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Health-care professionals' approach in feeding term small-for-gestational age infants and its potential implications to later growth outcomes

Lee LY, Muhardi L, Cheah FC, Supapannachart S, Teller IC, Bindels J, et al.

J Paediatr Child Health, 2018 Apr;54(4):370-376.
PMID: 29205630 DOI: 10.1111/jpc.13775

AIM: To understand feeding practices, nutrition management and postnatal growth monitoring of term small-for-gestational age (tSGA) infants in Southeast Asia.
METHODS: Anonymous questionnaires to assess practices on feeding, nutrition management and post-natal growth monitoring of tSGA infants were distributed among health-care professionals (HCPs) participating in regional/local perinatology symposia in Malaysia, Thailand and Singapore.
RESULTS: Three hundred seventy-seven respondents from Malaysia (37%), Thailand (27%), Singapore (18%) and other Asian countries (19%) participated in the survey. Respondents were neonatologists (35%), paediatricians (25%) and other HCPs (40%) including nurses and midwives. Exclusive human milk feeding was reported the most preferred feeding option for tSGA infants, followed by fortified human milk feeding (60% and 20%, respectively). This was consistent among the different countries. The perceived nutrient requirements of tSGA infants varied between countries. Most respondents from Malaysia and Singapore reported requirements to be similar to preterm infants, while the majority from Thailand reported that it was less than those of preterm infants. The World Health Organization Growth Chart of 2006 and Fenton Growth Charts of 2013 were the most frequently used charts for growth monitoring in the hospital and after discharge.
CONCLUSIONS: Nutrition management and perceived nutrient requirements for tSGA infants among practising HCPs in Southeast Asia showed considerable variation. The impetus to form standardised and evidence based feeding regimens is important as adequate nutritional management and growth monitoring particularly in this population of infants will have long term impact on population health.

Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
Fulltext Health-care provider screening for tobacco smoking and advice to quit - 17 countries, 2008-2011

Centers for Disease Control and Prevention (CDC)

MMWR Morb Mortal Wkly Rep, 2013 Nov 22;62(46):920-7.
PMID: 24257201

Tobacco use is the leading cause of preventable mortality in the world. Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) states that countries should promote cessation of tobacco use and adequate treatment for tobacco dependence. Health-care providers asking all patients about their tobacco use and advising tobacco users to quit are evidence-based strategies that increase tobacco abstinence. This report examines the proportion of tobacco smokers in 17 countries responding to the Global Adult Tobacco Survey (GATS) who saw a health-care provider in the past year and who reported that a health-care provider asked them about smoking and advised them to quit. Respondents were tobacco smokers aged ≥15 years surveyed during 2008-2011 in Bangladesh, Brazil, China, Egypt, India, Indonesia, Malaysia, Mexico, Philippines, Poland, Romania, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam. The proportion of smokers who had visited a health-care provider during the previous 12 months ranged from 21.6% in Egypt to 62.3% in Poland. Among these, the proportion reporting that a health-care provider asked if they smoked ranged from 34.9% in Vietnam to 82.1% in Romania. Among those screened for tobacco use, those who reported their health-care providers advised them to quit ranged from 17.3% in Mexico to 67.3% in Romania. In most countries, persons aged ≥45 years were more likely to report being screened and advised to quit than were persons aged ≤24 years. Health-care providers should identify smokers and provide advice and assistance in quitting at each visit as an adjunct to effective community interventions (e.g., increased price of tobacco products; smoke-free policies, mass media campaigns, and tobacco quitlines).
Study name: Global Adults Tobacco Survey (GATS-2011)

Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
Herbal medicines: predictors of recommendation by physicians

Aziz Z

J Clin Pharm Ther, 2004 Jun;29(3):241-6.
PMID: 15153085

We hypothesized that as the use of herbal medicines increases in the general population, so do patients' requests to physicians for recommendations. However, why some physicians recommend herbal medicines while others do not is not well understood.

