Displaying publications 1 - 20 of 576 in total

  1. Fletcher MJ, Tsiligianni I, Kocks JWH, Cave A, Chunhua C, Sousa JC, et al.
    NPJ Prim Care Respir Med, 2020 06 17;30(1):29.
    PMID: 32555169 DOI: 10.1038/s41533-020-0184-0
    Asthma imposes a substantial burden on individuals and societies. Patients with asthma need high-quality primary care management; however, evidence suggests the quality of this care can be highly variable. Here we identify and report factors contributing to high-quality management. Twelve primary care global asthma experts, representing nine countries, identified key factors. A literature review (past 10 years) was performed to validate or refute the expert viewpoint. Key driving factors identified were: policy, clinical guidelines, rewards for performance, practice organisation and workforce. Further analysis established the relevant factor components. Review evidence supported the validity of each driver; however, impact on patient outcomes was uncertain. Single interventions (e.g. healthcare practitioner education) showed little effect; interventions driven by national policy (e.g. incentive schemes and teamworking) were more effective. The panel's opinion, supported by literature review, concluded that multiple primary care interventions offer greater benefit than any single intervention in asthma management.
    Matched MeSH terms: Primary Health Care
  2. Dhabali AA, Awang R, Hamdan Z, Zyoud SH
    Int J Clin Pharmacol Ther, 2012 Dec;50(12):851-61.
    PMID: 23006441 DOI: 10.5414/CP201689
    OBJECTIVES: The objectives of this study were 1) to obtain information regarding the prescribing pattern of nonsteroidal anti-inflammatory drugs (NSAIDs) in the primary care setting at a Malaysian university, 2) to determine the prevalence and types of potential NSAID prescription related problems (PRPs), and 3) to identify patient characteristics associated with exposure to these potential PRPs.
    METHODS: We retrospectively collected data from 1 academic year using the electronic medical records of patients in the University Sains Malaysia (USM) primary care system. The defined daily dose (DDD) methodology and the anatomical therapeutic chemical (ATC) drug classification system were used in the analysis and comparison of the data. Statements representing potential NSAID PRPs were developed from authoritative drug information sources. Then, algorithms were developed to screen the databases for these potential PRPs. Descriptive and comparative statistics were used to characterize DRPs.
    RESULTS: During the study period, 12,470 NSAID prescriptions were prescribed for 6,509 patients (mean ± SD = 1.92 ± 1.83). This represented a prevalence of 35,944 per 100,000 patients, or 36%. Based on their DDDs, mefenamic acid and diclofenac were the most prescribed NSAIDs. 573 potential NSAID-related PRPs were observed in a cohort of 432 patients, representing a prevalence of 6,640 per 100,000 NSAIDs users, or 6.6% of all NSAID users. Multivariate logistic regression analysis revealed that patients with a Malay ethnic background (p < 0.001), members of the staff (p < 0.001), having 4 or more prescribers (p < 0.001) or having 2 - 3 prescribers (p = 0.02), and representing 4 or more long-term therapeutic groups (LTTGs) (p < 0.001) or 2 - 3 LTTGs (p < 0.001) were significantly associated with an increased chance of exposure to potential NSAID related PRPs.
    CONCLUSIONS: This is the first study in Malaysia that presents data on the prescribing pattern of NSAIDs and the characteristics of potential NSAID-related PRPs. The prevalence of potential NSAID-related PRPs is frequent in the primary care setting. Exposure to these PRPs is associated with specific sociodemographic and health status factors. These results should help to raise the awareness of clinicians and patients about serious NSAID PRPs.

