Displaying publications 41 - 60 of 6313 in total

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  1. Tan CS, Hassali MA, Neoh CF, Saleem F, Horne R
    Value Health Reg Issues, 2018 May;15:161-168.
    PMID: 29730249 DOI: 10.1016/j.vhri.2017.12.010
    BACKGROUND: Low rate of adherence was found strongly associated with patients' beliefs across the studies about chronic diseases with hypertension. A crucial move is needed to bridge the gap between appropriate assessment tools and local hypertensive patients' medication adherence.

    OBJECTIVE: To produce a translated version in Malay language of Beliefs about Medicines Questionnaire (BMQ) that was "conceptually equivalent" to the original English version for use in local clinical practice and research.

    METHODS: The forward translation process was conducted by two independent professional translators and back translation was done by two other independent translators. A reliability analysis was conducted on 238 conveniently selected hypertensive patients. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability for the randomly selected 40 patients in a period of 2 weeks. Discriminant validity was tested through Necessity-Concerns differential, BMQ subscales, and other parameters.

    RESULTS: The overall Cronbach alpha for the internal consistency was good (0.860). The subscales of the BMQ demonstrated adequate internal consistency, with Cronbach alpha value of 0.759 for Specific-Necessity, 0.762 for Specific Concern, 0.624 for General-Overuse, and 0.756 for General-Harm. The ICC was excellent (0.922). Discriminant validity revealed that BMQ Specific-Necessity score was significantly inversely correlated with the systolic blood pressure level. Systolic and diastolic blood pressure levels (P = 0.038; P = 0.05) were reported to be significantly correlated with the Necessity-Concerns differential, with Necessity score equal or exceeding Concerns score.

    CONCLUSIONS: The Malay-translated version of BMQ is a reliable and valid tool to assess patient belief about medication, especially medication adherence among the hypertensive patients in Malaysia.
    Matched MeSH terms: Cross-Sectional Studies
  2. Wang Y, Ghoshal AG, Bin Abdul Muttalif AR, Lin HC, Thanaviratananich S, Bagga S, et al.
    Value Health Reg Issues, 2016 May;9:72-77.
    PMID: 27881264 DOI: 10.1016/j.vhri.2015.11.004
    OBJECTIVES: Asia-Pacific Burden of Respiratory Diseases is a cross-sectional, observational study examining the burden of disease in adults with respiratory diseases across six countries. The aim of this study was to describe health care resource use (HCRU), work impairment, cost burden, and health-related quality of life (HRQOL) associated with respiratory disease in the Asia-Pacific.

    METHODS: Consecutive participants aged 18 years or older with a primary diagnosis of asthma, allergic rhinitis, chronic obstructive pulmonary disease, or rhinosinusitis were enrolled. Participants completed a survey detailing respiratory symptoms, HCRU, work productivity and activity impairment, and HRQOL. Locally sourced unit costs for each country were used in the calculation of total costs.

    RESULTS: The study enrolled 5250 patients. Overall, the mean annual cost for patients with a respiratory disease was US $4191 (SGD 8489) per patient. For patients who reported impairment at work, the mean annual cost was US $7315 (SGD 10,244), with productivity loss being the highest cost component for all four diseases (US $6310 [SGD 9100]). On average, patients were impaired for one-third of their time at work and 5% of their work time missed because of respiratory disease, which resulted in a 36% reduction in productivity. Patients with a primary diagnosis of chronic obstructive pulmonary disease had the greatest impact on HRQOL.

    CONCLUSIONS: In the Asia-Pacific, respiratory diseases have a significant impact on HCRU and associated costs, along with work productivity. Timely and effective management of these diseases has the potential to reduce disease burden and health care costs and improve work productivity and HRQOL.

    Matched MeSH terms: Cross-Sectional Studies
  3. Jannoo Z, Yap BW, Khan NM, Farcomeni A
    Value Health Reg Issues, 2019 May;18:159-164.
    PMID: 31082796 DOI: 10.1016/j.vhri.2019.03.004
    OBJECTIVES: To validate, from a psychometric perspective, the Problem Areas in Diabetes (PAID) questionnaire in patients with type 2 diabetes mellitus from Malaysia.

