MyMedR

Fulltext Personal continuity of care in a university-based primary care practice: impact on blood pressure control

Hanafi NS, Abdullah A, Lee PY, Liew SM, Chia YC, Khoo EM

PLoS One, 2015;10(7):e0134030.

PMID: 26214304 DOI: 10.1371/journal.pone.0134030

Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4) was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI), which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4). The majority was women (59.2%) and married (85.7%). The mean number of visits in a year was 3.85 (SD 1.36). A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff). The mean UPCI was 0.43 (SD 0.34). Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this.

Study site: Primary care clinic, University Malaya Medical Centre (UMMC)

Matched MeSH terms: Physicians, Family*

Physical disability and the role of the general practitioner in rehabilitation

Balasubramaniam P

Family Practitioner, 1981;4:11-14.

Matched MeSH terms: Physicians, Family

Fulltext Preventing diabetes: The task of the family doctor

Rajakumar MK

Asia Pac Fam Med, 2003;2(1):8-9.

Matched MeSH terms: Physicians, Family

Fulltext Primary care doctors' perceptions towards evidence-based medicine in Melaka State: a questionnaire study

Chan GC, Teng CL

Med J Malaysia, 2005 Jun;60(2):130-3.

PMID: 16114151

A cross sectional study using a self-administered questionnaire to determine the perceptions of primary care doctors towards evidence-based medicine (EBM) was conclucted in Melaka state. About 78% of the primary care doctors were aware of EBM and agreed it could improve patient care. Only 6.7% of them had ever conducted a Medline literature search. They had a low level of awareness of review publications and databases relevant to EBM; only about 33% of them were aware of the Cochrane Database of Systemic Reviews. Over half of the respondents had at least some understanding of the technical terms used in EBM. Ninety percent of the respondents had Internet access and the majority of them used it at home. The main barriers to practicing EBM were lack of personal time and lack of Internet access in the primary care clinics.

Matched MeSH terms: Physicians, Family/standards*

Recognising family medicine training

Kwa SK

Family Physician, 2003;12:1-2.

Matched MeSH terms: Physicians, Family

Fulltext Remission of recalcitrant dermatomyositis following a chiropractic adjustment

Chu ECP, Lo FS, Bhaumik A

J Family Med Prim Care, 2019 Nov;8(11):3742-3744.

PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.

Matched MeSH terms: Physicians, Family

Fulltext Reorientation of medical education for primary health care

Sahan AK

Med J Malaysia, 1987 Mar;42(1):1-8.

PMID: 3431498

There is universal concern on the current inequitable coverage and low quality of health care. The lead roles of medical practitioners in health care and how they are prepared for such roles are being re-examined in many countries. This paper attempts to rationalise the need to reorientate medical education towards primary health care, and to suggest possible emphasis and direction for change.

Matched MeSH terms: Physicians, Family/education*

Fulltext Risk factors for diabetic retinopathy in diabetic screened using fundus photography at a primary health care setting in East Malaysia

Mallika PS, Lee PY, Cheah WL, Wong JS, Syed Alwi SAR, Nor Hayati H, et al.

Malays Fam Physician, 2011;6(2):60-65.

MyJurnal

Introduction: This study reports on the prevalence of diabetic retinopathy (DR) and risk factors among diabetic patients, who underwent fundus photography screening in a primary care setting of Borneo Islands, East Malaysia. We aimed to explore the preliminary data to help in the planning of more effective preventive strategies of DR at the primary health care setting.
Materials and Methods: A cross-sectional study on 738 known diabetic patients aged 19-82 years was conducted in 2004. Eye examination consists of visual acuity testing followed by fundus photography for DR assessment. The fundus pictures were reviewed by a family physician and an ophthalmologist. Fundus photographs were graded as having no DR, NPDR, PDR and maculopathy. The data of other parameters was retrieved from patient’s record. Bi-variate and multivariate analysis was used to elucidate the factors associated with DR.
Results: Any DR was detected in 23.7% (95% CI=21 to 27%) of the patients and 3.2% had proliferative DR. The risk factors associated with any DR was duration of DM (OR =2.5, CI=1.6 to 3.9 for duration of five to 10 years when compared to <5 years) and lower BMI (OR=1.8, CI=1.1 to 3.0). Moderate visual loss was associated with DR (OR=2.1, CI=1.2 to 3.7).
Conclusions: This study confirms associations of DR with diabetic duration, body mass index and visual loss. Our data provide preliminary findings to help to improve the screening and preventive strategies of DR at the primary health care setting.
Keywords: Diabetic retinopathy, epidemiology, screening, primary health care, Malaysia
Study site: Klinik Kesihatan Jalan Masjid, Kuching, Sarawak, Malaysia