Matched MeSH terms: Practice Patterns, Physicians'/trends*
How diabetes risk assessment tools are implemented in practice: a systematic review

Dhippayom T, Chaiyakunapruk N, Krass I

Diabetes Res Clin Pract, 2014 Jun;104(3):329-42.
PMID: 24485859 DOI: 10.1016/j.diabres.2014.01.008

This review aimed to explore the extent of the use of diabetes risk assessment tools and to determine influential variables associated with the implementation of these tools. CINAHL, Google Scholar, ISI Citation Indexes, PubMed, and Scopus were searched from inception to January 2013. Studies that reported the use of diabetes risk assessment tools to identify individuals at risk of diabetes were included. Of the 1719 articles identified, 24 were included. Follow-up of high risk individuals for diagnosis of diabetes was conducted in 5 studies. Barriers to the uptake of diabetes risk assessment tools by healthcare practitioners included (1) attitudes toward the tools; (2) impracticality of using the tools and (3) lack of reimbursement and regulatory support. Individuals were reluctant to undertake self-assessment of diabetes risk due to (1) lack of perceived severity of type 2 diabetes; (2) impracticality of the tools; and (3) concerns related to finding out the results. The current use of non-invasive diabetes risk assessment scores as screening tools appears to be limited. Practical follow up systems as well as strategies to address other barriers to the implementation of diabetes risk assessment tools are essential and need to be developed.

Matched MeSH terms: Practice Patterns, Physicians'*
Fulltext How do health care professionals assess patients when initiating insulin therapy? A qualitative study

Lee PY, Lee YK, Khoo EM, Ng CJ

Prim Care Diabetes, 2014 Apr;8(1):49-55.
PMID: 24315732 DOI: 10.1016/j.pcd.2013.11.003

Aims: To explore how health care professionals (HCPs) assess patients when initiating insulintherapy in type 2 diabetes.
Methods: Focus group discussions and in-depth interviews were conducted with 41 healthcare professionals in Malaysia in 2010–2011. A semi-structured topic guide was used for theinterview. The interviews were transcribed verbatim and analysed using the Nvivo9 softwarebased on a thematic approach.
Results: HCPs were less likely to initiate insulin therapy in patients who were older, withirregular dietary patterns and poor financial status. They also assessed patients’ knowl-edge, views and misconceptions of insulin. However, there was a variation in how doctors assessed patients’ comorbidities before starting insulin therapy. Medical officers were more likely to initiate insulin therapy in patients with comorbidities and complications, whereas family medicine specialists were more cautious. In addition, most HCPs considered patients’ psychosocial status, including self-care ability, social support and quality of life.
Conclusions: HCPs’ assessment of patients’ need to start insulin therapy depends on their perception rather than objective evaluation of patients’ background, knowledge, perception and abilities. The background and the type of practice of HCPs influence their assessment.

Matched MeSH terms: Practice Patterns, Physicians'*
ISPAD Clinical Practice Consensus Guidelines 2022: The delivery of ambulatory diabetes care to children and adolescents with diabetes

Limbert C, Tinti D, Malik F, Kosteria I, Messer L, Jalaludin MY, et al.

Pediatr Diabetes, 2022 Dec;23(8):1243-1269.
PMID: 36537530 DOI: 10.1111/pedi.13417
Matched MeSH terms: Practice Patterns, Physicians'
Fulltext Impact of socio-economic class on colorectal cancer patient outcomes in Kuala Lumpur and Kuching, Malaysia

Kong CK, Roslani AC, Law CW, Law SC, Arumugam K

Asian Pac J Cancer Prev, 2010;11(4):969-74.
PMID: 21133609

OBJECTIVE: Research over the past several decades has indicated that low socioeconomic class has a direct effect on health outcomes. In Malaysia, class distribution may differ with the region. The objective of this study was to compare the presentation and survival of colorectal cancer patients in two dissimilar cities, Kuala Lumpur and Kuching, Sarawak.

METHODS: All patients diagnosed with a malignancy of the colon or rectum in Sarawak General Hospital and University of Malaya Medical Center from 1st Jan 2000-31st Dec 2006 were recruited. Data on presentation, socio-economic class and survival were obtained. The survival duration was categorized into more than three years or three years and less. Testing for significance was performed using the chi-square test, with p values less than 0.05 considered statistically significant.

RESULTS: A total of 565 patients in UMMC and 642 patients in SGH had a new diagnosis of colorectal carcinoma. Patients in Kuching had a longer duration of symptoms and more advanced stage at presentation, but this was not statistically significant. Lower socio-economic class was a significant factor for late and more advanced stage at diagnosis, as well as poorer three and five year survival rates. However, survival was lower for patients in Kuching compared to Kuala Lumpur, even after matching for socio-economic class.

