Displaying publications 1 - 20 of 88 in total

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  1. Abbavannagari Bharath Kumar, Marakanam Srinivasan Umashankar, Sandeep Podda
    MyJurnal
    Introduction: Diabetes is a chronic metabolic disease and noted to be incidence is intensifying globally and contem- plated as epidemic. The study is aimed to assess the coronary artery disease risk profile associated diabetes mellitus patient and to identify the clinical pharmacist care services in the management and to control the risk burden in the clinical practice. Method: A prospective observational study was conducted among the consecutive patients of coronary artery disease associated diabetic patients in a tertiary care teaching hospital over 6 months period. A sam- ple of 150 patients was recruited in the study. Data analysis was done with graph pad prism software 5.01. Results: The present study revealed that coronary artery disease in diabetes was more prevalent in age group between 41-50 years. About 54.66% patients with hyperlipidemia were at risk to develop the coronary artery disease complication. Glycated hemoglobin test was detected in 40% of the patient showing abnormal levels and around 43.33% of patient had an abnormal fasting blood sugar level. The study showed only 32% of patients was prescribed Insulin & oral hy- poglycemic agents and 13 % were treated with statins. Conclusion: It could be concluded that the causative factors should be controlled and treated with an early need for amalgamation of clinical pharmacist care services with the health care team on life style modification counseling could ultimately improve the patient health outcomes and also lowers progression of coronary artery disease risk complications among diabetic patients.
    Matched MeSH terms: Patient Care Team
  2. Abdul Aziz AF, Mohd Nordin NA, Ali MF, Abd Aziz NA, Sulong S, Aljunid SM
    BMC Health Serv Res, 2017 Jan 13;17(1):35.
    PMID: 28086871 DOI: 10.1186/s12913-016-1963-8
    BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking.

    METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted. In Phase One, experts chartered current care processes in public healthcare facilities, from acute stroke till discharge and also patients who presented late with stroke symptoms to public primary care health centres. In Phase Two, modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices. Care algorithms were designed around existing work schedules at public health centres.

    RESULTS: Indication for patients eligible for monitoring by primary care at public health centres were identified. Gaps in transfer of care occurred either at post discharge from acute care or primary care patients diagnosed at or beyond subacute phase at health centres. Essential information required during transfer of care from tertiary care to primary care providers was identified. Care algorithms including appropriate tools were summarised to guide primary care teams to identify patients requiring further multidisciplinary interventions. Shared care approaches with Specialist Stroke care team were outlined. Components of the iCaPPS were developed simultaneously: (i) iCaPPS-Rehab© for rehabilitation of stroke patients at community level (ii) iCaPPS-Swallow© guided the primary care team to screen and manage stroke related swallowing problems.

    CONCLUSION: Coordinated post stroke care monitoring service for patients at community level is achievable using the iCaPPS and its components as a guide. The iCaPPS may be used for post stroke care monitoring of patients in similar fragmented healthcare delivery systems or areas with limited access to specialist stroke care services.

    TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016).
    Matched MeSH terms: Patient Care Team/organization & administration
  3. Abu Kasim NH, Abu Kassim NL, Razak AA, Abdullah H, Bindal P, Che' Abdul Aziz ZA, et al.
    Eur J Dent Educ, 2014 Feb;18(1):51-7.
    PMID: 24423176 DOI: 10.1111/eje.12058
    Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.
    Matched MeSH terms: Patient Care Team
  4. Ahmad NA, Naimie Z, Lui JL, Aziz AA, Abdullah M, Abu Kasim NH, et al.
    J Dent Educ, 2012 Oct;76(10):1377-83.
    PMID: 23066138
    This study is part of ongoing educational research conducted by the Department of Conservative Dentistry, University of Malaya, Malaysia, to evaluate the perception of clinical pairing. A thirteen-question survey was distributed to 148 dental students after they had experienced four-handed dentistry. The objectives were to identify the advantages, disadvantages, and the acceptance of the implementation of clinical pairing from the students' point of view. The responses from the open-ended questions were categorized into six main themes (areas of interest): quality-related (Q), patient-related (PT), partner-related (P), lecturer-related (T), infection control (IC), and learning environment (L). Data analysis was done using SPSS version 18. Results indicated that the students perceived they possessed enough knowledge regarding clinical pairing. However, it was found that they still preferred to work independently as compared to working in pairs. The benefits of clinical pairing may not be viewed in the same vein by both dental students and teachers. The quality-related theme was perceived by students as the main advantage of clinical pairing, whilst the partner-related theme was perceived otherwise. The study also revealed that students may have some preconceived notions about pairing that may have impaired their acceptance. As a consequence, some reluctance was seen in their responses.
    Matched MeSH terms: Patient Care Team*
  5. Allayla, Tuqa Haitham, Nouri, Ahmed Ibrahim, Hassal, Mohamed Azmi
    MyJurnal
    Emergence of various global health problems has widened the pharmacist’s job scope. An accessible resource for health and medication information as the pharmacist strengthen the existing public health system. Achievement of optimal patient outcomes involves community and clinical pharmacist safe and effective medication use. However, the public is still unaware of the pharmacist’s role in public and global health. This essay aims to identify pharmacist’s role in overcoming global health problems with a literature review. Pharmacists’ role change from public care provider to public care profession. The roles of pharmacists in health care team as primary care practitioners can be seen in their management of tropical and chronic diseases. With their evaluation skills and extensive knowledge of drugs. Pharmacists can provide the best medical advice to the patients besides promoting selftreatment on minor ailments. Furthermore, they also help in reducing the medical costs and optimising medications for the patients. The faith of the public in pharmacists on vaccination proves that they accept the involvement of pharmacists in healthcare provision. However, the public awareness towards pharmacists’ role should be improved.
    Matched MeSH terms: Patient Care Team
  6. Azhar S, Hassali MA, Mohamed Ibrahim MI, Saleem F, Siow Yen L
    J Adv Nurs, 2012 Jan;68(1):199-205.
    PMID: 21658097 DOI: 10.1111/j.1365-2648.2011.05728.x
    This paper is a report of a study of nurses' perception towards the role of pharmacist in Pakistan healthcare setup.
    Matched MeSH terms: Patient Care Team/organization & administration*
  7. Bhattacharya K, Balasubramaniam S, Choy YS, Fietz M, Fu A, Jin DK, et al.
    Orphanet J Rare Dis, 2014;9:192.
    PMID: 25433535 DOI: 10.1186/s13023-014-0192-7
    Morquio A syndrome is an autosomal recessive lysosomal storage disease often resulting in life-threatening complications. Early recognition and proficient diagnosis is imperative to facilitate prompt treatment and prevention of clinical complications.
    Matched MeSH terms: Patient Care Team/standards
  8. Bilal S, Doss JG, Cella D, Rogers SN
    J Craniomaxillofac Surg, 2015 Mar;43(2):274-80.
    PMID: 25555894 DOI: 10.1016/j.jcms.2014.11.024
    Health-related quality of life (HRQoL) associated factors are vital considerations prior to treatment decision-making for head and neck cancer patients. The study aimed to identify potential socio-demographic and clinical prognostic value of HRQoL in head and neck cancer patients in a developing country. The Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N)-V4 in Urdu language was administered among 361 head and neck cancer patients. Data were statistically tested through multivariate analysis of variance (MANOVA) and regression modeling to identify the potentially associated factors. Treatment status, tumor stage and tumor site had the strongest negative impact on patients HRQoL, with a statistically significant decrement in FACT summary scales (effect size >0.15). Moderate associated factors of HRQoL included treatment type, marital status, employment status and age (effect size range 0.06-0.15). Weak associated factors of HRQoL with a small effect size (>0.01-0.06) included tumor size and type, gender, education level and ethnicity. This study reports 12 socio-demographic and clinical variables that have a significant impact on HRQoL of head, and neck cancer patients, and that should be considered during treatment decision-making by multidisciplinary teams and also in future HRQoL studies conducted in other developing countries.
    Matched MeSH terms: Patient Care Team
  9. Boon IS, Lim JS, Yap MH, Au Yong TPT, Boon CS
    J Med Imaging Radiat Sci, 2020 12;51(4S):S114-S115.
    PMID: 32859543 DOI: 10.1016/j.jmir.2020.08.011
    Matched MeSH terms: Patient Care Team
  10. Brock T, Vu T, Kadirvelu A, Lee CY, Kent F
    Med Educ Online, 2020 Dec;25(1):1780697.
    PMID: 32552527 DOI: 10.1080/10872981.2020.1780697
    BACKGROUND: To promote better collaboration for patient care, interprofessional education (IPE) is required in many health professions courses. However, successful IPE implementation at scale can be challenging because of complicated logistics and competing priorities. Implementing across multiple geographies adds further complexity.

