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  1. Lian PC, Marnoch G
    J Manag Med, 1999;13(2-3):178-89.
    PMID: 10747449
    This paper describes a study of the knowledge and attitudes of a sample of private medical practitioners in Malaysia in relation to questions posed on guidelines-based medicine. The study was conducted through a postal questionnaire sent to a sample of 2,000 private practitioners. Placing the research in context, a description of Malaysia and its health-care system is provided. Issues surrounding guidelines-based medicine in the Malaysian context are discussed. An analysis of the sample population's personal and professional characteristics is presented. Key research findings include identifying a substantial knowledge deficit--less than half of the respondents claimed to understand "guidelines". A majority of doctors (64 per cent) think guidelines are useful. Only 29 per cent of respondents knew where to find guidelines, with 22 per cent claiming to have used guidelines. The paper concludes with a discussion of issues in the implementation of guidelines-based medicine in Malaysia based on the study's findings.
    Matched MeSH terms: Physicians/psychology*; Physicians/statistics & numerical data
  2. Marnoch G, Lian PC
    Soc Sci Med, 2002 Mar;54(6):869-77.
    PMID: 11996021
    This paper considers the subject of managed care in Malaysia, providing a questionnaire-based analysis of the position adopted by private medical practitioners. Managed care is now seen as the dominant health care system in the United States, with many other countries around the world including Malaysia beginning to selectively use component parts to tackle particular health care problems. In this survey it was found that three out of four respondents have concerns regarding the implementation of managed care. The survey was used to identify and categorise these concerns. At the same time, three out of four respondents held the opinion that principles of managed care were already a reality or would be in the next 5 years. This group expressed an eagerness to be trained in managed care principles and be given the opportunity to be part of managed care organisations. It is argued that clinicians' knowledge and interest perceptions are an important influence on the implementation of managed care based systems. The survey-based evidence presented in this article is intended as a measure of current understandings and beliefs, in relation to clinical micro-management process associated with managed care.
    Matched MeSH terms: Physicians/psychology*; Physicians/statistics & numerical data
  3. Ng CJ, Low WY, Tan NC, Choo WY
    Int J Impot Res, 2004 Feb;16(1):60-3.
    PMID: 14963472 DOI: 10.1038/sj.ijir.3901141
    The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED (active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background.
    Matched MeSH terms: Practice Patterns, Physicians'; Physicians, Family/psychology*
  4. Ngim CF, Lai NM, Ibrahim H
    Prenat Diagn, 2013 Dec;33(13):1226-32.
    PMID: 24014379 DOI: 10.1002/pd.4233
    OBJECTIVE: Genetic counseling for thalassemia carriers is conducted by nongeneticist health care workers (HCWs) in many countries. The aim of the study was to assess Malaysian HCWs' genetic counseling practices with regards to discussing prenatal diagnosis (PND) and termination of pregnancy (TOP) when counseling thalassemia carriers.
    METHOD: A total of 118 Malaysian HCWs (52 doctors and 66 nurses) completed a structured questionnaire that enquired if they would discuss PND and TOP when counseling couples with thalassemia traits, and reasons for their responses were explored.
    RESULTS: All the nurses and 50 (96.1%) doctors were in favor of discussing PND. Only 29 (58%) doctors and 33 (50%) nurses were agreeable to discuss about the option of TOP. Main reasons given for declining to discuss TOP were views that "the condition was not serious enough" (54.9%), TOP is not permissible by their religion (17.6%) and abortion for this indication was illegal (13.7%).
    CONCLUSION: The results showed that HCWs in Malaysia lacked the comprehensive information and necessary skills required when counseling thalassemia carriers. When nongeneticist HCWs are tasked with such responsibilities, their practices and attitudes should be regularly evaluated so that areas of deficiencies could be identified and addressed.
    Matched MeSH terms: Physicians/psychology; Physicians/statistics & numerical data
  5. Low WY, Ng CJ, Tan NC, Choo WY, Tan HM
    Asian J Androl, 2004 Jun;6(2):99-104.