CONCLUSION: There is near-zero awareness of colorectal cancer screening in Malaysia. These findings support reaching out to communities of lower socioeconomic backgrounds to improve the colorectal cancer survival rates.

Matched MeSH terms: Practice Patterns, Physicians'
Improving cancer pain management in Malaysia

Lim R

Oncology, 2008;74 Suppl 1:24-34.
PMID: 18758194 DOI: 10.1159/000143215

Within Malaysia's otherwise highly accessible public healthcare system, palliative medicine is still an underdeveloped discipline. Government surveys have shown that opioid consumption in Malaysia is dramatically lower than the global average, indicating a failure to meet the need for adequate pain control in terminally ill patients. Indeed, based on daily defined doses, only 24% of patients suffering from cancer pain receive regular opioid analgesia. The main barriers to effective pain control in Malaysia relate to physicians' and patients' attitudes towards the use of opioids. In one survey of physicians, 46% felt they lacked knowledge to manage patients with severe cancer pain, and 64% feared effects such as respiratory depression. Fear of addiction is common amongst patients, as is confusion regarding the legality of opioids. Additional barriers include the fact that no training in palliative care is given to medical students, and that smaller clinics often lack facilities to prepare and stock cheap oral morphine. A number of initiatives aim to improve the situation, including the establishment of palliative care departments in hospitals and implementation of post-graduate training programmes. Campaigns to raise public awareness are expected to increase patient demand for adequate cancer pain relief as part of good care.

Matched MeSH terms: Practice Patterns, Physicians'
Fulltext Indications and outcome of anti-phospholipid syndrome testing in an obstetric population at Sabah Women & Children Hospital, Kota Kinabalu, Sabah, Borneo Malaysia

Valayatham V

Med J Malaysia, 2012 Aug;67(4):399-401.
PMID: 23082449 MyJurnal

AIM: We audited indications and outcomes of antiphospholipid syndrome (APS) screening in the pregnant population at our centre.
METHOD: Prospective and observational. All APS test results returned were audited for validity of indication and subsequent outcome.
RESULT: 24 of a total of 146 (16%) of requests for the antiphospholipid antibodies and lupus anticoagulant were not indicated. Two positive results returned for a total of 116 "indicated" requests (1.7%).
CONCLUSION: There needs to be increased awareness among obstetricians on the indications for screening for antiphospholipid syndrome (APS). The prevalence of antiphospholipid syndrome with obstetric manefestations in the study population is lower than rates published in the literature.

Matched MeSH terms: Practice Patterns, Physicians'/standards*
Integrated guidance on the care of familial hypercholesterolaemia from the International FH Foundation

Watts GF, Gidding S, Wierzbicki AS, Toth PP, Alonso R, Brown WV, et al.

Eur J Prev Cardiol, 2015 Jul;22(7):849-54.
PMID: 24776375 DOI: 10.1177/2047487314533218

Familial hypercholesterolaemia (FH) is a dominantly inherited disorder present from birth that markedly elevates plasma low-density lipoprotein (LDL) cholesterol and causes premature coronary heart disease. There are at least 20 million people with FH worldwide, but the majority remains undetected and current treatment is often suboptimal.To address this major gap in coronary prevention we present, from an international perspective, consensus-based guidance on the care of FH. The guidance was generated from seminars and workshops held at an international symposium. The recommendations focus on the detection, diagnosis, assessment and management of FH in adults and children, and set guidelines for clinical purposes. They also refer to best practice for cascade screening and risk notifying and testing families for FH, including use of genetic testing. Guidance on treatment is based on risk stratification, management of non-cholesterol risk factors and safe and effective use of LDL lowering therapies. Recommendations are given on lipoprotein apheresis. The use of emerging therapies for FH is also foreshadowed.This international guidance acknowledges evidence gaps, but aims to make the best use of contemporary practice and technology to achieve the best outcomes for the care of FH. It should accordingly be employed to inform clinical judgment and be adjusted for country-specific and local healthcare needs and resources.

