence on employees' health. Job dissatisfaction has been widely recognised as a workplace stressor that can influence employees' psychological and physical health statuses. However, job satisfaction is a multi-dimensional concept, and it is necessary to investigate its different facets and their unique consequences. Therefore, the aim of this study was to assess the relationship between the nine facets of job satisfaction and psychological health and somatic complaints (i.e., sleep disorders, headache, gastro-intestinal and respiratory problems).
Health-related quality of life in Malaysian gastrointestinal cancer patients and their family caregivers-a comparison study

Abdullah NN, Idris IB, Shamsuddin K, Abdullah NMA

Support Care Cancer, 2020 Apr;28(4):1891-1899.
PMID: 31359181 DOI: 10.1007/s00520-019-05007-5

PURPOSE: Gastrointestinal (GI) cancer has emerged as a major health problem. Cancer patients receive informal care from their families beyond formal care. There has been little evidence showing how the health-related quality of life (HRQOL) of the caregivers differs from that of the GI patients in Malaysia. A cross-sectional study was conducted in three referral hospitals in Malaysia. The objectives of this study were to determine the HRQOL of GI cancer patients and their family caregivers, and assess whether there is any significant relationship between the demographic factors, and the physical component summary (PCS) and mental component summary (MCS) scores for patients and caregivers.
METHODS: A total of 323 dyads of GI cancer patients and their caregivers completed the Medical Outcomes Study 12-item Short Form (MOS SF-12) questionnaire to measure their HRQOL during face-to-face interviews. The analyses were performed using SF-12 scoring software to compute PCS and MCS scores (HRQOL parameters). The independent t test, one-way ANOVA, and the Pearson correlation test were conducted to determine the demographic factors related to the HRQOL of the dyads.
RESULTS: The caregivers had higher scores in all domains for the SF-12 than the patients. There were significant differences found in the MCS scores of the patients according to ethnicity, origin of cancer, duration of cancer, and surgery. None of these factors had a significant relationship with the caregivers' HRQOL.
CONCLUSION: Caregivers had better HRQOL than cancer patients. Early intervention for cancer patients in the form of counselling and personalised pain management may enhance the HRQOL of patients.
Health-Related Quality of Life (HRQOL) of Gastrointestinal Cancer Caregivers: The Impact of Caregiving

Abdullah NN, Idris IB, Shamsuddin K, Abdullah NMA

Asian Pac J Cancer Prev, 2019 Apr 29;20(4):1191-1197.
PMID: 31030494

Objective: This study examined the quality of life (QOL) of caregivers for gastrointestinal (GI) cancer patients, and associated factors. Methods: A cross-sectional study was conducted at three referral hospitals in Klang Valley, Malaysia. A total of 323 pairs of patients and caregivers from the oncology units of these hospitals completed questionnaires in Malay. The QOL of caregivers was measured using The Malay Caregiver Quality of Life questionnaire. The independent variables were caregiver and patient factors, care-related factors, the Caregiver Strain Index-Malay, and the Multidimensional Scale of Perceived Social Support-Malay. Simple and multiple linear regression analyses were performed to determine the factors associated with the QOL. Variables with p < 0.05 were considered significant in the multiple analyses. Results: Female caregivers were 68.1% of the total, and 46.4% caregivers were spouses to cancer patients. Their mean age was 44.50 (13.29) years old. About 51.7% were of Malay ethnicity. The mean score for QOL was 80.17 (21.58). Being a male caregiver (beta = 5.165, p = 0.011) and of Indian ethnicity (beta = -9.163, p = 0.001) were strongly associated with caregiver QOL. Male patients contributed higher QOL scores for the caregivers compared to female patients. There was an inverse relationship among caregiving strain, duration of caregiving, and caregiver QOL. Conclusion: The identification of factors that affect QOL will allow healthcare providers to develop appropriate interventions. It is important that caregivers be in good health so as not to compromise the care they provide to their patients.
Fulltext Normograms of Ovarian Volume, Uterine Size and Endometrial Thickness in Urban Midlife Malaysia Women

Adeeb, N., Nur Azurah, A.G., Ong, F.B., Seri, S.S., Shamsuddin, K., Noor Aini, M.Y.

