Displaying publications 1 - 20 of 67 in total

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  1. Nies YH, Ali AM, Abdullah N, Islahudin F, Shah NM
    Patient Prefer Adherence, 2018;12:1955-1964.
    PMID: 30319245 DOI: 10.2147/PPA.S168638
    Purpose: The objective of this study was to explore the experiences and side-effects of breast cancer patients on chemotherapy in Malaysia.
    Participants and methods: Purposive sampling of 36 breast cancer patients who have completed chemotherapy and agreed to participate in semi-structured in-depth interviews. A constant comparative method and thematic analysis were used to analyze the interviews.
    Results: Data were categorized into six main themes: know nothing of chemotherapy; fear of chemotherapy; patients' beliefs in alternative treatments; symptom management; staying healthy after chemotherapy; and concerns of patients after chemotherapy.
    Conclusion: Despite complaints about the bad experiences of their chemotherapy-induced side-effects, these patients still managed to complete the entire course of chemotherapy. Moreover, there is a need for a clinical pharmacy service in the oncology clinic setting in Malaysia in order to provide relevant information to help patients understand the chemotherapy received.

    Study site: two tertiary care hospitals in Malaysia as well as the National Cancer Society Malaysia.

  2. Ahmad Nizaruddin M, Omar MS, Mhd-Ali A, Makmor-Bakry M
    Patient Prefer Adherence, 2017;11:1869-1877.
    PMID: 29138540 DOI: 10.2147/PPA.S144513
    Background: Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs).

    Participants and methods: A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.

    Results and discussion: Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents' medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.

    Conclusion: There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.

  3. Shima R, Farizah MH, Majid HA
    Patient Prefer Adherence, 2014;8:1597-609.
    PMID: 25484577 DOI: 10.2147/PPA.S69680
    PURPOSE: The aim of this study was to explore patients' experiences with their illnesses and the reasons which influenced them in not following hypertensive care recommendations (antihypertensive medication intake, physical activity, and diet changes) in primary health clinic settings.
    PATIENTS AND METHODS: A qualitative methodology was applied. The data were gathered from in-depth interviews with 25 hypertensive patients attending follow-up in nine government primary health clinics in two districts (Hulu Langat and Klang) in the state of Selangor, Malaysia. The transcribed data were analyzed using thematic analysis.
    RESULTS: There was evidence of lack of patient self-empowerment and community support in Malaysian society. Most of the participants did not take their antihypertensive medication or change their physical activity and diet after diagnosis. There was an agreement between the patients and the health care professionals before starting the treatment recommendation, but there lacked further counseling and monitoring. Most of the reasons given for not taking antihypertensive medication, not doing physical activity and not following diet recommendations were due to side effects or fear of the side effects of antihypertensive medication, patients' attitudes, lack of information from health care professionals and insufficient social support from their surrounding environment. We also observed the differences on these reasons for nonadherence among the three ethnic groups.
    CONCLUSION: Health care professionals should move toward supporting adherence in the management of hypertensive patients by maintaining a dialogue. Patients need to be given time to enable them to overcome their inhibition of asking questions and to accept the recommendations. A self-management approach must be responsive to the needs of individuals, ethnicities, and communities.
    KEYWORDS: adherence; hypertension; in-depth interview; qualitative research
    Study site: Klinik kesihatan, Selangor, Malaysia
  4. Chong EY, Palanisamy UD, Jacob SA
    Patient Prefer Adherence, 2019;13:195-207.
    PMID: 30774315 DOI: 10.2147/PPA.S182516
    Purpose: This study prepares the groundwork on the potential design and development of a mobile health (mHealth) app that will be able to bridge the communication gap between pharmacists and patients who are Deaf and Hard of Hearing (DHoH).

    Patients and methods: A focus group discussion was conducted with 12 community pharmacists. Participants were recruited using snowball sampling. Audio-recordings were transcribed verbatim, and analyzed using a thematic approach.

    Results: Three themes were apparent: 1) suggestions for app design and content, 2) perceived benefits of the app, and 3) potential challenges related to the app. Participants believed the app would be able to facilitate and improve communication, and hence relationship, between pharmacists and the DHoH. Potential challenges of the app were highlighted, such as the need for manpower to manage the app, and its cost to this group of economically disadvantaged people. There were also concerns about privacy and security.

