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  1. Sazlina SG
    Malays Fam Physician, 2015;10(1):2-10.
    PMID: 26425289 MyJurnal
    The world population of older people is on the rise with improved health services. With longevity, older people are at increased risk of chronic non-communicable diseases (NCDs), which are also leading causes of death among older people. Screening through case finding in primary care would allow early identification of NCDs and its risk factors, which could lead to the reduction of related complications as well as mortality. However, direct evidence for screening older people is lacking and the decision to screen for diseases should be made based on comorbidity, functional status and life expectancy, and has to be individualised.
    Matched MeSH terms: Risk Factors
  2. Lew LC, Choi SB, Khoo BY, Sreenivasan S, Ong KL, Liong MT
    Korean J Food Sci Anim Resour, 2018 Apr;38(2):350-361.
    PMID: 29805284 DOI: 10.5851/kosfa.2018.38.2.350
    Hypercholesterolemia is one of the primary risk factors for cardiovascular diseases. The use of lactobacilli probiotics to reduce blood cholesterol levels have been extensively reported. However, more information is needed to evaluate the possible mechanisms involved and to identify possible targets for further therapeutic development. In this study, strains of lactobacilli were screened based on the ability to assimilate cholesterol, and prevention of cholesterol accumulation in hepatic (HepG2) and intestinal (HT-29) cells. Cell free supernatant (CFS) from Lactobacillus plantarum DR7 showed a higher ability to assimilate cholesterol, reduction in cholesterol accumulation in both HepG2 and HT-29 cells, accompanied by reduced mRNA expression of HMG-CoA reductase (HMGCR) in HepG2 (p<0.05), compared to other lactobacilli. The reduction of HMGCR expression was also diminished in the presence of an AMPK inhibitor (Compound C), suggesting that L. plantarum DR7 exerted its effect via the AMPK pathway, typically via the phosphorylation of AMPK instead of the AMPK mRNA expression in HepG2 (p<0.05). Altogether, our present study illustrated that lactobacilli could exert cholesterol lowering properties along the AMPK pathway, specifically via phosphorylation of AMPK that led to reduced expression of HMGCR.
    Matched MeSH terms: Risk Factors
  3. Seah, B.H.A., Tow, S.L.C., Ong, K.C.B. Ong, Yang, C.C., Tsai, C.P., Lee, K.H., et al.
    Neurology Asia, 2017;22(4):341-348.
    MyJurnal
    Optic neuritis, which may be a precursor to multiple sclerosis (MS), is an uncommon disease in
    Asian patients. The Asian Collaborative Longitudinal Optic Neuritis Epidemiology (ACLONE) is
    an observational cohort study that assessed the risk of recurrent optic neuritis and/or progression
    of further neurologic events, either MS or neuromyelitis optica (NMO) in Asian patients with firstever
    optic neuritis. Secondary aims were to study the presenting characteristics and visual outcome,
    and to identify risk factors for development of either MS or NMO. A total of 112 patients (25 men
    and 87 women) aged from 12 to 61 years were recruited from Singapore, Taiwan, South Korea and
    Malaysia. Of these, 94 (84%) had unilateral optic neuritis, with the right eye involved in 45 patients
    and the left eye in 49 patients and the remaining 18 (16%) had bilateral optic neuritis. Follow up
    data was available for 104 patients, and patients were followed for a median duration of 25.9 months.
    Of these patients, 6 patients were adjudicated to have reached the primary endpoint (composite of
    MS/NMO and optic neuritis): 3 patients with recurrent optic neuritis also subsequently experienced
    neurologic symptoms, and 3 patients without recurrent eye involvement had neurologic symptoms.
    Only one patient was considered to have prototypical MS, the other 5 were diagnosed with NMO,
    all with subsequent antibody confirmation. Optic neuritis in Asian patients has significantly different
    presenting characteristics from the classic description. However, in the majority of the patients it is
    usually a benign disease, with good visual outcome and no further events.
    Matched MeSH terms: Risk Factors
  4. Shahir Asraf Abdul Rahim, Azrina Md Ralib, Abdul Hadi Mohamad, Ariff Osman, Mohd Basri Mat Nor
    MyJurnal
    Augmented renal clearance (ARC) is a phenomenon where there is elevated
    renal clearance and defined by creatinine clearance more than 130ml/min. ARC results
    in changes of the pharmacokinetic and pharmacodynamic of antimicrobial therapy being
    administered, which may result in its subtherapeutic dose. We evaluated the
    prevalence, risk factors and outcome of ARC in critically ill patients with sepsis. (Copied from article).
    Matched MeSH terms: Risk Factors
  5. Man REK, Veerappan AR, Tan SP, Fenwick EK, Sabanayagam C, Chua J, et al.
    Ocul Surf, 2017 Oct;15(4):742-748.
    PMID: 28442380 DOI: 10.1016/j.jtos.2017.04.004
    PURPOSE: To evaluate the incidence of symptomatic dry eye disease (SDED) and associated risk factors in a well-characterized cohort of ethnic Malays in Singapore.