Matched MeSH terms: Physicians, Family

Role of the general practitioner in the management of psychiatric disorders

Subramaniam M

Family Practitioner, 1988;11:13-16.

Matched MeSH terms: Physicians, Family

Royal College of General Practitioners publications

Gray DP

Family Practitioner, 1986;9:60-60.

Matched MeSH terms: Physicians, Family

Sexual Health Problems: Attitudes and Practices of Malaysian General Practitioners

Low WY, Khoo EM, Tan HM

ISBN: 0-86471-096-8

Citation: Low WY, Khoo EM, Tan HM. Sexual Health Problems: Attitudes and Practices of Malaysian General Practitioners. Auckland: Adis International Ltd, 2002

Matched MeSH terms: Physicians, Family

Speech by Dato' Paduka Dr Ruby binti Abdul Majeed, President of the Academy of Family Physicians of Malaysia on the occasion of the Convocation and Launching of the joint training programme between UPM and the Academy of Family Physicians of Malaysia

Abdul Majeed R

Family Physician, 2001;11(3):v-vi.

Matched MeSH terms: Physicians, Family

Fulltext Spotted bone disease (osteopoikilosis)

Omar M, Abdul Rahman AA, Mohd Hussein AM, Mustafa N

Family Physician, 2005;13(3):15-15.

MyJurnal

Osteopoikilosis is a rare bone dysplasia which is inherited as an autosomal dominant trait with a prevalence of less than 0.1 per million.1 It is characterised by dense ovoid or circular spots in cancellous bone which may appear at birth or during skeletal growth. It is usually found in the metaphyseal and epiphyseal regions of long bones, the carpals and tarsals, the end of large turbular bones and around the acetabula. It is clinically asymptomatic and occasionally associated with hereditary multiple exostosis and dermatofibrosis lenticularis disseminata. It is not associated with spontaneous fractures and treatment is unnecessary. However a case of osteosarcoma developing in a man with osteopoikilosis has been reported. The first case of osteopoikilosis was reported in Malaysia four years ago in a 25 years old lady who is also of Indian descent. It would be interesting to know if these two patients are related. Since the bone lesions could easily be mistaken for metastatic disease, it is important that family physicians be aware of the benign nature of this condition.

Matched MeSH terms: Physicians, Family

Fulltext The APEC Digital Hub-WONCA Collaborative Framework on Integration of Mental Health into Primary Care in the Asia Pacific

Dowrick C, Kassai R, Lam CLK, Lam RW, Manning G, Murphy J, et al.

J Multidiscip Healthc, 2020;13:1693-1704.

PMID: 33268991 DOI: 10.2147/JMDH.S271070

Mental ill health affects individual well-being and national economic prosperity and makes up a substantial portion of the burden of disease globally, especially in the Asia-Pacific region. Integrating mental health into primary care is widely considered a key strategy to improve access to mental health care. Integration, however, is a complex process that needs to be addressed at multiple levels. A collaboration between the Asia-Pacific Economic Cooperation (APEC) Digital Hub for Mental Health and the World Organization of Family Doctors (WONCA) is described in this paper, which outlines a framework and next steps to improve the mental health of communities in APEC economies. This paper notes gaps related to the integration of mental health into primary care across the region and identifies enablers and current best practices from several APEC economies. The potential of digital technology to benefit primary mental health care for populations in the APEC region, including delivery of training programs for healthcare staff and access to resources for patients, is described. Finally, key next steps are proposed to promote enhanced integration into primary care and improve mental health care throughout the APEC region.

