Displaying publications 41 - 60 of 196 in total

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  1. Chopra A, Lin HY, Navarra SV, Saeed MA, Sockalingam S, Thongpooswan S, et al.
    Int J Rheum Dis, 2021 Sep;24(9):1106-1111.
    PMID: 34375036 DOI: 10.1111/1756-185X.14185
    Rheumatoid arthritis (RA) is a major health burden in Asia Pacific affecting the quality of life of patients and consuming healthcare resources. According to recent estimates from the World Health Organization-International League Against Rheumatism-Community Oriented Program for Control of Rheumatic Diseases, prevalence is around 0.3%-0.5%. Management guidelines have helped to improve treatment across this diverse region. To gain better insight into current real-world management applications in view of these guidelines, virtual meetings were conducted in mid-2020 to explore perspectives of rheumatologists and patients, as well as discuss the impact of coronavirus disease 2019 on RA management. Patients and rheumatologists from Hong Kong, Malaysia, Singapore, the Philippines, Thailand, India, Pakistan, and Taiwan were included, representing a diverse mix of healthcare systems, wealth, ethnicity and culture. Despite many countries having prospered in recent years, similar challenges in RA diagnosis and treatment were identified. The daily impact and patient experience of RA were also similar across countries, marked by "silent" pain and disability, and universal misunderstanding of the disease. Late diagnosis and treatment, and barriers to access to appropriate treatment, remain problematic. The experience shared by Taiwan offers a glimmer of hope, however, wherein patient advocacy groups have succeeded in being included in policy-making decisions and securing access to advanced treatment. Real-world solutions that pay heed to the unique local needs and diversity of Asia Pacific are required to improve RA management, which will take time. In the interim, help can be sought from the trained, non-rheumatologist community to reduce some of the disease burden.
    Matched MeSH terms: Practice Patterns, Physicians'/trends*
  2. Khoo TB, Tan JW, Ng HP, Choo CM, Bt Abdul Shukor INC, Teh SH
    Int J Clin Pharm, 2017 Jun;39(3):551-559.
    PMID: 28417303 DOI: 10.1007/s11096-017-0463-1
    Background There is a lack of large comprehensive studies in developing countries on paediatric in-patient prescribing errors in different settings. Objectives To determine the characteristics of in-patient prescribing errors among paediatric patients. Setting General paediatric wards, neonatal intensive care units and paediatric intensive care units in government hospitals in Malaysia. Methods This is a cross-sectional multicentre study involving 17 participating hospitals. Drug charts were reviewed in each ward to identify the prescribing errors. All prescribing errors identified were further assessed for their potential clinical consequences, likely causes and contributing factors. Main outcome measures Incidence, types, potential clinical consequences, causes and contributing factors of the prescribing errors. Results The overall prescribing error rate was 9.2% out of 17,889 prescribed medications. There was no significant difference in the prescribing error rates between different types of hospitals or wards. The use of electronic prescribing had a higher prescribing error rate than manual prescribing (16.9 vs 8.2%, p 
    Matched MeSH terms: Practice Patterns, Physicians'/standards*
  3. Laurino MY, Leppig KA, Abad PJ, Cham B, Chu YWY, Kejriwal S, et al.
    J Genet Couns, 2018 02;27(1):21-32.
    PMID: 28699126 DOI: 10.1007/s10897-017-0115-6
    The Professional Society of Genetic Counselors in Asia (PSGCA) was recently established as a special interest group of the Asia Pacific Society of Human Genetics. Fostering partnerships across the globe, the PSGCA's vision is to be the lead organization that advances and mainstreams the genetic counseling profession in Asia and ensures individuals have access to genetic counseling services. Its mission is to promote quality genetic counseling services in the region by enhancing practice and curricular standards, research and continuing education. The PSGCA was formally launched during the Genetic Counseling Pre-Conference Workshop held at the 11th Asia-Pacific Conference on Human Genetics in Hanoi, Viet Nam, September 16, 2015. The pre-conference workshop provided an opportunity for medical geneticists and genetic counselors from across 10 Asia Pacific countries to learn about the varied genetic counseling practices and strategies for genetic counseling training. This paper provides an overview of the current status and challenges in these countries, and proposed course of unified actions for the future of the genetic counseling profession.
    Matched MeSH terms: Practice Patterns, Physicians'/trends*
  4. Balan S, Hassali MA, Mak VSL
    Res Social Adm Pharm, 2017 Nov;13(6):1219-1221.
    PMID: 28576615 DOI: 10.1016/j.sapharm.2017.05.013
    Matched MeSH terms: Practice Patterns, Physicians'*
  5. Ariff MI, Yahya A, Zaki R, Sarimin R, Mohamed Ghazali IM, Gill BS, et al.
    PLoS One, 2017;12(5):e0178137.
    PMID: 28562626 DOI: 10.1371/journal.pone.0178137
