Displaying publications 1 - 20 of 26 in total

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  1. Ting CY, Ho CC, Yee HJ
    Big Data, 2020 12;8(6):519-527.
    PMID: 33347366 DOI: 10.1089/big.2020.0028
    Recommending a retail business given a particular location of interest is nontrivial. Such a recommendation process requires careful study of demographics, trade area characteristics, sales performance, traffic, and environmental features. It is not only human effort taxing but often introduces inconsistency due to subjectivity in expert opinions. The process becomes more challenging when no sales data can be used to make a recommendation. As an attempt to overcome the challenges, this study used the machine learning approach that utilizes similarity measures to perform the recommendation. However, two challenges required careful attention when using the machine learning approach: (1) how to prepare a feature set that can commonly represent different types of retail business and (2) which similarity measure approach produces optimal recommendation accuracy? The data sets used in this study consist of points of interest, population, property, job type, and education level. Empirical studies were conducted to investigate (1) the overall accuracy of proposed similarity measure approaches to the retail business recommendation, and (2) whether the proposed approaches have a bias toward certain retail categories. In summary, the findings suggested that the proposed similarity-based techniques elicited an accuracy of above 70% and demonstrated higher accuracy when the recommendation was made within a set of similar retail businesses.
  2. Ting CY, Lee YF, Lim CJ, Ting RSK, Md Zahrin MM, Ahmad AS, et al.
    Transfus Med Hemother, 2021 May;48(3):188-195.
    PMID: 34177425 DOI: 10.1159/000512197
    Introduction: Past studies pay little attention to the intention to donate hematopoietic stem cells (HSC) among blood donors. This study investigated the level of and the influence of socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC among blood donors.

    Methods: This cross-sectional study recruited blood donors at selected public hospitals in the Malaysian State of Sarawak in 2019. A structured questionnaire was developed based on the review of relevant literature. It gathered information on socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC. Variables with a p value <0.200 in bivariate analysis were included in the variable selection for regression modeling to examine their associations with the intention to donate HSC.

    Results: A total of 569 blood donors participated (94.5% response rate). Overall, 87.1% reported a positive intention to donate HSC. In the regression model, the factor with the greatest association with intention to donate HSC was subjective norms about HSC donation (β = 0.35, 95% CI 0.27-0.42), followed by attitude about regulations of HSC donation (β= 0.21, 95% CI 0.13-0.35), self-efficacy on HSC donation (β = 0.15, 95% CI 0.09-0.32), attitude about the potential side effects of HSC donation (β = 0.14, 95% CI 0.02-0.10) and highest education level (β = 0.10, 95% CI 0.03-0.44).

    Conclusions: The findings can be used to formulate a better strategy in promoting HSC donation among blood donors in the region.

  3. Ting CY, Teh GC, Yu KL, Alias H, Tan HM, Wong LP
    Support Care Cancer, 2020 Apr;28(4):1703-1715.
    PMID: 31292755 DOI: 10.1007/s00520-019-04975-y
    PURPOSE: This study examined the prevalence of financial toxicity (FT) and associated factors among urologic cancer patients. The association between FT and health-related quality of life (HRQoL) was also investigated.

    METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale.

    RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL.

    CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.

  4. Ting CY, Teh GC, Yu KL, Alias H, Tan HM, Wong LP
    Eur J Cancer Care (Engl), 2020 Jul;29(4):e13248.
    PMID: 32495472 DOI: 10.1111/ecc.13248
    OBJECTIVE: This study examined the prevalence of self-perceived burden (SPB) and its association with health-related quality of life (HRQoL) among urologic cancer patients.

    METHODS: This was a prospective, cross-sectional study. A total of 429 respondents diagnosed with urologic cancers (prostate, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed by using a structured questionnaire. SPB and HRQoL were measured by the Self-perceived Burden Scale and the Functional Assessment of Cancer Therapy-General 7 Item Scale respectively.