Medicine & Health, 2007;2(1):66-79.
MyJurnal

Cancers of the ovary and corpus uteri afflict 5% and 3.6% Malaysian women respectively. Ovarian cancer (OC) remained the deadliest gynaecological malignancy in perimenopausal women mainly due to the lack of symptoms until the disease had spread. Ultrasonography could provide a preliminary screening allowing the clinician to tailor subsequent management and counselling for these women. To support the basis for selective screening, a study on 517 urban disease free women aged 45 years and above, uterus-intact, non-users of HRT was undertaken. This study presented normograms of ovary, uterus and endometrium derived from entry ultrasound assessment. The sample comprised of 58.0% premenopaused and 42.0% postmenopaused women with an average age of 51.27±5.35 years old. Over two thirds were Chinese followed by Malays and Indians. The findings indicated that the average uterine size and endometrial thickness (ET) was 7.21±1.67x4.36±1.30cm and 6.36±3.73mm respectively. Premenopausal women had larger uterus compared to those postmenopaused (p
Fulltext Utility of Pap Smears and Mammograms in Midlife Urban Malaysian Women

Adeeb, N., Nur-Azurah, A.G., Ong, F.B., Seri, S.S., Shamsuddin, K., Noor-Aini, M.Y., et al.

Medicine & Health, 2008;3(1):59-68.
MyJurnal

Cancers of the breast and cervix made up 30.4% and 12% of all cancer cases in Malaysia. Thus screening for reproductive organ cancers as women approached menopause becomes exceedingly important. The study reports the baseline assessment tests of 495 disease free urban Malaysian women aged 45 years and above who volunteered in a healthy lifestyle intervention study. The sample comprised of 58.0% premenopaused and 42.0% postmenopaused women with an average age of 51.27±5.35 years old. Over two thirds were Chinese followed by Malays and Indians. Overall, abnormal Pap smears were seen in 7.6% comprising of 1.3% cervical intraepithelial neoplasia (CIN), 6.1% human papilloma virus (HPV) infection and 0.2% atypical squmous cells of undetermined significances (ASCUS). Yeast and other infections were found in 6.9% and 1.9% respectively. Comparatively, postmenopausal women had a 2.8 fold higher cancerous changes whereas premenopausal women had a higher infection rate, 11.8% vs. 4.7% respectively (p=0.024) with comparable HPV infection rates in both. This study found 1.3% had breast cancer (BC) with 3.6% requiring a biopsy while 3.4% needed regular follow up. Postmenopaused women had more abnormal mammograms (p
Knowledge towards HPV infection and HPV vaccines among Syrian mothers

Alsaad MA, Shamsuddin K, Fadzil F

Asian Pac J Cancer Prev, 2012;13(3):879-83.
PMID: 22631665

Cervical cancer is caused by HPV infection and can be prevented by early vaccination.
OBJECTIVE: To assess Syrian women's level of knowledge and determinants of good knowledge of cervical cancer, HPV infection and its vaccines.
METHODS: A cross sectional survey was undertaken among mothers with daughters in sixth grade classes enrolled in primary schools in Aleppo city, Syria. Samples were selected through cluster sampling and data collected using a self-administered questionnaire.
RESULTS: Less than a third of the mothers had heard of HPV infection and vaccines against cervical cancer and levels of knowledge were generally low. Good knowledge was associated with high education level, higher family monthly income, having few--less than four children, positive history of cervical cancer screening, and working or having relatives working in the medical field. The main source of information was television and few reported health care providers as a source of knowledge on HPV infection and vaccine.
CONCLUSION: Since knowledge of HPV infection and its connection with cervical cancer and its vaccine are low, more efforts must be made to educate Syrians prior to introduction of any HPV vaccination programme. Public health efforts must focus on educating mothers, the public as well as health care providers.
Fulltext Work related determinants of breastfeeding discontinuation among employed mothers in Malaysia

Amin RM, Said ZM, Sutan R, Shah SA, Darus A, Shamsuddin K

Int Breastfeed J, 2011;6(1):4.
PMID: 21342506 DOI: 10.1186/1746-4358-6-4

This cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.
Illness perceptions of Libyans with T2DM and their influence on medication adherence: a study in a diabetes center in Tripoli