Matched MeSH terms: Physicians, Family

The Hon Secretary writes. A visit to the Hong Kong College of General Practitioner

Goh CS

Family Practitioner, 1982;5:78-78.

Matched MeSH terms: Physicians, Family

Fulltext The Rajakumar Movement

Harris N P

Malays Fam Physician, 2009;4(1):6-7.

Note by TCL: The Rajakumar Movement is the Wonca Asia Pacific Region Working Party for Young and Future Family Doctors. It was named in honour of Dr M K Rajakumar.

Matched MeSH terms: Physicians, Family

Fulltext The adaptation and validation of the satisfaction with stroke care questionnaire (Homesat) (SASC10-My™) for use in public primary healthcare facilities caring for long- term stroke survivors residing at home in the community

Abdul Aziz AF, Tan CE, Ali MF, Aljunid SM

Health Qual Life Outcomes, 2020 Jun 20;18(1):193.

PMID: 32563246 DOI: 10.1186/s12955-020-01450-9

BACKGROUND: Satisfaction with post stroke services would assist stakeholders in addressing gaps in service delivery. Tools used to evaluate satisfaction with stroke care services need to be validated to match healthcare services provided in each country. Studies on satisfaction with post discharge stroke care delivery in low- and middle-income countries (LMIC) are scarce, despite knowledge that post stroke care delivery is fragmented and poorly coordinated. This study aims to modify and validate the HomeSat subscale of the Dutch Satisfaction with Stroke Care-19 (SASC-19) questionnaire for use in Malaysia and in countries with similar public healthcare services in the region.

METHODS: The HomeSat subscale of the Dutch SASC-19 questionnaire (11 items) underwent back-to-back translation to produce a Malay language version. Content validation was done by Family Medicine Specialists involved in community post-stroke care. Community social support services in the original questionnaire were substituted with equivalent local services to ensure contextual relevance. Internal consistency reliability was determined using Cronbach alpha. Exploratory factor analysis was done to validate the factor structure of the Malay version of the questionnaire (SASC10-My™). The SASC10-My™ was then tested on 175 post-stroke patients who were recruited at ten public primary care healthcentres across Peninsular Malaysia, in a trial-within a trial study.

RESULTS: One item from the original Dutch SASC19 (HomeSat) was dropped. Internal consistency for remaining 10 items was high (Cronbach alpha 0.830). Exploratory factor analysis showed the SASC10-My™ had 2 factors: discharge transition and social support services after discharge. The mean total score for SASC10-My™ was 10.74 (SD 7.33). Overall, only 18.2% were satisfied with outpatient stroke care services (SASC10-My™ score ≥ 20). Detailed analysis revealed only 10.9% of respondents were satisfied with discharge transition services, while only 40.9% were satisfied with support services after discharge.

CONCLUSIONS: The SASC10-My™ questionnaire is a reliable and valid tool to measure caregiver or patient satisfaction with outpatient stroke care services in the Malaysian healthcare setting. Studies linking discharge protocol patterns and satisfaction with outpatient stroke care services should be conducted to improve care delivery and longer-term outcomes.

TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016.

Matched MeSH terms: Physicians, Family

The clinical problems of the general practitioner and multiple concurrent pathologies

McKay AB

Family Practitioner, 1977;2(8):101-105.

Matched MeSH terms: Physicians, Family

Fulltext The family physician in Asia: looking to the 21st century

Rajakumar MK

Family Medicine Education in the Asia-Pacific Region. Core Curriculum for Residency/Vocational Training and Core Content for Specialty Qualifying Examination., 1993.

Citation: Rajakumar MK. The family physician in Asia: looking to the 21st century. Family Medicine Education in the Asia-Pacific Region. Core Curriculum for Residency/Vocational Training and Core Content for Specialty Qualifying Examination. The Philippine Academy of Family Medicine, 1993. [Originally published in the Filipino Family Physician in 1993]

Republished in:
1. Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 40-45
2. An Uncommon Hero. p354-360

Matched MeSH terms: Physicians, Family

The family practitioner's role in sex education

Tan FEH

Family Practitioner, 1977;2(8):49-51.

Matched MeSH terms: Physicians, Family

Displaying publications 61 - 80 of 93 in total