    RESULTS AND CONCLUSION: Self-perceived burden was experienced by 73.2% of the respondents. Respondents who had a lower education level, a monthly household income

  5. Wong LP, Lai LL, See MH, Alias H, Danaee M, Ting CY, et al.
    Support Care Cancer, 2021 Oct;29(10):6087-6097.
    PMID: 33796935 DOI: 10.1007/s00520-021-06182-0
    OBJECTIVES: This study aimed to investigate the psychological distress and its associated factors among cancer survivors in Malaysia during the COVID-19 pandemic.

    METHODS: An anonymous Internet-based study was conducted between 23 April and 26 June 2020. During the study period, the country underwent phase 3 and phase 4 of the Movement Control Order (MCO), Conditional Movement Control Order (CMCO), and Recovery Movement Control Order (RMCO). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-assessment scale for measuring distress (total HADS score; HADS-T) with two subscales, namely, anxiety (HADS-A) and depression (HADS-D). Perceived threat of infection was measured based on the health belief model.

    RESULTS: From a total of 631 responses received, the proportion of participants with anxiety and depression symptoms (above threshold score of 8 on HADS-A and HADS-D) was 29.0 and 20.9%, respectively. Psychological distress (HADS-T > 16) was reported in 22.3% of the respondents. A total of 16.5% had combined anxiety and depression symptoms. The highest HADS-A (6.10; 95% CI 5.64-6.56), HADS-D (5.61; 95% CI 5.14-6.08), and HADS-T (11.71; 95% CI 10.84-12.58) scores were reported among respondents during phase 4 of the MCO. Partial least square-based structural equation modelling (PLS-SEM) revealed that self-perceived health status, perceived susceptibility, and severity of COVID-19 have the greatest effect, leading to higher HADS-A, HADS-D, and HADS-T scores.

    CONCLUSION: Heightened psychological distress was evident in cancer survivors particularly during the enforcement of the MCO over COVID-19. Providing support to address cancer survivors' psychological and emotional needs during the COVID-19 pandemic is essential.

  6. Omar K, Baha Raja D, Abdul Taib NA, Rajaram N, Ahmed J, Arvinder-Singh HS, et al.
    Travel Med Infect Dis, 2022;47:102318.
    PMID: 35342008 DOI: 10.1016/j.tmaid.2022.102318
    BACKGROUND: Guided by the best practices adapted from national and international bodies including the World Health Organization (WHO), the Centers for Disease Control (CDC), and the UK Joint Biosecurity Centre (JBC), this paper aims to develop and provide an empirical risk stratification and assessment framework for advancing the safe resumption of global travel during the COVID-19 pandemic.

    METHOD: Variables included in our model are categorized into four pillars: (i) incidence of cases, (ii) reliability of case data, (iii) vaccination, and (iv) variant surveillance. These measures are combined based on weights that reflect their corresponding importance in risk assessment within the context of the pandemic to calculate the risk score for each country. As a validation step, the outcome of the risk stratification from our model is compared against four countries.

    RESULTS: Our model is found to have good agreement with these benchmarked risk designations for 27 out of the top 30 countries with the strongest travel ties to Malaysia (90%). Each factor within this model signifies its importance and can be adapted by governing bodies to address the changing needs of border control policies for the recommencement of international travel.

    CONCLUSION: In practice, the proposed model provides a turnkey solution for nations to manage transmission risk by enabling stakeholders to make informed, evidence-based decisions to minimize fluctuations of imported cases and serves as a structure to support the improvement, planning, and activation of public health control measures.

  7. Baha Raja D, Abdul Taib NA, Teo AKJ, Jayaraj VJ, Ting CY
    Int Health, 2023 Jan 03;15(1):37-46.
    PMID: 35265998 DOI: 10.1093/inthealth/ihac005
    BACKGROUND: The computer simulation presented in this study aimed to investigate the effect of contact tracing on coronavirus disease 2019 (COVID-19) transmission and infection in the context of rising vaccination rates.

    METHODS: This study proposed a deterministic, compartmental model with contact tracing and vaccination components. We defined contact tracing effectiveness as the proportion of contacts of a positive case that was successfully traced and the vaccination rate as the proportion of daily doses administered per population in Malaysia. Sensitivity analyses on the untraced and infectious populations were conducted.