    Conclusions: This study allowed community pharmacists, one of the end-users of the app, to provide feedback on the contents and design of the app, which would allow them to provide pharmaceutical care services to patients who are DHoH, and better serve them. Potential benefits and challenges of the app were also identified. Undoubtedly, through the mHealth app, community pharmacists will be better equipped to serve and communicate with the DHoH, and this will hopefully translate to improved health outcomes in these patients.

  5. Al-Jumah KA, Hassali MA, Al-Zaagi I
    PMID: 24707170 DOI: 10.2147/PPA.S58565
    OBJECTIVE: The aim of this study was to cross-culturally adapt the Armando Patient Satisfaction Questionnaire into Arabic and validate its use in the general population.

    METHODS: The translation was conducted based on the principles of the most widely used model in questionnaire translation, namely Brisling's back-translation model. A written authorization allowing translation into Arabic was obtained from the original author. The Arabic version of the questionnaire was distributed to 480 participants to evaluate construct validity. Statistical Package for Social Sciences version 17.0 for Windows was used for the statistical analysis.

    RESULTS: The response rate of this study was 96%; most of the respondents (52.5%) were female. Internal consistency was assessed using Cronbach's α, which showed that this questionnaire provides a high reliability coefficient (reaching 0.9299) and a high degree of consistency and thus can be relied upon in future patient satisfaction research.

  6. Chong WW, Aslani P, Chen TF
    Patient Prefer Adherence, 2013;7:813-25.
    PMID: 23986631 DOI: 10.2147/PPA.S48486
    BACKGROUND: Recent studies have shown that pharmacists have a role in addressing antidepressant nonadherence. However, few studies have explored community pharmacists' actual counseling practices in response to antidepressant adherence-related issues at various phases of treatment. The purpose of this study was to evaluate counseling practices of community pharmacists in response to antidepressant adherence-related issues.

    METHODS: A simulated patient method was used to evaluate pharmacist counseling practices in Sydney, Australia. Twenty community pharmacists received three simulated patient visits concerning antidepressant adherence-related scenarios at different phases of treatment: 1) patient receiving a first-time antidepressant prescription and hesitant to begin treatment; 2) patient perceiving lack of treatment efficacy for antidepressant after starting treatment for 2 weeks; and 3) patient wanting to discontinue antidepressant treatment after 3 months due to perceived symptom improvement. The interactions were recorded and analyzed to evaluate the content of consultations in terms of information gathering, information provision including key educational messages, and treatment recommendations.

    RESULTS: There was variability among community pharmacists in terms of the extent and content of information gathered and provided. In scenario 1, while some key educational messages such as possible side effects and expected benefits from antidepressants were mentioned frequently, others such as the recommended length of treatment and adherence-related messages were rarely addressed. In all scenarios, about two thirds of pharmacists explored patients' concerns about antidepressant treatment. In scenarios 2 and 3, only half of all pharmacists' consultations involved questions to assess the patient's medication use. The pharmacists' main recommendation in response to the patient query was to refer the patient back to the prescribing physician.

    CONCLUSION: The majority of pharmacists provided information about the risks and benefits of antidepressant treatment. However, there remains scope for improvement in community pharmacists' counseling practice for patients on antidepressant treatment, particularly in providing key educational messages including adherence-related messages, exploring patients' concerns, and monitoring medication adherence.

  7. Md Redzuan A, Lee MS, Mohamed Shah N
    Patient Prefer Adherence, 2014;8:263-70.
    PMID: 24600208 DOI: 10.2147/PPA.S56467
    PURPOSE: Asthma affects an estimated 300 million people worldwide. Poor adherence to prescribed preventive medications, especially among children with asthma, leads to increased mortality and morbidity. The purpose of this study was to assess the adherence and persistence levels of asthmatic children at the Universiti Kebangsaan Malaysia Medical Center (UKMMC), a tertiary care teaching hospital, and to determine the factors that influence adherence to prescribed preventive medications.

    PATIENTS AND METHODS: Participants were asthmatic patients aged 18 years and younger with at least one prescription for a preventive medication refilled between January and December 2011. Refill records from the pharmacy dispensing database were used to determine the medication possession ratio (MPR) and continuous measure of gaps (CMG), measures of adherence and persistence levels, respectively.

