Displaying publications 1 - 20 of 76 in total

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  1. Aljunid SM, Zwi AB
    Med J Malaysia, 1996 Dec;51(4):426-36.
    PMID: 10968029
    A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.
    Comment in: Hee HW. Differences in public and private health services in a rural district of Malaysia. Med J Malaysia. 1997 Sep;52(3):296-8
    Matched MeSH terms: Private Practice
  2. Wong LP
    Vaccine, 2009 Mar 4;27(10):1622-7.
    PMID: 19100803 DOI: 10.1016/j.vaccine.2008.11.107
    Physicians' experiences in providing human papillomavirus (HPV) immunization were assessed by mailed questionnaire. Response rate of 41.4% was achieved. Malay Muslim physicians were more likely to agree that cultural sensitivity is an issue when recommending HPV vaccines. Pediatricians and family physicians were more likely to agree that acceptance is better if vaccines were recommended to prevent cervical cancer than to prevent a sexually transmitted disease. Near 70% rated success of HPV vaccines recommendation in their practice as very poor with the majority patients preferred to postpone immunization. Physicians reported cultural disparities in vaccine uptake and perceived high vaccination cost limits its use.
    Matched MeSH terms: Private Practice
  3. Maniam T, Ting GS
    Med J Malaysia, 1990 Sep;45(3):225-30.
    PMID: 2152083
    The prescriptions of all patients who attended an urban general practice from September 1987 to December 1987 were studied. Of the 111 patients (60 females and 51 males) who received a psychotropic prescription the commonest presenting complaint was insomnia (56 patients or 50.5%). This was followed by tension, headache and unexplained aches and pains (19 patients or 17.1%), and anxiety (nine patients or 8.1%). Consistent with these presentations a vast majority (92.8%) received a benzodiazepine. The commonest drugs prescribed were Lorazepam and Bromazepam whereas the longer acting benzodiazepines were rarely used. Polypharmacy was rare.
    Matched MeSH terms: Private Practice
  4. Chan SC, Chandramani T, Chen TY, Chong KN, Harbaksh S, Lee TW, et al.
    Med J Malaysia, 2005 Oct;60(4):475-82.
    PMID: 16570710
    An audit of hypertension management was done in October 2004 in nine general practice (GP) clinics. Two structure, ten process and two outcome indicators were assessed. Results showed that targets were achieved in only four indicators, i.e., weight recording (89%), BP monitoring (85.8%), follow-up interval not exceeding 6 months (87.9%) and mean diastolic BP (73.9%). The other indicators (hypertension registry, reminder mechanisms for defaulters, recording of smoking, height, fundoscopy, monitoring of lipid profile, blood sugar, ECG, renal function and achievement of target mean systolic pressure) showed adequacy percentages varying from 22.1 to 68.7. Out of the 1260 patients assessed, 743 (59%) achieved a mean BP < or = 140/90 (or < or = 130/80 mmHg with diabetes mellitus / renal insufficiency) in the last 3 recorded readings. There was a vast difference between individual clinics. Reasons for not achieving targets were discussed and remedial measures for implementation were recommended.
    Matched MeSH terms: Private Practice
  5. Norazida AR, Sivasampu S, Teng CL
    Med J Malaysia, 2014 Oct;69(5):219-23.
    PMID: 25638235 MyJurnal
    BACKGROUND: The indiscriminate use of cough and cold medicines (CCMs) in children has become a public health concern. The study evaluates the prescription pattern of CCMs in primary care setting.
    METHODS: Analysis of CCMs prescription data among children aged 12 years and below who had participated in the National Medical Care Survey (NMCS) 2010. Data was extracted from NMCS 2010, a cross-sectional survey on the primary healthcare service which was carried out from December 2009 to April 2010 in public and private primary care clinics in Malaysia.
    RESULT: Of 21,868 encounters for NMCS 2010, 3574 (16.3%) were children 12 years old and below; 597 (17%) were from public clinics and 2977 (83%) were from private clinics. Of these 3574 encounters, 1748 (49%) children were prescribed with CCM with total of 2402 CCMs. On average, CCMs were prescribed at a rate of 1.3 CCMs per encounter in public clinics and 1.4 CCMs per encounter in private clinics. CCMs containing single ingredient constituted 77% of the prescriptions while 23% were of multiple ingredient preparations. There were 556 (23%) CCMs prescribed to children younger than 2 years. Majority (65%) were prescribed with one CCM per visit, 32% received two CCMs and 3% of the children received three or more CCMs per visit.