    RESULTS: At a vaccination rate of 1.4%, contact tracing with an effectiveness of 70% could delay the peak of untraced asymptomatic cases by 17 d and reduce it by 70% compared with 30% contact tracing effectiveness. A similar trend was observed for symptomatic cases when a similar experiment setting was used. We also performed sensitivity analyses by using different combinations of contact tracing effectiveness and vaccination rates. In all scenarios, the effect of contact tracing on COVID-19 incidence persisted for both asymptomatic and symptomatic cases.

    CONCLUSIONS: While vaccines are progressively rolled out, efficient contact tracing must be rapidly implemented concurrently to reach, find, test, isolate and support the affected populations to bring COVID-19 under control.

  8. Lau TSC, Kamel Ariffin MR, Yip SC, Chin JJ, Ting CY
    Heliyon, 2024 Jan 30;10(2):e24185.
    PMID: 38298683 DOI: 10.1016/j.heliyon.2024.e24185
    In recent research, Durandal, a signature scheme based on rank metrics following Schnorr's approach, was introduced to conceal secret key information by selectively manipulating the vector subspace of signatures. Later, an enhancement, namely the SHMW signature scheme, with smaller keys and signatures while maintaining EUF-CMA security, was proposed. Both Durandal and SHMW require adversaries to solve hard problems (i.e., Rank Support Learning, Rank Syndrome Decoding, and Affine Rank Syndrome Decoding) for secret key retrieval, in which the parameters are designed to withstand at least 128-bit computational complexity. The authors claimed that the security of the SHMW scheme is deemed superior to that of the original Durandal scheme. In this paper, we introduce a novel approach to identifying weak keys within the Durandal framework to prove the superiority of the SHMW scheme. This approach exploits the extra information in the signature to compute an intersection space that contains the secret key. Consequently, a cryptanalysis of the SHMW signature scheme was carried out to demonstrate the insecurity of the selected keys within the SHWM scheme. In particular, we proposed an algorithm to recover an extended support that contains the secret key used in the signature schemes. Applying our approach to the SHMW scheme, we can recover its secret key with only 97-bit complexity, although it was claimed that the proposed parameters achieve a 128-bit security level. The results of our proposed approaches show that the security level of the SHMW signature scheme is inferior compared to that of the original Durandal scheme.
  9. Yusof SN, Kamel Ariffin MR, Yip SC, Lau TSC, Mahad Z, Chin JJ, et al.
    Heliyon, 2024 Feb 29;10(4):e25470.
    PMID: 38370193 DOI: 10.1016/j.heliyon.2024.e25470
    In 1999, the Polynomial Reconstruction Problem (PRP) was put forward as a new hard mathematics problem. A univariate PRP scheme by Augot and Finiasz was introduced at Eurocrypt in 2003, and this cryptosystem was fully cryptanalyzed in 2004. In 2013, a bivariate PRP cryptosystem was developed, which is a modified version of Augot and Finiasz's original work. This study describes a decryption failure that can occur in both cryptosystems. We demonstrate that when the error has a weight greater than the number of monomials in a secret polynomial, p, decryption failure can occur. The result of this study also determines the upper bound that should be applied to avoid decryption failure.
  10. Oh AL, Makmor-Bakry M, Islahudin F, Ting CY, Chan SK, Tie ST
    Trop Med Int Health, 2024 May;29(5):434-445.
    PMID: 38470004 DOI: 10.1111/tmi.13987
    OBJECTIVES: Treatment interruption is associated with poor tuberculosis (TB) treatment outcomes and increased drug resistance. To address the issue, we aimed to investigate the characteristics, predictors and consequences of treatment interruption.

    METHODS: We conducted a retrospective cohort study by retrieving 4 years (2018-2021) of TB patients' records at 10 public health clinics in Sarawak, Malaysia. Adult patients (≥18 years) with drug-susceptible TB were selected. Treatment interruption was defined as ≥2 weeks of cumulative interruption during treatment. The Chi-square test, Mann-Whitney U test, Kaplan-Meier and Cox proportional hazards regression were used to analyse the data, with p 