    METHODS: A total of 497 patients with type 2 diabetes mellitus were recruited from public hospitals in the state of Selangor through convenience sampling. Construct validity was evaluated through confirmatory factor analysis. Internal consistency of the instrument was tested by Cronbach α. Criterion validity and discriminant validity were also used.

    RESULTS: The PAID instrument consisted of 3 factors: social support problem, food-related problem, and emotional distress problem. The Cronbach α values of the 3 factors showed adequate internal consistency with α values greater than 0.90. The present confirmatory factor analysis model achieved a good fit with a comparative fit index value of 0.923. Satisfactory criterion validity was also demonstrated because there existed positive significant association between glycated hemoglobin A1c and diabetes duration.

    CONCLUSIONS: The PAID questionnaire in Malaysia was found to be a reliable and valid instrument exhibiting good psychometric properties.

    Matched MeSH terms: Cross-Sectional Studies
  4. Shafie AA, Chhabra IK, Hui Yi JW, Mohammed NS, Ibrahim HM
    Value Health Reg Issues, 2021 May;24:47-56.
    PMID: 33508751 DOI: 10.1016/j.vhri.2020.08.003
    OBJECTIVE: The objective of this study was to examine the cross-sectional convergent and known-group validity of the Malay-language EQ-5D-3L instrument in children and adults with transfusion-dependent thalassemia (TDT).

    METHODS: A cross-sectional health-related quality of life survey involving TDT patients from 12 different treatment centers across Malaysia was conducted using the Malay PedsQL 4.0 Generic Core Scales and the Malay EQ-5D-3L questionnaire. Patients with non-TDT and other hemoglobinopathies were excluded. Convergent, discriminant, and known-group validity of the EQ-5D-3L was assessed against the PedsQL 4.0 Generic Core Scales in children. In the adult population, known-group validity of the EQ-5D-3L was assessed using an a priori hypothesis between patients' demographic characteristics and health outcomes obtained from literature.

    RESULTS: A total of 370 children and 225 adults were sampled. The mean (standard deviation) EQ-5D-3L scores of the children were 0.892 (0.082) and the adults were 0.887 (0.085). Convergent and discriminant validity was identified when correlated with the PedsQL domain in children. In both groups, known-group validity was evident when comparing groups of patients with reported problems to the group of patients with no reported problems on the EQ-5D-3L domains based on the a priori hypothesis derived from literature.

    CONCLUSION: This study found convergent, discriminant, and known-group validity of the Malay EQ-5D-3L in a population-based sample of patients with TDT. Hence, the instrument is valid for the assessment of health-related quality of life in children and adults with TDT in Malaysia.

    Matched MeSH terms: Cross-Sectional Studies
  5. Shiroiwa T, Murata T, Ahn J, Li X, Nakamura R, Teerawattananon Y, et al.
    Value Health Reg Issues, 2022 Nov;32:62-69.
    PMID: 36099801 DOI: 10.1016/j.vhri.2022.07.002
    OBJECTIVES: Almost all preference-based measures (PBMs) have been developed in Western countries, with none having been formulated in Asian countries. In this study, we construct a new generic PBM based on concept elicitation using interview surveys in East and Southeast Asian countries and qualitative analysis.

    METHODS: This cross-sectional study included 225 adults recruited from 9 East and Southeast Asian countries or regions (Indonesia, Japan, Korea, mainland China, Malaysia, the Philippines, Singapore, Taiwan, and Thailand). Trained interviewers conducted semistructured interviews with 25 participants from the general population of each country/region. Qualitative data were analyzed using a content analysis approach. The selection of items was determined based on interview surveys and team member discussions. The description of items was considered based on a detailed qualitative analysis of the interview survey.

    RESULTS: A new region-specific PBM-the Asia PBM 7 dimensions instrument-was designed. It reflects East and Southeast Asian values and comprises 7 items: pain, mental health, energy, mobility, work/school, interpersonal interactions, and burden to others.

    CONCLUSIONS: The new region-specific instrument is one of the first PBMs developed in the context of non-Western countries. The Asia PBM 7 dimensions contains 7 items that address the core concepts of health-related quality of life that are deemed important based on East and Southeast Asian health concepts.