    CONCLUSION: Prescription of CCMs to children is common. Prevalence of CCM prescriptions among young children is of concern, in view of concerns about the safety and adverse effects related to the use of CCMs in this age group. Firmer policies and greater effort is needed to monitor the prescriptions of CCMs to children.
    Matched MeSH terms: Private Practice
  6. Ab Rahman N, Teng CL, Sivasampu S
    BMC Infect Dis, 2016 05 17;16:208.
    PMID: 27188538 DOI: 10.1186/s12879-016-1530-2
    BACKGROUND: Antibiotic overuse is driving the emergence of antibiotic resistance worldwide. Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia.

    METHODS: We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic.

    RESULTS: Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics.

    CONCLUSIONS: Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing inappropriate prescribing.
    Matched MeSH terms: Private Practice; Private Practice/statistics & numerical data
  7. Siti Fathilah Kamaluddin
    MyJurnal
    This is a follow-up study to assess the socio demographic profile of a sample of 28,605 women seeking pregnancy terminations at a private clinic in Penang over a seven year period as compared to an earlier study in 1995 of a sample of 23,986 women over a six and a half year period at the same clinic. This study was conducted using computerized patient medical records and paper reports generated from the computer data. The earlier 1995 study showed that the profile of a typical abortion client was a Chinese (60%), housewife (45%) in her late twenties (47%) with a monthly household income of less than RM1,200 (58%), having her first abortion (51%) and who had used contraception before (78%). For the seven year period from 1998-2005, the follow-up profile of a woman seeking an abortion in the same clinic in urban Malaysia was one with a monthly household income of less than RM2,000 (100%) in her late twenties (54%) who had used contraception in the past (85%). It is noted that the percentage of Malay respondents has increased (34%). The percentage of women who had a prior abortion at this clinic or elsewhere has also increased (68%), as compared to the preliminary study. Non-use of contraception remained an issue and traditional methods still outweighed the use of more effective contraceptive methods. In conclusion, fewer housewives and more Malay and Indonesian factory workers contributed to the clinic client profile over these seven years compared to that of the earlier study in 1995.
    Matched MeSH terms: Private Practice
  8. Ariff KM, Schattner P
    Med J Malaysia, 1998 Mar;53(1):82-6.
    PMID: 10968143
    A survey of domestic childhood accidental injuries was conducted at a rural general practice in Arau, Perlis. Data was collected from parents or other caregivers of 171 children, aged 12 years and below, using a pretested questionnaire. Male children between the ages of 6 and 12 years were the most common group affected, with a male to female ratio of 1.7:1. The three most common accidents were injuries from falls (28%), cuts, lacerations, bruises and puncture wounds not resulting from falls (26%), and thermal injuries (22%). The most commonly affected parts of the body were the limbs. Most injuries to children between ages 4 to 12 years occurred in the house compounds, while those to children below 4 years occurred in the kitchen and other locations within the house. Major contributing factors to the injuries were the existence of unsafe home environments, the risk taking activities of the children, the presence of hazardous products in the household and unrealistic parental attitudes to injury prevention.
    Matched MeSH terms: Private Practice
  9. Leong YP, Sappany A
    Med J Malaysia, 1995 Dec;50(4):330-3.
    PMID: 8668052
    The management of abdominal aortic aneurysms (AAA) at a private medical centre was reviewed. The criteria for surgery were AAA more than or equal to five centimeters in diameter, symptomatic AAA even if less than five centimeters and ruptured AAA. A total of 67 patients were seen between October 1991 to September 1994. The age range was 48 to 94 years, mean = 69.8. There were 58 males to nine females. Twelve patients presented with ruptured AAA. There were three suprarenal AAA and three mycotic AAA. Aneurysmectomies were performed on 50 patients. This include all patients with ruptured AAA. There was no mortality in the elective cases. One patient with ruptured AAA died, ie. an operative mortality of eight per cent. It was concluded that a very low operative mortality can be achieved in this group of high risk patients. Our results were comparable to those reported by other centres in the developed countries. Important factors contributing to these results include a team approach in a unit interested in this disease, careful pre-operative preparation and a rigid post-operative regime. For ruptured AAA, survival of the patient depended on a successful and timely operation. It was also concluded that no patient should be deemed unfit for surgery or denied an operation if they needed to have one and it was safe to transport patients with ruptured AAA to a centre where the operation can be performed.