    PMID: 15154082
    Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED).
    Methods: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs.
    Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impotent drugs. Cardiovascular side effects and cost were two most important drug barriers.
    Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patients and drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.
    Matched MeSH terms: Physicians, Family*; Physicians, Primary Care
  6. Cheung TK, Lim PW, Wong BC
    Dig Dis Sci, 2007 Nov;52(11):3043-8.
    PMID: 17436083 DOI: 10.1007%2Fs10620-007-9764-x
    Noncardiac chest pain (NCCP) is common and has a significant impact on health care. Primary care physicians (PCPs)' attitudes, clinical approach, preference of diagnostic tests, referral patterns, and comfort in managing patients with NCCP in the Asia-Pacific region are not known. Consequently, we performed this survey in the Asia-Pacific region. The self-completed questionnaire was sent to PCPs in the Asia-Pacific region. A 28-item questionnaire contained questions on demographic information, characteristics of practice, preferences of diagnostic tests, referral patterns, treatment plans, and opinion on Helicobacter pylori and NCCP. A total of 108 (74%) PCPs returned the questionnaire. A mean of 18% of the patients were diagnosed with NCCP by PCPs in the past 6 months. Ninety-four percent of PCPs had treated NCCP patients in the last 6 months. Only 38% of the PCPs were comfortable in diagnosing NCCP but 85.2% believed that they should manage NCCP patients. PCPs in Malaysia and Philippines were more likely to refer patients to subspecialists. Fifty-seven and four-tenths percent of PCPs believed that H. pylori infection plays a role in the development of NCCP. The study demonstrates clearly that the understanding, diagnostic strategies, and treatment strategies of NCCP in the Asia-Pacific region are suboptimal and thus highlights the importance of educational and training programs tailored for PCPs in NCCP.
    Matched MeSH terms: Practice Patterns, Physicians'; Physicians, Family*
  7. Teng CL, Achike FI, Phua KL, Norhayati Y, Nurjahan MI, Nor AH, et al.
    Int J Antimicrob Agents, 2004 Nov;24(5):496-501.
    PMID: 15519484 DOI: 10.1016/j.ijantimicag.2004.06.015
    Antibiotic prescribing by primary care doctors has received renewed interest due to the continuing emergence of antibiotic resistance and the attendant cost to healthcare. We examined the antibiotic prescribing rate in relation to selected socio-demographic characteristics of the prescribers at the Seremban Health Clinic, a large public primary care clinic, designated for teaching, in the state of Negeri Sembilan, Malaysia. Data were obtained from: (1) retrospective review of prescriptions for the month of June 2002 and (2) a questionnaire survey of prescribers. A total of 10667 prescriptions were reviewed. The overall antibiotic prescribing rate was 15%; the rate (16%) was higher for the general Outpatient Department (OPD) than the 3% for the Maternal & Child Health Clinic (MCH). The antibiotic prescription rates for upper respiratory tract infection (URTI) were 26% and 16%, respectively, for the OPD and MCH. Half of all the antibiotic prescriptions were for URTI making prescribing for URTI an appropriate target for educational intervention. The URTI-specific antibiotic prescription rate did not correlate with the prescribers' intention to specialise, patient load, perceived patient's expectation for an antibiotic, or the score for knowledge of streptococcal tonsillitis. Prescribing behaviours and record-keeping practices requiring correction were identified.
    Study site: Klinik Kesihatan Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*; Physicians, Family
  8. Wong LP, Edib Z, Alias H, Mohamad Shakir SM, Raja Muhammad Yusoff RNA, Sam IC, et al.
    J Obstet Gynaecol, 2017 Oct;37(7):937-943.