Matched MeSH terms: Practice Patterns, Physicians'/standards*
International survey of contact lens prescribing for extended wear

Efron N, Morgan PB, Woods CA, International Contact Lens Prescribing Survey Consortium

Optom Vis Sci, 2012 Feb;89(2):122-9.
PMID: 22179218

PURPOSE: To determine the extent of extended wear (EW) contact lens prescribing worldwide and to characterize the associated demographics and fitting patterns.
METHODS: Up to 1000 survey forms were sent to contact lens fitters in up to 39 countries between January and March every year for five consecutive years (2006-2010). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected since 1997 was also analyzed to assess EW fitting trends since that time.
RESULTS: Details for lens modality were received for 107,094 rigid and soft lens fits of which 88,392 were for soft lens daily wear (DW) and 7470 were for soft lens EW. Overall, EW represents 7.8% of all soft lens fits, ranging from 0.6% in Malaysia to 27% Norway. Compared with DW fittings, EW fittings can be characterized as follows: older age (32.7 ± 13.6 vs. 29.4 ± 12.0 years for DW); males are over-represented; greater proportion of refits; 72% silicone hydrogel; higher proportion of presbyopia and spherical designs; and higher proportion of monthly lens replacement. Of those wearing EW lenses, 80% use multipurpose solutions, whereas 9% do not use any care system. Between 1997 and 1999, the rate of EW prescribing decreased from 5 to 1% of all soft lens fits; it increased to a peak of 12% in 2006, and settled back to 8% by 2010.
CONCLUSIONS: EW prescribing has failed to break through the "glass ceiling" of 15% and is unlikely to become a mainstream lens wearing modality until the already low risks of ocular complications can be reduced to be equivalent to that for DW.

Matched MeSH terms: Practice Patterns, Physicians'/trends*
Fulltext Interventional Pulmonology and COVID-19: Experience from a Malaysian Tertiary Hospital

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
Fulltext Iraqi parents' views of barriers to childhood immunization

Al-Lela OQ, Bahari MB, Al-Abbassi MG, Salih MR, Basher AY

East Mediterr Health J, 2013 Mar;19(3):295-7.
PMID: 23879083

Deficiencies in knowledge about immunization among parents often leads to poor utake or errors in immunization dosage and timing. The aims of this study were to determine Iraqi parents' views of barriers to immunization and beliefs about ways to promote immunization. A questionnaire survey was carried out among 528 Iraqi parents with children who had incomplete immunization status. The main barriers to immunization agreed by the parents were lack of vaccine availability (51.5% of parents) and parents' lack of education (42.4%), while 88.4% of parents thought that lack of funding was not an important barrier. More than 60% of the parents suggested promoting childhood immunization via the media, and 77.5% thought that an increase in funding would not remove barriers to childhood immunization. Better vaccine availability in public health clinics and improving parents' literacy might enhance immunization uptake in Iraq.

Matched MeSH terms: Practice Patterns, Physicians'*
Irrational use of medicine in Arab countries: findings from a systematic review of literature (2000-2019)

Mhadi AA, Ong SC, Abed Y, Abu Ali KA

Int J Pharm Pract, 2023 Apr 10;31(2):165-175.
PMID: 36595471 DOI: 10.1093/ijpp/riac082

OBJECTIVE: This study aimed to analyse the patterns of the irrational use of medicines in Arab countries and to determine the factors contributing to these patterns.
METHODS: A systematic literature review was conducted using two major databases: PubMed and Scopus. The systematic search targeted original studies conducted in Arab countries from 2000 to 2019. A conceptual framework was adopted from a previous study and was utilized to assess the irrational use of medicines and its influencing factors.
RESULTS: A total of 136 studies from 16 Arab countries were included. Almost all were cross-sectional studies. Most focused on evaluating the irrational use of medicines rather than investigating the cause. The number of medications per encounter was 2.3 which is within the limits of developed countries (2.7). The percentage of antibiotics per 100 encounter was 50.1% and the percentage of injections prescribed per 100 encounter was 15.2%. The consumption of antibiotic and injections was much higher than that recommended by WHO. At the same time, the review identified that one fourth of all medications were unnecessarily prescribed.
SUMMARY: The literature review revealed that the irrational use of medicine is prevalent in most Arab countries. Excessive use of antibiotics was the most commonly observed pattern. Therefore, there is a need to conduct further research to identify the factors that drive the irrational use of medicines in Arab countries and then to make recommendations to mitigate this issue.