    Matched MeSH terms: Cross-Sectional Studies
  6. Azmi S, Goh A, Muhammad NA, Tohid H, Rashid MRA
    Value Health Reg Issues, 2018 May;15:42-49.
    PMID: 29474177 DOI: 10.1016/j.vhri.2017.06.002
    BACKGROUND: Anemia is common among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) and an independent risk factor for renal disease progression. Health economic evidence is important in Malaysia and yet cost and quality-of-life (QOL) data are scarce.

    OBJECTIVES: To investigate prevalence, factors associated with anemia, and cost and QOL among T2DM patients with CKD. Here, we present the estimated 1-year cost and QOL related to anemia in this group.

    METHODS: A cross-sectional, observational study was performed at 20 government clinics. Treatment cost was calculated on the basis of resource utilization ascertained through data extracted from medical records and patient recall. QOL was elicited using the short form 36 health survey version 2 questionnaire. Propensity score matching was performed and costs and QOL were analyzed by anemia status and CKD stage.

    RESULTS: Data for 816 patients were obtained. The propensity score matching enabled a comparison of 257 patients with and without anemia. Annual treatment costs were significantly higher for patients with anemia (Ringgit Malaysia [RM] 4219 [US $983] vs. RM2705 [US $630]; P = 0.01). QOL scores were lower for patients with anemia but not statistically significant (physical component summary score: 44.8 vs. 46.2; P = 0.052; mental component summary score: 51.3 vs. 51.7; P = 0.562). Costs were higher and QOL lower among CKD stage 5 patients.

    CONCLUSIONS: This study was the first to examine anemia in this group of patients. Costs were significantly higher among anemic patients compared with nonanemic patients; patients with higher CKD stage 5 fared less well than did those in lower stages. This information suggests the need to increase detection, prevention, and early treatment of anemia when managing T2DM patients, particularly those with CKD.
    Matched MeSH terms: Cross-Sectional Studies
  7. Dzulkipli MR, Shafie AA, Maon SN, Ramli A, Yahaya AHM, Ho SW, et al.
    Value Health Reg Issues, 2024 Mar;40:19-26.
    PMID: 37972430 DOI: 10.1016/j.vhri.2023.10.003
    OBJECTIVES: Early access to innovative oncology medicine is crucial to provide better treatment alternatives to patients with cancer. However, innovative oncology medicines often come at higher prices, thus limiting the government's ability for its universal coverage. Hence an alternative paying mechanism is needed. This study is intended to determine the willingness to pay (WTP) for innovative oncology medicines among Malaysians.

    METHODS: A cross-sectional contingent valuation study on 571 Malaysians was conducted to elicit respondents' WTP value via bidding game approach. A double-bounded dichotomous choice was used in 3 hypothetical scenarios: innovative diabetes medicine, innovative oncology medicine one-off (IOMO), and innovative oncology medicine insurance. Univariate logistic regression was used to determine the factors affecting respondent's WTP, whereas the mean WTP value and the factors affecting amount to WTP was determined using a parametric 2-part model.

    RESULTS: This study received 95% response rate. The mean age of the respondents is 48 years (SD 17) with majority of the respondents female (60.3%) and from ethnic Malay (62%). About 343 (64.7%) of the respondents expressed WTP for IOMO. Those in higher income bracket were willing to pay more for the access of IOMO than the overall WTP mean value (P = .046, coefficient 351.57).

    CONCLUSIONS: More than half of Malaysian are willing to pay for IOMO at mean value of Malaysian Ringgit 279.10 (US dollar 66.77). Collaborative funding mechanisms and appropriate financial screening among the stakeholders could be introduced as methods to expedite the access of innovative oncology medicine among patients with cancer in Malaysia.