    PMID: 28641049 DOI: 10.1080/01443615.2017.1317239
    Assessing physicians' experiences in HPV vaccine recommendation and delivery to adolescent boys is essential to providing an understanding of the issues of vaccine acceptance and an insight for policymakers to enhance HPV vaccinations among adolescent boys. Between January and April 2014 a mail survey was conducted using physicians in Malaysia known to provide either one or both HPV vaccine (Gardasil and Cervarix) immunisation services. A total of 357 completed questionnaires were received (response rate 22.5%). Of these, 335 physicians see adolescent boys aged 11 to 18 years old in their practice. Only 26.3% (n = 88) recommended the HPV vaccine to these boys. A total of 46.6% (n = 41) have successfully given the HPV vaccine to adolescent boys. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to the boys (37.2%) and a lack of awareness of the availability of the vaccine for boys (32.8%) were the most commonly cited reasons for non-recommendation. Impact statement Recommending the HPV vaccine for adolescent boys remains a challenge for physicians. Our study provides evidence of challenges and barriers faced by Malaysian physicians who recommend the HPV vaccines (Gardasil and Cervarix) in their practices. In this study, physicians reported HPV vaccine uptake by adolescent boys was very poor. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to boys and a lack of awareness of the availability of the vaccine for boys were the most commonly cited reasons for non-recommendation. Physicians viewed that support and encouragement from the health authorities are needed to promote the recommendation of the HPV vaccine to adolescent boys. Physicians were also of the opinion that the lay public should be educated about the availability of the HPV vaccine for boys, and its benefits, safety and efficacy, and the high susceptibility of boys to getting HPV infections. The findings provide insights that could be helpful to policymakers or high-level decision-makers of the potential strategies to enhance HPV uptake among adolescent boys.
    Matched MeSH terms: Practice Patterns, Physicians'; Physicians/psychology*
  9. Ooi CY, Hanafi NS, Liew SM
    Singapore Med J, 2019 Nov;60(11):596-604.
    PMID: 30644527 DOI: 10.11622/smedj.2019011
    INTRODUCTION: Colorectal cancer (CRC) was the third most commonly diagnosed cancer worldwide in 2008 (1.23 million cases, 9.7%). CRC screening was shown to be effective in reducing 70% of CRC mortality. However, the screening rate for CRC remains poor.

    METHODS: A cross-sectional survey was conducted among primary care physicians (PCPs) in public primary care clinics in Kuala Lumpur, Malaysia. A 30-item self-administered questionnaire was used to assess the knowledge and practice of CRC screening.

    RESULTS: The response rate was 86.4% (n = 197/228). Less than half (39.1%) of the respondents answered correctly for all risk stratification scenarios. Mean knowledge score on CRC screening modalities was 48.7% ± 17.7%. The knowledge score was positively associated with having postgraduate educational qualification and usage of screening guidelines. Overall, 69.9% of PCPs reported that they practised screening. However, of these, only 25.9% of PCPs screened over 50% of all eligible patients. PCPs who agreed that screening was cost-effective (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.69‒6.59) and those who agreed that they had adequate resources in their locality (OR 1.92, 95% CI 1.01‒3.68) were more likely to practise screening. Knowledge score was not associated with the practice of screening (p = 0.185).

    CONCLUSION: Knowledge and practice of CRC screening was inadequate among PCPs. Knowledge of screening did not translate into its practice. PCPs' perceptions about cost-effectiveness of screening and adequate resources were important determinants of the practice of screening.

    Matched MeSH terms: Practice Patterns, Physicians'; Physicians, Primary Care*
  10. Wong SS, Abdullah N, Abdullah A, Liew SM, Ching SM, Khoo EM, et al.
    BMC Fam Pract, 2014 Apr 16;15:67.
    PMID: 24739595 DOI: 10.1186/1471-2296-15-67
    BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease with repeated exacerbations resulting in gradual debilitation. The quality of life has been shown to be poor in patients with COPD despite efforts to improve self-management. However, the evidence on the benefit of self-management in COPD is conflicting. Whether this could be due to other unmet needs of patients have not been investigated. Therefore, we aimed to explore unmet needs of patients from both patients and doctors managing COPD.

