Displaying publications 61 - 80 of 111 in total

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  1. Azmi S, Nazri N, Azmi AH
    Med J Malaysia, 2012 Dec;67(6):577-81.
    PMID: 23770948 MyJurnal
    This study investigates the views of general medical practitioners (GP) to the extended role of the community pharmacists (CP). A self-administered questionnaire was distributed to all private clinics (n=438) run by GPs in the state of Penang. The questionnaire asked GP's views on ideas for new services provided by community pharmacists. Three hundred and twenty-seven questionnaires were collected, giving a response rate of 74.5%. More than 50% of respondents were in favour of the community pharmacist involvement in activities of providing public health education (58.7%), contacting GPs on matters related to prescribing and prescription errors (56.0%), and referring patients who exhibit drug-related problems (53.0%). However, the respondents had a mixed opinion regarding the roles of CPs in smoking cessation programme (34.8%) and providing drug information to physicians (43.0%). Additional research is needed to explain GPs attitudes towards the acceptability of the new role of the pharmacist.
    Matched MeSH terms: General Practitioners
  2. Jamshed SQ, Ibrahim MI, Hassali MA, Masood I, Low BY, Shafie AA, et al.
    South Med Rev, 2012 Jul;5(1):22-30.
    PMID: 23093896
    OBJECTIVES: In developing countries out-of-pocket payments (OOP) are as high as 80% of healthcare spending. Generic medicines can be instrumental in reducing this expenditure. The current study is aimed to explore the knowledge, perception, and attitude of general practitioners towards generic medicines in Karachi, Pakistan.
    METHODS: This exploratory, descriptive study was conducted on a sample of 289 randomly selected general practitioners who were dispensing at their private clinics in Karachi, Pakistan. The questionnaires were distributed and collected by hand. Data was entered to SPSS version 17. Fischer's exact test was applied to see the association between variables.
    RESULTS: A total of 206 questionnaires were included in the study. A response rate of 71.3% was achieved. Out of 206 respondents, 139 (67.5%) were male while 67 (32.5%) respondents were female. Close to three quaters of the respondents (n= 148; 71.8%) showed correct knowledge about generic medicines being a 'copy of the brand name medicines' and 'interchangeable with brand name medicines' (n= 148; 71.8%). In terms of safety, the majority of respondents (n=85; 41.26%) incorrectly understood that the generic medicines are less safe than brand name medicines. The total percentage of correct responses was seen in 53% of the respondents. More than half of the respondents agreed that locally manufactured medicines are of the same effectiveness as brand name medicines (n=114; 55.4%). Male practitioners with practice experience of 11-15 years showed positive perception towards the quality of multinational products. The Majority of respondents believed that their prescribing decision is influenced by medical representatives (n=117; 56.8%). More than three-quarters of the respondents expressed their wish to prescribe low cost medicines in their practice (n=157; 76.2%). More than one third of the respondents expressed their uneasiness to prescribe products from all local manufacturers (n=72; 35%).
    CONCLUSION: There were gaps identified in the knowledge of respondents. Although good perception and attitude were noted among the respondents, dissemination of information regarding generic medicines may perhaps strengthen generic prescribing. There is a need to introduce 'Quality by Design' concept in local manufacturing units. This, in turn, can inculcate confidence in prescribers towards locally manufactured generic medicines.
    KEYWORDS: Karachi; Pakistan; attitude; dispensing doctor; general practitioner; generic medicines; perception
    Matched MeSH terms: General Practitioners
  3. Lim TO
    Med J Malaysia, 1991 Jun;46(2):155-62.
    PMID: 1839420
