METHOD: In-depth interviews (IDIs) will be conducted with Malaysian healthcare providers and cancer survivors and findings will be analysed thematically. The insights will be used in a subsequent phase to co-design a guideline to maintain the delivery of quality cancer care in Malaysia via a three-round modified Delphi survey with a broad range of cancer stakeholders.
EXPECTED RESULTS: Findings derived from IDIs and existing literature will be included for rating across three rounds by the expert panel. Feedback provided will be refined until consensus on the best practises for cancer care continuity during crises is achieved.
CONCLUSION: The output of the present study is not only expected to ensure the continuity of delivery of high-quality cancer care in Malaysia during the ongoing pandemic but also to be adapted during unforeseen crises in the near future.
POLICY SUMMARY STATEMENT: Collaborative work between policy makers, public health physicians, members of the multidisciplinary oncology team as well as cancer survivors is vital in developing an evidenced- based contingency plan for maintaining access to cancer care.
OBJECTIVE: To identify community pharmacists-led interventions in TB management with their corresponding impacts in TB case detection and treatment outcomes.
METHODS: A systematic search was performed in six electronic databases and health organization websites, from database inception to August 2, 2022. Studies which described TB screening, referral and/or treatment monitoring by community pharmacists with their corresponding outcomes were screened and reviewed independently by two reviewers. The studies were checked for the risk of bias using Cochrane risk of bias tools. All data of included studies were analysed qualitatively and presented narratively.
RESULTS: The search yielded 8,121 studies and five reports for initial screening. Sixteen studies and two case study reports were included in this review. Community pharmacists were involved throughout the TB care cascade, contributing their services in TB screening, referrals and in directly observed treatment-short course (DOTS) program. These interventions showed improvements in the effective control and prevention of further spread of TB, which improves individual, community and population level outcomes.
CONCLUSIONS: The inclusion of community pharmacists into TB program can improve the continuity of care, bridging the gaps in TB case detection and treatment monitoring. Adequate training and support are essential, to further empower the role of community pharmacists in TB control and prevention, in building a TB-free world.
DESIGN: Scoping review, following the Arksey and O'Malley's framework, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.
DATA SOURCES: PubMed, Web of Science and Scopus were searched from 1 January 2020 through 31 December 2021.
ELIGIBILITY CRITERIA: Original articles, reviews, case studies and reports written in English were included. Works without full article and articles that did not answer the research questions were excluded.
DATA EXTRACTION AND SYNTHESIS: Data were extracted using a standardised data extraction form in Microsoft Excel. The findings of all included articles were synthesised narratively.
RESULTS: Eighty-five records were reviewed and 25 studies were included. For the field hospital implementation strategies, 'surge capacity', namely space, human resource, supply and system, was discussed in addition to the preparation and workflow of other services such as pharmacy, rehabilitation, food and nutrition. The management of COVID-19 field hospitals is challenging with respect to staff and resource shortages, inability to anticipate patient load and poor communication. The opportunities and recommendations for improvement of management were also highlighted.
CONCLUSIONS: The compilation of lessons learnt may help improve the future management of field hospitals, administratively and clinically.
METHODS: Eligible studies were included if they used any models to assess the impact of COVID-19 disruptions on any health services. Articles published from January 2020 to December 2022 were identified from PubMed, Embase and CINAHL, using detailed searches with key concepts including COVID-19, modelling and healthcare disruptions. Two reviewers independently extracted the data in four domains. A descriptive analysis of the included studies was performed under the format of a narrative report.
RESULTS: This scoping review has identified a total of 52 modelling studies that employed several models (n=116) to assess the potential impact of disruptions to essential health services. The majority of the models were simulation models (n=86; 74.1%). Studies covered a wide range of health conditions from infectious diseases to non-communicable diseases. COVID-19 has been reported to disrupt supply of health services, demand for health services and social change affecting factors that influence health. The most common outcomes reported in the studies were clinical outcomes such as mortality and morbidity. Twenty-five studies modelled various mitigation strategies; maintaining critical services by ensuring resources and access to services are found to be a priority for reducing the overall impact.
CONCLUSION: A number of models were used to assess the potential impact of disruptions to essential health services on various outcomes. There is a need for collaboration among stakeholders to enhance the usefulness of any modelling. Future studies should consider disparity issues for more comprehensive findings that could ultimately facilitate policy decision-making to maximise benefits to all.