    METHODS: We conducted a qualitative study with doctors and patients in Malaysia. We used convenience sampling to recruit patients until data saturation. Eighteen patients and eighteen doctors consented and were interviewed using a semi-structured interview guide. The interviews were audio-recorded, transcribed verbatim and checked by the interviewers. Data were analysed using a thematic approach.

    RESULTS: The themes were similar for both the patients and doctors. Three main themes emerged: knowledge and awareness of COPD, psychosocial and physical impact of COPD and the utility of self-management. Knowledge about COPD was generally poor. Patients were not familiar with the term chronic obstructive pulmonary disease or COPD. The word 'asthma' was used synonymously with COPD by both patients and doctors. Most patients experienced difficulties in their psychosocial and physical functions such as breathlessness, fear and helplessness. Most patients were not confident in self-managing their illness and prefer a more passive role with doctors directing their care.

    CONCLUSIONS: In conclusion, our study showed that knowledge of COPD is generally poor. There was mislabelling of COPD as asthma by both patients and physicians. This could have resulted in the lack of understanding of treatment options, outcomes, and prognosis of COPD. The misconception that cough due to COPD was contagious, and breathlessness that resulted from COPD, had important physical and psychosocial impact, and could lead to social isolation. Most patients and physicians did not favour self-management approaches, suggesting innovations based on self-management may be of limited benefit.

    Matched MeSH terms: Physicians, Primary Care/standards*; Physicians, Primary Care/statistics & numerical data
  11. Khan AH, Syed Sulaiman A, Hassali AA, Saleem F, Aftab RA, Ali I
    Value Health, 2014 Nov;17(7):A725.
    PMID: 27202576 DOI: 10.1016/j.jval.2014.08.050
    Conference abstract:
    Objectives: To evaluate physician’s knowledge and adherence to asthma guideline adherence (GINA 2011) at emergency department of Hospital Pulau Pinang, Malaysia and to calculate cost of adhered and non-adhered prescriptions
    Methods: A cross-sectional survey was conducted to evaluate knowledge of GINA, 2011 asthma guideline at emergency department of Hospital Pulau Pinang, Malaysia. A total of 810 patient prescriptions of 27 doctors (30 prescriptions per doctor) were viewed to asses doctor’s guideline adherence. Patients’ prescriptions were categorised in terms of asthma severity as mild, moderate and severe. Prescriptions were labelled as adhered or non-adhered in terms of doctor treatment according to patient asthma severity as recommended by CPG (GINA 2011). Cost of adhered and non-adhered was calculated according to asthma severity.
    Results: Twenty two (81.5%) doctor’s had adequate GINA, 2011 asthma guideline knowledge (Mean 16.7, SD ± 1.5). Six hundred and twenty eight (77.5%) patients received guideline (GINA 2011) adhered pharmacotherapy. Six hundred and seventy eight (83.7%) patients asthma were classified as mild asthma, 128 (15.8%) patients were classified as moderate asthma and 4 (0.5%) patients were classified as severe asthma. Pearson correlation indicated no statistical significant association between asthma guideline adherence and asthma guideline knowledge score (p=0.27). Univariate analysis indicate that patients with age group 25-35 years and with hypertension as co-morbidity received significantly better pharmacotherapy (p=0.04, p=0.03 respectively). Total cost of 628 adhered prescriptions was RM 5792.87 whereas cost of 182 non-adhered prescriptions was RM 1759.09. Cost of single mild asthma adhered prescription (RM 9.18) was less as compared to non adhered mild asthma prescription (RM 10.39).
    Conclusions: Emergency doctor’s had adequate GINA, 2011 asthma guideline knowledge. Majority of patients received GINA, 2011 asthma guideline adhered pharmacotherapy. Cost effective medication can significantly reduce socioeconomic burden related to asthma.
    Matched MeSH terms: Physicians
  12. Yaroko A, Mohamad I, Hashim H
    Malays Fam Physician, 2014;9(1):30-2.