    Matched MeSH terms: Cross-Sectional Studies
  8. Albaroodi KA, Syed Sulaiman SA, Shafie AA, Awaisu A, Lajis R
    Value Health, 2014 Nov;17(7):A590.
    PMID: 27202012 DOI: 10.1016/j.jval.2014.08.2023
    Widespread evidence has demonstrated the negative effects of tobacco smoking in patients with diabetes. Although many studies have explored the prevalence of tobacco smoking in the general population, data are lacking regarding its prevalence in a specific population with a chronic disease such as diabetes.
    Objectives: This study aims to determine the prevalence of tobacco smoking among patients with diabetes in Hospital Pulau Pinang, Malaysia.
    Methods: A cross-sectional survey was conducted to study diabetic patients who attended the endocrine clinic at Hospital Pulau Pinang in Malaysia from March to August 2012. All the diabetic patients who attended the endocrine clinic during that period were asked about their smoking status, and their medical records were reviewed. A total of 1,118 patients with diabetes were reviewed to determine the prevalence of tobacco smoking in diabetic patients at the endocrine clinic of Hospital Pulau Pinang.
    Results: The majority of the study population was male, with Malay and Chinese patients in almost equal proportions and a smaller proportion of Indian patients. Most of these patients had started smoking before they were diagnosed with diabetes. Among the 1,118 diabetic patients, only 108 patients smoked; therefore, the prevalence of tobacco smoking in our patients with diabetes was 9.66%.
    Conclusions: A low prevalence of tobacco smoking was estimated in this study. This prevalence is close to the corresponding value in the general population in Malaysia.
    Study site: Endocrine clinic, Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Cross-Sectional Studies
  9. Hadi H, Elkalmi R, Awadh A, Jamshed S, Al-Shami A
    Value Health, 2014 Nov;17(7):A605.
    PMID: 27202095 DOI: 10.1016/j.jval.2014.08.2105
    Objectives: To evaluate the knowledge and perception of medical and pharmacy students toward the usage of sunblock as skin protection against ultraviolet (UV).
    Methods: This cross-sectional study was conducted among the undergraduate final year medical and pharmacy students at the International Islamic University Malaysia (IIUM). Validated questionnaire were used to collect the data. The questionnaires were distributed to 134 students from medicine and 100 pharmacy students. Descriptive and inferential statistics are used whenever appropriate.
    Results: Overall, 161 participants out of a total of 234 completed the questionnaire with 101 medical students (75.4%) and 60 pharmacy students (60.0%). Majority of the respondents were female 64 (63.4%) and 37 (36.6%) were male. The median of knowledge scores of the final year medical students was significantly lower than the final year pharmacy students (p<0.01). There is no significant differnce between the knowledge of the female and male students (Mann Whitney U Test value = 0.27, p<0.01). This study reported that 24 (39.3 %) of pharmacy students were influenced by the media to use sunblock whereas 35 (34.7%) of medical students had the highest influence from friends to use sunblock. However, this study showed there was no significant difference in the perception of pharmacy and medical students p=0.020.
    Conclusion: In conclusion, the knowledge of pharmacy students is significantly higher than the knowledge of medical students had on the usage of sunblock. Both medical and pharmacy students have the same level of perception towards the usage of sunblock.
    Matched MeSH terms: Cross-Sectional Studies
  10. Yong YV, Shafie AA
    Value Health, 2014 Nov;17(7):A568.
    PMID: 27201892 DOI: 10.1016/j.jval.2014.08.1892
    Objectives: To assess the feasibility of a computer-based Standard Gamble (SG) visual prop whilst measuring utilities of different asthma health states at the same time.
    Methods: Twenty adult asthma patients literate in either Malay or English language were conveniently sampled from a public hospital in Penang, Malaysia. They were interviewed by two trained interviewers using a bilingual script. Each patient was requested to value the given health states using Visual Analogue Scale (VAS) prior to SG exercise. There were three chronic health states (C1-C3) for 10 years, three temporary states (T1-T3) for 3 months, and two anchor states (healthy and dead). During the SG exercise, the visual prop was fully operated by the interviewers. The probability of being in a worse state was changed in a ‘ping-pong’ fashion until the indifference point was reached.
    Results: All patients understood the SG exercise and rated SG easier than VAS. Around 85% (n=17) completed SG within 30 minutes. There was 90% (n=18) who ranked T3 as the worst temporary health state during VAS. Two patients provided logical inconsistency data in SG. The preferences by SG were higher than VAS. Preferences were also higher in temporary states measured by chained SG than other states by conventional SG. The mean utilities for C1=0.56 (SD 0.38), C2=0.47 (SD 0.33), C3=0.53 (SD 0.38), T1=0.65 (SD 0.31), T2=0.53 (SD 0.35), and T3=0.38 (SD 0.38).