Ashur ST, Shah SA, Bosseri S, Morisky DE, Shamsuddin K

Libyan J Med, 2015 Jan;10(1):29797.
PMID: 28349791 DOI: 10.3402/ljm.v10.29797

Background The surrounding environment influences the constitution of illness perceptions. Therefore, local research is needed to examine how Libyan diabetes patients perceive diabetes and how their perceptions influence their medication adherence. Methods A cross-sectional study was conducted at the National Centre for Diabetes and Endocrinology in Tripoli, Libya, between October and December 2013. A total of 523 patients with type 2 diabetes participated in this study. A self-administered questionnaire was used for data collection; this included the Revised Illness Perception Questionnaire and the eight-item Morisky Medication Adherence Scale. Results The respondents showed moderately high personal control and treatment control perceptions and a moderate consequences perception. They reported a high perception of diabetes timeline as chronic and a moderate perception of the diabetes course as unstable. The most commonly perceived cause of diabetes was Allah's will. The prevalence of low medication adherence was 36.1%. The identified significant predictors of low medication adherence were the low treatment control perception (p=0.044), high diabetes identity perception (p=0.008), being male (p=0.026), and employed (p=0.008). Conclusion Diabetes illness perceptions of type 2 diabetic Libyans play a role in guiding the medication adherence and could be considered in the development of medication adherence promotion plans.
Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya

Ashur ST, Shah SA, Bosseri S, Fah TS, Shamsuddin K

Libyan J Med, 2016 Jan;11(1):31086.
PMID: 28349838 DOI: 10.3402/ljm.v11.31086

Background Achieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status. Methods A cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA) and the eight-item Morisky Medication Adherence Scale (MMAS-8(©)), while glycaemic control status was based on the HbA1c level. Results Mean HbA1c was 8.9 (±2.1), and of the 523 patients, only 114 (21.8%) attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03-2.91), patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05-3.54), patients on insulin (OR=3.14, 95% CI=1.66-6.03), and low-medication adherents (OR=2.25, 95% CI=1.36-3.73) were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77-0.94). Conclusion The findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.
Fulltext Use of traditional medicine among type 2 diabetic Libyans

Ashur ST, Shah SA, Bosseri S, Shamsuddin K

East Mediterr Health J, 2017 Jul 16;23(5):375-382.
PMID: 28730591 DOI: 10.26719/2017.23.5.375

The use of traditional medicines is common among patients with chronic illnesses and this practice might pose health risks. The use among Libyan patients with diabetes is unknown. Therefore, this study aimed to estimate the prevalence of traditional medicine use in the previous year among Libyans with type 2 diabetes and to examine the association between its use and sociodemographic and clinical characteristics of the patients. A cross-sectional study was conducted at a large diabetes centre in Tripoli. A self-reported questionnaire was used for data collection. Of the 523 respondents, 28.9% used traditional remedies. Sex was the only variable significantly associated with traditional medicine use; more women used traditional medicines (P = 0.01). A total of 77 traditional medicine items were reported to be used, of which herbs were the most common. The use of traditional medicine for diabetes is prevalent and some of the reported items could pose health risks. Health education programmes are suggested to raise the awareness of the health risks of this practice.
Fulltext Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients

Ashur ST, Shamsuddin K, Shah SA, Bosseri S, Morisky DE

East Mediterr Health J, 2015 Dec 13;21(10):722-8.
PMID: 26750162 DOI: 10.26719/2015.21.10.722

No validation study has previously been made for the Arabic version of the 8-item Morisky Medication Adherence Scale (MMAS-8(©)) as a measure for medication adherence in diabetes. This study in 2013 tested the reliability and validity of the Arabic MMAS-8 for type 2 diabetes mellitus patients attending a referral centre in Tripoli, Libya. A convenience sample of 103 patients self-completed the questionnaire. Reliability was tested using Cronbach alpha, average inter-item correlation and Spearman-Brown coefficient. Known-group validity was tested by comparing MMAS-8 scores of patients grouped by glycaemic control. The Arabic version showed adequate internal consistency (α = 0.70) and moderate split-half reliability (r = 0.65). Known-group validity was supported as a significant association was found between medication adherence and glycaemic control, with a moderate effect size (ϕc = 0.34). The Arabic version displayed good psychometric properties and could support diabetes research and practice in Arab countries.
Fulltext Healthcare provider-patient communication: a satisfaction study in the outpatient clinic at Hospital Kuala Lumpur