MATERIALS AND METHODS: In-depth interview using semistructured open-ended questions were designed to explore the challenges of implementing PEC. Fifteen private optometrists across Malaysian were interviewed via purposive sampling until the data were saturated. The interviews were audio-recorded, transcribed and analysed.
RESULTS: Four major themes emerged: working environment, support and recognition, self-sufficiency and customer influence. The first major theme identified a lack of time and equipment in the workplace as a barrier to PEC implementation. The second major theme acknowledges the lack of support and recognition for PEC practise from financial bodies, the government, Malaysian Optical Council (MOC) and other eye professionals. Meanwhile, some practising optometrists faced significant challenges due to their lack of self-sufficiency regarding skills, knowledge and confidence. The final major theme, customer influence, reflects the customer's role in shaping eye care delivery through their perception and acceptance of PEC.
CONCLUSION: Each of the issues identified played a significant impact in impeding PEC implementation in Malaysia. This study is the first step toward developing tailored interventions to improve eye care delivery in Malaysia.
MATERIALS AND METHODS: This study employs a crosssectional study design and utilises self-reported data obtained from locally validated personal stress inventory questionnaires. The data collection period spanned from August 1 to 31, 2020. The study sample consisted of 163 healthcare drivers affiliated with the Negeri Sembilan State Health Department. The Chi-square test and Fisher's exact test were the first used to determine the association between variables prior to conducting multiple logistic regression to predict the relationship between dependent and independent variables.
RESULTS: In COVID-19's first year, 7.4% (n = 12) of healthcare drivers reported perceived stress with ambulance drivers reporting more stress (10.6%; n = 5) than non-ambulance drivers (6.0%; n = 7). Simple statistical analysis identified perceived stress significantly associated with household income, smoking status and performing on-call. Further analysis by multiple logistic regression found that perceived stress was significantly related to smoking (aOR 19.9, 95% CI: 1.86-213.90), and performing on-call (aOR 8.69, 95% CI 1.21-62.28). Nevertheless, no association was found between perceived stress and age, ethnicity, marital status, education, household income, co-morbidities, driving assignment, employment duration, needing a part-time job or motor vehicle accident history.
CONCLUSION: The study found that the perceived stress amongst Malaysian healthcare drivers during the COVID-19 pandemic was relatively low. This could be due to fewer lifethreatening tasks, emergencies, assigned tasks and increase income due to overtime during the COVD-19 pandemic. The OSH team's efforts to provide consistent safety and health training, including stress management, may have contributed to the healthcare driver's ability to effectively manage the stressful circumstances encountered during the pandemic. In order to enhance salary competitiveness, employers should provide financial management education alongside subsidised housing and childcare provisions. Healthcare drivers who smoke should be taught different stress reduction techniques so that they can handle their stress in a healthy way.
MATERIALS AND METHODS: This qualitative study involved five public healthcare clinics in the Kuching district with indepth interviews (IDI) conducted on 14 primary care doctors (PCDs). Semi-structured interviews and in-depth discussions were conducted via videoconferencing. One representative was selected from each clinic at initiation, followed by snowball method for subsequent subject selection until saturation of themes. Interviews were transcribed verbatim, and analysis based on framework analysis principles via NVivo software. Themes were analysed deductively according to study objectives and evidence from literature.
RESULTS: Three main themes emerged from the IDI: (1) The perception of depression in elderly patients, (2) The perceived barriers to screening, and (3) The screening processes. Majority of the PCDs perceived depression as part of ageing process. Time constraints, lack of privacy in consultation rooms, dominant caregivers and failure to recognise recurrent somatic symptoms as part of depression influenced PCDs decision to screen. Screening was technically challenging for PCDs to use the DASS-21, which was not socio-culturally validated for local native population. Only 21.4% of respondents (3/14) reported screening at least three out 10 elderly patients seen over 1- month period. During the covid pandemic, due to the same human resource support and practices, most participants thought their screening for depression in elderlies had not changed.
CONCLUSION: Awareness of depression among PCDs needs to be re-enforced via continuous medical education programs to use appropriate screening tools, address infrastructure related barriers to optimise screening practices. The use of appropriate locally validated and socio-culturally adapted tool is vital to correctly interpret the screening test for patients.