    PMID: 25606296 MyJurnal
    Rhinoliths result from neglected nasal foreign bodies that gradually increase in size. They are usually discovered incidentally during routine ENT examination or due to the associated symptoms such as nasal obstruction or persistent foul-smelling unilateral nasal discharge. A case of a 14-year-old girl was reported with a year history of the symptom. The foul-smelling nasal discharge noted by her mother was not the main concern to them. She was referred by her primary care physician as she complained of impacted ear wax. However, rhinolith was incidentally found upon routine clinical examination in the ENT clinic and was removed uneventfully.
    Matched MeSH terms: Physicians, Primary Care
  13. Mahmoud MA, Alsowaida Y, Alshammari T, Khan TM, Alrasheedy A, Hassali MA, et al.
    Saudi Pharm J, 2014 11;22(5):411-8.
    PMID: 25473329 DOI: 10.1016/j.jsps.2013.07.005
    OBJECTIVE: To assess community pharmacists' knowledge, behaviors and experiences relating to Adverse Drug Reaction (ADR) reporting in Saudi Arabia.

    METHODS: A cross-sectional study was conducted using a validated self-administered questionnaire. A convenience sample of 147 community pharmacists working in community pharmacies in Riyadh, Saudi Arabia.

    RESULTS: The questionnaire was distributed to 147 pharmacists, of whom 104 responded to the survey, a 70.7% response rate. The mean age of participants was 29 years. The majority (n = 101, 98.1%) had graduated with a bachelorette degree and worked in chain pharmacies (n = 68, 66.7%). Only 23 (22.1%) said they were familiar with the ADR reporting process, and only 21 (20.2%) knew that pharmacists can submit ADR reports online. The majority of the participants (n = 90, 86.5%) had never reported ADRs. Reasons for not reporting ADRs most importantly included lack of awareness about the method of reporting (n = 22, 45.9%), misconception that reporting ADRs is the duty of physician and hospital pharmacist (n = 8, 16.6%) and ADRs in community pharmacies are simple and should not be reported (n = 8, 16.6%). The most common approach perceived by community pharmacists for managing patients suffering from ADRs was to refer him/her to a physician (n = 80, 76.9%).

    CONCLUSION: The majority of community pharmacists in Riyadh have poor knowledge of the ADR reporting process. Pharmacovigilance authorities should take necessary steps to urgently design interventional programs in order to increase the knowledge and awareness of pharmacists regarding the ADR reporting process.

    Matched MeSH terms: Physicians
  14. Kumar A, Mitra K, Nagarajan S, Poudel B
    N Am J Med Sci, 2014 Mar;6(3):119-25.
    PMID: 24741550 DOI: 10.4103/1947-2714.128473
    BACKGROUND: In future, increase in the number of healthcare professionals is dependent on the career interest among present undergraduate medical students. Based on their interest to pursue their specialty, the availability of medical doctors in each specialty could be done.
    AIMS: This study was to find out future career interest and factors that influence undergraduate medical students to choose their future specialization.
    MATERIALS AND METHODS: The study was carried out among first-year medical students from five countries. The students were asked to complete an 8-item questionnaire. Two thousand one hundred fifty three participants were enrolled in the study. Data were analyzed in Microsoft-Excel and Statistical Package for the Social Sciences.
    RESULTS: Of the 2153 participants, only 1470 responded. Among the 1470 participants, 169 participants were excluded due to the ambiguity in responses, finally making it to 1301 participants. Among them, Anatomy (49.3%) followed by Biochemistry (26.7%) and Physiology (24%) were the most preferred subjects.
    CONCLUSIONS: Anatomy was the most preferred basic science subject among the other subjects and the students were interested to pursuing surgery in future. Furthermore, the most preferred future specialties were surgery, internal medicine and pediatrics with gender variations; males preferring surgery and females in obstetrics and gynecology.
    KEYWORDS: China; First year medical students; Malaysia; Medical Education; Post-Graduation; SAARC country
    Matched MeSH terms: Physicians
  15. Norlehan AS, Aisyah MZ, Rozimah O, Lee PY, Ng CJ
    Malays Fam Physician, 2014;9(2):34-40.