Azizam NA, Shamsuddin K

Malays J Med Sci, 2015 May-Jun;22(3):56-64.
PMID: 26715897 MyJurnal

BACKGROUND: There is growing interest in research on patient satisfaction with healthcare provider (HCP) communication as a measure of healthcare quality and HCPs' communication competency. This study aimed to determine the levels of patient satisfaction with healthcare provider-patient communication (HCP-PC) and its associated factors at the outpatient clinic at Hospital Kuala Lumpur.
METHODS: A cross-sectional study was conducted on a convenience sample in July 2012 using self-administered questionnaires for the data collection. Both overall and domain-specific satisfaction were measured, with the three domains being exchanging information (EI), socio-emotional behaviour (SB), and communication style (CS).
RESULTS: The findings show that 92.8% of the 283 respondents were satisfied with overall HCP-PC, 89.5% with EI, 91.3% with SB, and 72.2% with CS. Satisfaction was statistically higher among Malays for CS and higher among those with low education and poor health for EI, SB and CS. EI and overall communication satisfaction were also higher among patients who reported short wait times, and patients who were in gender concordance with their HCPs showed higher SB satisfaction.
CONCLUSION: Basic and continuous communication skills training and patient activation programs should be established to increase patient satisfaction. Health information technology use should be actively promoted to allow for structured and standardised information exchange between HCPs and patients.
KEYWORDS: communication; patient satisfaction; primary care

Study site: outpatient clinic at Hospital Kuala Lumpur
Azizam NA, Shamsuddin K
Fulltext Risk factors for antenatal hypovitaminosis D in an urban district in Malaysia

Bukhary NBI, Isa ZM, Shamsuddin K, Lin KG, Mahdy ZA, Hassan H, et al.

BMC Pregnancy Childbirth, 2016 07 13;16(1):156.
PMID: 27411716 DOI: 10.1186/s12884-016-0939-3

BACKGROUND: Pregnant women form one of the high risk groups facing hypovitaminosis D. Low level of vitamin D will affect directly or indirectly both mother and fetus. Screening vitamin D in the first trimester of pregnancy is important to determine the necessary preventive action. Therefore, this study was aimed to determine the prevalence of hypovitaminosis D and its risk factors among pregnant women in the first trimester.
METHODS: A cross sectional study was carried out among first trimester pregnant women during their first antenatal visit. Samples were taken from different ethnicities in an urban district in Malaysia. A total of 396 respondents (99 % response rate) aged 18-40 years completed self-administered and guided questionnaire (characteristics and risk factors), validated semi-quantitative food frequency questionnaire for vitamin D in Malaysia (FFQ vitamin D/My), anthropometric measures (weight and height), blood test for serum 25(OH)D, skin measurement using Mexameter (MX 18) and Fitzpatrick Skin Type Chart Measurement (FSTCM). Data were analyzed to determine the association between risk factors and hypovitaminosis D.
RESULTS: The prevalence of hypovitaminosis D (serum 25(OH)D
Fulltext Factors related to the practice of breast self examination (BSE) and Pap smear screening among Malaysian women workers in selected electronics factories