    Study site: University Sains Malaysia (USM) primary care system.
    Matched MeSH terms: Primary Health Care*
  3. Dhabali AA, Awang R, Zyoud SH
    J Clin Pharm Ther, 2012 Aug;37(4):426-30.
    PMID: 22081958 DOI: 10.1111/j.1365-2710.2011.01314.x
    WHAT IS KNOWN AND OBJECTIVE: Drug-drug interactions (DDIs) cause considerable morbidity and mortality worldwide and may lead to hospital admission. Sophisticated computerized drug information and monitoring systems, more recently established in many of the emerging economies, including Malaysia, are capturing useful information on prescribing. Our aim is to report on an investigation of potentially serious DDIs, using a university primary care-based system capturing prescription records from its primary care services.
    METHODS: We retrospectively collected data from two academic years over 20 months from computerized databases at the Universiti Sains Malaysia (USM) from users of the USM primary care services.
    RESULTS AND DISCUSSION: Three hundred and eighty-six DDI events were observed in a cohort of 208 exposed patients from a total of 23,733 patients, representing a 2-year period prevalence of 876·4 per 100,000 patients. Of the 208 exposed patients, 138 (66·3%) were exposed to one DDI event, 29 (13·9%) to two DDI events, 15 (7·2%) to three DDI events, 6 (2·9%) to four DDI events and 20 (9·6%) to more than five DDI events. Overall, an increasing mean number of episodes of DDIs was noted among exposed patients within the age category ≥70 years (P=0·01), an increasing trend in the number of medications prescribed (P<0·001) and an increasing trend in the number of long-term therapeutic groups (P<0·001).
    WHAT IS NEW AND CONCLUSION: We describe the prevalence of clinically important DDIs in an emerging economy setting and identify the more common potentially serious DDIs. In line with the observations in developed economies, a higher number of episodes of DDIs were seen in patients aged ≥70 years and with more medications prescribed. The easiest method to reduce the frequency of DDIs is to reduce the number of medications prescribed. Therapeutic alternatives should be selected cautiously.

    Study site: e Universiti Sains Malaysia (USM
    Matched MeSH terms: Primary Health Care/statistics & numerical data*
  4. Dhabali AA, Awang R, Zyoud SH
    Int J Clin Pharmacol Ther, 2011 Aug;49(8):500-9.
    PMID: 21781650 DOI: 10.5414/cp201524
    BACKGROUND: The prescription of contraindicated drugs is a preventable medication error, which can cause morbidity and mortality. Recent data on the factors associated with drug contraindications (DCIs) is limited world-wide, especially in Malaysia.

    AIMS: The objectives of this study are 1) to quantify the prevalence of DCIs in a primary care setting at a Malaysian University; 2) to identify patient characteristics associated with increased DCI episodes, and 3) to identify associated factors for these DCIs.

    METHODS: We retrospectively collected data from 1 academic year using computerized databases at the Universiti Sains Malaysia (USM) from patients of USM's primary care. Descriptive and comparative statistics were used to characterize DCIs.

    RESULTS: There were 1,317 DCIs during the study period. These were observed in a cohort of 923 patients, out of a total of 17,288 patients, representing 5,339 DCIs per 100,000 patients, or 5.3% of all patients over a 1-year period. Of the 923 exposed patients, 745 (80.7%) were exposed to 1 DCI event, 92 (10%) to 2 DCI events, 35 (3.8%) to 3 DCI events, 18 (2%) to 4 DCI events, and 33 patients (3.6%) were exposed to 5 or more DCI events. The average age of the exposed patients was 30.7 ± 15 y, and 51.5% were male. Multivariate logistic regression analysis revealed that being male (OR = 1.3; 95% CI = 1.1 - 1.5; p < 0.001), being a member of the staff (OR = 3; 95% CI = 2.5 - 3.7; p < 0.001), having 4 or more prescribers (OR = 2.8; 95% CI = 2.2 - 3.6; p < 0.001), and having 4 or more longterm therapeutic groups (OR = 2.3; 95%CI = 1.7 - 3.1; p < 0.001), were significantly associated with increased chance of exposure to DCIs.