    METHODS: We included 1682 participants (mean age [SD]: 57 [10]years; 55.4% female) without SDED from the Singapore Malay Eye Study (SiMES), a population-based longitudinal study with baseline examination (SiMES-1) conducted between 2004 and 2006, and follow-up examination (SiMES-2) conducted between 2010 and 2013. SDED was considered to be present if a participant answered "often" or "all the time" to any of the six questions from the Salisbury Eye Evaluation Study dry eye questionnaire. Age-standardized incidence of SDED was calculated as the crude 6-year cumulative incidence standardized to Singapore's population census. Gender-stratified multivariable log-binomial regression models were utilized to determine the independent risk factors of incident SDED.

    RESULTS: At the 6-year follow-up, 86 of 1682 participants had developed SDED, which was equivalent to an age-standardized 6-year incidence of 5.1% (95% CI 4.1-6.4%). There were no differences in the incidence of SDED between men and women (P = 0.9). Multivariable models revealed that presence of glaucoma and poorer self-rated health were independently associated with incident SDED in men (P = 0.003 and 0.03, respectively), while contact lens wear (P = 0.002), history of thyroid disease (P = 0.03), and having had cataract surgery (P = 0.02) were predictive of incident SDED in women.

    CONCLUSION: One in twenty adult Malays developed SDED over a 6-year period. Risk factors for incident SDED were different between men and women. Future studies and public health interventions should consider this gender-specific difference in risk factors.
    Matched MeSH terms: Risk Factors
  6. Jesse FFA, Bitrus AA, Abba Y, Raju VN, Hambali IU, Peter ID, et al.
    Vet World, 2018 Feb;11(2):172-176.
    PMID: 29657399 DOI: 10.14202/vetworld.2018.172-176
    Background and Aim: Caprine arthritis encephalitis (CAE) is an important viral disease of small ruminants particularly in dairy goats with severe social and economic implication. Hence, this study was designed to determine the seroprevalence of CAE virus (CAEV) among goat population in selected small ruminant farms in Selangor and the risk factors associated with the occurrence of the disease.

    Materials and Methods: Blood samples were collected from a total of 91 goats selected at random. Blood serum was harvested and used for competitive enzyme-linked immunosorbent assay test to detect antibodies against CAE virus.

    Results: The result obtained showed that 8/91 (8.8%) of the goats were seropositive for CAEV. In addition, biosecurity management, source of origin and sex of the animal were observed to be important risk factors associated with the occurrence of CAE in goats.

    Conclusion: The findings of this study affirmed that the seroprevalence of CAEV infection among goat population in small ruminant farms in Selangor, Malaysia, is low. However, there is need to institute strict control measures such as testing and culling positive animals or separation of infected animals from those that tested negative to the disease for effective eradication of the disease.