    Eight general practitioners participated in a survey of content of general practice. This is useful as an indicator or morbidity in the community as well as of workload of general practice. A total of 3164 consultations were recorded, of which 2764 (87%) were because of an illness and the rest (13%) for other reasons like medical examinations, antenatal check, family planning advice, pregnancy tests, pap smear and vaccination. The old and the young have high consultation rates for an illness, men consulted as often as women. The most common illness seen was upper respiratory tract infections, accounting for 37% of all illnesses. Other common minor illnesses were skin infections (6%), genito-urinary infections (5%), minor musculoskeletal (6%) and gastrointestinal (6%) complaints as well as minor injuries and cuts (4%). Major disorders form an unusually low proportion (18%) of all illnesses seen, in comparison with figures from United Kingdom. The common major disorders seen were hypertension, asthma, chronic rheumatic disorders and diabetes. Circulatory disorders were remarkably rare, accounting for only 1% of illnesses. Psychological disorders, both major and minor, were also rarely seen, accounting for only 1% of illnesses which is in marked contrast with figures from the United Kingdom. Factors contributing to these notable findings are discussed.
    Matched MeSH terms: General Practitioners
  4. Appannan VR, Mohamad I, Ramli RR, Johan KB
    Malays Fam Physician, 2018;13(1):55-56.
    PMID: 29796214 MyJurnal
    A 5-year-old girl presented with a history of
    fever for four days associated with odynophagia.
    She was treated with amoxycillin prescribed
    by a general practitioner for 3 days prior to
    presentation. However, the symptoms were
    worsening and associated with drooling of
    saliva and poor oral intake. There was history
    of recurrent acute tonsillitis in the past two
    years, with 5 to 6 episodes per year. The child
    had completed regular immunizations up to her
    current age. There was no similar presentation
    amongst family members and friends. (Copied from article).
    Matched MeSH terms: General Practitioners
  5. Lam CS, Umi Kalthum MN, Norshamsiah MD, Bastion M
    Malays Fam Physician, 2018;13(3):32-37.
    PMID: 30800232
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids, particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent, and children are commonly being prescribed topical anti-inflammatories, including topical steroids, by general practitioners. Furthermore, topical steroids are also available over the counter, and this availability contributes to overuse without proper monitoring by an ophthalmologist. We present a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids among children for vernal keratoconjunctivitis. The medications were prescribed initially by general ophthalmologists and were continually bought over the counter by parents. At the presentation to our center, these patients were already compromised visually, exhibiting glaucomatous optic disc changes and high intraocular pressure. The series highlights the optic nerve damage resulting in irreversible visual compromises among children on long-term, topical steroids and the importance of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: General Practitioners
  6. Lam, C.S., Umi Kalthum, M.N., Norshamsiah, M.D., Bastion, M.L.C.
    Malaysian Family Physician, 2018;13(3):32-37.
    MyJurnal
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids,
    particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent,
    and children are commonly being prescribed topical anti-inflammatories, including topical steroids,
    by general practitioners. Furthermore, topical steroids are also available over the counter, and this
    availability contributes to overuse without proper monitoring by an ophthalmologist. We present
    a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids
    among children for vernal keratoconjunctivitis. The medications were prescribed initially by general
    ophthalmologists and were continually bought over the counter by parents. At the presentation to
    our center, these patients were already compromised visually, exhibiting glaucomatous optic disc
    changes and high intraocular pressure. The series highlights the optic nerve damage resulting in
    irreversible visual compromises among children on long-term, topical steroids and the importance
    of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: General Practitioners
  7. Mubarak N, Raja SA, Khan AS, Kanwal S, Saif-Ur-Rehman N, Aziz MM, et al.
    Risk Manag Healthc Policy, 2021;14:1615-1627.
    PMID: 33907479 DOI: 10.2147/RMHP.S296113
    Background: There is a growing global interest in formulating such policies and strategic plans that help devise collaborative working models for community pharmacists (CPs) and general practitioners (GPs) in primary care settings.