    Clinical Practice Guideline (CPG) provides evidence-based guidance for the management of Dengue Infection in adult patients. A cross sectional study was conducted to evaluate awareness and utilization of CPG among doctors in public or private hospitals and clinics in Malaysia. Doctors practicing only at hospital Medical and Emergency Departments were included, while private specialist clinics were excluded in this study. A multistage proportionate random sampling according to region (Central, Northern, Southern, Eastern, Sabah and Sarawak) was performed to select study participants. The overall response rate was 74% (84% for public hospitals, 82% for private hospitals, 70% for public clinics, and 64% for private clinics). The CPG Awareness and Utilization Feedback Form were used to determine the percentage in the study. The total numbers of respondent were 634 with response rate of 74%. The mean lengths of service of the respondent were 13.98 (11.55).A higher percentages of doctors from public facilities (99%) were aware of the CPG compared to those in private facilities (84%). The percentage of doctors utilising the CPG were also higher (98%) in public facilities compared to private facilities (86%). The percentage of Medical Officer in private facilities that utilizing the CPG were 84% compares to Medical Officer in public facilities 98%. The high percentage of doctors using the CPG in both public (97%) and private (94%) hospitals were also observed. However, only 69% of doctors in private clinics utilised the CPG compared to doctors in public clinics (98%). Doctors in both public and private facilities were aware of the dengue CPG. However, most doctors in private clinic were less likely to utilise the CPG. Therefore, there is a need to increase the level of CPG utilisation especially in private clinics.
    Study site: primary care and hospital from Medical and Emergency Department, public and private health facilities in Malaysia
    Matched MeSH terms: Practice Patterns, Physicians'*
  6. Da Silva RD, Leow JJ, Abidin ZA, Linden-Castro E, Castro EIB, Blanco LT, et al.
    Int Braz J Urol, 2019 10 19;45(5):882-888.
    PMID: 31626517 DOI: 10.1590/S1677-5538.IBJU.2019.05.04
    Matched MeSH terms: Practice Patterns, Physicians'/trends
  7. Saleem Z, Hassali MA, Hashmi FK, Godman B, Bhutta OA
    Hosp Pract (1995), 2019 Aug;47(3):149-154.
    PMID: 31180791 DOI: 10.1080/21548331.2019.1628614
    Background: The extensive use of broad-spectrum antimicrobials in immunocompromised patients is inevitable in situations where culture and sensitivity testing is challenging. However, their overuse leads to an increase in antimicrobial resistance (AMR), which is a growing concern. Method: A repeated point prevalence survey (PPS) was conducted to assess the pattern of antimicrobial prescribing in a specialized cancer care hospital in Pakistan using the methodology employed by the European Centre of Disease Prevention and Control. Results: Out of 313 hospitalized patients, 156 (49.8%) were prescribed one or more antimicrobials, 82 (50.9) in 2017 and 74 (48.7) in 2018. The average bed occupancy in the hospital was 80.3%. Fever in neutropenic patients (20.2%), lower respiratory tract infections (17.8%), and sepsis (14.9%) were the three most common clinical indications. The total number of prescribed antimicrobials was 242, of whom, 41 (16.9%) were given orally and 201 (83.1%) were given parenterally. The most commonly used antimicrobials were piperacillin plus enzyme inhibitor (31.8%), meropenem (7.9%), ceftriaxone (6.2%) and vancomycin (6.2%). Of the total prescribed antimicrobials, 42 (17.3%) antimicrobials were used in surgical departments, 89 (36.8) in adult medical departments, 73 (30.1%) in pediatric medical departments and 38 (15.7) in the intensive care unit (ICU). In addition to these antibacterials, there was relatively high use of antivirals (acyclovir; 4.1%) and antifungals (fluconazole; 3.7%, amphotericin B; 2.9%). Conclusion: The study concluded that broad-spectrum antimicrobial usage in cancer hospitals in Pakistan is high, which can be a risk factor for the emergence of AMR. Repeated PPS is a fruitful way to maintain a focus on inappropriate antimicrobial use and develop pertinent intervention programs targeteing specific issues to improve future use.
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  8. Koh W, Chakravarthy M, Simon E, Rasiah R, Charuluxananan S, Kim TY, et al.
    BMC Anesthesiol, 2021 08 16;21(1):205.
    PMID: 34399681 DOI: 10.1186/s12871-021-01414-6
    BACKGROUND: Anesthesia leads to impairments in central and peripheral thermoregulatory responses. Inadvertent perioperative hypothermia is hence a common perioperative complication, and is associated with coagulopathy, increased surgical site infection, delayed drug metabolism, prolonged recovery, and shivering. However, surveys across the world have shown poor compliance to perioperative temperature management guidelines. Therefore, we evaluated the prevalent practices and attitudes to perioperative temperature management in the Asia-Pacific region, and determined the individual and institutional factors that lead to noncompliance.