    Matched MeSH terms: Risk Factors
  7. Zalbahar N, Najman J, McIntyre HD, Mamun A
    Clin Obes, 2017 Aug;7(4):206-215.
    PMID: 28557382 DOI: 10.1111/cob.12200
    The purpose of this study was to examine the association of parental pre-pregnancy weight and body mass index (BMI) on offspring weight and BMI change from childhood to adulthood. We analysed BMI data from a subsample of parents (n = 1494) from the Mater-University of Queensland Study of Pregnancy cohort that started in the early 1980s in Brisbane, Australia: data were collected at pre-pregnancy and then also for offspring at 5, 14 and 21-year follow-ups. Multiple regression for continuous outcomes and multinomial regression for categorical outcomes were performed. A total of 14.7% of offspring experienced BMI change from normal at 5 years to overweight or obese (OW/OB) at 14 years, 15.3% of normal at 14 years to OW/OB at 21 years and 22.8% from normal at 5 years to OW/OB at 21 years. Overall, the strength of the association of parental BMI with offspring BMI was stronger as offspring become older. Pre-pregnancy parental BMI differentially impacts offspring OW/OB across the life course. For every unit increase in paternal and maternal BMI z-score, offspring BMI z-score increased, on average, by between 0.15% (kg m-2) and 0.24% (kg m-2) throughout all three stages of life when both parents were OW/OB; these associations were stronger than with one parent. Parental pre-pregnancy BMI and OW/OB is a strong predictor of offspring weight and BMI change from early life to adulthood.
    Matched MeSH terms: Risk Factors
  8. Solehan Imran Shariffudin, Jafri Mohd. Rohani, Mohd Firdaus Mohd Taib, Roseni Abd. Aziz
    MyJurnal
    Geographically, Malaysia is situated in the equatorial region, thus having a climate of hot and humid throughout the
    year. Effect of heat stress and physical work load at construction industry need to be investigated because of the high number of
    accidents. Thus, perception of physical workload and heat stress by the construction workers in Malaysia needed to be investigated
    and documented. The aim of this paper is to establish a set of questionnaires containing the item generation regarding on physical
    workload and the heat stress perception of construction workers. Physical workload factors such as fatigue, risks, concentration,
    work rhythm, responsibility, satisfaction, and autonomy are inserted as the items in assessing the physical workload. While heat
    stress are assessed using heat risk factors such as temperature, humidity, heat radiation, air movement, workload, clothing and
    acclimatisation. A questionnaire has been developed resulted from various reviewing of literatures on physical workload and heat
    stress and better suited to the Malaysia working environment.
    Matched MeSH terms: Risk Factors
  9. Lee, Wen Jih, Ong, Lieh Yan, Koay, Siew Ni, Kwan, Zuan Er
    MyJurnal
    Objective: The main aim of this study is to assess the prevalence of early
    readmissions to inpatient care in Hospital Bahagia Ulu Kinta and the associated
    socio-demographic and clinical factors.

    Methods: This is an observational study
    for all patients with readmissions within 3 months from the last discharge, dated
    from 1 January 2013 to 31 December 2013. Related socio-demographic and
    clinical details are obtained from the medical records and compared between the
    patients who were readmitted within the first month after discharge to those who
    were readmitted later in the second and third month.

    Results: Total of 149
    records of patients who were readmitted within 3 months of last discharge were
    analyzed. Majority of them were from the same state of Perak (83.9%), male
    (74.5%), single (71.1%), unemployed (85.9%), taken care by family (75.2%),
    achieved secondary education level (59.7%) with mean age of 37.89 years (SD
    11.53). They were discharged for a mean of 32.52 days (SD 26.48) before
    readmission with a mean duration of 72.98 days in the previous admission, and
    mean previous admissions of 10.17 times. 69.8% of the patients were treated for
    psychotic disorders and the main reason for readmission was relapse (84.6%).
    Up to 34.2% of the patients reported to have substance abuse while 25.5% had
    medical co-morbidities. Most of the patients (63.8%) were not compliant to the
    treatment from the last discharge. Socioeconomic and clinical factors did not
    show statistical significance when the readmissions within the first month after
    discharge were compared to those who were admitted later at the second and
    third month.