    PMID: 25883763
    INTRODUCTION: Continuous professional development (CPD) is an important aspect of a medical practitioner's career. AIMing to be at par with other developed countries for high quality of professional practice, Malaysia is planning to implement compulsory CPD for the doctors.
    AIM: The aim of the study was to explore the private general practitioners' (GPs) views, experiences and needs regarding CPD programme in the primary care service.
    METHODS: This study used a qualitative methodology. Seven semi-structured interviews and three focus group discussions were conducted with private general practitioners from an urban area of Malaysia between January and December 2012. An interview topic guide was developed based on literature review and researchers' discussions and it was used to guide the interviews. All the interviews were audio-recorded, transcribed verbatim and the transcripts formed the data for analysis using the thematic approach.
    RESULTS: GPs undertook a wide range of CPD programmes to keep up with medical advances, meet patients' expectations and improve financial rewards. Conferences, lectures and online recourses were the most mentioned methods of keeping updated. Some of the GPs felt that peer motivation and networking seem to motivate and facilitate participation in CPD programmes. However, they were wary of the validity and relevance of some CPD programmes, particularly those related to pharmaceutical industry. Although the participants agreed to the new mandatory CPD regulation, they voiced concerns on how it would be implemented and wished for a more effective method of monitoring.
    CONCLUSIONS: Organised peer support and relevant CPD content may improve GP participation in CPD but adequate regulatory measure should be in place to monitor the CPD activities.
    KEYWORDS: Private general practitioner; continuous; medical education; primary care; professional development; qualitative study
    Matched MeSH terms: Physicians, Primary Care
  16. Tong SF, Low WY, Ismail SB, Trevena L, Wilcock S
    Transl Androl Urol, 2013 Dec;2(4):281-90.
    PMID: 26816741 DOI: 10.3978/j.issn.2223-4683.2013.09.14
    BACKGROUND: Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors' decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors' perceptions of men's receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men.
    METHODS: This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors' intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors' attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors' intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated.
    RESULTS: 198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men's receptivity to sexual health inquiry significantly predicted the doctors' intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (P<0.0001) and health checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (P<0.001). Lower cost to health checks only predicted their intention in the follow-up visits (P=0.010).
    CONCLUSIONS: Whilst sexual health inquiry should be initiated in an appropriate context, 'perceived receptivity' to sexual health inquiry significantly affected doctors' intention in initiating sexual health inquiry to their male patients. Malaysian men's health may be substantially improved by strategies that assist doctors to identify patient 'receptivity'.
    Matched MeSH terms: Physicians, Primary Care
  17. Aziz NA, Muhamad S, Manaf MR, Hamid MZ
    Int J Prev Med, 2013 Jun;4(6):664-70.
    PMID: 23930184
    BACKGROUND: Primary health care workers (PHCW) are the front-liners in any infectious disease outbreaks. The recent outbreak of H1N1 influenza demonstrated that uptake of H1N1 vaccination remained low amongst PCHW despite its proven effectiveness. This trend is worrying as PHCW are the first point of contact in any emerging outbreak of future influenza epidemic. To investigate factors influencing willingness of H1N1 vaccination amongst PHCW.
    METHODS: A cross-sectional survey using self-reported questionnaire assessing perception and practice towards H1N1 Influenza A vaccination. A score of 34/50 was used as a cut-off score that divide good and poor perception. Logistic regression analysis used to explore the association between acceptance to be vaccinated and chosen variables.
    RESULTS: The mean age was 33.91 (SD: 8.20) with mean year of service of 9.23 (SD: 8.0). Acceptance of H1N1 vaccination was 86.3%. A total of 85.9% perceived the vaccination can prevent serious disease. Willingness to be vaccinated influenced by perception at risk of having illness (OR: 10.182, CI: 1.64-63.23, P 0.013) and need for vaccination (OR: 11.35, CI: 4.67-27.56, P < 0.0001).