    METHODS: A 40-question anonymous online questionnaire was distributed to anesthesiologists and anesthesia trainees in six countries in the Asia-Pacific (Singapore, Malaysia, Philippines, Thailand, India and South Korea). Participants were polled about their current practices in patient warming and temperature measurement across the preoperative, intraoperative and postoperative periods. Questions were also asked regarding various individual and environmental barriers to compliance.

    RESULTS: In total, 1154 valid survey responses were obtained and analyzed. 279 (24.2%) of respondents prewarm, 508 (44.0%) perform intraoperative active warming, and 486 (42.1%) perform postoperative active warming in the majority of patients. Additionally, 531 (46.0%) measure temperature preoperatively, 767 (67.5%) measure temperature intraoperatively during general anesthesia, and 953 (82.6%) measure temperature postoperatively in the majority of patients. The availability of active warming devices in the operating room (p 

    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
  9. Sachithanandan A
    Singapore Med J, 2011 Sep;52(9):702; author reply 703.
    PMID: 21947151
    Comment on: Ahmad WAW, Ramesh SV, Zambahari R. Malaysia-Acute CORonary syndromes Descriptive study (ACCORD): evaluation of compliance with existing guidelines in patients with acute coronary syndrome. Singapore Med J 2011; 52:508-11.
    Matched MeSH terms: Practice Patterns, Physicians'*
  10. Battah MM, Zainal H, Ibrahim DA, Md Hanafiah NHB, Sulaiman SAS
    PLoS One, 2024;19(6):e0304209.
    PMID: 38838036 DOI: 10.1371/journal.pone.0304209
    Non-Hodgkin lymphoma (NHL) is a hematological malignancy that requires effective pharmacotherapy for optimal management. There is limited information regarding Yemeni clinicians' knowledge and practice of NHL pharmacotherapy. This study aims to assess the knowledge and practice of physicians and nurses in Yemen regarding pharmacotherapy of NHL. A cross-sectional study was conducted in Sana'a, Yemen, from January 1, 2022, to January 31, 2023. Two self-administrated and validated questionnaires were distributed to 99 physicians and 164 nurses involved in pharmacotherapy for NHL in different oncology centers and units across Yemen. Convenience samples were used to recruit participants. A binary logistic regression analysis was performed to identify factors associated with nurses' and physicians' knowledge and practice. The correlation coefficient was used to examine the relationship between knowledge and practice. A total of 77 physicians and 105 nurses completed the questionnaires. The results showed that 54.3% of nurses and 66.2% of physicians had poor knowledge of NHL pharmacotherapy. In terms of practice, 83.8% of nurses and 75.3% of physicians exhibited poor practice regarding NHL pharmacotherapy. Multivariable logistic regression analysis identified that nurses who received sufficient information about chemotherapy displayed a significant association with good knowledge, while nurses working in the chemotherapy administration department were significant predictors of good practice. Among physicians, those working in the National Oncology Center (NOC) in Sana'a demonstrated good practice. Correlation analysis revealed a positive relationship between nurses' knowledge and their practice. The study's results confirm deficiencies in knowledge and practice of pharmacotherapy for NHL among physicians and nurses in Yemen. Efforts should be made to enhance their understanding of treatment guidelines and to improve patient care. Improvement in educational programs and training opportunities may contribute to improving patient outcomes in the management of NHL.
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  11. Lim WY, Hss AS, Ng LM, John Jasudass SR, Sararaks S, Vengadasalam P, et al.
    BMC Fam Pract, 2018 07 19;19(1):120.
    PMID: 30025534 DOI: 10.1186/s12875-018-0808-4
    BACKGROUND: To evaluate the effectiveness of a structured prescription review and prescriber feedback program in reducing prescribing errors in government primary care clinics within an administrative region in Malaysia.

