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Fulltext Detection of Strongyloides stercoralis infection among cancer patients in a major hospital in Kelantan, Malaysia

Zueter AM, Mohamed Z, Abdullah AD, Mohamad N, Arifin N, Othman N, et al.

Singapore Med J, 2014 Jul;55(7):367-71.
PMID: 25091885

INTRODUCTION: Strongyloidiasis is one of the most commonly neglected but clinically important parasitic infections worldwide, especially among immunocompromised patients. Evidence of infection among immunocompromised patients in Malaysia is, however, lacking. In this study, microscopy, real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assays (ELISAs) were used to detect Strongyloides stercoralis (S. stercoralis) infection among cancer patients in a Malaysian hospital.

METHODS: A total of 192 stool and serum samples were collected from cancer patients who were receiving chemotherapy with or without steroid treatment at a hospital in northeastern Malaysia. Stool samples were examined for S. stercoralis using parasitological methods and real-time PCR. Serology by ELISA was performed to detect parasite-specific immunoglobulin G (IgG), IgG4 and immunoglobulin E (IgE) antibodies. For comparison, IgG4- and IgG-ELISAs were also performed on the sera of 150 healthy individuals from the same area.

RESULTS: Of the 192 samples examined, 1 (0.5%) sample was positive for S. stercoralis by microscopy, 3 (1.6%) by real-time PCR, 8 (4.2%) by IgG-ELISA, 6 (3.1%) by IgG4-ELISA, and none was positive by IgE-ELISA. In comparison, healthy blood donors had significantly lower prevalence of parasite-specific IgG (2.67%, p < 0.05) and IgG4 (2.67%, p < 0.05) responses.

CONCLUSION: This study showed that laboratory testing may be considered as a diagnostic investigation for S. stercoralis among immunocompromised cancer patients.

Matched MeSH terms: Adult; Young Adult
Fulltext Hybrid mesh for nasal airflow studies

Zubair M, Abdullah MZ, Ahmad KA

Comput Math Methods Med, 2013;2013:727362.
PMID: 23983811 DOI: 10.1155/2013/727362

The accuracy of the numerical result is closely related to mesh density as well as its distribution. Mesh plays a very significant role in the outcome of numerical simulation. Many nasal airflow studies have employed unstructured mesh and more recently hybrid mesh scheme has been utilized considering the complexity of anatomical architecture. The objective of this study is to compare the results of hybrid mesh with unstructured mesh and study its effect on the flow parameters inside the nasal cavity. A three-dimensional nasal cavity model is reconstructed based on computed tomographic images of a healthy Malaysian adult nose. Navier-Stokes equation for steady airflow is solved numerically to examine inspiratory nasal flow. The pressure drop obtained using the unstructured computational grid is about 22.6 Pa for a flow rate of 20 L/min, whereas the hybrid mesh resulted in 17.8 Pa for the same flow rate. The maximum velocity obtained at the nasal valve using unstructured grid is 4.18 m/s and that with hybrid mesh is around 4.76 m/s. Hybrid mesh reported lower grid convergence index (GCI) than the unstructured mesh. Significant differences between unstructured mesh and hybrid mesh are determined highlighting the usefulness of hybrid mesh for nasal airflow studies.

Matched MeSH terms: Adult
Iatrogenic inguinal chyle fistula: a rare case report

Zubaidah NH, Jasmi AY, Hanafiah H, Shaker AH, Asri CM, Emad AR, et al.

Rom J Morphol Embryol, 2012;53(2):431-2.
PMID: 22732820

Chyle fistula may be common in the neck and thorax region but it is a rare entity in the inguinal region. The rarity of the incidence of chyle fistula and the tremendous response to conservative management are the important aspects to be remembered. We hereby report a case of iatrogenic inguinal chyle fistula complicating a femoral vein cannulation.

Matched MeSH terms: Young Adult
Fulltext Combined laparoscopic and thoracoscopic repair of a large traumatic diaphragmatic hernia: a case report

Zubaidah NH, Azuawarie A, Ong KW, Gee T

Med J Malaysia, 2015 Feb;70(1):57-8.
PMID: 26032535 MyJurnal

Traumatic diaphragmatic hernia is a well known complication of blunt trauma to the abdomen and thorax. In the acute setting, laparotomy is mandatory. In this current era, this condition can be managed with minimally invasive surgery. We hereby report a case of delayed large left diaphragmatic hernia that was repaired with a combination of laparoscopic and thoracoscopic approach.