    Matched MeSH terms: Private Practice*
  10. Arshad, A., Rashid, R.
    MyJurnal
    Introduction: Primary care management of knee osteoarthritis OA has received little attention in the scientific literature and the main reason of this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting. Materials and Methods: A cross sectional survey of 100 randomly selected general practitioners (GPs) in the northern states of Malaysia (Kedah, Perlis, Pulau Pinang) was undertaken using questionnaires. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment of OA. They were also asked their usage of conventional and complementary medication. Results: 80 (80%) GPs responded to the questionnaires sent. 85% of GPs were in solo practice and 15% in group practice. Most of the GPs surveyed (69%) were in practice for more than 10 years, 21% in 5- 10 years and 10% were in practice for less than 5 years. 65% GPs surveyed see an average of more than 20 patients per week, 25% see about 10- 20 patients and 10% see less than 10 patients per week. 75% of GPs surveyed would arrange an X-ray. 65% of GPs surveyed will arrange a blood test, mostly serum uric acid, rheumatoid factor and ESR. Pharmacological management consists of first line treatment with analgesics (32%), NSAIDs (59%) or a combination of the two (4%). Non-pharmacological management consist of advise an exercise (37%), weight reduction (23%) and referral to physiotherapy (8%). 89% of GPs surveyed prescribed some form of complementary medications. 68% prescribed glucosamine sulphate, 29% chondroitin sulphate, 18% cod liver oil, 12% evening primrose oil. Only 5% of GPs surveyed perform intra- articular injection. Conclusion: The data suggest that in the primary care, majority of GP over investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesic and NSAIDs. The use of physiotherapy and non drug approach were enormously under-utilized. There is a need to further educate GPs in the management of OA.
    Matched MeSH terms: Private Practice
  11. Penang Chapter, College of General Practitioners, Malaysia
    Med J Malaysia, 1977 Sep;32(1):56-8.
    PMID: 609345
    Matched MeSH terms: Private Practice
  12. 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: Private Practice
  13. Rajakumar MK, Ton SH, Lim KF, Oorloff KH
    Med J Malaysia, 1984 Mar;39(1):65-8.
    PMID: 6513842
    179 heterosexuals, selected for VDRL testing on the basis of a history of involvement in promiscuous sexual activity, mainly prostitution, had their serum also tested for hepatitis B infection markers, HBsAg, HBeAg and anti-HBe. 51 samples (29%) were found to be positive for at least one of the three markers, at levels higher than the already high levels in voluntary random blood donors in Malaysia.
    Matched MeSH terms: Private Practice
  14. Ngeow TF, Chia SF, Ong CB
    Aust Fam Physician, 1981 May;10(5):397-9, 401-3.
    PMID: 7283844
    In a survey of 5233 patients seen in the clinics of three general practitioners, 339 patients were found to be doctor hoppers (6.48 per cent). Respiratory symptoms and fever were the commonest presentation affecting mainly the paediatric age group. No improvement in the symptoms was quoted as the most common reason for switching to another doctor. Many factors contributed to doctor hopping and these were best considered in relation to the illness, the patient and the doctor: From the point of prevention, the doctor himself has a significant role to play, particularly in improving the doctor-patient relationship and patient compliance.
    Study site: Johor (Johor Bahru, Batu Pahat, Muar)
    Matched MeSH terms: Private Practice
  15. O'Holohan DR
    Family Practitioner, 1982;5:13-21.