    RESULTS: The sample consisted of 218 children with asthma from the General and Respiratory pediatric clinics at UKMMC. The overall adherence level was 38% (n=83; MPR ≥80%), and the persistence level was 27.5% (n=60; CMG ≤20%). We found a significant association between the adherence and persistence levels (r=0.483, P<0.01). The presence of comorbidities significantly predicted the adherence (odds ratio [OR] =16.21, 95% confidence interval [CI]: 7.76-33.84, P<0.01) and persistence level (OR =2.63, 95% CI: 0.13-52.79, P<0.01). Other factors, including age, sex, ethnicity, duration of asthma diagnosis, and number of prescribed preventive medications did not significantly affect adherence or persistence (P>0.05).

    CONCLUSION: In conclusion, the adherence level among children with asthma at UKMMC was low. The presence of comorbidities was found to influence adherence towards preventive medications in asthmatic children.

  8. Ahmad NS, Islahudin F
    Patient Prefer Adherence, 2018;12:1231-1237.
    PMID: 30038489 DOI: 10.2147/PPA.S151603
    Background: The lack of price control in Malaysia has led to increased market competition, resulting in high medicine prices, notably in the private sector. This largely affects patients' out-of-pocket expenses in the private sector. Although generic medicines are preferred due to affordability, the prices are still notably high.

    Methods: This study compares innovator and generic medicine prices to estimate treatment affordability in the private sector. Private hospitals and community retail pharmacies were examined from 2011 to 2015. Data were collected on the basis of recommendations by the World Health Organization's Health Action International.

    Results: The markup of generic medicines was significantly higher than that of innovator medicines during the study period (p<0.001). While the markup of generic medicine was 31%-402% (36%-171% and 31%-402% for core and supplementary list items), that of innovator medicine was 24%-86% (28%-86% and 24%-80% for core and supplementary list items). There was no significant increase in the median price ratio for 11 selected generic medicines (from 1.8±3.9 to 2.9±8.2) (p>0.05). However, the median price ratio of the 11 innovator medicines significantly increased (from 4.9±6.1 to 11.2±20.3) (p=0.045). Affordability of all generic medicines was below the 2-day wage for treatment, with captopril (25 mg tablet) reporting the highest cost (1.1-1.7-day wages). Among innovator medicines, omeprazole (20 mg capsule; 6.2-7.0 days' wages) reported the highest median treatment cost.

    Conclusion: There is a need for policies to control national drug prices, to ensure medicine prices are monitored. This can help keep out-of-pocket expenses, especially in middle-income countries such as Malaysia, at a minimal in the private sector.

  9. Appalasamy JR, Quek KF, Md Zain AZ, Joseph JP, Seeta Ramaiah S, Tha KK
    Patient Prefer Adherence, 2020;14:1979-1990.
    PMID: 33116441 DOI: 10.2147/PPA.S253918
    Introduction: Self-efficacy is positively associated with medication understanding and use self-efficacy (MUSE) among post-stroke patients. It is also closely related to knowledge, belief, and perception, which vary among people from different socioeconomic backgrounds and cultures. As interventions using video and peer stories have emerged to be successful on behavior modification, this study aimed to explore the effectiveness of video narratives incorporated with Health Belief constructs on MUSE and its associated factors among patients with stroke at a local setting.

    Methods: A randomized controlled trial (RCT) for 12 months was carried out on patients diagnosed with stroke at Hospital Kuala Lumpur, Malaysia. The RCT recruited up to 216 eligible patients who were requested to return for two more follow-ups within six months. Consented patients were randomized to either standard care or intervention with video narratives. The control of potential confounding factors was ensured, as well as unbiased treatment review with prescribed medications, only obtained onsite.

    Results and Discussion: A repeated measure of MUSE mean score differences at T0 (baseline), T2 (6th month) and T4 (12th month) for antithrombotic, antihypertensive, and all medication categories indicated significant within and between groups differences in the intervention group (p<0.05). Moreover, this impact was reflected upon continuous blood pressure (BP) monitoring compared to the control group (F (1214) =5.23, p=0.023, ƞ2=0.024). Though BP measure differences were non-significant between the groups (p=0.552), repeated measure analysis displayed significant mean differences between intervention and control group on BP control over time (F (1.344, 287.55) =8.54, P<0.001, ƞ2=0.038). Similarly, the intervention's positive impact was also present with similar trends for knowledge, illness perception, and the belief about medicine. Though significant differences (p<0.05) of all outcome measures gradually decreased between T2 and T4 in the intervention group; nevertheless, these positive findings confirmed that personalized video narratives were able to motivate and influence MUSE and its associated factors among post-stroke patients. The significant improvement in medication-taking self-efficacy and the sustenance of BP monitoring habits among patients in the intervention group strengthened our conceptual framework's practicality.