Matched MeSH terms: Adult
Fulltext Hospital-acquired vancomycin-resistant enterococci: now appearing in Kuala Lumpur Hospital

Zubaidah AW, Ariza A, Azmi S

Med J Malaysia, 2006 Oct;61(4):487-9.
PMID: 17243529 MyJurnal

Hospital-acquired vancomycin-resistant enterococci (VRE) were first reported in the late 1980s and have since been an increasing problem worldwide. Kuala Lumpur Hospital thus far, to the best of our knowledge has been spared from this pathogen. We describe the first confirmed case of Enterococcus faecium exhibiting the van A phenotype in our hospital, in a patient with chronic renal failure who was successfully treated with linezolid. The microbiology laboratory plays an important role in the identification and detection of VRE.

Matched MeSH terms: Adult
Fulltext Necrotizing fasciitis

Zubaidah AW, Lim VKE

Med J Malaysia, 1996 Mar;51(1):134-6.
PMID: 10967993

A 31-year-old Pakistani man was admitted to hospital after sustaining a Grade I compound fracture of the mid-shaft of the left tibia and fibula following a motor vehicle accident. He developed septicaemic shock, acute renal failure and Group A streptococcal necrotizing fasciitis of the left leg. The patient underwent an above knee amputation followed by disarticulation of the left hip with extensive debridement. He was treated with benzylpenicillin, vancomycin, inotropes and continuous haemodialysis and survived without further sequelae. Subsequently, skin grafting was done over the wound site. This case highlights the role of Group A streptococcus as a cause of this rare and life-threatening infection.

Matched MeSH terms: Adult
Fulltext A magnetic resonance imaging study on the articulatory and acoustic speech parameters of Malay vowels

Zourmand A, Mirhassani SM, Ting HN, Bux SI, Ng KH, Bilgen M, et al.

Biomed Eng Online, 2014;13:103.
PMID: 25060583 DOI: 10.1186/1475-925X-13-103

The phonetic properties of six Malay vowels are investigated using magnetic resonance imaging (MRI) to visualize the vocal tract in order to obtain dynamic articulatory parameters during speech production. To resolve image blurring due to the tongue movement during the scanning process, a method based on active contour extraction is used to track tongue contours. The proposed method efficiently tracks tongue contours despite the partial blurring of MRI images. Consequently, the articulatory parameters that are effectively measured as tongue movement is observed, and the specific shape of the tongue and its position for all six uttered Malay vowels are determined.Speech rehabilitation procedure demands some kind of visual perceivable prototype of speech articulation. To investigate the validity of the measured articulatory parameters based on acoustic theory of speech production, an acoustic analysis based on the uttered vowels by subjects has been performed. As the acoustic speech and articulatory parameters of uttered speech were examined, a correlation between formant frequencies and articulatory parameters was observed. The experiments reported a positive correlation between the constriction location of the tongue body and the first formant frequency, as well as a negative correlation between the constriction location of the tongue tip and the second formant frequency. The results demonstrate that the proposed method is an effective tool for the dynamic study of speech production.

Matched MeSH terms: Adult
Fulltext An imported case of acute melioidosis caused by ST881 Burkholderia pseudomallei

Zong Z, Wang X, Deng Y

Southeast Asian J. Trop. Med. Public Health, 2016 Mar;47(2):219-22.
PMID: 27244959

A previously healthy Chinese male working in Malaysia returned to China with high fever. A blood culture showed Burkholderia pseudomallei strain WCBP1. This isolate was sequenced, showing type, ST881, which appears to be present in Malaysia. WCP1 had unusual susceptibility to aminoglycosides and habored the Yersinia-like fimbrial gene cluster for virulence. The patient's condition deteriorated rapidly but he recovered after receiving meropenem and intensive care support. Melioidosis is a potential problem among Chinese imigrant workers with strains new to China being identified.

Matched MeSH terms: Adult
Misidentification of Burkholderia pseudomallei as Burkholderia cepacia by the VITEK 2 system

Zong Z, Wang X, Deng Y, Zhou T

J Med Microbiol, 2012 Oct;61(Pt 10):1483-1484.
PMID: 22820689 DOI: 10.1099/jmm.0.041525-0

A previously healthy Chinese male returned from working in the Malaysian jungle with a fever. A blood culture grew Gram-negative bacilli that were initially identified as Burkholderia cepacia by the VITEK 2 system but were subsequently found to be Burkholderia pseudomallei by partial sequencing of the 16S rRNA gene. The identification of B. pseudomallei using commercially available automated systems is problematic and clinicians in non-endemic areas should be aware of the possibility of melioidosis in patients with a relevant travel history and blood cultures growing Burkholderia spp.