    Conclusions: Due to limitations, further studies need to be done to
    identify risk factors associated with readmissions and adequate measures need to
    be taken to prevent these readmissions.
    Matched MeSH terms: Risk Factors
  10. Nur Hidayah Rani, Emilia Zainal Abidin, Noor Afifah Ya'acob, Karmegam Karuppiah, Irniza Rasdi
    MyJurnal
    Pineapple plantation workers are exposed to strenuous physical activities. This study aims to determine the prevalence
    of musculoskeletal symptoms (MSS), analyse the body postural risks related to work tasks and identify relevant MSS risk factors
    among pineapple plantation workers. This was a cross-sectional study performed at a pineapple plantation in Johor in 2016. MSS,
    information on socio-demographic background and occupational history were collected via structured questionnaires. Identification
    and risk assessment of ergonomic hazard and postural risk analysis were performed for a subset of workers. Data were entered into
    statistical software and analyse according to relevant objectives. A total of 108 workers participated in this study. The prevalence
    of MSS was 87.0% and was highest for the lower back (64.8%). In terms of ergonomic hazards, Harvesting were categorised as a
    task with the highest risk. Harvesting was also the task with the highest postural risk. From the multivariate analysis, lower back
    pain is mainly contributed by a working tenure of 10 to 25 years (Odds Ratio, OR: 3.90; 95% Confidence Interval, CI 1.05-14.4) and
    more than 25 years (OR: 7.45 (95% CI 1.26 to 44.0). Workers who worked more than 7-hour daily have a higher risk for reporting
    lower back pain. Pineapple plantation workers are exposed to excessive bending, twisting and carrying of heavy loads that may be
    linked to MSS. Effective preventive strategies are required to address MSS in this population in order to minimize risk for subsequent
    musculoskeletal disorders.
    Matched MeSH terms: Risk Factors
  11. Nurfarah Wahidah Mohd Nor Rasid, Nurul Syafiqah Noh, Munirah Mohd Adnan, Azizah Yusoff
    MyJurnal
    Prolonged work with highly repetitious flexion and extension of the wrist and forceful grip task were shown to increase the risk of developing carpal tunnel syndrome (CTS) among dental personnel. The present study was carried out to determine the prevalence, risk factors and coping strategies of probable CTS among clinical dental support staff in Hospital Universiti Sains Malaysia (HUSM). A cross-sectional study was conducted and a set of questionnaire consisting of socio-demographic status, work-related and psychosocial risk factors and coping strategies was distributed. Ninety-five clinical dental support staff completed and returned the questionnaire with a response rate of 80.5%. The prevalence of probable CTS was 38.9%, with the highest prevalence was found among dental surgery assistants (40.5%) followed by dental technologists (29.7%). There was no significant association between work-related or psychosocial risk factors with probable CTS (p>0.05). Most of the respondents with symptoms of CTS chose religion as the coping mechanism; mean 7.11 (SD 1.13). Awareness training should be emphasized among clinical dental support staff on the prevention of CTS.