    DISCUSSION AND CONCLUSIONS: This is the first study in Malaysia that presents data on the prevalence of DCIs. The prescription of contraindicated drugs was found to be frequent in this primary care setting. Exposure to DCI events was associated with specific socio-demographic and health status factors. Further research is needed to evaluate the relationship between health outcomes and the exposure to DCIs.
    Matched MeSH terms: Primary Health Care/standards; Primary Health Care/statistics & numerical data*
  5. Lane MJ, Zulkifli A
    Family Physician, 1995;7:16-20.
    The aim of this study was first to analyse the prescribing habits of primary care doctors with a view to providing feedback which may help them to rationalise their prescribing. This analysis was helped by comparing the prescribing practices in two different settings and thus highlighting anomalous differences. The second aim of this study was to obtain data on the diagnoses being made in primary care settings in Malaysia as this information, though available from other countries, is limited here. Lists of the most commonly prescribed drugs and most common diagnoses made are provided, together with tables showing the most commonly prescribed drugs for the ten most common diagnoses. Differences in prescribing habits between the two settings are discussed and possible reasons are suggested.
    Matched MeSH terms: Primary Health Care
  6. Muthanna A, Salim HS, Hamat RA, Shamsuddin NH, Zakariah SZ
    Malays J Med Sci, 2018 Nov;25(6):6-21.
    PMID: 30914875 MyJurnal DOI: 10.21315/mjms2018.25.6.2
    This review highlights the clinical scoring tools used for the management of acute pharyngotonsillitis in primary care clinics. It will include the prevalence of group A pharyngotonsillitis among children and adults worldwide and the selective tests employed for diagnosing group A streptococcal pharyngotonsillitis. Pharyngotonsillitis is one of the common reasons for visits to primary care clinics worldwide, and physicians tend to prescribe antibiotics according to the clinical symptoms, which leads to overprescribing antibiotics. This in turn may lead to serious health impacts and severe reactions and may promote antibiotic resistance. These significantly add on to the health care costs. The available information from health organisations and previous studies has indicated the need to manage the diagnosis of pharyngotonsillitis to improve prescribing habits in primary care clinics.
    Matched MeSH terms: Primary Health Care
  7. Nik Yusof Fuad NF, Ching SM, Awg Dzulkarnain DH, Cheong AT, Zakaria ZA
    BMC Complement Med Ther, 2020 Jun 26;20(1):197.
    PMID: 32586306 DOI: 10.1186/s12906-020-02984-7
    BACKGROUND: Complementary alternative medicine (CAM) is widely used among postpartum mothers to maintain their well-being. This study aims to determine the prevalence and factors associated with CAM use among postpartum mothers in a primary-care clinic in Malaysia.

    METHODS: This is a cross-sectional study of 725 postpartum mothers, aged 18 and above, attending a primary-care clinic. The systematic sampling method was used to recruit patients through a structured, self-administered questionnaire. Data analysis was conducted using SPSS version 23. Multiple logistic regression was used to identify the predictors of CAM use among postpartum mothers.

    RESULTS: The prevalence of CAM use among postpartum mothers was 85.5%. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping were the most widely used methods of CAM (84.1%) among postpartum mothers, followed by biological-based therapies (33.1%). More than half of the respondents (52.1%) opted to use CAM, as they had observed good results from other CAM users. However, our study showed that 57.1% of mothers who consumed herbal medicine reported neonatal jaundice in their newborn. The median of the expenditure on CAM usage was 250 Malaysian Ringgits, or USD 61.3 per month. According to multiple logistic regression analyses, being Muslim (OR = 5.258, 95% CI: 2.952-9.368), being Malay (OR = 4.414, 95% CI: 1.18-16.56), having a higher educational level (OR = 2.561, 95% CI: 1.587-4.133) and having delivered via spontaneous vaginal delivery (OR: 5.660, 95% CI: 3.454-9.276) had a significantly positive association with CAM use among postpartum mothers.

    CONCLUSIONS: The prevalence of CAM use was high (8 out of 10) among postpartum mothers. Postpartum mothers who are Malay, Muslim, have a higher educational level and who have had spontaneous vaginal delivery tended to use CAM more. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping, were the most widely used forms of CAM, followed by biological-based therapies. More than half of the mothers who consumed herbal medicine reported neonatal jaundice in their newborn. Thus, education to increase awareness regarding the consumption of herbs is urgently required in this country.