  10. Ngadimon IW, Islahudin F, Hatah E, Mohamed Shah N, Makmor-Bakry M
    Patient Prefer Adherence, 2015;9:665-73.
    PMID: 25999702 DOI: 10.2147/PPA.S82844
    BACKGROUND: The purpose of this study was to establish baseline information on the current level of knowledge about, attitude toward, and experience with antibiotic usage, and preferences for shared decision making among adolescents in Malaysia.
    METHODS: A cross-sectional survey, involving 1,105 respondents who were aged between 13 and 17 years and who lived in Malaysia, was conducted using a validated questionnaire. The survey assessed knowledge, attitude, and experience with regard to antibiotic usage, and adolescents' preferences for the style of shared decision-making process.
    RESULTS: The majority (n=786 [71.13%]) of the respondents had a low level of knowledge, 296 (26.79%) had a moderate level of knowledge, and 23 (2.08%) had a high level of knowledge. Further, they demonstrated a slightly negative attitude mean score of 3.30±0.05 (range: 0-8 points) but a positive experience mean score of 2.90±0.029 (range: 0-4 points). There was a positive correlation between knowledge and attitude scores, with a higher knowledge level associated with a more positive attitude toward antibiotic usage (r=0.257, P<0.001). Higher knowledge scores were associated with a more negative experience with antibiotic usage (r=-0.83, P=0.006). When assessing preference in shared decision making, more adolescents preferred an active role (n=408 [37%]) compared with collaborative (n=360 [32.6%]) or passive (n=337 [30.5%]) (P=0.028) roles.
    CONCLUSION: Current health care settings should involve adolescents in the decision-making process. Education packages can be introduced to improve adolescents' knowledge of and practice of taking antibiotics, as well as to encourage their participation in decision making, in an attempt to reduce misuse of antibiotics.
    Study site: 14 secondary schools, Malaysia
    KEYWORDS: antibiotic usage; attitude; experience; knowledge
  11. Hudu SA, Malik YA, Niazlin MT, Harmal NS, Adnan A, Alshrari AS, et al.
    PMID: 24101865 DOI: 10.2147/PPA.S49776
    This study aimed to evaluate the level of hepatitis B immunity among undergraduate students 23 years after commencement of the nationwide hepatitis B childhood immunization program in Malaysia.
  12. Chuah PL, Jamal NF, Siew CJ, Ahmad Bustamam RS, Jeyasingam V, Khong KC
    Patient Prefer Adherence, 2021;15:2175-2184.
    PMID: 34588767 DOI: 10.2147/PPA.S310409
    Purpose: To evaluate the rate and predictors of non-adherence to imatinib in gastrointestinal stromal tumor (GIST) patients, as well as to compare the difference in health-related quality of life (HRQOL) between adherent and non-adherent patients.

    Patients and Methods: A cross-sectional study at the Oncology Clinic, Hospital Kuala Lumpur was conducted from March to August 2018. All patients with metastatic and/or unresectable GIST aged ≥18 years old and on at least 3 months of imatinib were included. Adherence to imatinib was assessed using the 10-item validated Medication Compliance Questionnaire, with a score of <100% indicating non-adherence. Non-adherence predictors were determined by multiple logistic regressions. HRQOL was evaluated by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). The difference in the mean HRQOL scores between adherent and non-adherent groups was determined by multivariate analysis of variance.

    Results: A total of 89 patients were enrolled, of which 49 (55.1%) were considered non-adherent. The significant predictors of non-adherence were age (adjusted odds ratio [OR] 0.93; CI 0.89-0.98; P = 0.007), presence of nausea and vomiting (OR 5.63; CI 1.25-25.27; P = 0.024), and presence of comorbidities (OR 4.56; CI 1.44-14.40; P = 0.010). Patients who were in the adherent group showed significantly better score in overall HRQOL, F (15, 73) = 2.09, P < 0.02; Pillai's trace = 0.3, partial eta squared = 0.30.