    Objective: To conceptualize a stakeholder-driven framework to improve collaboration between CPs and GPs in Malaysian primary care to effectively manage medicines in chronic diseases.

    Design and Setting: A qualitative study that involved individual semi-structured interviews of the leadership of various associations, guilds, and societies representing CPs, GPs, and Nurses in Malaysia.

    Methods: This study collected and reported data in accordance with the guidelines of the Consolidated Criteria for Reporting of Qualitative Studies. Key informants were recruited based on purposive (expert) sampling. Interviews were transcribed verbatim and data were coded based on the principles of thematic analysis in NVivo.

    Results: A total of 12 interviews (5 CPs, 5 GPs, and 2 nurses) were conducted. Five themes emerged: Theme 1 highlighted a comparison of community pharmacy practice in Malaysia and developed countries; Theme 2 involved current practices in Malaysian primary care; Theme 3 encompassed the advantages of CP-GP collaboration in chronic diseases; Theme 4 highlighted the barriers which impede collaboration in Malaysian primary care; and Theme 5 delineated the way forward for CP-GP collaboration in Malaysia.

    Conclusion: The actionable insights obtained from the Malaysian stakeholders offered an outline of a framework to enhance collaboration between CPs and GPs in primary care. Generally, stakeholders were interested in CP-GP collaboration in primary care and identified many positive roles performed by CPs, including prescription review, adherence support, and patient education. The framework of the way forward includes: separation of CP and GP roles through a holistic revision of relevant legislation to grant an active role to CPs in chronic care; definition of protocols for collaborative practices; incentivization of both stakeholders (CPs and GPs); and design and implementation of an effective regulatory mechanism whereby the Malaysian Ministry of Health may take a leading role.

    Matched MeSH terms: General Practitioners
  8. Tang WS, Chan MW, Kow FP, Ambigapathy R, Wong JHW, Thiruvengadam V, et al.
    Malays Fam Physician, 2021 Mar 25;16(1):75-83.
    PMID: 33948145 DOI: 10.51866/oa1096
    Background: The low detection rate of tuberculosis (TB) cases in Malaysia remains a challenge in the effort to end TB by 2030. The collaboration between private and public health care facilities is essential in addressing this issue. As of now, no private-public health care collaborative program in pulmonary tuberculosis (PTB) screening exists in Malaysia.

    Aim: To determine the feasibility of a collaborative program between private general practitioners (GPs) and the public primary health clinics in PTB screening and to assess the yield of smear-positive PTB from this program.

    Methods: A prospective cohort study using convenient sampling was conducted involving GPs and public health clinics in the North-East District, Penang, from March 2018 to May 2019. In this study, GPs could direct all suspected PTB patients to perform a sputum acid fast bacilli (AFB) direct smear in any of the dedicated public primary health clinics. The satisfaction level of both the GPs and their patients were assessed using a self-administered client satisfaction questionnaire. IBM SPSS Statistical Software was used to analyze the data.

    Results: Out of a total of 31 patients who underwent the sputum investigation for PTB, one (3.2%) was diagnosed to have smear-positive PTB. Most of the patients (>90%) and GPs (66.7%) agreed to continue with this program in the future. Furthermore, most of the patients (>90%) were satisfied with the program structure.

    Conclusion: It is potentially feasible to involve GPs in combating TB. However, a more structured program addressing the identified issues is needed to make the collaborative program a success.