    METHODS: This was a three group, pragmatic, cluster randomised trial. In phase 1, we randomised 51 clinics to a full intervention group (prescription review and league tables plus authorised feedback letter), a partial intervention group (prescription review and league tables), and a control group (prescription review only). Prescribers in these clinics were the target of our intervention. Prescription reviews were performed by pharmacists; 20 handwritten prescriptions per prescriber were consecutively screened on a random day each month, and errors identified were recorded in a standardised data collection form. Prescribing performance feedback was conducted at the completion of each prescription review cycle. League tables benchmark prescribing errors across clinics and individual prescribers, while the authorised feedback letter detailed prescribing performance based on a rating scale. In phase 2, all clinics received the full intervention. Pharmacists were trained on data collection, and all data were audited by researchers as an implementation fidelity strategy. The primary outcome, percentage of prescriptions with at least one error, was displayed in p-charts to enable group comparison.

    RESULTS: A total of 32,200 prescriptions were reviewed. In the full intervention group, error reduction occurred gradually and was sustained throughout the 8-month study period. The process mean error rate of 40.7% (95% CI 27.4, 29.5%) in phase 1 reduced to 28.4% (95% CI 27.4, 29.5%) in phase 2. In the partial intervention group, error reduction was not well sustained and showed a seasonal pattern with larger process variability. The phase 1 error rate averaging 57.9% (95% CI 56.5, 59.3%) reduced to 44.8% (95% CI 43.3, 46.4%) in phase 2. There was no evidence of improvement in the control group, with phase 1 and phase 2 error rates averaging 41.1% (95% CI 39.6, 42.6%) and 39.3% (95% CI 37.8, 40.9%) respectively.

    CONCLUSIONS: The rate of prescribing errors in primary care settings is high, and routine prescriber feedback comprising league tables and a feedback letter can effectively reduce prescribing errors.

    TRIAL REGISTRATION: National Medical Research Register: NMRR-12-108-11,289 (5th March 2012).
    Matched MeSH terms: Practice Patterns, Physicians'*
  12. Ottesen TD, Wickersham JA, Lawrence JC, Antoniak S, Zezuilin O, Polonsky M, et al.
    PLoS One, 2024;19(7):e0305086.
    PMID: 39028735 DOI: 10.1371/journal.pone.0305086
    BACKGROUND: HIV incidence and mortality are increasing in Ukraine despite their reductions globally, in part due to suboptimal antiretroviral therapy (ART) coverage in key populations of people with HIV (PWH) where the epidemic is concentrated. As physicians are gatekeepers to ART prescription, stigma and discrimination barriers are understudied as a key to meeting HIV treatment targets in key populations.

    METHODS: A national sample (N = 204) of ART-prescribing physicians in Ukraine were surveyed between August and November 2019. Participants underwent a series of randomized, hypothetical HIV clinical scenarios and decided whether to initiate or defer (or withhold) ART. Scenarios varied based on 5 distinct CD4 counts (CD4: 17, 176, 305, 470, or 520 cells/mL) and 10 different PWH key populations. Z scores and McNemar's test for paired samples were used to assess differences between key populations and CD4 count. Feeling thermometers were used to assess stigma-related measures toward key populations among physicians.

    RESULTS: Physicians were highly experienced (mean = 19 years) HIV treaters, female (80.4%), and trained in infectious diseases (76.5%). Patients who drink alcohol (range: 21.6%-23.5%) or use (PWUD range: 16.7%-20.1%) or inject (PWID range: 15.5%-20.1%) drugs were most likely to have ART deferred, even at AIDS-defining CD4 counts. PWID maintained on methadone, however, were significantly (p<0.001) less likely to have ART deferred compared with those who were not (range: 7.8%-12.7%) on methadone. Men who have sex with men (range: 5.4%-10.8%), transgender women (range: 4.9%-11.3%), sex workers (range: 3.9%-10.3%),and having an HIV-uninfected sex partner (range: 3.9%-9.3%) had the lowest likelihood of ART deferral. Increasing levels of stigma (i.e., feeling thermometers) towards a key population was correlated with ART deferral (i.e., discrimination).