Matched MeSH terms: Adult
Evaluating the filial behaviour scale across three cultural groups using exploratory structural equation modelling

Zong X, Ingoglia S, Lo Coco A, Tan JP, Inguglia C, Liga F, et al.

Int J Psychol, 2023 Feb;58(1):42-51.
PMID: 36181306 DOI: 10.1002/ijop.12880

Filial piety is a Confucian concept that guides how children treat and take care of their parents. The Filial Behaviour Scale (FBS) is a 25-item instrument developed in the Chinese context measuring behavioural manifestations of filial piety. Although the components of filial piety have been found to be relevant across cultures, little research has investigated the psychometric properties of the FBS in other cultural contexts. The present study evaluated the factor structure, internal consistency, measurement invariance and construct validity of the FBS across three cultural groups: the United States, Italy and Malaysia. Participants were 1090 emerging adults (67% females; Mage = 21.29 years, SD = 1.97; White Americans: n = 455, White Italians: n = 428, Malays: n = 328). A two-factor structure emerged across groups: Obedience/Obligation (behaviours showing obedience and obligation towards parents) and Relationship (behaviours expressing affection and promoting positive parent-child relationships). The two factors demonstrated adequate internal consistency, full configural, partial metric and partial scalar invariance, as well as unique associations with depressive symptoms and parent-child relationships across groups. These findings yielded a more nuanced understanding of filial behaviour and supported the utility of a two-factor FBS among emerging adults in various cultural contexts.

Matched MeSH terms: Adult; Young Adult
Can Bahraini patients accept e-health systems?

Zolait A, Radhi N, Alhowaishi MM, Sundram VPK, Aldoseri LM

Int J Health Care Qual Assur, 2019 May 13;32(4):720-730.
PMID: 31111785 DOI: 10.1108/IJHCQA-05-2018-0106

PURPOSE: The purpose of this paper is to examine whether Bahraini individuals accept e-health system and the prominent factors affecting e-health system adoption in Bahrain.
DESIGN/METHODOLOGY/APPROACH: The authors adopted a quantitative and qualitative approach, i.e., a self-administered questionnaire, unstructured and a semi-structured interview, which were used to collect the data. A questionnaire was distributed to Bahraini residents selected randomly. The framework was based on the technology acceptance model (TAM) and theory of reasoned action (TRA). Important variables from both the TAM model and TRA theory were extracted and jointly used to build the research model.
FINDINGS: The findings indicated that the most factors affecting e-health adoption are trust, health literacy and attitude. Additionally, people in the private and government sectors understand e-health benefits.
PRACTICAL IMPLICATIONS: If healthcare professionals understand the factors affecting e-health system adoption from an individual and organisational perspective, then nurses, pharmacists and others will be more conscious about e-health and its adoption status.
ORIGINALITY/VALUE: E-health system adoption has become increasingly important to governments, individuals, and researchers in recent years. A novel research framework, based on TAM and TRA, was used to produce a new integrated model.

Matched MeSH terms: Adult
Fulltext Internet pornography exposures amongst young people in Malaysia: A cross-sectional study looking into the role of gender and perceived realism versus the actual sexual activities

Zohor Ali AA, Muhammad NA, Jamil TR, Ahmad S, Abd Aziz NA

Addict Behav Rep, 2021 Dec;14:100350.
PMID: 34041356 DOI: 10.1016/j.abrep.2021.100350

Despite the wide accessibility to internet, pornography activities among youths are not well described in conservative countries like Malaysia. This study aimed to determine the prevalence, elicit gender differences and identify associated factors of pornographic exposure including perceived realism among college students. This cross-sectional study was conducted among students aged 18 to 25 years from seven colleges in Penang, Malaysia. A self-administered questionnaire was used to obtain data on socio-demographic characteristics, pornography exposure, pattern of use, sexual exposure and perceived realism. Among 986 participants, the prevalence of lifetime pornography exposure was 74.5%. More males (71.7%) were exposed to pornography, had started at earlier age, were frequent users and using the internet alone at home (p

Matched MeSH terms: Adult; Young Adult
Fish-associated Streptococcus agalactiae ST283: first human cases reported from Malaysia

Zohari Z, Barkham T, Mohamad Maswan N, Chen SL, Muthanna A, Lee KW, et al.