  11. Ting CY, Chang KM, Kuan JW, Sathar J, Chew LP, Wong OJ, et al.
    Int J Med Sci, 2019;16(4):556-566.
    PMID: 31171907 DOI: 10.7150/ijms.27610
    Background: Clinical significance of germinal center B-cell (GCB) and non-GCB sub-categorization, expression of MYC, BCL2, BCL6, CD5 proteins and Epstein Barr virus encoded RNA (EBER) positivity in diffuse large B-cell lymphoma (DLBCL) remain controversial. Could these biomarkers accurately identify high risk DLBCL patients? Are MYC, BCL2 and BCL6 proteins expression feasible as baseline testing to predict c-Myc, BCL2 or BCL6 gene rearrangements? Aims: To investigate prognostic values of GCB/non-GCB sub-categorization, Double Protein Expression Lymphoma (DPL), Triple Protein Expression Lymphoma (TPL), positivity of CD5 protein and EBER in patients with DLBCL disease. To evaluate correlation between BCL2 , c-Myc and BCL6 gene rearrangements with BCL2, MYC and BCL6 proteins expression. Methods: Diagnostic tissue samples of 120 DLBCL patients between January 2012 to December 2013 from four major hospitals in Malaysia were selected. Samples were subjected to immunohistochemical staining, fluorescent in-situ hybridization (FISH) testing, and central pathological review. Pathological data were correlated with clinical characteristics and treatment outcome. Results: A total of 120 cases were analysed. Mean age of diagnosis was 54.1 years ± 14.6, 64 were males, 56 were females, mean follow up period was 25 months (ranged from 1 to 36 months). Of the 120 cases, 74.2% were non-GCB whereas 25.8% were GCB, 6.7% were EBER positive, 6.7% expressed CD5 protein, 13.3% were DPL and 40% were TPL. The prevalence of c-Myc, BCL2, BCL6 gene rearrangements were 5.8%, 5.8%, and 14.2%, respectively; and 1.6% were Double Hit Lymphoma (DHL). EBER positivity, DPL, TPL, c-Myc gene rearrangement, BCL2 gene rearrangement, extra copies of BCL2 gene and BCL6 gene rearrangement were associated with shorter median overall survival (P<0.05). IPI score was the significant determinants of median overall survival in DPL and TPL (P<0.05). CD5 protein expression and GCB/non-GCB sub-categorization did not affect treatment outcome (P>0.05). Overall, c-Myc, BCL2 and BCL6 gene rearrangements showed weak correlation with expression of MYC, BCL2 and BCL6 proteins (P>0.05). Fluorescent in situ hybridization is the preferred technique for prediction of treatment outcome in DLBCL patients. Conclusion:c-Myc, BCL2, and BCL6 gene rearrangements, EBER expression, DHL, TPL and IPI score are reliable risk stratification tools. MYC, BCL2 and BCL6 proteins expression are not applicable as baseline biomarkers to predict c-Myc, BCL2, and BCL6 gene rearrangements.
  12. Ting CY, Ahmad Zaidi Adruce S, Hassali MA, Ting H, Lim CJ, Ting RS, et al.
    Trials, 2018 Jun 05;19(1):310.
    PMID: 29871651 DOI: 10.1186/s13063-018-2649-9
    BACKGROUND: Amidst the high disease burden, non-adherence to medications among patients with type 2 diabetes mellitus (T2DM) has been reported to be common and devastating. Sarawak Pharmaceutical Services Division has formulated a pharmacist-led, multiple-theoretical-grounding, culturally sensitive and structured group-based program, namely "Know Your Medicine - Take if for Health" (MEDIHEALTH), to improve medication adherence among Malay patients with T2DM. However, to date, little is known about the effectiveness and sustainability of the Program.

    METHODS/DESIGN: This is a prospective, parallel-design, two-treatment-group randomized controlled trial to evaluate the effectiveness and sustainability of MEDIHEALTH in improving medication adherence. Malay patients who have underlying T2DM, who obtain medication therapy at Petra Jaya Health Clinic and Kota Samarahan Health Clinic, and who have a moderate to low adherence level (8-item Morisky Medication Adherence Scale, Malaysian specific, score <6) were randomly assigned to the treatment group (MEDIHEALTH) or the control group. The primary outcome of this study is medication adherence level at baseline and 1, 3, 6 and 12 months post-intervention. The secondary outcomes are attitude, subjective norms, perceived behavioural control, intention and knowledge related to medication adherence measured at baseline and 1, 6 and 12 months post-intervention. The effectiveness and sustainability of the Program will be triangulated by findings from semi-structured interviews with five selected participants conducted 1 month after the intervention and in-depth interviews with two main facilitators and two managerial officers in charge of the Program 12 months after the intervention. Statistical analyses of quantitative data were conducted using SPSS version 22 and Stata version 14. Thematic analysis for qualitative data were conducted with the assistance of ATLAS.ti 8.