    OBJECTIVE: This paper describes the implementation of a full cohort IPE activity for medical and pharmacy students delivered at both the Australian and Malaysian campuses of Monash University.

    DESIGN: We designed a 150-minute, blended learning activity centred around asthma care for second-year medical and pharmacy students. Student perceptions were measured with a pre- and post-activity survey using the validated ten-item, three-factor, SPICE-R2 instrument. Analysis focused on differences between professions and countries.

    RESULTS: All second-year medicine (N = 301 in Australia and N = 107 in Malaysia) and pharmacy students (N = 168 in Australia and N = 117 in Malaysia) participated in the learning activity. A total of 326/693 (47%) students participated in the associated research by completing both the pre- and post-activity surveys. The pre-activity survey showed significant differences in four items between medicine and pharmacy students in Australia and two items in Malaysia. Post-activity, we observed significant changes in 8/10 items when the two professions were combined. Specifically, we noted changes across the countries in perceptions of roles and responsibilities for collaborative practice and patient outcomes from collaborative practice.

    CONCLUSIONS: IPE across different professions and countries is feasible. Positive outcomes in role understanding and perceived patient outcomes are achievable through a context-sensitive, locally driven approach to implementation. Longitudinal experiences may be required to influence perceptions of teamwork and team-based care.

    Matched MeSH terms: Patient Care Team/organization & administration
  11. Chan MW, Cheah HM, Mohd Padzil MB
    Int J Clin Pharm, 2019 Oct;41(5):1282-1289.
    PMID: 31302884 DOI: 10.1007/s11096-019-00878-4
    Background Hyperphosphatemia is a common consequence in end stage renal disease. It is associated with increased cardiovascular risk and mortality, also development of hyperparathyroidism and mineral bone disease. A patient educational program involving physician, pharmacist and dietician was developed to manage hyperphosphatemia among hemodialysis patients. Objective To investigate the efficacy of the program in optimal phosphate control among hemodialysis patients. Setting Kuala Lipis Hospital, Malaysia. Method This was a non-randomized, single-arm community trial running for a period of 6 months. The program consisted of a small group seminar and individual counseling sessions. Two individual counseling sessions were conducted for each patient, focusing on diet and medication adherence, by an accredited dietician and pharmacist respectively. The group seminar was delivered by a multidisciplinary team involving a physician, pharmacist and dietician. Topics included basic knowledge of hyperphosphatemia, phosphate binder and dietary phosphate control. Eligible and consented patients had knowledge and medication adherence assessment, measurement of pre-dialysis serum calcium, albumin, phosphate, haemoglobin and alkaline phosphatase before and after the educational program. Main outcome measure Phosphate level, knowledge and medication adherence assessment. Results Fifty-seven patients completed the program and were included into final data analysis. The median (IQR) phosphate level (mmol/L) was 1.86 (1.45-2.24) before and decreased to 1.47 (1.21-1.91) and 1.49 (1.28-1.81) 3 months and 6 months after PEP (p patients with uncontrolled phosphate level was reduced from 59.3 to 35.6% and 42.1% after the PEP (p = 0.003). The mean knowledge score almost doubled after the intervention, with a mean pre-score of 8.61 (95% CI 7.85-9.37) to mean post-score of 15.31 (95% CI 14.85-15.76). The adherence to phosphate binder also improved from 17.2 to 41.4% after PEP (p = 0.007). Conclusion A multidisciplinary patient education program is an effective approach to manage hyperphosphatemia among hemodialysis patients in Malaysia.
    Matched MeSH terms: Patient Care Team