    Matched MeSH terms: Primary Health Care
  8. Ooi CP, Loke SC, Zaiton A, Tengku-Aizan H, Zaitun Y
    Med J Malaysia, 2011 Jun;66(2):108-12.
    PMID: 22106688 MyJurnal
    Knowledge of the characteristics of older adults with type 2 diabetes mellitus (T2DM) is indispensible for improvement of their care. A cross-sectional study in two rural public primary healthcare centres in Malaysia identified 170 actively engaged older patients with T2DM, with suboptimal glycaemic control and frequent hypoglycaemia. The prevalence of multiple co-morbidities, complications of T2DM, high cardiovascular risk, neurological, musculoskeletal and visual deficits suggested high risk of disabilities and dependency but not yet disabled. This short window for interventions presents as an opportunity for development of a more comprehensive approach extending beyond glycaemia control to risk management, preventing functional loss and continuity of social participation.
    Study site: Klinik Kesihatan, Selangor, Malaysia
    Matched MeSH terms: Primary Health Care*
  9. Chew BH, Lee PY, Mastura I, Cheong AT, Sri Wahyu T, Zaiton A
    An audit of Diabetes Control and Management-Diabetes Registry Malaysia (ADCM-DRM) was started to monitor the provision of diabetes care in the country. A total of 20,646 patients were registered in the registry until 31st December 2008. This report set out to determine the Type 2 diabetes controls and treatment profiles of these cohorts of patients. This was a registry-based observational study conducted from May to December, 2008. An online standard case record form was available for site data providers to register their diabetic patients aged 18 years old and above annually. Demographic data, diabetes duration, treatment modalities, as well as various risk factors and diabetes complications were reported. Data were analyzed using Data Analysis and Statistical Software (Stata) version 9. A total of 81 centres, 6 of which were hospitals, participated in this registry until 31st December 2008, contributing a total of 20646 patients. A majority of them (99.2%) had Type 2 diabetes mellitus. The mean HbA1c was 8.0% (SD 2.10), with 30.1% and 17.9% of the patients who attained HbA1c < 7% and HbA1c < 6.5%, respectively. Metformin was prescribed more than sulfonylurea while only 11% had insulin. A review of the diabetic care policy and strategies in the primary health care clinics is needed to implement a more effective treatment of diabetes in this country.
    Matched MeSH terms: Primary Health Care
  10. Nik Azis NM, Zainol Abidin K
    Our study aimed to assess the knowledge, attitudes and practice behaviours of primary healthcare professionals in government Maternal and Child Healthcare Clinics (MCHC) on the association between oral health and pregnancy outcomes namely pre-term and/or low birth weight (PT/LBW) infants and to identify the barriers of utilisation of oral healthcare services by pregnant mothers. Questionnaires were distributed to government healthcare professionals working at all seven government MCHC in the Manjung District, Malaysia. 136 out of 158 questionnaires were returned completed yielding a 92% response rate. The questionnaire covers respondents characteristics, attitude and practice behaviours related to oral health and barriers faced when referring pregnant mothers to the dental clinic. 65% of respondents noticed dental/ gum problems in the pregnant mothers that they encountered. The two most frequent response for outcome of delivery linked to gum/ dental problems were premature delivery (49%) responses and low birth weight (27%). Although 95% of the respondents believed that regular dental check-ups is compulsory for pregnant mothers, only 69% regularly refer pregnant mothers for dental check-ups. There was a significance between healthcare professionals that receive continuing dental education and their referrals of antenatal mothers for dental check-ups .
    Study site: Maternal and Child Health Clinics (Klinik Kesihatan), Manjung District, Perak, Malaysia.
    Matched MeSH terms: Primary Health Care
  11. Syed A, Mohd Don Z, Ng CJ, Lee YK, Khoo EM, Lee PY, et al.
    BMJ Open, 2017 05 09;7(5):e014260.
    PMID: 28490553 DOI: 10.1136/bmjopen-2016-014260
    OBJECTIVE: To investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations.
    DESIGN: Conversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin.
    SETTING: Primary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia.