    DISCUSSION: This study provides evidence on the effectiveness and sustainability of a structured group-based educational program that employs multiple theoretical grounding and a culturally sensitive approach in promoting medication adherence among Malays with underlying T2DM. Both the quantitative and qualitative findings of this study could assist in the future development of the Program.

    TRIAL REGISTRATION: National Medical Research Register, NMRR-17-925-35875 (IIR). Registered on 19 May 2017. ClinicalTrials.gov, NCT03228706 . Registered on 25 July 2017.

  13. Ting CY, Abd Wahab MS, Lee KS, Tan RT, Ming LC
    Ther Innov Regul Sci, 2017 Mar;51(2):212-220.
    PMID: 30231729 DOI: 10.1177/2168479016674041
    BACKGROUND: Because of the large size of Sarawak and the high proportion of people residing in rural areas in this Malaysian state, disseminating drug-related information there can be challenging. It is, therefore, important to recognize the type of mass media for drug-related information that are salient to the people of Sarawak. This study was aimed at identifying the use of and the preferences for mass media to obtain drug-related information among the public in Sarawak. We also aimed to recognize the media perceived as the most reliable for drug-related information.

    METHODS: This was a cross-sectional study using a self-administered questionnaire carried out from September to October 2013. Survey respondents were recruited from 4 divisions in Sarawak: Kuching, Sibu, Miri, and Bintulu.

    RESULTS: A total of 433 completed questionnaires were obtained at the end of the study period. All respondents had access to common mass media such as television (89.8%, 389/433), radio (68.6%, 297/433), and the Internet (66.1%, 286/433). Among all respondents, television (71.4%, 309/433) was noted as the most preferred media for drug-related information. Compared with rural respondents, urban respondents were significantly more likely to have access to and prefer the Internet to obtain drug-related information. On the other hand, rural respondents were more likely to have access to and prefer radio for such information compared to their urban counterparts.

    CONCLUSIONS: Television can be an important and attractive choice of mass media in a quality use of medicines (QUM) campaign. The Internet can be used to disseminate drug-related information in urban areas, whereas radio can be used in a QUM campaign targeting the rural public.

  14. Ting CY, Ho CC, Yee HJ, Matsah WR
    Big Data, 2018 03;6(1):42-52.
    PMID: 29570414 DOI: 10.1089/big.2017.0085
    Studies have shown that certain features from geography, demography, trade area, and environment can play a vital role in retail site selection, largely due to the impact they asserted on retail performance. Although the relevant features could be elicited by domain experts, determining the optimal feature set can be intractable and labor-intensive exercise. The challenges center around (1) how to determine features that are important to a particular retail business and (2) how to estimate retail sales performance given a new location? The challenges become apparent when the features vary across time. In this light, this study proposed a nonintervening approach by employing feature selection algorithms and subsequently sales prediction through similarity-based methods. The results of prediction were validated by domain experts. In this study, data sets from different sources were transformed and aggregated before an analytics data set that is ready for analysis purpose could be obtained. The data sets included data about feature location, population count, property type, education status, and monthly sales from 96 branches of a telecommunication company in Malaysia. The finding suggested that (1) optimal retail performance can only be achieved through fulfillment of specific location features together with the surrounding trade area characteristics and (2) similarity-based method can provide solution to retail sales prediction.
  15. Wong LP, Xu X, Alias H, Ting CY, Tan HM, Lin Y
    Urol Oncol, 2024 Apr 25.
    PMID: 38670816 DOI: 10.1016/j.urolonc.2024.04.004
    OBJECTIVE: This study aimed to investigate the level of family caregivers' (FC) burden and the extent to which patient- and caregiver-related factors influence the caregiving burden among FCs of urologic cancer (UC) patients.