  12. Chen PC
    Ann Acad Med Singap, 1984 Apr;13(2):264-71.
    PMID: 6497324
    The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.
    Matched MeSH terms: Patient Care Team
  13. Chen PC
    Trop Geogr Med, 1977 Jun;29(2):192-6.
    PMID: 906079
    Domiciliary deliveries have always been the responsibility of traditional birth attendants. Since Independence, acquired in 1957, educated young women have been trained as auxiliary midwives and sent to serve in rural communities where they usually are met with resistance by the established traditional birth attendants. To counter this and to incorporate the traditional birth attendants into the health team, new roles were developed for each so that the two would be able to cooperate and support each other rather than rival and antagonise each other. A specific experience in one area of Malaysia is examined as an example.
    Matched MeSH terms: Patient Care Team*
  14. Chen PCY
    Soc Sci Med Med Psychol Med Sociol, 1981 Mar;15A(2):127-36.
    PMID: 7244696 DOI: 10.1016/0271-7123(81)90032-8
    Malaysia has a large variety of traditional medical systems that are a direct reflection of the wide ethnic diversity of its population. These can be grouped into four basic varieties, namely, traditional “native”. traditional Chinese. traditional Indian, and modem medicine, examples of which are described. In spite of the great inroads made by modem medicine, the traditional systems are firmly established. Patients move from one system to another or use several systems simultaneously. The integration of the traditional Malay birth attendant into the health team is described. The forces influencing the development, acceptance, and integration of the medical systems are discussed.
    Matched MeSH terms: Patient Care Team
  15. Chong PF, Paraidathathu T
    Asia Pac J Clin Nutr, 2013;22(4):548-56.
    PMID: 24231015 DOI: 10.6133/apjcn.2013.22.4.15
    The effectiveness of the Nutrition Support Team (NST) at Hospital Sungai Buloh, a large public hospital in Kuala Lumpur, Malaysia, in optimising parenteral nutrition (PN) has not been evaluated. To evaluate the effects of this NST in optimising patient outcomes, treatment outcomes, and adherence to biochemical monitoring guidelines, two groups of patients, those given PN before (n = 106) NST intervention and those given PN after (n=106) NST intervention, were retrospectively compared. Intervention by the NST significantly reduced metabolic abnormalities, reducing sodium abnormalities from 67% to 44% (p<0.01); potassium abnormalities from 42% to 15% (p<0.01); magnesium abnormalities from 13% to 3% (p<0.05) and phosphate abnormalities from 21% to 9% (p=0.01). Intervention by the NST also significantly reduced the incidence of hypertriglyceridemia from 68% to 45% (p=0.002) and significantly improved adherence to biochemical monitoring guidelines from 46% to 72% (p<0.01). However, the length of hospital stay, patient mortality, and duration of PN were similar in both groups. This study failed to demonstrate that the establishment of a NST gave better outcomes in terms of the common measures of effectiveness. In conclusion, although management by an NST significantly reduced metabolic abnormalities and improved adherence to biochemical monitoring guidelines, the NST did not improve patient mortality rates and length of hospital stay.
    Matched MeSH terms: Patient Care Team*
  16. Chu ECP, Lo FS, Bhaumik A
    J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
    PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19
    Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.
    Matched MeSH terms: Patient Care Team
  17. Chua SS, Kok LC, Yusof FA, Tang GH, Lee SW, Efendie B, et al.
    BMC Health Serv Res, 2012;12:388.
    PMID: 23145922 DOI: 10.1186/1472-6963-12-388