    Conclusions: The SG methods including the props are feasible for utilities measurement in asthma, based on the agreements achieved with other studies on the pattern of utilities measured in this preliminary study.
    Matched MeSH terms: Cross-Sectional Studies
  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: Cross-Sectional Studies
  12. Wang DY, Ghoshal AG, Razak Bin Abdul MA, Lin HC, Thanaviratananich S, Bagga S, et al.
    Value Health, 2014 Nov;17(7):A776-7.
    PMID: 27202870 DOI: 10.1016/j.jval.2014.08.351
    Objectives: Respiratory diseases represent significant impact on health care resources. A cross-sectional, observational study, Asia-Pacific Burden of Respiratory Diseases (APBORD), was conducted to examine burden of disease in adults with respiratory diseases across 6 countries - India, Korea, Malaysia, Singapore, Taiwan, and Thailand. We examined the extent to which cough is a presenting symptom and reason for medical visits for participants with Asthma, Allergic Rhinitis (AR), COPD or Rhinosinusitis.
    Methods: Participants aged ≥18 years, presenting to a physician with primary diagnosis of Asthma, AR, COPD or Rhinosinusitis were enrolled. Participants completed a survey which contained questions related to demographics, respiratory symptoms, health care resource use and quality of life.
    Results: A total of 13,902 participants were screened, of which 7,030 were eligible and 5,250 enrolled. The highest percentage of participants receiving care for a respiratory disorder had primary diagnosis of AR 14.0%, (95%CI: 13.4%, 14.6%), followed by Asthma 13.5% (12.9%, 14.1%), Rhinosinusitis 5.4% (4.6%, 5.3%) and COPD 4.9%, (5.0%, 5.7%). Cough or coughing up phlegm was reported as symptom by more than half the participants. Cough or coughing up phlegm was reported as the main reason for medical visit by more than 20% of participants. Among all symptoms reported, cough was most frequently reported by participants with a primarydiagnosis of COPD (73%), followed by Asthma (61%), Rhinosinusitis (59%), and AR (47%). In addition, cough was the most frequently reported main reason for seeking medical care among participants with a primary diagnosis of COPD (43%), for Asthma (33%), for Rhinosinusitis (13%), and for AR (11%).
    Conclusions: Cough is a prominent symptom and major driver of medical care for patients with Asthma, Allergic Rhinitis, COPD or Rhinosinusitis. These data suggest that patients presenting with cough should be investigated comprehensively for any underlying more serious respiratory disorders to help with appropriate disease management.
    Matched MeSH terms: Cross-Sectional Studies
  13. Iqbal MS, Iqbal MZ, Iqbal MW, Bahari MB
    Value Health, 2015 Nov;18(7):A620.
    PMID: 26533480 DOI: 10.1016/j.jval.2015.09.2170
    Objectives: To evaluate the prevalence and patterns of CAM use among diabetes patients in Pakistan. In addition, the study also focused on the perceived effectiveness of CAM over conventional therapies, information seeking behavior and CAM disclosure to healthcare providers.
    Methods: A prospective, cross-sectional and self-administered questionnaire based study was conducted in tertiary care public hospitals in Pakistan. A prevalence based sample of 350 diabetes patients attending the tertiary hospital in Punjab, Pakistan were selected for the study. All obtained data were analyzed using descriptive and inferential statistics.
    Results: Overall, 327 questionnaires were completed and included in the analysis, showing that 52.8% of diabetics had used CAM, with most (62.4%) believing that CAM therapies assist body’s natural forces to heal. CAM usage was significantly associated with gender (P=0.001), level of education (P=0.001), employment status (P=0.03) and monthly income (P<0.001).
    Conclusions: Diabetes treatment and management requires compliance to effective therapies at early stages. Healthcare providers should engage diabetics in an open non-judgmental dialogue to ascertain better understanding of diabetes and its management options.
    Matched MeSH terms: Cross-Sectional Studies
  14. Md Rezal RS, Hassali MA, Saleem F, Kumar R
    Value Health, 2015 Nov;18(7):A848-9.
    PMID: 26534536 DOI: 10.1016/j.jval.2015.09.420
    Conference abstrract
    Objectives: Antimicrobial resistance is associated with irrational use of antibiotics in general practice. We aimed to assess the frequency with which patients with Upper Respiratory Tract Infections were prescribed with antibiotics and the patterns of antibiotic prescription at primary healthcare centres in Malaysia.