    Matched MeSH terms: General Practitioners
  9. Nicholas Pang, Sofeinah Didora Judip, Jeanny John, Erwani Minin, Noor Rajrinnie Rajak, Luqman Ridha Anwar, et al.
    MyJurnal
    Introduction: University-wide healthcare programme are difficult to implement without complete protocols. This paper describes a collaborative academia-nursing programme to design a quick, user-friendly primary care screen- ing toolkit, to be used at community level at each faculty in UMS. Methods: A Primary Care Condition Assessment Questionnaire was designed by family medicine physicians, mental health doctors, and public health physicians. The questionnaire was pilot tested in 2 different faculties. The Primary Care Condition Assessment Questionnaire was manualized, and a one-day intervention training programme was administered. Subsequently 19 nurses and assistant medical officers were trained in the questionnaire administration and given concurrent communication skills and collaborative practice training to operate the questionnaire. Qualitative assessments of abilities to perform common primary health assessments were performed. Results: Trained nurses qualitatively felt they were more con- fident to perform primary care screening of common healthcare conditions and were able to deliver advice and refer screen-positive individuals to appropriate referral pathways. Conclusion: Public health programmes like HUMS2U put healthcare into the hands of nurses, allowing task-shifting to adequately trained non-specialist professions, and empowers nurses in basic non-communicable disease training and management. Further research will be performed to assess efficacy of the programme at all 23 faculties and departments of the university.
    Matched MeSH terms: General Practitioners
  10. Khoo SB
    Malays Fam Physician, 2011;6(1):7-14.
    MyJurnal
    Anaemia is the most common haematological problem in the elderly population. Using WHO criteria for anaemia (Hb of <12 g/dL in women and <13 g/dL in men), the prevalence of anaemia in the elderly has been found to range from 8-44% with the highest prevalence in men 85 years and older. Anaemia must not be considered simply as part of ageing because in 80% of cases, there is an underlying cause for Hb
    levels of <12 g/dL in the elderly. Anaemia has negative impacts on the quality of life for the elderly and there is evidence of improved morbidity and
    mortality after correction of anaemia. Chronic disease and thalassaemia may also cause microcytic anaemia besides iron deficiency and not all vitamin B12 and folate deficiency present with macrocytic megaloblastic anaemia. Nutritional deficiency anaemias are common, easily diagnosed, treatments are simple, inexpensive and effective. Tests for nutritional anaemia have to be given priority in the assessment before a patient is subjected to invasive tests to look for less common causes of anaemia. Serum ferritin which is the best non-invasive test for the diagnosis of iron deficiency anaemia may be increased in the elderly while serum iron and transferrin decrease with ageing. Serum methylmalonic acid (MMA) and homocysteine (HC) levels are sensitive for detecting subclinical vitamin B12 and folate deficiency. Routine iron therapy in non-anaemic elderly or in those without iron deficiency anaemia is of no use and may be detrimental to their health. Folate therapy may improve anaemia but may mask the signs and symptoms of neurological damage due to concomitant
    vitamin B12 deficiency. Blood transfusion offers prompt symptom relief of anaemia in patients with terminal malignancy irrespective of the causes for the anaemia.
    Matched MeSH terms: General Practitioners
  11. Chan SC, Mohd Amin S, Lee TW
    Malays Fam Physician, 2016;11(2-3):2-8.
    PMID: 28461851
    BACKGROUND: The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent.

    OBJECTIVE: This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination.

    DISCUSSION: Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems).
    Matched MeSH terms: General Practitioners
  12. Teng CL, Leong KC, Aljunid SM, Cheah M
    Asia Pac Fam Med, 2004;3(1&2):38-45.
    Aims. To document the antibiotic prescribing rate for upper respiratory tract infections (URTI) in general practice and its associated factors. Methods. Data extracted from a morbidity survey of 150 general practice clinics in three urban areas in Malaysia. Participating general practitioners recorded demographic, morbidity and process of care data for 30 consecutive adult patients using a structured form. [year of study=1999] Results. URTI contributed 940 (27.0%) of the total of 3481 encounters recorded. Antibiotic was prescribed in 68.4% of encounters with URTI; a significant proportion of the antibiotic choice was inappropriate. Half the antibiotics prescribed in this study were due to URTI. [overall antibiotic prescribing rate for all encounters=33.4%] Conclusions. General practitioners need to re-examine their own prescribing for URTI and decide whether it is consistent with current guidelines. Rational prescribing is not just part of the professional role of doctors, but will go a long way to impede the emergence of antibiotic resistance.
    Matched MeSH terms: General Practitioners
  13. 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: General Practitioners
  14. Malek KA, Abdul-Razak S, Abu Hassan H, Othman S
    Malays Fam Physician, 2019;14(3):37-45.
    PMID: 32175039
    Introduction: Managing adolescent pregnancy in the primary care setting is complex, as it requires doctors to navigate through a combination of medical, social, financial and legal needs. Objective: This study explores the perspectives of private general practitioners on their roles and challenges in managing adolescent pregnancy in Malaysia.

    Methods: Nineteen private general practitioners in Selangor and Kuala Lumpur participated in in-depth interviews in 2015. A topic guide was used for interview navigation. Participants were asked to discuss their experiences and approaches in managing pregnant adolescents. We used purposive sampling to recruit consenting private general practitioners who had experience in managing adolescent pregnancy. The verbatim transcripts of the audio-recorded interviews were analyzed using thematic analysis. Data reached saturation at the nineteenth in-depth interview. Results: Two themes emerged. Under the theme 'inadvertent advocator,' participants described their tasks with regards to building trust, calming angry parents and delivering comprehensive counseling and care related to the sexual and reproductive health of adolescents, including requests for abortions. Theme two, 'challenges of private general practitioners,' refers mainly to personal and religious conflicts arising from a request for an abortion and deficiencies in support and multidisciplinary integration within their practice settings.