    CONCLUSIONS: Despite international and Ukrainian guidelines recommending ART prescription for all PWH, irrespective of risk or CD4 count, ART deferral by experienced HIV experts remains high in certain key populations, especially in PWH and substance use disorders. Strategies that initiate ART immediately after diagnosis (i.e., rapid start antiretroviral therapy), independent of risk group, should be prioritized to truly mitigate the current epidemic.

    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  13. Sia WT, Tay JC, Lee TC, Nah SA, A Nallusamy MA, Mahendran HA
    Pediatr Surg Int, 2025 Jan 28;41(1):76.
    PMID: 39873765 DOI: 10.1007/s00383-025-05969-0
    INTRODUCTION: The advancements in neonatal resuscitation and surgical care have enabled children with congenital abnormalities to receive corrective surgeries and achieve lifespans well into adulthood. These patients may require long-term follow-up as they continue to have risks of developing sequelae from their original diseases or surgical interventions.

    PURPOSE: This study aimed to investigate the current practice and barriers to the transition of care (TOC) from the perspectives of adult surgeons.

    METHODS: A cross-sectional study was conducted with purposive sampling of adult surgeons from different subspecialties. An online self-administered questionnaire was distributed.

    RESULTS: There were 60 respondents. 62% of the respondents had experience managing referrals for continuation of care or complications in patients with congenital abnormalities. 38% of the respondents believed that TOC should be implemented when patients reached ages 17-18 years. 93% of the respondents agreed that a proper TOC model would greatly benefit patient care, and 97% asserted the need to develop TOC pathways in Malaysia. The absence of a proper guideline was the greatest barrier to a smooth TOC.

    CONCLUSION: This study offered insights into the obstacles to TOC based on the perspectives and experiences of adult surgeons who participated. While not exhaustive, our study provided a better understanding of the challenges in developing the appropriate referral pathways for the continued care of these patients.

    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  14. Sim SK, Rahman MM, Wong HF
    Med J Malaysia, 2025 Jan;80(1):60-67.
    PMID: 39812430
    INTRODUCTION: Chronic non-specific low back pain (cnLBP) is a common primary care health issue. While acupuncture offers promising potential as a complementary treatment, its acceptance and integration into standard medical care for cnLBP remains inconsistent. This study investigated the predictors of acupuncture referral for cnLBP using the Theory of Planned Behaviour (TPB).

    MATERIALS AND METHODS: This was a cross-sectional observational study. Medical practitioners were recruited from the Malaysian Medical Association via email invitations. Data were collected via a validated online questionnaire and analysed using SPSS, employing bivariate correlation and multiple linear regression analyses to examine the predictors of referral behaviour.

    RESULTS: A total of 389 medical practitioners were recruited. The respondents were predominantly general practitioners aged 35-44 years, with 10-19 years of clinical experience, and approximately 90.0% managed cnLBP. Despite the high awareness of the Traditional and Complementary Medicine Act (92.0%), only 33.2% referred patients to acupuncture. Few had acupuncture training (3.6%) or personal experience (7.7%), and services were available in 12.1% of the workplaces. Medical practitioners possess substantial knowledge about acupuncture treatment for cnLBP; however, misconceptions and uncertainties regarding its mechanisms persist. Using multiple linear regression analysis, the significant predictors of acupuncture referral were self-experience (β=0.151, p<0.01), attitude (β=0.189, p<0.001), and perceived behavioural control (β=0.101, p<0.05).

    CONCLUSIONS: Despite positive attitudes and substantial awareness, barriers hinder the broader integration of acupuncture in cnLBP treatment. Targeted education, institutional support, and enhanced research collaborations are essential for improving referral rates and expanding the treatment options for cnLBP.