J Med Microbiol, 2023 Jun;72(6).
PMID: 37389575 DOI: 10.1099/jmm.0.001729

In South East Asia, Streptococcus agalactiae ST283 causes sepsis in healthy adults. Raw freshwater fish consumption is the only known risk factor. These two case reports are the first from Malaysia. Although they cluster with Singapore ST283, the epidemiology is complicated by the flow of people and fish across borders.

Matched MeSH terms: Adult
Fulltext Impact of place of residence on place of death in Wales: an observational study

Ziwary SR, Samad D, Johnson CD, Edwards RT

BMC Palliat Care, 2017 Dec 12;16(1):72.
PMID: 29233123 DOI: 10.1186/s12904-017-0261-5

BACKGROUND: Previous research in England showed that deprivation level of a person's place of residence affects the place of death and quality of care received at the end of life. People dying in their preferred place of death has also been shown to act as an indication for high quality of end of life care services and social equality. This study expands on current research to explore the effects of deprivation and place of residence on health related choices and place of death in Wales.
METHODS: We used ten years combined mortality statistics from 2005 to 2014 and Welsh Index of Multiple Deprivation rankings for each lower super output area. After accounting for the population's age, the number of deaths in Hospital, Hospice, Home, Care Home, Psychiatric Units, and Elsewhere were compared across deprivation quintiles.
RESULTS: Distribution of place of death was found to be concentrated in three places - hospital (60%), home (21%) and care home (13%). Results from this study shows a high number of hospital deaths, especially for more deprived areas, despite being the least preferred place of death.
CONCLUSION: This is the first Welsh study investigating place of death in relation to deprivation, which could be of major importance to academics, end of life care providers and policy makers interested in to reduce health care inequality in Wales.

Matched MeSH terms: Adult
Fulltext The relationship between life-time noise exposure and experience of tinnitus among young adults in the International Islamic University (IIUM) Kuantan

Zirwatu Hanani, Wan Ahmad Wan Aslynn, Marina L. Alisaputri

International Journal of Allied Health Sciences, 2019;3(4):914-922.
MyJurnal

Introduction: Clinical studies have shown that people suffering from tinnitus are at a high risk of developing serious psychological disturbances or serious psychological distress (Erlandsson &
Widen, 2004 in Hiller and Goebel, 1998). Thus the purpose of this study was to determine the
relationship between life-time noise exposure and tinnitus experience among young adults in IIUM Kuantan. Methods: A cross sectional study was used to determine whether there is any association between tinnitus experiences and life-time noise exposure among 11 young adults in IIUM Kuantan from age of 18 to 35 years old who are exposed to the noise. Hearing assessment was done using otoscopy, tympanometry and pure tone audiometry. Participants were asked to fill in a questionnaire on tinnitus experience, and were fitted with a noise dosimeter that measured their noise exposure during waking hours. Values collected from dosimeter were then converted into cumulative life-time noise exposure which refers to the equivalent noise exposure per year (Jokitulppo, Tolvenen & Bjork, 2005). Results: Average cumulative life-time noise exposure of the participants is 72.54 dBA ± 6.9459. Fifty five percent (55%) reported of sometimes having tinnitus. No correlation was found between cumulative life-time noise exposure and tinnitus experience. Conclusion: The cumulative life-time noise exposure among young adults in IIUM Kuantan was found to be lower than the level considered as hazardous. Despite reports of tinnitus experience, there was no evidence that the tinnitus was due to noise exposure.

Matched MeSH terms: Adult; Young Adult
Fulltext Knowledge, attitude and practice towards sexually transmitted diseases amongst the inmates of women shelters homes at Klang Valley

Zin NM, Ishak I, Manoharan K

BMC Public Health, 2019 Jun 13;19(Suppl 4):639.
PMID: 31196029 DOI: 10.1186/s12889-019-6863-5

BACKGROUND: Previous studies show that there is a changing trend of sexual and reproductive behaviour among youth and this requires more attention and awareness especially on sexually transmitted diseases (STD). This study was carried out to evaluate the knowledge, attitude and practice of sexually transmitted diseases among selected inmates of women shelter homes.

METHODS: A cross-sectional study was carried out by involving 60 participants whom aged in between 13 to 25 years old. The questionnaires were developed in 'Bahasa Melayu' and it has been anonymous guided questionnaires.