    Conclusion: General practitioners practicing in the private sector identify themselves as active players in supporting pregnant adolescents but face many challenges arising from the personal, religious, professional and community levels. Addressing these challenges is important for optimal care delivery to pregnant adolescents in this community.

    Matched MeSH terms: General Practitioners
  15. Nantha YS, Hs AS
    Korean J Fam Med, 2020 Jul;41(4):267-270.
    PMID: 31992021 DOI: 10.4082/kjfm.18.0056
    BACKGROUND: The provision of sick leave to patients in general practice often entails a complex decision-making process. Commonly, general practitioners believe that the act of providing sick leave can become confrontational. We assessed the intention, attitude, subjective norm, and perceived behavioral control of general practitioners in relation to sick leave provision at public health clinics in Malaysia.

    METHODS: A cross-sectional study design was implemented using data from 86 primary health care clinics in two states in Malaysia from February 2014 to March 2015. A questionnaire that comprised indirect measures were developed on the basis of the Theory of Planned Behavior. The questionnaire assessed several dimensions related to sickness certification provision viz., intention, attitude, subjective norm, and perceived behavioral control.

    RESULTS: The mean scores in this study revealed that physicians acknowledged that patient factors such as clinical symptoms (6.59±0.04), debilitating signs and symptoms of diseases (6.45±0.06), importance of illness recovery (6.07±0.07), and approval of employers (5.35±0.09) played an important role in their decision to provide sick leave.

    CONCLUSION: The act of providing sickness certification to patients is a complex decision-making process. The findings of this study can be used to devise a targeted intervention to reduce the conflict that physicians face in issuing sick leaves.

    Matched MeSH terms: General Practitioners
  16. Kuppusamy P, Govindan N, Yusoff MM, Ichwan SJA
    Saudi J Biol Sci, 2017 Sep;24(6):1212-1221.
    PMID: 28855814 DOI: 10.1016/j.sjbs.2014.09.017
    Colon cancer is the most common type of cancer and major cause of death worldwide. The detection of colon cancer is difficult in early stages. However, the secretory proteins have been used as ideal biomarker for the detection of colon cancer progress in cancer patients. Serum/tissue protein expression could help general practitioners to identify colon cancer at earlier stages. By this way, we use the biomarkers to evaluate the anticancer drugs and their response to therapy in cancer models. Recently, the biomarker discovery is important in cancer biology and disease management. Also, many measurable specific molecular components have been studied in colon cancer therapeutics. The biomolecules are mainly DNA, RNA, metabolites, enzymes, mRNA, aptamers and proteins. Thus, in this review we demonstrate the important protein biomarker in colon cancer development and molecular identification of protein biomarker discovery.
    Matched MeSH terms: General Practitioners
  17. Hassali MA, Al-Haddad M, Shafie AA, Tangiisuran B, Saleem F, Atif M, et al.
    J Patient Saf, 2012 Jun;8(2):76-80.
    PMID: 22561848 DOI: 10.1097/PTS.0b013e31824aba86
    OBJECTIVE: This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia.
    METHODS: A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry.
    RESULTS: A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers.
    CONCLUSIONS: General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.
    Matched MeSH terms: General Practitioners/psychology*
  18. Hassali MA, Kamil TK, Md Yusof FA, Alrasheedy AA, Yusoff ZM, Saleem F, et al.
    Expert Rev Anti Infect Ther, 2015 Apr;13(4):511-20.
    PMID: 25704246 DOI: 10.1586/14787210.2015.1012497
    BACKGROUND: Antibiotics are widely prescribed especially for upper respiratory tract infections (URTIs). Their irrational use can increase costs and resistance.
    AIM: Assess knowledge, attitude and prescribing of antibiotics for URTIs in Selangor, Malaysia, using a cross-sectional survey among general practitioners (GPs) working in private clinics in 2011.
    RESULTS: One hundred and thirty-nine physicians completed the questionnaire (response rate = 34.8%). 49.6% (n = 69) agreed antibiotics are helpful in treating URTIs, with most GPs agreeing antibiotics may reduce URTI duration and complications. The majority of GPs reported they felt patients expected antibiotics, with 36.7% (n = 51) agreeing patients would change doctors if they did not prescribe antibiotics and 21.6% (n = 30) agreeing when requested they prescribe antibiotics even if they believe them to be unnecessary. When assessed against six criteria, most GPs had a moderate level of knowledge of prescribing for URTIs. However, antibiotic prescriptions could be appreciably reduced.
    CONCLUSION: Further programs are needed to educate GPs and patients about antibiotics building on current initiatives.
    KEYWORDS: Malaysia; antibiotics; education programs; irrational use of medicines; patients; physicians; respiratory tract infections
    Matched MeSH terms: General Practitioners/education; General Practitioners/psychology*
  19. Ho KC, Russell V, Nyanti L, Chan MW, Hassali MA, Dawood OT, et al.
    Asian J Psychiatr, 2020 Feb;48:101899.
    PMID: 31901584 DOI: 10.1016/j.ajp.2019.101899
    INTRODUCTION: Most primary care in Malaysia is provided by general practitioners in private practice. To date, little is known about how Malaysian General Practitioners (GPs) manage patients with depression. We surveyed privately practising primary care physicians in the state of Penang, Malaysia, in relation to their experience of the Malaysian Clinical Practice Guideline (CPG) in Major Depressive Disorder, their current practice and perceived barriers in managing depression effectively.