    Study site: Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Risk Factors
  12. Vedanthan R, Bernabe-Ortiz A, Herasme OI, Joshi R, Lopez-Jaramillo P, Thrift AG, et al.
    Cardiol Clin, 2017 Feb;35(1):99-115.
    PMID: 27886793 DOI: 10.1016/j.ccl.2016.08.010
    Elevated blood pressure, a major risk factor for ischemic heart disease, heart failure, and stroke, is the leading global risk for mortality. Treatment and control rates are very low in low- and middle-income countries. There is an urgent need to address this problem. The Global Alliance for Chronic Diseases sponsored research projects focus on controlling hypertension, including community engagement, salt reduction, salt substitution, task redistribution, mHealth, and fixed-dose combination therapies. This paper reviews the rationale for each approach and summarizes the experience of some of the research teams. The studies demonstrate innovative and practical methods for improving hypertension control.
    Matched MeSH terms: Risk Factors
  13. Balakumar P, Maung-U K, Jagadeesh G
    Pharmacol Res, 2016 11;113(Pt A):600-609.
    PMID: 27697647 DOI: 10.1016/j.phrs.2016.09.040
    Noncommunicable diseases (NCDs) have become important causes of mortality on a global scale. According to the report of World Health Organization (WHO), NCDs killed 38 million people (out of 56 million deaths that occurred worldwide) during 2012. Cardiovascular diseases accounted for most NCD deaths (17.5 million NCD deaths), followed by cancers (8.2 million NCD deaths), respiratory diseases (4.0 million NCD deaths) and diabetes mellitus (1.5 million NCD deaths). Globally, the leading cause of death is cardiovascular diseases; their prevalence is incessantly progressing in both developed and developing nations. Diabetic patients with insulin resistance are even at a greater risk of cardiovascular disease. Obesity, high cholesterol, hypertriglyceridemia and elevated blood pressure are mainly considered as major risk factors for diabetic patients afflicted with cardiovascular disease. The present review sheds light on the global incidence of cardiovascular disease and diabetes mellitus. Additionally, measures to be taken to reduce the global encumbrance of cardiovascular disease and diabetes mellitus are highlighted.
    Matched MeSH terms: Risk Factors
  14. Aniza, I, Nurmawati, A, Hanizah, Y, Ahmad Taufik, J
    MyJurnal
    Cardiovascular disease (CVD) is the leading cause of death in Malaysia and many parts of the world. Potentially modifiable risk factors for CVD include diabetes mellitus, hypertension, abdominal obesity, smoking and psychosocial stress. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. However, many patients have never achieved adequate control of CVD risk factors despite them being identified. The aims of this study were to measure the prevalence of cardiovascular diseases and to determine its associated factors. A cross sectional study was carried out in a rural area of Malaysia from March 2011 to November 2011 on 1489 respondents aged 18 and above who were selected via convenient sampling. The survey was conducted via a face-to-face interview using a standardized self administered questionnaire. Prevalence of cardiovascular disease identified was 72 cases (4.8%). Overall, the prevalence of modifiable risk factors were predominant compared to non modifiable, with abdominal obesity (51.2%) hypertension (39.5%) and psychosocial stress (33.8%) being among the highest. However, the prevalence of other modifiable risk factors was relatively low with smoking (25.2%), and diabetes mellitus (10.9%) respectively. Respondent with diabetes mellitus and hypertension were 4 times more likely to have cardiovascular disease and those who are obese had associated 2.5risks towards cardiovascular disease. Therefore, community health intervention measures should be mobilized,specifically on prevention and control of lifestyle-related risk factors.
    Matched MeSH terms: Risk Factors
  15. Chong LS, Chin YS, Gan WY, Nasir MT
    Asia Pac J Clin Nutr, 2017 Mar;26(2):326-333.
    PMID: 28244713 DOI: 10.6133/apjcn.012016.10
    BACKGROUND AND OBJECTIVES: To determine the associations between socio-demographic characteristics and pubertal status with disordered eating among primary school children.

    METHODS AND STUDY DESIGN: Using a stratified multi-stage sampling, a total of 816 children (282 boys and 534 girls) aged 10 to 11 years from 12 selected primary schools in the state of Selangor, participated in this study. Data were collected on socio-demographic characteristics, pubertal status and disordered eating behaviors. The Pubertal Development Scale and the Children's Eating Attitudes Test (ChEAT) were used to assess pubertal status and disordered eating, respectively. Logistic regression analysis was conducted to determine the risk factors of disordered eating.

    RESULTS: The prevalence of disordered eating was 30.8% (32.8% in boys and 29.7% in girls). However, the sex difference in the prevalence was not statistically significant. Age, ethnicity and pubertal status were significantly associated with disordered eating in univariate logistic regression analysis. Multivariate logistic regression analysis showed that among boys, being either in an advanced or post-pubertal stage (adjusted OR=8.64) and older age group (adjusted OR=2.03) were risk factors of disordered eating. However, among girls, being a Malay (adjusted OR=3.79) or Indian (adjusted OR=5.04) in an advanced or post-pubertal stage (adjusted OR=2.34) and older age group (adjusted OR=1.53) were risk factors of disordered eating.

    CONCLUSION: This study found one in three children had disordered eating. Since ethnicity and pubertal status were identified as risk factors, ethnicity-specific intervention programs on the prevention of disordered eating among children should take into consideration their pubertal status.