Chee H, Rashidah S, Shamsuddin K, Intan O

BMC Womens Health, 2003 May 28;3(1):3.
PMID: 12769827

BACKGROUND: The Malaysian Ministry of Health promotes breast self-examination (BSE) for all women, and Pap smear screening every three years for all sexually active women ages 20 years and above. The objectives of this paper were to examine the practice of these two screening tests among women production workers in electronics factories, and to identify factors related to practice. METHODS: This was a cross-sectional survey of women production workers from ten electronics factories. Data was collected by a self-administered questionnaire from a total of 1,720 women. The chi-square test, odds ratio and binomial logistic regression were used in bivariate and multivariate analysis. RESULTS: Prevalence rates were 24.4% for BSE once a month, and 18.4% for Pap smear examination within the last three years. Women who were significantly more likely to perform BSE every month were 30 years and older, Malays, with upper secondary education and above, answered the BSE question correctly, and had a Pap smear within the last three years. The proportion of women who had a Pap smear within the last three years were significantly higher among those who were older, married, with young children, on the contraceptive pill or intra-uterine device, had a medical examination within the last five years, answered the Pap smear question correctly, and performed BSE monthly. CONCLUSION: Screening practice rates in this study were low when compared to national rates. Socio-demographic and health care factors significantly associated with screening practice are indicative of barriers which should be further understood so that more effective educational and promotional strategies could be developed.
Fulltext Body mass index and factors related to overweight among women workers in electronic factories in Peninsular Malaysia

Chee HL, Kandiah M, Khalid M, Shamsuddin K, Jamaluddin J, Nordin NA, et al.

Asia Pac J Clin Nutr, 2004;13(3):248-54.
PMID: 15331336

Factors related to overweight were examined in a cross-sectional survey that included 1612 women workers from 10 large electronics assembly factories in Peninsular Malaysia. Respondents were Malaysian citizens, direct production workers below the supervisory level, and had worked at least a year in the factory where they were presently employed. Heights and weights were taken to calculate the body mass index (BMI). Weights and BMI increased with increasing age. After adjusting for age, odds ratios for overweight were significantly raised for married women in relation to not married women (OR 1.5, 95% CI=1.15-2.02), lower secondary education in relation to higher than upper secondary education (OR 1.8, 95% CI=1.06-3.14), monthly income RM800-999 (OR 1.7, 95% CI=1.21-2.45) and >/=RM1,000 (OR 1.8, 95% CI=1.23-2.72) in relation to
Fulltext Knowledge and practice of breast self examination and Pap smear screening among a group of electronics women workers

Chee HL, Rashidah S, Shamsuddin K, Sharifah Zainiyah SY

Med J Malaysia, 2003 Aug;58(3):320-9.
PMID: 14750370

A total of 486 Malaysian women electronics workers participated in a study of reproductive health knowledge and cancer screening. The practice of Breast Self Examination (BSE) was found to be related to educational attainment; while ever having had a Pap smear was found to be related to being older than 30 years old, being ever married, living with family or relatives, and not staying in hostels. Knowledge on reproductive health was found to be higher for older women, married women, living with family or relatives, not staying in hostels, ever having done BSE and ever having had a Pap smear.
Fulltext Desferrioxamine treatment in thalassaemia: a cost utility analysis

Dahlui, M., Hishamshah, M.I., Rahman, A.J. A, Shamsuddin, K., Aljunid, S.M.

Malaysian Journal of Public Health Medicine, 2007;7(2):4-9.
MyJurnal

A cost-utility analysis was performed desferrioxamine treatment in thalctssaemia patients at two tertiary hospitals in Malaysia in 2004. A hundred and twelve transfusion dependent thalassaemia patients were grouped according to the status of desferrioxamine; optimum and sulwptimum. Cost analysis was from a patient and hospital perspectives while Quality Adjusted Life Years (QALYs) was the health outcome of choice. Incremental Cost·Effectiveness Ratio (ICER) was also stipulated to show the difference in cost for an additional QALY if patient currently on suboptimum desferrioxamine to switch using optimum desferrioxamine. Results on cost analysis showed the mean cost of treatment for thalassaemia patients on optimum desferrioxamirie was higher than those on sub·optimum desferrioxamine; (RM14, 775.00+SDRM4,737.00 and RM10,780+RM3,655, respectively). QALYs were 19.186+6.591 and 9.859+5275 in the optimum and suboptirnum group, respectively. Costutility analysis showed the cost per QALYs in optimum desferrioxamine group was RM59,045.00 compared to RM44,665.00 in suboptimum desferrioxamine group. ICER of patients on sub-optimum desferrioxamine switching to optimum desferrioxarnine was only RM420.39. Sensitivity analysis showed that the results were robust in the best and worst scenarios. In conclusion, although it is expensive for thalassaemia patients to use optimum desferrioxamine compared to sub-optimum desferrioxamine, the cost per QALYs gained was undoubtedly low.

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