    PARTICIPANTS: Clinicians and seven patients with type 2 diabetes to whom insulin had been recommended. Purposive sampling was used to select a sample high in variance across healthcare settings, participant demographics and perspectives on insulin.
    PRIMARY OUTCOME MEASURES: Interaction between doctors and patients in a clinical consultation involving the use of a PDA about starting insulin.
    RESULTS: Doctors brought the PDA into the conversation mainly by asking information-focused 'yes/no' questions, and used the PDA for information exchange only if patients said they had not read it. While their contributions were limited by doctors' questions, some patients disclosed issues or concerns. Although doctors' PDA-related questions acted as a presequence to deliberation on starting insulin, their interactional practices raised questions on whether patients were informed and their preferences prioritised.
    CONCLUSIONS: Interactional practices can hinder effective PDA implementation, with habits from ordinary conversation potentially influencing doctors' practices and complicating their implementation of patient-centred decision-making. Effective interaction should therefore be emphasised in the design and delivery of PDAs and in training clinicians to use them.
    Matched MeSH terms: Primary Health Care
  12. Pereira XV, Zainab AM
    Malays Fam Physician, 2007;2(3):102-105.
    PMID: 25606094 MyJurnal
    The management of depression in the primary care setting should ideally take a biological, psychological, and sociological approach. Antidepressants are the most commonly used biological agents in the treatment of depression. Psychological therapies and psychosocial interventions improve the outcome of treatment when combined with pharmacotherapy. Clinical depression is treatable and thus efforts should be made to alleviate the suffering of patients with depression.
    Matched MeSH terms: Primary Health Care
  13. Mohd-Sidik S, Arroll B, Goodyear-Smith F, Zain AM
    Int J Psychiatry Med, 2011;41(2):143-54.
    PMID: 21675346 DOI: 10.2190/PM.41.2.d
    OBJECTIVE: To determine the diagnostic accuracy of the two questions with help question (TQWHQ) in the Malay language. The two questions are case-finding questions on depression, and a question on whether help is needed was added to increase the specificity of the two questions.
    METHOD: This cross sectional validation study was conducted in a government funded primary care clinic in Malaysia. The participants included 146 consecutive women patients receiving no psychotropic drugs and who were Malay speakers. The main outcome measures were sensitivity, specificity, and likelihood ratios of the two questions and help question.
    RESULTS: The two questions showed a sensitivity of 99% (95% confidence interval 88% to 99.9%) and a specificity of 70% (62% to 78%), respectively. The likelihood ratio for a positive test was 3.3 (2.5 to 4.5) and the likelihood ratio for a negative test was 0.01 (0.00 to 0.57). The addition of the help question to the two questions increased the specificity to 95% (89% to 98%).
    CONCLUSION: The two qeustions on depression detected most cases of depression in this study. The questions have the advantage of brevity. The addition of the help question increased the specificity of the two questions. Based on these findings, the TQWHQ can be strongly recommended for detection of depression in government primary care clnics in Malaysia. Translation did not apear to affect the validity of the TQWHQ.
    Matched MeSH terms: Primary Health Care/methods*
  14. Latiff LA, Parhizkar S, Zainuddin H, Chun GM, Rahiman MA, Ramli NL, et al.
    Glob J Health Sci, 2012 Mar;4(2):95-102.
    PMID: 22980156 DOI: 10.5539/gjhs.v4n2p95
    The World Health Organization confirmed that the novel influenza A, H1N1 as a pandemic on 11 June 2009. After less than three months, 182 countries were affected by the pandemic accounting for about 150,000 infected cases and 3000 mortality. Successful H1N1 pandemic management strategies' shaped by making changes in health behavior. The aim of this study was to document patients' knowledge, attitudes and practices (KAP) regarding the pandemic influenza A (H1N1) and its prevention. We performed a cross-sectional study on knowledge, attitudes and practices (KAP) on preventive measures of Influenza A (H1N1) involving 322 patients attending Klinik Kesihatan Jinjang, a primary health care clinic in Kuala Lumpur, Malaysia from May 10 to 26, 2010 using a face to face interview with a structured pre-tested