    Matched MeSH terms: Risk Factors
  16. Leong BD, Zainal AA, Hanif H, Tajri HM, Govindarajantran N, Pillay K, et al.
    Ann Vasc Dis, 2018 Jun 25;11(2):223-227.
    PMID: 30116415 DOI: 10.3400/avd.oa.18-00018
    Objective: Native fistula creation for hemodialysis in patients who have exhausted all their superficial veins presents a challenge to vascular practice. We review our experience in transposed basilic vein fistula (BVT) creation and its usage for hemodialysis. Materials and Methods: We analyzed the hospital operative registry from January 2009 till June 2012 to identify the total number of BVT created in our center. Medical records of all patients were traced, and patients were interviewed using a standard proforma. In our center, BVT is performed as a two-stage procedure. All patients were routinely assessed with duplex scan preoperatively and postoperatively. Results: Two hundred thirty-nine patients were recruited in the study. Of these patients, 50.6% were male and 49.4% were female. Mean age was 53.4 years. Of these patients, 81.2% had history of other previous fistula creation. Risk factors profile includes diabetes mellitus in 59.8%, hypertension in 86.2%, and smoking in 13.0%. Of these patients, 84.5% had no operative complication. Commonest complication was wound infection, 6.3%, followed by hemorrhage or hemotoma required surgical intervention, 5.9%, and pseudoaneurysm, 1.3%. Primary and secondary patencies were at 84.2% and 86.1% at 1 year and 67.7% and 70.5% at 3 years, respectively. Conclusion: BVT is a credible option for challenging patients with absence of superficial veins for native fistula creation with good patency and low operative complication rate. Preoperative ultrasound assessment improves patient selection and outcome of BVT.
    Matched MeSH terms: Risk Factors
  17. Ulaganathan V, Kandiah M, Mohd Shariff Z
    J Gastrointest Oncol, 2018 Aug;9(4):650-663.
    PMID: 30151261 DOI: 10.21037/jgo.2018.04.01
    Background: Metabolic syndrome was linked with various chronic diseases, including cancer. The study on the effect of metabolic syndrome on colorectal cancer (CRC) was not conducted in Malaysia. Therefore, this study aims to determine the association between metabolic syndromes and its components with CRC, based on the three established definitions.

    Methods: A multi-centred matched case control study was conducted in five local hospitals. A total of 140 histologically confirmed CRC cases were matched with 280 cancer free controls. Mean value and prevalence of the components of metabolic syndrome between cases and controls were measured based on the three definitions. A multiple variable analysis using Cox regression was conducted to measure the strength of the association between the definitions of MetS, components of MetS and risk of CRC.

    Results: Multiple variable analyses showed that metabolic syndrome significantly and independently increased the risk of CRC, with an odds ratio ranging from 1.79 to 2.61. This study identified that the definition of metabolic syndrome by the International Diabetes Federation is the most sensitive in predicting the risk of CRC, compared to metabolic syndrome as defined by the World Health Organization and National Cholesterol Education Program Adults Treatment Panel III. Abdominal obesity, low HDL-cholesterol, and hypertension were identified as the three core risk factors, which promote inflammatory signals that contribute to metabolic syndrome and an increased risk of CRC.

    Conclusions: These data hypothesized that simple measurement of abdominal obesity, abnormal BP and HDL-cholesterol especially using International Diabetes Federation (IDF) definition of MetS for South Asians for to detect individuals at CRC risk may have higher clinical utility than applying other universal complex MetS definitions.