    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  15. Huan NC, Ng KL, Tang JT, Kua HN, Daut UN, Muhammad NA, et al.
    Ann Acad Med Singap, 2020 12;49(12):1013-1017.
    PMID: 33463660 DOI: 10.47102/annals-acadmedsg.2020364
    The ongoing pandemic of COVID-19 has presented multiple challenges to global healthcare services, dictating changes in almost every aspect of daily medical practice. Performing aerosol generating procedures (AGPs) in the field of interventional pulmonology can lead to profound formation of aerosols, leading to a high risk of infection among healthcare workers (HCWs). We share our experiences on performing AGPs in the midst of a COVID-19 pandemic by focusing on changes in AGP practices. In a pandemic, HCWs ought to adapt to the ever-changing situation and use available resources to provide the best possible healthcare to patients, ensure safety of staff, and continue medical education of future pulmonologists.
    Matched MeSH terms: Practice Patterns, Physicians'/trends
  16. Kabir MA, Goh KL, Khan MM, Al-Amin AQ, Azam MN
    Asia Pac J Public Health, 2015 Mar;27(2):NP1170-81.
    PMID: 22426560 DOI: 10.1177/1010539512437401
    This study examines the safe delivery practices of Bangladeshi women using data on 4905 ever-married women aged 15 to 49 years from the 2007 Bangladesh Demographic and Health Survey. Variables that included age, region of origin, education level of respondent and spouse, residence, working status, religion, involvement in NGOs, mass media exposure, and wealth index were analyzed to find correlates of safe delivery practices. More than 80% of the deliveries took place at home, and only 18% were under safe and hygienic conditions. The likelihood of safe deliveries was significantly lower among younger and older mothers than middle-aged mothers and higher among educated mothers and those living in urban areas. Economically better-off mothers and those with greater exposure to mass media had a significantly higher incidence of safe delivery practices. A significant association with religion and safe delivery practices was revealed. Demographic, socioeconomic, cultural, and programmatic factors that are strongly associated with safe delivery practices should be considered in the formulation of reproductive health policy.
    Matched MeSH terms: Practice Patterns, Physicians'/standards*
  17. Harrison ML, Dickson BFR, Villanueva-Uy MET, Dwi Putri N, Adrizain R, Kartina L, et al.
    Pediatr Infect Dis J, 2025 Apr 01;44(4):e113-e116.
    PMID: 39961140 DOI: 10.1097/INF.0000000000004614
    We evaluated antibiotic prescribing practices for neonates and infants hospitalized with infections in resource-constrained healthcare settings, where antimicrobial resistance is responsible for significant neonatal morbidity and mortality. A point prevalence survey of 667 admitted infants across 10 clinical sites in Southeast Asia revealed a total of 405 antibiotics were prescribed to 218 infants, with high use of World Health Organization-classified "Watch," "Reserve" and "Not Recommended" antibiotics.
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  18. Dhabali AA, Awang R, Zyoud SH
    Int J Clin Pharmacol Ther, 2011 Aug;49(8):500-9.
    PMID: 21781650 DOI: 10.5414/cp201524
    BACKGROUND: The prescription of contraindicated drugs is a preventable medication error, which can cause morbidity and mortality. Recent data on the factors associated with drug contraindications (DCIs) is limited world-wide, especially in Malaysia.

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

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

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

    DISCUSSION AND CONCLUSIONS: This is the first study in Malaysia that presents data on the prevalence of DCIs. The prescription of contraindicated drugs was found to be frequent in this primary care setting. Exposure to DCI events was associated with specific socio-demographic and health status factors. Further research is needed to evaluate the relationship between health outcomes and the exposure to DCIs.
    Matched MeSH terms: Practice Patterns, Physicians'/standards; Practice Patterns, Physicians'/statistics & numerical data*
  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 MW, Yong SC, Boo NY
    Med J Malaysia, 2004 Dec;59(5):598-603.
    PMID: 15889561
    The objectives of this prospective, observational study were to determine the current indications of requesting chest radiograph in sick infants in a neonatal intensive care unit (NICU) and the effect of a user-guided request form for chest radiographs of sick infants. During the three-month study period, a total of 423 chest radiographs were requested on 159 sick newborn infants in the intensive area of this NICU. A majority (55.6%) of these chest radiographs were performed to verify positions tips of either central catheters (27.4%) or endotracheal tubes (28.1%). The number of chest radiographs done during the period when the user-guided request forms were utilised was significantly lower (1.24 per patient) than before (1.37 per patient) or after (1.58 per patients) the period when these forms were in use (p=0.01). The rate of radiological abnormalities detected in radiographs requested to verify position of tips of endotracheal tubes were significantly greater during the period when user-guided forms were used than when they were not (p=0.01). A significantly higher proportion of changes in management were instituted when the user-guided forms were in use than during the period when they were not used (p=0.03). We conclude that a user-guided radiographic request form helps doctors in NICU to carry out their management more effectively.
    Matched MeSH terms: Practice Patterns, Physicians'
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