    Methods: The study targeted all primary public healthcare centres in the district of Kota Setar, Kedah, Malaysia. A retrospective prescription analysis was conducted whereby prescriptions from 1st January 2014 to 31st March 2014 were screened and retrieved for antibiotics prescribed for upper respiratory infections. The data was entered into Microsoft Excel spread sheet, and exported to Statistical Package for Social Sciences, version 20 for further analysis. Frequencies and percentages were used to summarize the data. The Jonckheere–Terpstra test was used to evaluate the trend of antibiotic prescription. Where significant associations were reported, effect size was calculated by using Kendall tau correlation coefficient. P value of <0.05 was considered to be of statistical significance.
    Results: For the period of three months, 123,524 prescriptions were screened and analysed. 2270 (31.8%) prescriptions contained antibiotics prescribed for all URTIs visits. Among all antibiotics, macrolides were the most commonly prescribed antibiotic, constituting of 61% (n=1404) of total antibiotics prescribed for all cases. The Jonckheere–Terpstra test revealed a statistical relationship between prescribers and the diagnosis of the disease (p=0·001). Furthermore, a weak positive trend of association was reported with FMS being more accurate in diagnosis followed by MOs and AMOs (τ=0·122).
    Conclusions: Practicing physicians should adhere to the standard treatment practices, as antibiotic use in viral aetiology is ineffective, and encourages the persistence development of resistance. A comprehensive development of national antibiotic stewardship program is recommended to ensure organised and regulated control of antibiotic use in Malaysia.
    Matched MeSH terms: Cross-Sectional Studies
  15. Khan AH, Aftab RA, Sulaiman SA, Ali I
    Value Health, 2015 Nov;18(7):A840.
    PMID: 26534490 DOI: 10.1016/j.jval.2015.09.373
    Objectives: To review patient’s prescriptions and calculate direct cost for the treatment and management of asthma
    Methods: A prospective cross-sectional detailed review of 180 prescriptions written by 6 doctors was conducted at respiratory department of Hospital Pulau Pinang, Malaysia. Medication price was confirmed from the hospital formulary. Interview with the key personals were conducted to identify activities of each service provided to asthma patients. This was followed by determination of time taken to complete each activity using stopwatch. The duration was captured 15 times for each for three alternate days and summarized as the mean time (minutes) for each activity. The cost of each employee per single activity was obtained by multiplying the mean time (minute) spent by that employee doing a specific activity by his/her salary per minute
    Results: A total of 6 different classes of medications were prescribed to 180 asthma patients. β agonist was the most prescribed class of asthma medication that included Salbutamol 72 (39.8) and albuterol 20 (11) followed by Corticosteroids that included budisonide 59 (32.8%), prednisolone 16 (8.8%) and fluticasone 11 (6.1%). Fifty one (28.3%) units of budisonide/formoterol combination medication were prescribed followed by fluticasone/salmeterol 40 (22.2%). A total of RM 10610.79(USD) medication were prescribed to 180 asthma patients with average cost of RM 59.08 per patient. The combination medication of budisonide/formoterol RM.5253 (USD) made the majority of total cost of asthma medication. Spirometry was performed for all 180 patients at every hospital visit that costed RM 5400.00. The cost of services provided by doctors and nursing staff for 180 asthma patients for single visit was RM 1198.8 and RM 331.2 respectively
    Conclusions: Combination medication adds a substantial cost to over all asthma cost. Careful selection of asthma pharmacotherapy can greatly reduce medication cost without compromising on treatment outcomes
    Matched MeSH terms: Cross-Sectional Studies
  16. Nazir SU, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Value Health, 2015 Nov;18(7):A613.
    PMID: 26533439 DOI: 10.1016/j.jval.2015.09.2128
    Objectives: Diabetes mellitus is a serious health problem. Medication adherence is a key determinant of therapeutic success in patients with diabetes mellitus. The purpose of this study was to assess medication adherence and its potential association with diabetes related knowledge in patients with type 2 diabetes mellitus.
    Methods: This study was carried out at the outpatient clinics of a public sector teaching hospital in Sargodha, Pakistan. Besides demographic and disease-related questions, previously validated questionnaires, Morisky Medication Adherence Scale and Michigan diabetes knowledge test was used to assess the medication adherence and diabetes related knowledge, respectively. Descriptive statistics were used to determine the demographic and disease characteristics of the patients while Spearman rank correlation was employed to measure the association between medication adherence and knowledge.