    Matched MeSH terms: Risk Factors
  18. Norazman Mohd Rosli, Shamsul Azhar Shah, Mohd Ihsani Mahmood
    MyJurnal
    Tuberculosis (TB) is known as a disease that prone to spatial clustering. Recent development has seen a sharp rise in the number of epidemiologic studies employing Geographical Information System (GIS), particularly in identifying TB clusters and evidences of etiologic factors. The aim of this systematic review is to determine evidence of TB clustering, type of spatial analysis commonly used and the application of GIS in TB surveillance and control. A literature search of articles published in English language between 2000 and November 2015 was performed using MEDLINE and Science Direct using relevant search terms related to spatial analysis in studies of TB cluster. The search strategy was adapted and developed for each database using appropriate subject headings and keywords. The literature reviewed showed strong evidence of TB clustering occurred in high risk areas in both developed and developing countries. Spatial scan statistics were the most commonly used analysis and proved useful in TB surveillance through detection of outbreak, early warning and identifying area of increased TB transmission. Among others are targeted screening and assessment of TB program using GIS technology. However there were limitations on suitability of utilizing aggregated data such as national cencus that were pre-collected in explaining the present spatial distribution among population at risk. Spatial boundaries determined by zip code may be too large for metropolitan area or too small for country. Nevertheless, GIS is a powerful tool in aiding TB control and prevention in developing countries and should be used for real-time surveillance and decision making.
    Matched MeSH terms: Risk Factors
  19. Aziz H, Hatah E, Makmor-Bakry M, Islahudin F, Ahmad Hamdi N, Mok Pok Wan I
    Malays Fam Physician, 2018;13(2):2-9.
    PMID: 30302177 MyJurnal
    Background: Limited efforts have been made to evaluate medication adherence among subsidized and self-paying patients.

    Objective: To investigate medication adherence among patients with and without medication subsidies and to identify factors that may influence patients' adherence to medication. Setting: Government healthcare institutions in Kuala Lumpur, Selangor, and Negeri Sembilan and private healthcare institutions in Selangor and Negeri Sembilan, Malaysia.

    Methods: This cross-sectional study sampled patients with and without medication subsidies (self-paying patients). Only one of the patient's medications was re-packed into Medication Event Monitoring Systems (MEMS) bottles, which were returned after four weeks. Adherence was defined as the dose regimen being executed as prescribed on 80% or more of the days. The factors that may influence patients' adherence were modelled using binary logistic regression. Main outcome measure: Percentage of medication adherence.

    Results: A total of 97 patients, 50 subsidized and 47 self-paying, were included in the study. Medication adherence was observed in 50% of the subsidized patients and 63.8% of the self-paying patients (χ2=1.887, df=1, p=0.219). None of the evaluated variables had a significant influence on patients' medication adherence, with the exception of attending drug counselling. Patients who attended drug counselling were found to be 3.3 times more likely to adhere to medication than those who did not (adjusted odds ratio of 3.29, 95% CI was 1.42 to 7.62, p = 0.006).

    Conclusion: There is no significant difference in terms of medication adherence between subsidized and self-paying patients. Future studies may wish to consider evaluating modifiable risk factors in the examination of non-adherence among subsidized and self-paying patients in Malaysia.

    Matched MeSH terms: Risk Factors
  20. Tan AKG, Yen ST, Fang X, Chiang FS
    Int Health, 2019 03 01;11(2):150-158.
    PMID: 30321364 DOI: 10.1093/inthealth/ihy072
    BACKGROUND: This study examined the factors associated with body mass index (BMI) categories of Malaysian adolescents by physical activity (PA) status.

    METHODS: Data were obtained from the 2012 Malaysia Global School-based Student Health Survey. Generalized ordered logit regression analysis was conducted on 24 339 adolescents by PA status.

    RESULTS: Early- (ages 11-13) and middle-stage (ages 14-16) adolescents were associated with higher overweight and obesity risks than their older peers (ages 17-18). Male adolescents faced higher underweight and obesity likelihoods than females. Hunger due to food shortage at home was associated with higher likelihoods of underweight and normal weight BMI categories. Smokers were more likely to be underweight or normal weight than non-smokers. Segmented-sample analysis by PA status indicated that, while the direction of associations was parallel across PA status, the magnitudes of association between age, hunger and smoking status with BMI status were greater among active than inactive adolescents.

    CONCLUSIONS: Male adolescents faced a dual burden of underweight and obesity. Other sociodemographic and dietary-lifestyle factors were associated with adolescent BMI categories. Segmented-sample analysis by PA status uncovered varying associations between factors that would otherwise be masked in pooled sample analysis. Public health authorities should take these factors into consideration when deliberating programs to ensure healthy adolescent body weight.

    Matched MeSH terms: Risk Factors
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