Matched MeSH terms: Practice Patterns, Physicians'*
Issues surrounding HPV vaccine delivery in a multi-ethnic country in Asia: the physician's perspective

Wong LP

J Community Health, 2011 Feb;36(1):14-22.
PMID: 20431926 DOI: 10.1007/s10900-010-9275-0

The study was conducted to investigate issues surrounding human papillomavirus (HPV) vaccine delivery in a multi-ethnic, multi-religious and multi-cultural society. A qualitative in-depth interview study was conducted with a sample of 20 physicians. Physicians described the success of HPV vaccines recommendation as very poor. Many expressed reluctance to offer the vaccine to preadolescents. The most notable barrier to vaccination was the vaccine's high cost. Parents of eligible vaccinees were concerned about the efficacy and side effects of the new vaccine, while adult women have low risk perception for HPV infection. Promoters and inhibitors of HPV vaccination in our multi-ethnic, multi-religious and multi-cultural community were identified. This study suggests the need to strengthen the infrastructure necessary for HPV vaccine delivery and to specifically target poor underserved women.

Matched MeSH terms: Practice Patterns, Physicians'*
Fulltext Knowledge and perceptions of prescribers regarding adherence to standard treatment guidelines for malaria: a comparative cross-sectional study from Pakistan

Malik M, Hassali MA, Shafie AA, Hussain A

East Mediterr Health J, 2014 Apr;20(4):221-8.
PMID: 24952118

Despite the availability of standard treatment guidelines for malaria in Pakistan adherence to protocols by prescribers is poor. This descriptive, cross-sectional study aimed to explore the perceptions and knowledge of prescribers in Islamabad and Rawalpindi cities towards adherence to standard treatment guidelines for malaria. A questionnaire was distributed to a random sample of 360 prescribers; 64.7% were satisfied with the available antimalarial drugs and 41.3% agreed that antimalarial drugs should only be prescribed after diagnostic testing. Only half the prescribers had the guidelines available in their health facility. Almost all the prescribers (97.7%) agreed that there was a need for more educational programmes about the guidelines. Most prescribers were unaware of the correct standard treatment regimen for Plasmodium falciparum and P. vivax malaria. There were no differences in knowledge between males and females, but prescribers having more experience, practising as general practitioners and working in private health-care facilities possessed significantly better knowledge than their counterparts.

Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
Fulltext Knowledge and practice of colorectal cancer screening in an urban setting: cross-sectional survey of primary care physicians in government clinics in Malaysia

Ooi CY, Hanafi NS, Liew SM

Singapore Med J, 2019 Nov;60(11):596-604.
PMID: 30644527 DOI: 10.11622/smedj.2019011

INTRODUCTION: Colorectal cancer (CRC) was the third most commonly diagnosed cancer worldwide in 2008 (1.23 million cases, 9.7%). CRC screening was shown to be effective in reducing 70% of CRC mortality. However, the screening rate for CRC remains poor.
METHODS: A cross-sectional survey was conducted among primary care physicians (PCPs) in public primary care clinics in Kuala Lumpur, Malaysia. A 30-item self-administered questionnaire was used to assess the knowledge and practice of CRC screening.
RESULTS: The response rate was 86.4% (n = 197/228). Less than half (39.1%) of the respondents answered correctly for all risk stratification scenarios. Mean knowledge score on CRC screening modalities was 48.7% ± 17.7%. The knowledge score was positively associated with having postgraduate educational qualification and usage of screening guidelines. Overall, 69.9% of PCPs reported that they practised screening. However, of these, only 25.9% of PCPs screened over 50% of all eligible patients. PCPs who agreed that screening was cost-effective (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.69‒6.59) and those who agreed that they had adequate resources in their locality (OR 1.92, 95% CI 1.01‒3.68) were more likely to practise screening. Knowledge score was not associated with the practice of screening (p = 0.185).
CONCLUSION: Knowledge and practice of CRC screening was inadequate among PCPs. Knowledge of screening did not translate into its practice. PCPs' perceptions about cost-effectiveness of screening and adequate resources were important determinants of the practice of screening.