    METHOD: A cross-sectional survey was conducted on caregivers of UC patients who sought cancer care. The modified caregiver strain index (MCSI) was used to assess FC burden.

    RESULTS: Just over half (54.3%) of FCs had moderate/high MCSI scores (score 9-26). By demographics, FCs who were unemployed (OR = 5.55, 95%CI 1.50-20.60) and perceived their current health condition as moderate/poor (OR = 6.05, 95%CI 1.95-18.78) reported higher odds of increased FC burden. Patient performance status played a pivotal role in exacerbating FC burden, whereby the odds of higher FC burden was 13 times higher in caregivers of UC patients having an Eastern Cooperative Oncology Group (ECOG) performance rating score of 3-4 (OR = 13.06, 95%CI 1.44-111.26) than those with a score of 0. Perceived lower levels of confidence in care provision were significantly associated with a higher level of strain (OR = 6.76, 985%CI 1.02-44.90).

    CONCLUSION: Care recipient performance status was a strong patient-related factor associated with higher FC burden regardless of duration of caregiving and other caregiver-related factors after adjusting for caregiver demographics.

  16. Ting CY, Adruce SAZ, Hassali MA, Ting H, Lim CJ, Ting RS, et al.
    Trials, 2019 05 10;20(1):267.
    PMID: 31077233 DOI: 10.1186/s13063-019-3348-x
    After publication of the original article [1], the authors have notified us that there are changes to the primary outcome of the study, instrument, subject's inclusion criteria, the funding and acknowledgements. These changes were made during the recruitment of participants and after approved by the Medical Research and Ethics Committee (MREC), National Institutes of Health Malaysia, on 16th November 2018.
  17. Ahmad K, Anchah L, Ting CY, Lim SE
    Contemp Clin Trials Commun, 2024 Apr;38:101280.
    PMID: 38435429 DOI: 10.1016/j.conctc.2024.101280
    AIMS: This study presents a protocol for the Pharmacy Integrated Community Care (PICC) program, meticulously designed to enhance Hemoglobin A1c (HbA1c) levels and augment knowledge about diabetes mellitus (DM) among individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) in the Sarawak State of Malaysia.

    METHODS: From 1 May to December 31, 2023, a prospective, multicenter, parallel-design randomised controlled trial will be conducted with two groups, each consisting of 47 participants. The intervention group will receive a structured, four-session group-based program guided by experienced pharmacists, focusing on medication adherence and diabetes management. The control group will follow the standard Diabetes Mellitus Adherence Clinic program. The primary outcomes of this study encompass enhancements in knowledge regarding diabetes medication management and adherence, followed by subsequent changes in HbA1c levels.

    CONCLUSIONS: The successful implementation of the PICC program holds promise for enhancing health outcomes in the T2DM population, potentially leading to more effective diabetes management initiatives and better health practices in the community.

    TRIAL REGISTRATION CLINICALTRIALSGOV IDENTIFIER: NCT05106231.

  18. Ting CY, Loo SC, Ting H, Ang WC, Jabar AHAA
    Ther Innov Regul Sci, 2017 Jul;51(4):439-445.
    PMID: 30227047 DOI: 10.1177/2168479017699531
    BACKGROUND: Compliance of community pharmacists (CPs) and private general medical practitioners (GPs) with Malaysian Laws on Poisons and Sale of Drugs is crucial in encouraging rational supply of medicine to patients that will subsequently lead to rational use of medicine, especially controlled medicine and psychotropic substances. This study aims to identify the trend of yearly compliance rate of both CPs and GPs with the Malaysian Laws on Poisons and Sale of Drugs, and to quantify the effectiveness of disciplinary actions in improving their compliance level.

    METHODS: This is a retrospective observation study from the Sarawak state Pharmaceutical Enforcement Division (PED) inspection reports on CPs and GPs from January 1, 2012, to December 31, 2014. Descriptive statistics in numbers and percentages are used to present the results.