    MATERIAL AND METHODS: A questionnaire based on the study aims and previous literature was developed by the authors and mailed to all currently registered GPs in private clinics in Penang. Survey responses were analysed using SSPS version 21.

    RESULTS: From a total of 386 questionnaires distributed, 112 (29%) were returned. Half of the respondents were unaware of the existence of any CPG for depression. One quarter reported not managing depression at all, while one third used anxiolytic monotherapy in moderate-severe depression. Almost 75 % of respondents reported making referrals to specialist psychiatric services for moderate-severe depression. Time constraints, patient non-adherence and a lack of depression management skills were perceived as the main barriers to depression care.

    CONCLUSIONS: Our findings highlight the need to engage privately practising primary care physicians in Malaysia to improve their skills in the management of depression. Future revisions of the Malaysian Depression CPG should directly involve more GPs from private practices at the planning, development and implementation stages, in order to increase its impact.

    Matched MeSH terms: General Practitioners/statistics & numerical data*
  20. Lim SC, Mustapha FI, Aagaard-Hansen J, Calopietro M, Aris T, Bjerre-Christensen U
    Med Educ Online, 2020 Dec;25(1):1710330.
    PMID: 31891330 DOI: 10.1080/10872981.2019.1710330
    Background: Continuing Medical Education (CME) is a cornerstone of improving competencies and ensuring high-quality patient care by nurses and physicians. The Ministry of Health (MOH) Malaysia collaborated with Steno Diabetes Centre to improve diabetes-related competencies of general physicians and nurses working in primary care through a six-month training programme called the Steno REACH Certificate Course in Clinical Diabetes Care (SRCC).Objective: This impact evaluation aimed to assess the effect of participation of general physicians and nurses in the SRCC in selected public primary healthcare clinics in Kuala Lumpur and Selangor, Malaysia.Design: The quasi-experimental, embedded, mixed-methods study used concurrent data collection and the Solomon four-group design. Participants in an intervention group (Arm 1) and control group (Arm 3) were assessed by pre-and post-test, and participants in separate intervention (Arm 2) and control (Arm 4) groups were assessed by post-test only. Quantitative and qualitative methods were used to assess the effect of the programme.Results: Thirty-four of the 39 participants in the intervention groups (Arms 1 and 2) completed the SRCC and were included in the analysis. All 35 participants in the control groups (Arms 3 and 4) remained at the end of the study period. Significant improvements in diabetes-related knowledge, skills and clinical practise were found among general physicians and nurses in the intervention group after the six-month SRCC, after controlling the pretest effects. No clear changes could be traced regarding attitudes.Conclusion: SRCC participants had significant improvements in knowledge, skills and clinical practice that meet the current needs of general physicians and nurses working in primary care in Malaysia. Thus, SRCC is an effective CME approach to improving clinical diabetes care that can be scaled up to the rest of the country and, with some modification, beyond Malaysia.
    Matched MeSH terms: General Practitioners/education*
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