    Results: Three hundred and ninety two patients were interviewed. Out of 392 patients, 245 (62.5%) of the patients had average knowledge about diabetes while 282 (71.9 %) were categorized as poor adherent. Only 13 patients (3.3 %) were considered as good adherent in the study. The correlation coefficient between total scores of knowledge and total medication adherence score was 0.036 (p< 0.05), indicating a weak correlation between knowledge scores and adherence level.
    Conclusions: Knowledge of diabetes mellitus among these patients was average; however, adherence to drug therapy was also poor. Patients’ knowledge about diabetes had positive association with medication adherence. Improving diabetes knowledge of people can result in better adherence, which may result in better control of diabetes.
    Matched MeSH terms: Cross-Sectional Studies
  17. Azmi S, Feisul MI, Abdat A, Goh A, Abdul Aziz SH
    Value Health, 2015 Nov;18(7):A600.
    PMID: 26533372 DOI: 10.1016/j.jval.2015.09.2060
    Conference abstract:
    Objectives: The aim of the study was to explore the association of waist circumference with glycaemic control in Malaysian patients with type 2 diabetes.
    Methods: We utilised data of type 2 diabetes patients followed up in Malaysian public sector primary care clinics contained in the National Diabetes Registry in the year 2012. The variable of interest was poor glycaemic control, defined as HbA1c≥ 6.5%. Multiple logistic regression was used to explore the association between glycaemic control and waist circumference, which was adjusted for age, sex, duration of diabetes, systolic blood pressure, total cholesterol, use of insulin and other medications.
    Results: A total of 98,825 patients with type 2 diabetes were included in the study. The mean age of patients was 59.9 years (SD: 10.9) and 38.9% were males. The mean duration of diabetes was 6.8 years (SD: 5.0) and 76.2% of patients had HbA1c ≥ 6.5%. The mean waist circumference was 94.0 cm (SD: 11.8) for male and 90.7 cm (SD: 11.8) for female; while 78.3% of the patients had waist circumference above the cut-off (≥ 90 cm for men and ≥ 80 cm for women). Larger waist circumference was found to be significantly associated with HbA1c≥ 6.5% (adj. OR 1.009; p< 0.001; 95% CI: 1.007–1.011) after adjusting for confounding factors.
    Conclusions: Analysis showed that glycaemic control was poorer in patients with higher waist circumference than in patients with lower waist circumference.
    Matched MeSH terms: Cross-Sectional Studies
  18. Azmi S, Feisul MI, Abdat A, Goh A, Abdul Aziz SH
    Value Health, 2015 Nov;18(7):A597.
    PMID: 26533354 DOI: 10.1016/j.jval.2015.09.2042
    Conference abstract:
    Objectives: The aim of the study was to explore the association of waist circumference with microvascular complications in Malaysian patients with type 2 diabetes.
    Methods: We utilised data of type 2 diabetes patients followed up in Malaysian public sector primary care clinics contained in the National Diabetes Registry in the year 2012. Variables of interest were the presence of microvascular complications, namely nephropathy and retinopathy. Multiple logistic regression was used to explore the association between presence of microvascular complications and waist circumference, which was adjusted for age, sex, duration of diabetes, systolic blood pressure, insulin use, total cholesterol and HbA1c.
    Results: A total of 114,719 patients with type 2 diabetes were included in the study. The mean age of patients was 59.8 years (SD: 11.2) with mean duration of diabetes of 6.8 years (SD: 5.1). Male
    patients comprised 39.9% of the sample population and 83.5% of the patients were overweight with BMI ≥ 23 kg/m2. Nephropathy and retinopathy was present in 9.1% and 7.9% of patients respectively. The mean waist circumference was 94.1 cm (SD: 11.8) for males and 90.8 cm (SD: 11.8) for females; while 78.4% of the patients had waist circumference above the cut off (≥ 90 cm for men and ≥ 80 cm for women). Larger waist circumference was found to be significantly associated with nephropathy (adj. OR 1.005; p-value< 0.001; 95% CI: 1.003–1.008) after adjusting for confounding factors. However, waist circumference was not significantly associated with retinopathy (adj. OR 0.998; p= 0.209; 95% CI: 0.996–1.001).
    Conclusions: Analysis showed that patients with higher waist circumference were more likely to have nephropathy than patients with lower waist circumference. The analysis also showed that waist circumference was not associated with retinopathy in the study population.
    Matched MeSH terms: Cross-Sectional Studies
  19. Kongpakwattana K, Dejthevaporn C, Krairit O, Dilokthornsakul P, Mohan D, Chaiyakunapruk N
    Value Health, 2019 10;22(10):1137-1145.
    PMID: 31563256 DOI: 10.1016/j.jval.2019.04.1937
    BACKGROUND: Although an increase in the burden of Alzheimer's disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HRQOL) associated with AD in low- and middle-income countries is still lacking.