    RESULTS: From years 2012 to 2014, the compliance rate of GPs increased from 34% to 51%, while the compliance rate of CPs remained almost constant, with a slight drop from 53% (2012) to 50% (2014). The most common noncompliance found among CPs is with the Poison Acts 1952 Section 26 Condition 2: "Records for the supply of preparations containing Pseudoephedrine, Ephedrine and Dextromethorphan," and among GPs, it is the Regulation 12 of Poisons Regulation 1952: "labeling of dispensed medicines." Warning letter is the most effective disciplinary action for both CPs (75% improvement) and GPs (67.8% improvement).

    CONCLUSION: This study serves as a baseline that provides valuable insights to policy makers, researchers, and other stakeholders in developing better enforcement strategies.

  19. Ting CY, Ahmad Zaidi Adruce S, Lim CJ, Abd Jabar AHA, Ting RS, Ting H, et al.
    Res Social Adm Pharm, 2021 02;17(2):344-355.
    PMID: 32327398 DOI: 10.1016/j.sapharm.2020.03.026
    BACKGROUND: A pharmacist-led structured group-based intervention (MEDIHEALTH) was formulated to improve medication adherence among Malay type 2 diabetes mellitus (T2DM) patients in the Malaysian state of Sarawak.

    OBJECTIVES: The objective of this study was to examine the effectiveness of MEDIHEALTH and its mechanism of impact for improving medication adherence and the glycated haemoglobin (HbA1c) level.

    METHODS: A two group and parallel randomised controlled trial with a twelve months follow-up period was conducted at two primary health clinics in Malaysia that were surrounded by Malay communities. Malay T2DM patients whose HbA1c was >7% and total score on the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) was <26 were recruited and parallelly randomised to the MEDIHEALTH or usual care (control) groups. The extended theory of planned behaviour was employed to test the mechanism of impact. Repeated measure analysis of variance was used to assess the difference in the estimated marginal mean of the SEAMS scores and HbA1c level between the intervention and control groups at different times.

    RESULTS: A total of 142 participants were recruited and randomised; three from the intervention group and eight from the control group withdrew before receiving any treatment. Hence, 68 participants in the intervention group and 63 in the control group were included for analyses. The MEDIHEALTH group had a significantly greater increase in the SEAMS score compared to the control group (p 
  20. Ting CY, Ting RS, Lim CJ, King TL, Ting H, Gerofi J
    Contraception, 2019 07;100(1):65-71.
    PMID: 30871936 DOI: 10.1016/j.contraception.2019.02.013
    OBJECTIVES: This study compared the condom failure rate, safety and acceptability of two new synthetic adhesive male condoms, Wondaleaf-Cap® (WLC) and Wondaleaf-On-Man® (WLM), with a marketed latex external condom Durex®-Together (DT).

    STUDY DESIGN: We enrolled healthy married, monogamous, heterosexual condom users in a randomized controlled, cross-over, pilot trial in Malaysia. We randomized participants to six groups with different condom use-orders of the experimental WLC and WLM and control latex condom for four episodes for vaginal sex over 1 month for each condom type. We summarized the clinical and non-clinical failure rate, safety and acceptability of each condom type using descriptive statistics. We tested differences in condom failure and acceptability using generalized estimating equations and repeated measure ANOVA respectively.

    RESULTS: We screened 75 couples and randomized 50 eligible couples. Two couples withdrew before receiving any condom. The remaining used 576 condoms with 192 uses for each condom variant. Clinical failure rates of WLC, WLM and DT were 1.04%, 0% and 0.52%, respectively. Non-clinical failure rates of WLC, WLM and DT were 2.08%, 3.12% and 1.04%, respectively. Removal was found more painful with Wondaleaf products than the DT. Preferences of participants for WLC, WLM and DT were 33.3%, 29.2% and 25%, respectively. Overall, WLC and DT had greater acceptances among male participants than WLM.

    CONCLUSION: Results of this pilot study support that use of synthetic adhesive male condoms is associated with failure rates similar to those seen with existing latex, and with greater acceptability. A larger study to ascertain non-inferiority is underway.

    IMPLICATIONS: The availability of synthetic adhesive male condoms may increase the acceptability of condom use. However, removal pain and clinical performance requires further study.

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