    Malaria is still a very real threat to health in S.E. Asia including Malaysia. While there has been a dramatic fall in the number of cases and also the number of deaths from the disease in Malaysia cases are still occurring and there has actually been a rise in the number of deaths in the past year. Parts of Perak and the East Coast states are still high risk areas in Peninsular Malaysia. While 95 percent of the population of Peninsular Malaysia is now malaria-free there has also been a concomitant loss of herd immunity which means that if a non-immune person contracts falciparum malaria he stands a greater chance of a fatal outcome. Doctors and other health personnel should be more malaria conscious and make a practice of making blood films of all cases of fever. This is especially important in the rural areas and Estate Hospital Assistants must be encouraged to look for malaria parasites in their fever patients. The younger generation of EHAs have little experience of malaria and a definite policy of education to bring them up to date in antimalarial work and microscopic detection of the parasite should be under taken by the industry. Some problems of chemotherapy and drug resistance are discussed.
    Matched MeSH terms: Private Practice
  16. Ho KC, Russell V, Nyanti L, Chan MW, Hassali MA, Dawood OT, et al.
    Asian J Psychiatr, 2020 Feb;48:101899.
    PMID: 31901584 DOI: 10.1016/j.ajp.2019.101899
    INTRODUCTION: Most primary care in Malaysia is provided by general practitioners in private practice. To date, little is known about how Malaysian General Practitioners (GPs) manage patients with depression. We surveyed privately practising primary care physicians in the state of Penang, Malaysia, in relation to their experience of the Malaysian Clinical Practice Guideline (CPG) in Major Depressive Disorder, their current practice and perceived barriers in managing depression effectively.

    MATERIAL AND METHODS: A questionnaire based on the study aims and previous literature was developed by the authors and mailed to all currently registered GPs in private clinics in Penang. Survey responses were analysed using SSPS version 21.

    RESULTS: From a total of 386 questionnaires distributed, 112 (29%) were returned. Half of the respondents were unaware of the existence of any CPG for depression. One quarter reported not managing depression at all, while one third used anxiolytic monotherapy in moderate-severe depression. Almost 75 % of respondents reported making referrals to specialist psychiatric services for moderate-severe depression. Time constraints, patient non-adherence and a lack of depression management skills were perceived as the main barriers to depression care.

    CONCLUSIONS: Our findings highlight the need to engage privately practising primary care physicians in Malaysia to improve their skills in the management of depression. Future revisions of the Malaysian Depression CPG should directly involve more GPs from private practices at the planning, development and implementation stages, in order to increase its impact.

    Matched MeSH terms: Private Practice/statistics & numerical data*
  17. Erni Noor, Nur Azielyana Noor Kamaruzaman, Nur Syahira Mohd Jeffri, Nik Nazurah Nik Eezammudden, Nur Zety Mohd Noh
    Compendium of Oral Science, 2018;5(1):37-45.
    MyJurnal
    Objectives: Periodontitis is a chronic disease which remain undiagnosed and untreated without proper examination and referral to specialist clinic for further management Therefore, this study was conducted to evaluate the pattern of referrals to Universiti Teknologi MARA (UiTM) Periodontal Specialist Clinic. Materials and methods: A total of 176 periodontal cases referred to UiTM Periodontal Specialist Clinic in year 2011 and 2016 were identified and patient’s referral forms were collected. The data obtained were the referred cases from undergraduate student clinics, other specialist clinics, UiTM primary dental care clinic and private dental clinics. Descriptive data analysis was conducted using frequency distribution by SPSS. Chi square analysis was used to evaluate the association of source of referral, diagnosis and reason for referrals to Periodontal Specialist Clinic. Results: There was increased referral cases to Periodontal Specialist Clinic in 2016 (86.9%) compared to 2011 (13.1%). Most referral to Periodontal Specialist Clinic were received from faculty’s undergraduate student clinic in both 2011 and 2016 (46%), followed by other specialists (27.3%), primary care clinic (25.6%) and private practice (1.1%). 96% of cases were referred for intervention by periodontist as more than half of the cases were referred for the non-surgical periodontal treatment. Chi square analysis showed the association between source of referral and reason for referral was statistically significant (p value=0.000). Conclusion: Proper periodontal screening in all patients and necessary referral to specialist clinic is crucial to prevent undiagnosed periodontal disease.