questionnaire. The majority of the respondents were females (56.8%), Malays (43.2%) aged between 18-27 years old (28.9%). There were significant association between knowledge on the complication of H1N1, effectiveness of the treatment, preventive measures of Influenza A (H1N1) and race (p<0.001) and educational level (p<0.001). There were also significant associations between attitude scores of these patients and their gender (p=0.03), and educational level (p=0.001). Practice scores related to H1N1 were found to be significantly associated with race (p<0.001) and educational level (p<0.001). The significant associations were observed between knowledge and attitude (p<0.001), knowledge and practices (p<0.001), as well as attitude and practices related to H1N1 (p<0.001). Knowledge has a crucial effect on patients' attitude and practice particularly in a pandemic spread. So health policy makers should attempt to disseminate information about preventive measures to community in order to improve their preventive practices during pandemics.
    Matched MeSH terms: Primary Health Care*
  15. Hasan UA, Mohd Hairon S, Yaacob NM, Daud A, Abdul Hamid A, Hassan N, et al.
    PMID: 31514391 DOI: 10.3390/ijerph16183356
    Background: Structured education is needed to cultivate safe sharp disposal behavior among diabetic patients. Thus, this study aimed to assess the effectiveness of the Diabetes Community Sharp Disposal Education Module in improving knowledge and sharp disposal practice among Malaysian Type 2 diabetic patients. Methods: This quasi-experimental study was conducted at primary health clinics in two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. A total of 132 Type 2 diabetic patients on insulin therapy were involved, with 68 participants in each control and intervention group. The health education intervention was based on the validated Diabetes Community Sharp Disposal Education Module. The knowledge and practices were measured using a validated questionnaire at baseline, one month, and three months after the intervention. Results: There was a significant increment in the mean knowledge score for intervention group; from baseline to one month follow up and from baseline to three months follow up [Greenhouse-Geisser; F(1.5, 199.7) = 62.38, p < 0.001; effect size (η2) = 0.318]. Intervention group had significantly higher mean knowledge score as compared to control group; at one month and three months follow up [F(1, 134) = 17.38, p < 0.001; effect size (η2) = 0.115]. There was a statistically significant increment in the proportion of participants in the intervention group who practiced the proper community sharp disposal method over time, X2(2) = 52.061, p < 0.001. Conclusions: The Diabetes Community Sharp Disposal Education Module was an effective health education tool to improve knowledge and encourage Malaysian diabetic patients to engage with proper sharp disposal practices.
    Matched MeSH terms: Primary Health Care
  16. Chow SK, Yew KC, Yeap SS
    Family Physician, 2003;12(1):33-34.
    Musculoskeletal complaints are one of the most common presenting symptoms to primary care physicians. However, in Malaysia, there has been no prospective survey to look at this problem. This was a descriptive study to look at the prevalence of non-traumatic musculoskeletal complaints presenting to the primary care clinic at University Malaya Medical Center, Kuala Lumpur. Over a 3-week period, there were 408/4201 patients (9.7%) with non-traumatic musculoskeletal disorders. The most common regional problem was backache and the most commonly made diagnosis was non-specific musculoskeletal pain. In conclusion, musculoskeletal disorders form a significant proportion of primary care consultations and thus should be included in the curriculum for the primary care physician training. Keywords: musculoskeletal disorders, arthritis, primary care
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.
    Matched MeSH terms: Primary Health Care
  17. Nasir NM, Ariffin F, Yasin SM
    Med J Malaysia, 2018 06;73(3):163-169.
    PMID: 29962500 MyJurnal
    INTRODUCTION: Medication adherence has been found to be an important determinant in achieving glycaemic control in Type 2 Diabetes (T2DM) patients. In other patient populations, physician-patient interaction satisfaction was found to influence medication adherence. It is then important to identify if this is also a factor amongst T2DM patients on insulin as poor adherence was associated with increased all-cause mortality.