RESULTS: The result showed that the mean age of the participants was 17.9 years old and most of the participants have completed secondary school (91.7%). Overall, the level of knowledge of participants on STDs were classified into three groups; 'high knowledge' (33.3%), 'medium knowledge' (35.0%) and 'low knowledge' (31.7%). The majority have heard of HIV/AIDS (95%) but with respect to other STDs was less well known. Whereas, the mean score for attitude was 23.1 out total 25. Their knowledge level was not influenced by their age (p = 0.61) and socio-economic status (p = 0.85). However, their attitude was influenced by their age (p

Matched MeSH terms: Adult; Young Adult
Fulltext Changes in trends and pattern of strong opioid prescribing in primary care

Zin CS, Chen LC, Knaggs RD

Eur J Pain, 2014 Oct;18(9):1343-51.
PMID: 24756859 DOI: 10.1002/j.1532-2149.2014.496.x

BACKGROUND: This study evaluated the prescribing trends of four commonly prescribed strong opioids in primary care and explored utilization in non-cancer and cancer users.
METHODS: This cross-sectional study was conducted from 2000 to 2010 using the UK Clinical Practice Research Datalink. Prescriptions of buprenorphine, fentanyl, morphine and oxycodone issued to adult patients were included in this study. Opioid prescriptions issued after patients had cancer medical codes were defined as cancer-related use; otherwise, they were considered non-cancer use. Annual number of prescriptions and patients, defined daily dose (DDD/1000 inhabitants/day) and oral morphine equivalent (OMEQ) dose were measured in repeat cross-sectional estimates.
RESULTS: In total, there were 2,672,022 prescriptions (87.8% for non-cancer) of strong opioids for 178,692 users (59.9% female, 83.9% non-cancer, mean age 67.1 ± 17.0 years) during the study period. The mean annual (DDD/1000 inhabitants/day) was higher in the non-cancer group than in the cancer group for all four opioids; morphine (0.73 ± 0.28 vs. 0.12 ± 0.04), fentanyl (0.46 ± 0.29 vs. 0.06 ± 0.24), oxycodone (0.24 ± 0.19 vs. 0.038 ± 0.028) and buprenorphine (0.23 ± 0.15 vs. 0.008 ± 0.006). The highest proportion of patients were prescribed low opioid doses (OMEQ ≤ 50 mg/day) in both non-cancer (50.3%) and cancer (39.9%) groups, followed by the dose ranks of 51-100 mg/day (26.2% vs. 28.7%), 101-200 mg/day (15.1% vs. 19.2%) and >200 mg/day (8.25% vs. 12.1%).
CONCLUSIONS: There has been a huge increase in strong opioid prescribing in the United Kingdom, with the majority of prescriptions for non-cancer pain. Morphine was the most frequently prescribed, but the utilization of oxycodone, buprenorphine and fentanyl increased markedly over time.

Matched MeSH terms: Adult; Young Adult
Fulltext Drug Utilization and Drug Pricing in the Private Primary Healthcare System in Malaysia: An Employer Price Control Mechanism

Zin CS, Taufek NH, Bux SH

Front Public Health, 2020;8:551328.
PMID: 33365294 DOI: 10.3389/fpubh.2020.551328

Uncontrolled drug pricing in the private healthcare system in Malaysia leads to high drug prices; however, its impact on employee drug utilization and employer reimbursement coverage is unclear. This study examined patterns of drug pricing and drug utilization among employees covered by employer medical insurance. A drug price control mechanism was also devised for the employer to ensure fair benefits to all parties without compromising the quality of patient care. This retrospective study was conducted among International Islamic University Malaysia (IIUM) community members who sought outpatient treatment at the IIUM panel of health clinics serviced by general practitioners from January 2016 to September 2019. Prescription data (drug type, dose, quantity, duration, price, and manufacturer), patient characteristics (age, sex, and diagnosis) and total charges were extracted from the claims database of PMCare, the insurance company managing IIUM medical claims. Patterns of commonly prescribed drugs, drug pricing, profit margins, and total charges per clinic visit were evaluated. Descriptive statistics were used, and all analyses were performed using Stata v15.1. There were a total of 161,146 prescriptions for 10,150 patients in the IIUM community during the study period (48.85% women, mean ± standard deviation; age: 26.33 ± 17.63 years). The most commonly prescribed drug was paracetamol (25.3%), followed by chlorpheniramine (9.46%), cetirizine (7.3%), diphenhydramine (6.13%), loratadine (4.57%), and diclofenac (4.36%). Generic paracetamol (500 mg), which serves as a prime example for details on drug pricing, is commonly charged between Ringgit Malaysia (RM) 5 and 10 for 10 tablets with a profit between 2,400 and 4,900% according to the average cost price of RM 0.20 per 10 tablets. Most patients were charged within the approved coverage limit of RM 45 per clinic visit, with only 2.41% of patients being charged with costs that exceeded this limit. Uncontrolled drug pricing in the private healthcare system in Malaysia indicates that drug prices differ greatly across private healthcare providers most of the prices were charged with high profit margins. Employers may consider a multilayer capping system to prevent inappropriate drug pricing, which will inevitably benefit patients clinically and economically and provide greater patient access to better drug treatment.