    Matched MeSH terms: Private Practice
  18. Teng CL, Tong SF, Khoo EM, Lee V, Zailinawati AH, Mimi O, et al.
    Aust Fam Physician, 2011 May;40(5):325-9.
    PMID: 21597554
    Background: Overprescription of antibiotics is a continuing problem in primary care. This study aims to assess the antibiotic prescribing rates and antibiotic choices for upper respiratory tract infections (URTI) and urinary tract infections (UTI) in Malaysian primary care.
    Method: Antibiotic prescribing data for URTI and UTI was extracted from a morbidity survey of randomly selected primary care clinics in Malaysia.
    Results: Analysis was performed of 1163 URTI and 105 UTI encounters. Antibiotic prescribing rates for URTI and UTI were 33.8% and 57.1% respectively. Antibiotic prescribing rates were higher in private clinics compared to public clinics for URTI, but not for UTI. In URTI encounters, the majority of antibiotics prescribed were penicillins and macrolides, but penicillin V was notably underused. In UTI encounters, the antibiotics prescribed were predominantly penicillins or cotrimoxazole.
    Discussion: Greater effort is needed to bring about evidence based antibiotic prescribing in Malaysian primary care, especially for URTIs in private clinics.
    Keywords: general practice, prescriptions, drug; upper respiratory tract infection; urinary tract infection; antibiotics, guideline; evidence based medicine
    Study site: Klinik Kesihatan, Malaysia
    Matched MeSH terms: Private Practice
  19. Ramachandran S, Ngeow YF
    Genitourin Med, 1990 Oct;66(5):334-6.
    PMID: 2245980 DOI: 10.1136/sti.66.5.334
    The prevalence of sexually transmitted diseases was determined among 370 prostitutes in Kuala Lumpur, Malaysia. Chlamydial cervicitis (26.5%) was detected more frequently than gonorrhoea (14.25%) and was associated more often with pelvic inflammatory disease. Concurrent infections and asymptomatic infections were common. Seropositivity to hepatitis B and syphilis were 66.3% and 13.6% respectively. Women under 20 years of age had significantly higher rates of infection with Chlamydia trachomatis and hepatitis B virus than older women.
    Study site: private clinic, Kuala Lumpur, Malaysia
    Matched MeSH terms: Private Practice
  20. Tun Firzara AM, Ng CJ
    BMJ Open, 2016 Sep 29;6(9):e011467.
    PMID: 27687897 DOI: 10.1136/bmjopen-2016-011467
    OBJECTIVE: Screening for prostate cancer remains controversial. General practitioners (GPs) play an important role in assisting men to make an informed decision on prostate cancer screening. The aim of this study was to determine the knowledge and practice of prostate cancer screening among private GPs in Malaysia.
    DESIGN: A cross-sectional study.
    SETTING: Private general practices in Selangor, Malaysia.
    PARTICIPANTS: 311 randomly selected full-time private GPs were recruited between September 2013 and January 2014.
    OUTCOME MEASURES: Questionnaires were distributed to the GPs via postal mail and clinic visits. The main outcomes were: knowledge of prostate cancer risk factors and screening tests; GPs' prostate cancer screening practices; and factors influencing GPs' decision to screen for prostate cancer. Associations between covariates and propensity to screen for prostate cancer were determined using logistic regression.
    RESULTS: The response rate was 65%. The proportion of GPs who overestimated the positive predictive values of prostrate-specific antigen (PSA), digital rectal examination (DRE) and a combination of PSA and DRE was 63%, 57% and 64%, respectively. About 49.5% of the respondents would routinely screen asymptomatic men for prostate cancer; of them, 94.9% would use PSA to screen. Male GPs who would consider having a PSA test performed on themselves were six times more likely to screen asymptomatic men than GPs who would not have the test (OR=6.88, 95% CI 1.40 to 33.73), after adjusting for age and duration of practice.
    CONCLUSIONS: GPs overestimated the accuracy of PSA in prostate cancer screening. Their intention to screen for prostate cancer themselves predicted their propensity to screen their patients for prostate cancer. This finding highlights the potential of using a new approach to change GPs' screening practices via addressing GPs' own screening behaviour.
    KEYWORDS: PREVENTIVE MEDICINE; PRIMARY CARE
    Matched MeSH terms: Private Practice
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