    Conclusion: Non-adherence to long-term treatment with imatinib among patients with GIST should not be underestimated. Significant predictors of non-adherence among this population are younger age, presence of nausea and vomiting, as well as comorbidities. Patients with good adherence portrayed better HRQOL.

  13. Islahudin F, Shahdan IA, Mohamad-Samuri S
    Patient Prefer Adherence, 2017;11:913-918.
    PMID: 28546742 DOI: 10.2147/PPA.S132282
    BACKGROUND: There is a steep increase in the consumer use of complementary alternative medicine (CAM), with many users unaware of the need to inform their health care providers. Various predictors including psychosocial factors such as beliefs and behavior have been accounted for preference toward CAM use, with varying results.
    METHODS: This study investigates the belief and attitude regarding preference toward CAM use among the Malaysian population by using a questionnaire-based, cross-sectional study.
    RESULTS: A large majority of the 1,009 respondents admitted to taking at least one type of CAM (n=730, 72.3%). Only 20 (1.9%) respondents were found to have negative beliefs (total score <35), 4 (0.4%) respondents had neutral beliefs (total score =35), and 985 (97.6%) respondents had positive belief toward CAM (total score >36). A total of 507 (50.2%) respondents were categorized as having a negative CAM attitude, while 502 (49.8%) respondents were categorized as having a positive CAM attitude. It was demonstrated that there was a positive correlation between belief and attitude score (ρ=0.409, P<0.001). Therefore, the higher the belief in CAM, the more positive the attitude was toward CAM. Those who were using CAM showed a stronger belief (P=0.002), with a more positive attitude (P<0.001) toward it, than those who were not using CAM.
    CONCLUSION: Identifying belief regarding preference toward CAM use among the public could potentially reveal those with a higher tendency to use CAM. This is important as not everyone feels the need to reveal the use of CAM to their health care providers, which could lead to serious repercussions such as interactions and adverse effects.
  14. Bukhsh A, Khan TM, Nawaz MS, Ahmed HS, Chan KG, Lee LH, et al.
    Patient Prefer Adherence, 2018;12:2377-2385.
    PMID: 30519003 DOI: 10.2147/PPA.S177314
    Objective: Association of various self-care activities on glycemic control of people with diabetes (PWD) in Pakistan is yet to be explored. The current study aimed to evaluate the association of various diabetes-related self-care activities with glycated hemoglobin (HbA1c) levels and to examine the predictive relationship of patients' demographic variables with their self-care activities.

    Patients and methods: A cross-sectional study was conducted on adult PWD (N=218) who were diagnosed with type 2 diabetes mellitus of at least 1 year duration. Self-care activities were examined by using the Urdu version of Diabetes Self-management Questionnaire. Linear regression analysis was conducted to examine the significant predictors for diabetes-related self-care activities and glycemic control.

    Results: Mean age of the patients was 50.77±13.3 years. Poor glycemic control (HbA1c $7%) was observed in majority of the patients (83%). Linear regression analysis revealed that glucose management (β=-0.44; 95% CI -0.438, -0.209; P<0.001) was the strongest predictor for low levels of patients' HbA1c, followed by dietary control (β=-0.19; 95% CI -0.248, -0.018; P=0.024) and physical activity (β=-0.17; 95% CI -0.165, -0.023; P=0.010), respectively. Linear regression analysis showed that use of oral hypoglycemic agents only (β=-0.218; 95% CI -0.956, -0.200; P=0.003) and higher education level (β=0.204; 95% CI 0.138, 0.777; P=0.005) were significant predictors for higher scores of patients' self-care activities.

    Conclusion: The findings support that PWD having better self-reported self-care activities achieve better glycemic control. Patients' self-care activities should be monitored on a regular basis, especially for those who are at risk of poor glycemic control.
  15. Huri HZ, Mat Sanusi ND, Razack AH, Mark R
    Patient Prefer Adherence, 2016;10:807-23.
    PMID: 27257374 DOI: 10.2147/PPA.S99544
    BACKGROUND: Erectile dysfunction (ED) is one of the most common health problems in men. ED can significantly affect a man's psychological well-being and overall health.

    PURPOSE: To investigate the association of psychological factors, patients' knowledge, and management among ED patients.