Matched MeSH terms: Practice Patterns, Physicians'
Fulltext Knowledge and practice of complementary medicine amongst public primary care clinic doctors in Kinta district, Perak

Ismail IA, Chan SC

Med J Malaysia, 2004 Mar;59(1):4-10.
PMID: 15535328 MyJurnal

The knowledge and practice of doctors (n=40) towards complementary medicine (CM) in 16 health clinics in the Kinta District were assessed by questionnaire. Thirty-four (85%) responded. More than half felt that acupuncture (73.50), homeopathy (59%) and herbal medicine (59%) were occasionally harmful. Forty-four percent felt manipulative therapy was frequently harmful. Relaxation technique (79%) and nutritional therapy (44%) were considered most frequently useful. 59% used some form of CM. There were no significant differences found in usage rates by gender, age group and exposure to CM during undergraduate training. Sixty-seven percent had encouraged patients to seek CM. Seventy-three percent perceived an increasing demand for CM. Eighty-eight percent were in favour of a hospital based CM referral center. Only 6% were trained in CM.
Study site: Klinik kesihatan, Perak, Malaysia

Matched MeSH terms: Practice Patterns, Physicians'*
Fulltext Knowledge and practice of medical doctors on chronic obstructive pulmonary disease: a preliminary survey from a state hospital

Fauzi ARM

Med J Malaysia, 2003 Jun;58(2):205-12.
PMID: 14569740 MyJurnal

This study was done to ascertain the knowledge and practice of medical officers on spirometry and management of COPD in a medical department of a state hospital. A total of 81 questionnaires with nine items were distributed to medical officers in the medical department (MD) and in other departments (controls). Eight incomplete questionnaires were rejected. In all 15 (21%) respondents were analysed from MD and 58 (79%) from the control group. The respondents from MD were aware that spirometry was important in COPD (100% versus 69%, P < 0.01) but in practice both groups were as likely to use peak expiratory flow rate. Respondents from MD were more likely to treat mild COPD (73% versus 12%, P < 0.001) according to Malaysian Thoracic Society COPD guidelines and also more likely to perform steroid trial (93% versus 37%, P < 0.001). Only 9 (60%) from MD and 33(57%) would refer patients for home oxygen assessment. This preliminary survey suggests that there was lack of translation of knowledge into practice particularly in terms of use of spirometry in COPD as well as lack of awareness for home oxygen assessment. A bigger survey involving all doctors in the state to answer issues raised in this preliminary survey is being conducted.

Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
Fulltext Knowledge and practice of prostate cancer screening among general practitioners in Malaysia: a cross-sectional study

Tun Firzara AM, Ng CJ

BMJ Open, 2016 Sep 29;6(9):e011467.
PMID: 27687897 DOI: 10.1136/bmjopen-2016-011467

OBJECTIVE: Screening for prostate cancer remains controversial. General practitioners (GPs) play an important role in assisting men to make an informed decision on prostate cancer screening. The aim of this study was to determine the knowledge and practice of prostate cancer screening among private GPs in Malaysia.
DESIGN: A cross-sectional study.
SETTING: Private general practices in Selangor, Malaysia.
PARTICIPANTS: 311 randomly selected full-time private GPs were recruited between September 2013 and January 2014.
OUTCOME MEASURES: Questionnaires were distributed to the GPs via postal mail and clinic visits. The main outcomes were: knowledge of prostate cancer risk factors and screening tests; GPs' prostate cancer screening practices; and factors influencing GPs' decision to screen for prostate cancer. Associations between covariates and propensity to screen for prostate cancer were determined using logistic regression.
RESULTS: The response rate was 65%. The proportion of GPs who overestimated the positive predictive values of prostrate-specific antigen (PSA), digital rectal examination (DRE) and a combination of PSA and DRE was 63%, 57% and 64%, respectively. About 49.5% of the respondents would routinely screen asymptomatic men for prostate cancer; of them, 94.9% would use PSA to screen. Male GPs who would consider having a PSA test performed on themselves were six times more likely to screen asymptomatic men than GPs who would not have the test (OR=6.88, 95% CI 1.40 to 33.73), after adjusting for age and duration of practice.
CONCLUSIONS: GPs overestimated the accuracy of PSA in prostate cancer screening. Their intention to screen for prostate cancer themselves predicted their propensity to screen their patients for prostate cancer. This finding highlights the potential of using a new approach to change GPs' screening practices via addressing GPs' own screening behaviour.
KEYWORDS: PREVENTIVE MEDICINE; PRIMARY CARE

Matched MeSH terms: Practice Patterns, Physicians'

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