    CONCLUSIONS: PCHW were generally willing to be vaccinated should H1N1 Influenza epidemic emerges in the future. However, acceptance of vaccination was influenced by factors of benefit to prevent illness and reduction of spread of the illness. Fear of side-effects remained a barrier toward acceptance which should be taken into account in planning of preparation for future wave of outbreak.
    Matched MeSH terms: Physicians, Primary Care
  18. Hwu WL, Okuyama T, But WM, Estrada S, Gu X, Hui J, et al.
    Mol Genet Metab, 2012 Sep;107(1-2):136-44.
    PMID: 22864057 DOI: 10.1016/j.ymgme.2012.07.019
    Mucopolysaccharidosis (MPS) type VI (Maroteaux-Lamy syndrome) is a clinically heterogeneous lysosomal storage disorder. It presents significant diagnostic and treatment challenges due to the rarity of the disease and complexity of the phenotype. As information about MPS VI in Asia-Pacific countries is limited, a survey was conducted to assess current practices for diagnosis and management of MPS VI in this region. The participants were selected based on their experience in diagnosing and managing MPS patients.
    Matched MeSH terms: Physicians
  19. Fathil SM, Soong NS, Mustafa NM, Arith A, Ng WN, Bahrum NA, et al.
    Med J Malaysia, 2011 Jun;66(2):89-91.
    PMID: 22106683 MyJurnal
    Pain management in Malaysian Emergency Departments has not been studied well. Convenience sampling was used to recruit 402 patients who presented with acute pain over a 2-week period. The 11-point Numerical Rating Scale was used to quantify pain. Pain relieving medications were prescribed to 178 patients (44.3%) in the Emergency Department. These patients had a median pain score of 7 on arrival. Nonsteroidal anti inflammatory drugs were the most commonly prescribed class of analgesic. Pain was found to be inadequately treated.
    Matched MeSH terms: Practice Patterns, Physicians'
  20. Lai NM, Teng CL, Lee ML
    BMC Med, 2011;9:30.
    PMID: 21450083 DOI: 10.1186/1741-7015-9-30
    BACKGROUND: Independent evaluation of clinical evidence is advocated in evidence-based medicine (EBM). However, authors' conclusions are often appealing for readers who look for quick messages. We assessed how well a group of Malaysian hospital practitioners and medical students derived their own conclusions from systematic reviews (SRs) and to what extent these were influenced by their prior beliefs and the direction of the study results.
    METHODS: We conducted two cross-sectional studies: one with hospital practitioners (n = 150) attending an EBM course in June 2008 in a tertiary hospital and one with final-year medical students (n = 35) in November 2008. We showed our participants four Cochrane SR abstracts without the authors' conclusions. For each article, the participants chose a conclusion from among six options comprising different combinations of the direction of effect and the strength of the evidence. We predetermined the single option that best reflected the actual authors' conclusions and labelled this as our best conclusion. We compared the participants' choices with our predetermined best conclusions. Two chosen reviews demonstrated that the intervention was beneficial ("positive"), and two others did not ("negative"). We also asked the participants their prior beliefs about the intervention.
    RESULTS: Overall, 60.3% correctly identified the direction of effect, and 30.1% chose the best conclusions, having identified both the direction of effect and the strength of evidence. More students (48.2%) than practitioners (22.2%) chose the best conclusions (P < 0.001). Fewer than one-half (47%) correctly identified the direction of effect against their prior beliefs. "Positive" SRs were more likely than "negative" SRs to change the participants' beliefs about the effect of the intervention (relative risk (RR) 1.8, 95% confidence interval 1.3 to 2.6) and "convert" those who were previously unsure by making them choose the appropriate direction of effect (RR 1.9, 95% confidence interval 1.3 to 2.8).
    CONCLUSIONS: The majority of our participants could not generate appropriate conclusions from SRs independently. Judicious direction from the authors' conclusions still appears crucial to guiding our health care practitioners in identifying appropriate messages from research. Authors, editors and reviewers should ensure that the conclusions of a paper accurately reflect the results. Similar studies should be conducted in other settings where awareness and application of EBM are different.
    Matched MeSH terms: Physicians
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