    OBJECTIVES: This study aimed to collect real-world cost and HRQOL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand.

    METHODS: We recruited AD patients aged ≥60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HRQOL, and caregiving information using standardized tools. The hospital's database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HRQOL.

    RESULTS: Among 148 community-dwelling patients, average annual total societal costs of AD care were $8014 (95% confidence interval [CI]: $7295-$8844) per patient. Total costs of patients with severe stage ($9860; 95% CI: $8785-$11 328) were almost twice as high as those of mild stage ($5524; 95% CI: $4649-$6593). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient's HRQOL (P value

    Matched MeSH terms: Cross-Sectional Studies
  20. Saleem F, Hassali MA, Verma AK, Aljadhey H
    Value Health, 2015 Nov;18(7):A614-5.
    PMID: 26533446 DOI: 10.1016/j.jval.2015.09.2138
    Objectives: An adequate disease-related knowledge is important in treatment and management of ailments. Within this context, patients are needed to have correct knowledge and positive attitude especially when they are faced with an emergence of chronic diseases. The aim of this study therefore is to assess the level of type 2 diabetes mellitus (T2DM) awareness and disease related attitude among general population at Bujang Valley, Merbok, Kedah, Malaysia.
    Methods: A questionnaire based, cross sectional study was conducted. The Diabetes Attitude Scale was used to assess the knowledge and attitude of respondents towards T2DM. Data was described descriptively and SPSS v.22 was used for data analysis.
    Results: Out of three hundred and seventy seven respondents, majority of the respondents (n=156, 41.4%) were in age group of more than 40 years old and the cohort was dominated by Malay ethnic group. Females subjugated over males (n=229, 60.7%) and the highest number of respondents were working as businessman (n=115, 30.5%). Corresponding to the marital status, majority of the respondent were married (n=247, 65.5%). Majority of the respondents (n=274, 72.7%) were reported as healthy with no chronic disease. The respondents reported certain misapprehensions where they believed that T2DM have lesser complications, blood glucose control is needed for Type 1 Diabetes Mellitus only and the emotional effects of T2DM are minor.
    Conclusions: The study reported insufficient level of knowledge among the respondents in management of T2DM. General population needs to have good collaboration with healthcare professionals to get more education and knowledge related to T2DM for their empowerment.
    Matched MeSH terms: Cross-Sectional Studies
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