    BACKGROUND: The roles of pharmacists have evolved from product oriented, dispensing of medications to more patient-focused services such as the provision of pharmaceutical care. Such pharmacy service is also becoming more widely practised in Malaysia but is not well documented. Therefore, this study is warranted to fill this information gap by identifying the types of pharmaceutical care issues (PCIs) encountered by primary care patients with diabetes mellitus, hypertension or hyperlipidaemia in Malaysia.
    METHODS: This study was part of a large controlled trial that evaluated the outcomes of multiprofessional collaboration which involved medical general practitioners, pharmacists, dietitians and nurses in managing diabetes mellitus, hypertension and hyperlipidaemia in primary care settings. A total of 477 patients were recruited by 44 general practitioners in the Klang Valley. These patients were counselled by the various healthcare professionals and followed-up for 6 months.
    RESULTS: Of the 477 participants, 53.7% had at least one PCI, with a total of 706 PCIs. These included drug-use problems (33.3%), insufficient awareness and knowledge about disease condition and medication (20.4%), adverse drug reactions (15.6%), therapeutic failure (13.9%), drug-choice problems (9.5%) and dosing problems (3.4%). Non-adherence to medications topped the list of drug-use problems, followed by incorrect administration of medications. More than half of the PCIs (52%) were classified as probably clinically insignificant, 38.9% with minimal clinical significance, 8.9% as definitely clinically significant and could cause patient harm while one issue (0.2%) was classified as life threatening. The main causes of PCIs were deterioration of disease state which led to failure of therapy, and also presentation of new symptoms or indications. Of the 338 PCIs where changes were recommended by the pharmacist, 87.3% were carried out as recommended.
    CONCLUSIONS: This study demonstrates the importance of pharmacists working in collaboration with other healthcare providers especially the medical doctors in identifying and resolving pharmaceutical care issues to provide optimal care for patients with chronic diseases.
    TRIAL REGISTRATION: ClinicalTrials.gov NCT00490672.
    Study name: Cardiovascular Risk Factors Intervention Strategies (CORFIS) trial
    Matched MeSH terms: Patient Care Team
  18. Chua, Philip Yi Shean, Lee, Sue Laine, Tow, Zhen Jiang, Mantok, Richmund, Muhamad Khairul Hawari Muhamad Nor, Dorairaja, Lavena, et al.
    Int J Public Health Res, 2013;3(1):223-231.
    MyJurnal
    Rapid Rural Appraisal (RRA) is a systematic, semi-structured activity carried out in the field by a multidisciplinary team that is designed to obtain new information and hypotheses about rural life. This article reports the results of an RRA conducted in Kampung Paris 1 (KGP1), Kinabatangan, Sabah under the Annual Health Promotion Program of the School of Medicine, Universiti Malaysia Sabah. A systematic random sampling was used to recruit the villagers and data was obtained through compilation of pre-existing data, field observation, structured interviews with key informants and villagers. Cardiorespiratory diseases were prevalent in KGP1. Common water sources such as rain water collected in dug wells in KGP1 were unhygienic. Dangerous toxic fumes were produced by the burning of municipal wastes nearby village houses. The villagers of KGP1 were exposed to various farm animals, which may harbor zoonoses. Health care services are limited in KGP1. Villagers who were not poor (>RM897) represented 48% of the population, followed by the poor (RM503-897), 20% and the hardcore poor (1.00 person per bedroom. Poor water hygiene, polluted air from open burning, exposure to farm animals, poverty, poor education, overcrowding and inadequate health care services were among the few possible factors affecting the health of villagers in KGP1. Formal rigorous research should be conducted in the future to facilitate specific health interventions in areas of need such as KGP1.
    Matched MeSH terms: Patient Care Team
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