    PATIENTS AND METHODS: A total of 93 patients with an age range from 31 to 81 years who have undergone treatment for ED were included in this study.

    RESULTS: It was found that the feeling of blame (P=0.001), guilt (P=0.001), anger or bitterness (P=0.001), depression (P=0.001), feeling like a failure (P=0.001), and the feeling of letting down a partner during intercourse (P=0.001) were significantly associated with ED. Age was also found to be significantly associated with patients' psychological scale (P=0.004). In addition, the majority of patients in this study practice the right method of administration of ED therapy. However, no significant correlation was found between patients' knowledge of ED therapy and demographic characteristics.

    CONCLUSION: This study concluded that ED does affect psychological well-being of people. In addition, patient's knowledge about ED and its management is also crucial in ensuring that the patient achieves optimal therapeutic outcomes from ED therapy.

  16. Ng YK, Shah NM, Loong LS, Pee LT, Hidzir SAM, Chong WW
    Patient Prefer Adherence, 2018;12:615-624.
    PMID: 29731609 DOI: 10.2147/PPA.S159113
    Purpose: This study investigated patients' and pharmacists' attitudes toward concordance in a pharmacist-patient consultation and how patients' attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use.

    Subjects and methods: A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t-test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients' self-efficacy in decision making.

    Results: A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p<0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients' perceived level of involvement, and attitudes toward concordance are significant predictors of patients' self-efficacy in decision making (p<0.05).

    Conclusion: Patients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients' involvement in medication-related decision making.

  17. Ong WM, Chua SS, Ng CJ
    Patient Prefer Adherence, 2014;8:237-46.
    PMID: 24627628 DOI: 10.2147/PPA.S57567
    BACKGROUND: Self-monitoring of blood glucose (SMBG) helps to improve glycemic control and empowerment of people with diabetes. It is particularly useful for people with diabetes who are using insulin as it facilitates insulin titration and detection of hypoglycemia. Despite this, the uptake of SMBG remains low in many countries, including Malaysia.

    PURPOSE: This study aimed to explore the barriers and facilitators to SMBG, in people with type 2 diabetes using insulin.

    PATIENTS AND METHODS: Qualitative methodology was employed to explore participants' experience with SMBG. Semistructured, individual in-depth interviews were conducted on people with type 2 diabetes using insulin who had practiced SMBG, in the primary care clinic of a teaching hospital in Malaysia. Participants were purposively sampled from different age groups, ethnicity, education level, and level of glycemic control (as reflected by the glycated hemoglobin [HbA1c]), to achieve maximum variation in sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked, and analyzed using a thematic approach.

    RESULTS: A total of 15 participants were interviewed, and thematic saturation was reached. The factors that influenced SMBG were mainly related to cost, participants' emotion, and the SMBG process. The barriers identified included: frustration related to high blood glucose reading; perception that SMBG was only for insulin titration; stigma; fear of needles and pain; cost of test strips and needles; inconvenience; unconducive workplace; and lack of motivation, knowledge, and self-efficacy. The facilitators were: experiencing hypoglycemic symptoms; desire to see the effects of dietary changes; desire to please the physician; and family motivation.

    CONCLUSION: Participants' perceptions of the purpose of SMBG, the emotions associated with SMBG, and the complexity, pain, and cost related to SMBG as well as personal and family motivation are the key factors that health care providers must consider when advising people with diabetes on SMBG.

  18. Al-Qerem W, Hammad A, Alsajri AH, Al-Hishma SW, Ling J, Mosleh R
    Patient Prefer Adherence, 2022;16:307-319.
    PMID: 35153477 DOI: 10.2147/PPA.S350917
    PURPOSE: The Coronavirus Disease 2019 (COVID-19) pandemic poses a serious threat to countless lives. Development of an efficient vaccination can help end the pandemic. Vaccine hesitancy/refusal is a huge issue that could stymie attempts to combat the disease. The goal of this study is to examine COVID-19 vaccine hesitancy in Iraq where at the end of July 2021, only 7.4% of the population was vaccinated.

    PARTICIPANTS AND METHODS: This is a cross-sectional web-based study. A survey was used to assess knowledge, attitudes and practice (KAP) toward COVID-19. Willingness to be vaccinated against COVID-19 was assessed, with a logistic regression used to identify variables associated with vaccine acceptance. Motives for vaccination refusal/hesitation were reported.