Matched MeSH terms: Adult; Young Adult
Dose and duration of opioid use in patients with cancer and noncancer pain at an outpatient hospital setting in Malaysia

Zin CS, Rahman NA, Ismail CR, Choy LW

Pain Pract, 2017 07;17(6):774-781.
PMID: 27676695 DOI: 10.1111/papr.12525

BACKGROUND: There are currently limited data available on the patterns of opioid prescribing in Malaysia. This study investigated the patterns of opioid prescribing and characterized the dosing and duration of opioid use in patients with noncancer and cancer pain.
METHODS: This retrospective, cross-sectional study was conducted at an outpatient hospital setting in Malaysia. All prescriptions for opioids (dihydrocodeine, fentanyl, morphine, and oxycodone) issued between January 2013 and December 2014 were examined. The number of prescriptions and patients, the distribution of mean daily dose, annual total days covered with opioids, and annual total opioid dose at the individual level were calculated and stratified by noncancer and cancer groups.
RESULTS: A total of 1015 opioid prescriptions were prescribed for 347 patients from 2013 to 2014. Approximately 41.5% of patients (N = 144/347) and 58.5% (N = 203/347) were associated with noncancer and cancer diagnosis, respectively. Oxycodone (38.0%) was the highest prescribed primarily for the noncancer group. The majority of patients in both noncancer (74.3%) and cancer (60.4%) groups were receiving mean daily doses of < 50 mg morphine equivalents. The chronic use of opioids (> 90 days per year) was associated with 21.8% of patients in the noncancer group and 17.5% in the cancer group.
CONCLUSIONS: The finding from this study showed that 41.5% of opioid users at an outpatient hospital setting in Malaysia received opioids for noncancer pain and 21.8% of these users were using opioids for longer than 90 days. The average daily dose in the majority of patients in both groups of noncancer and cancer was modest.
Study site: outpatient clinic, hospital, Malaysia

Matched MeSH terms: Adult; Young Adult
Fulltext Differential Patterns of Adherence to Opioid Therapy in Opioid Naïve and Opioid Existing Patients With Different Age Groups

Zin CS, Taufek NH, Ahmad MM

Front Pharmacol, 2019;10:1286.
PMID: 31736760 DOI: 10.3389/fphar.2019.01286

Limited data are available on the adherence to opioid therapy and the influence of different patient groups on adherence. This study examined the patterns of adherence in opioid naïve and opioid existing patients with varying age and gender. This retrospective cohort study was conducted using the prescription databases in tertiary hospital settings in Malaysia from 2010 to 2016. Adult patients aged ≥18 years, receiving at least two opioid prescriptions, were included and stratified into the opioid naïve and existing patient groups. Adherence to opioid therapy was measured using the proportion of days covered (PDC), which was derived by dividing the total number of days covered with any opioids by the number of days in the follow-up period. Generalized linear modeling was used to assess factors associated with PDC. A total of 10,569 patients with 36,650 prescription episodes were included in the study. Of these, 91.7% (n = 9,696) were opioid naïve patients and 8.3% (n = 873) were opioid existing patients. The median PDC was 35.5% (interquartile range (IQR) 10.3-78.7%) and 26.8% (IQR 8.8-69.5%) for opioid naïve and opioid existing patients, respectively. A higher opioid daily dose (coefficient 0.010, confidence interval (CI) 0.009, 0.012 p < 0.0001) and increasing age (coefficient 0.002, CI 0.001, 0.003 p < 0.0001) were associated with higher levels of PDC, while lower PDC values were associated with male subjects (coefficient -0.0041, CI -0.072, -0.010 p = 0.009) and existing opioid patients (coefficient -0.134, CI -0.191, -0.077 p < 0.0001). The suboptimal adherence to opioid medications was commonly observed among patients with non-cancer pain, and the opioid existing patients were less adherent compared to opioid naïve patients. Increasing age and a higher daily opioid dose were factors associated with higher levels of adherence, while male and opioid existing patients were potential determinants for lower levels of adherence to opioid medications.

Matched MeSH terms: Adult

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