    METHODS: This was a cross sectional study involving 197 T2DM patients on insulin from two government primary health clinics in Gombak. Physician-patient interaction satisfaction was assessed using Skala Kepuasan Interaksi Perubatan (SKIP-11) consisting of 3 subdomains (Distress Relief, Rapport and Interaction Outcome). Medication adherence level was measured using a single item selfreport question. Data analysis for descriptive, inferential and multivariate analysis statistics were performed.

    RESULTS: The mean age of the study participants was 57.12 (SD: 9.27). Majority were Malay, female, unemployed with mean BMI of 27.5. Majority reported full adherence (62.9%). High scores in the Interaction Outcome subdomain was associated with better adherence. Factors associated with high scores in this subdomain included patient education level, number of oral hypoglycaemic agent and type of insulin regime taken. This study also found that high scores in the Interaction Outcome domain is associated with lower HbA1c (p<0.05).

    CONCLUSION: Physician-patient interaction satisfaction is an important factor in achieving better medication adherence which also leads to better glycaemic control in this group of patients. There is a need to identify strategies to improve satisfaction in this domain to improve patient adherence.

    Matched MeSH terms: Primary Health Care/statistics & numerical data
  18. Sazlina SG, Browning CJ, Yasin S
    BMJ Open, 2012;2(6).
    PMID: 23161092 DOI: 10.1136/bmjopen-2012-002119
    INTRODUCTION: Like many countries Malaysia is facing an increase in the number of people with type 2 diabetes mellitus diabetes (T2DM) and modifiable lifestyle factors such as sedentary behaviour are important drivers of this increase. The level of physical activity is low among elderly Malay people. In Malaysia, strategies to promote physical activity in elderly Malay people with T2DM are not well documented in the research literature. This paper discusses an intervention to increase physical activity in elderly Malay people with T2DM. The aim of our study was to evaluate the effectiveness of personalised feedback alone and in combination with peer support in promoting and maintaining physical activity in comparison with usual care.
    METHODS AND ANALYSIS: A three-arm randomised controlled trial will be conducted among sedentary Malay adults aged 60 years and above with T2DM attending an urban primary healthcare clinic in Malaysia. The participants will be randomised into three groups for a 12-week intervention with a follow-up at 24 and 36 weeks to assess adherence. The primary outcome of this study is pedometer-determined physical activity. Glycaemic and blood pressure control, body composition, cardiorespiratory fitness, balance, lipid profile, health-related quality of life, psychological well-being, social support and self-efficacy for exercise are the secondary measures. Linear mixed models will be used to determine the effect of the intervention over time and between groups. ETHICAL AND DISSEMINATION: The Monash University Human Research Ethics Committee and the Malaysian Ministry of Health's Medical Research Ethics Committee approved this protocol. The findings of this study will be presented at international conferences and published in peer-reviewed journals.
    TRIAL REGISTRATION: This study protocol has been registered with the Malaysian National Medical Research Registry and with the Current Controlled Trial Ltd (http://www.controlled-trials.com/ISRCTN71447000/).
    Matched MeSH terms: Primary Health Care
  19. Yadav H
    There has been a significant decline in maternal mortality from 540 per 100,000 live births
    in I957 to 28 per 100,000 in 2010. This decline is due to several factors. Firstly the introduction of the rural health infrastructure which is mainly constructing health centres and midwife clinics for the rural population. This provided the accessibility and availability of primary health care and specially, antenatal care for the women. This also helped to increase the antenatal coverage for the women to 98% in 2010 and it increased the average number of antenatal visits per women from6 in 1980 to 12 visits in 2010 for pregnant women. Along with the introduction of health centres, another main feature was the introduction of specific programmes to address the needs of the women and children. In the 1950s the introduction of Maternal and Child Health (MCH) programme was an important
    step. Later in the late 1970s there was the introduction of the High Risk Approach in MCH care and Safe Motherhood in the 1980s. In 1990, an important step was the introduction of the Confidential Enquiry into Maternal Deaths (CEMD). Another significant factor in the reduction is the identification of high risk mothers and this is being done by the introduction of the colour coding system in the health centres. Other factors include the increase in the number of safe deliveries by skilled personnel and the reduction in the number of deliveries by the Traditional Birth Attendants (TBAs). The reduction in fertility rate from 6.3 in 1960 to 3.3 in 2010 has been another important factor. To achieve the 2015 Millennium Development Goals (MDG) to further reduce maternal deaths by 50%, more needs to be done especially to identify maternal deaths that are missed by omission or misclassification and also to capture the late maternal deaths.
    Matched MeSH terms: Primary Health Care
  20. Woon TH
    Family Physician, 1996;9:12-16.
    This article highlighted the recent development in the prevention and management of child abuse in Malaysia. There is now a willingness to recognise the conlplex social, moral, medical, educational, legal and economic problems related to child abuse. Multidisciplinary research, comprehensive and longitudinal targeted services to prevent child abuse and neglect are needed.
    Matched MeSH terms: Primary Health Care
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