    RESULTS: A total of 1542 participants (females = 56.7%) completed the questionnaire. Participants displayed high knowledge and good protective practices toward COVID-19 (median score = 15 out of 19 and 20 out of 25 respectively). 88.6% were willing to be vaccinated. Variables associated with vaccine acceptance included have not been infected with COVID-19 (OR=0.53, p=0.01), low- and moderate-income (ORs=0.42 and 0.63, p<0.01 respectively), low education level (OR=0.33, p-value<0.01) and perceived degree of vaccination importance (OR=1.30, P-value<0.01). The most mentioned reasons for vaccine refusal were concerns about vaccine safety and side effects (90.35%) and the need for more information about the vaccine (81.2%).

    CONCLUSION: Participants showed high acceptance toward COVID-19 vaccination, nevertheless more efforts should be applied to overcome barriers mentioned by the participants.

  19. Ng DL, Gan GG, Chai CS, Chee KH, Tan KL, Tan SB, et al.
    Patient Prefer Adherence, 2019;13:1363-1373.
    PMID: 31616136 DOI: 10.2147/PPA.S204246
    Introduction and aim: Patient quality of life (QOL) while on long-term oral anticoagulant therapy has been receiving greater attention in recent years due to the increase in life expectancy brought about by advances in medical care. This study aimed to compare the QOL, treatment satisfaction, hospitalization and bleeding rate in patients on long-term warfarin versus direct oral anticoagulants (DOAC).

    Methods: This was a cross-sectional study of patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE) on long-term anticoagulant therapy attending the cardiology clinic and anticoagulation clinic of the University Malaya Medical Centre from July 1, 2016, to June 30, 2018. Patient QOL was assessed by using the Short Form 12 Health Survey (SF12), while treatment satisfaction was assessed by using the Perception of Anticoagulation Treatment Questionnaire 2 (PACT-Q2).

    Results: A total of 208 patients were recruited; 52.4% received warfarin and 47.6% received DOAC. There was no significant difference in QOL between warfarin and DOAC based on SF12 (physical QOL, P=0.083; mental QOL, P=0.665). Nevertheless, patients in the DOAC group were significantly more satisfied with their treatment compared to the warfarin group based on PACT-Q2 (P=0.004). The hospitalisation rate was significantly higher in the warfarin group than the DOAC group (15.6% versus 3.0%, P=0.002). Clinically relevant minor bleeds and severe bleeding events were non-significantly higher in the warfarin group than the DOAC group (66.7% versus 40.0%, P=0.069).

    Conclusion: Compared to warfarin, treatment of NVAF and VTE with DOAC showed comparable QOL, higher treatment satisfaction, lesser hospitalization, and a non-significant trend toward fewer bleeding episodes.

  20. Hassan FH, Zakaria AS, Ahmad Rusli Y, Haris SM, Mohd Azraai H
    Patient Prefer Adherence, 2023;17:1731-1740.
    PMID: 37492636 DOI: 10.2147/PPA.S407347
    PURPOSE: This study compared the satisfaction of recipients of conventional speech-language therapy (C-SLT), speech-language teletherapy (SLTT), and hybrid speech-language therapy (H-SLT), and determined sociodemographic factors that affect their satisfaction.

    PATIENTS AND METHODS: Participants were clients and caregivers of a speech-language clinic at a public university. Services were primarily provided by student clinicians, who were undergoing supervised clinical training. An online survey was distributed, which consisted of three sections: Background Information, Overall Satisfaction in SLT, and Satisfaction in SLTT. All participants completed the first two sections, while the third section was completed only by those who experienced SLTT or H-SLT.

    RESULTS: Most of the respondents were caregivers (89.7%), female (79.4%), of Malay ethnicity (80.9%), have received tertiary education (77.9%), within the low-income category (66.2%), held a job (76.5%), and resided in central West Malaysia (83.8%). Many participants experienced C-SLT (51%), followed by H-SLT (34%), and SLTT (15%). There were no significant differences in the overall satisfaction of the participants across three modes of services delivery (F[2,67] = 0.02, p = 0.95), and in the satisfaction with teletherapy between the H-SLT and SLTT groups (t = 0.90, p = 0.38). Income was the only sociodemographic factor that was correlated with the satisfaction level in teletherapy (r = 0.37, p = 0.04).

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