Displaying publications 81 - 100 of 635 in total

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  1. Ch'ng KS
    Family Physician, 2000;11:16-7.
    Matched MeSH terms: Primary Health Care
  2. Chia YC, Goh KL
    Family Physician, 2001;11:17-19.
    Matched MeSH terms: Primary Health Care
  3. Loh KY, Sivalingam N
    Family Physician, 2005;13:20-21.
    Matched MeSH terms: Primary Health Care
  4. Woon TH
    Family Physician, 1996;9:12-16.
    This article highlighted the recent development in the prevention and management of child abuse in Malaysia. There is now a willingness to recognise the conlplex social, moral, medical, educational, legal and economic problems related to child abuse. Multidisciplinary research, comprehensive and longitudinal targeted services to prevent child abuse and neglect are needed.
    Matched MeSH terms: Primary Health Care
  5. Lee BS
    Family Practitioner, 1975;2(1):27-29.
    Matched MeSH terms: Primary Health Care
  6. Doshi HH
    Family Physician, 2003;11:9-11.
    In the light of present HIV worldwide epidemic. there is a need to teach the busy general practitioners how to recognise HIV & AIDS. Due to the deadly nature of this infection and its manifold presentations from opportunistic diseases. the busy general practitioners in primary care may be misled in making the correct diagnosis. In Malaysia. the doctors in the primary care level constitute 70 to 75% of the doctors' population. The rest are specialists in secondary and tertiary care institutions. Family Physicians from the Font liners to recognise and detect early cases of HlV in all its early manifestalions on the various systems. Any doctors in primary medicine whether from private or public sector, amy be confronted by patients who present with trivial complaints. These patients may be fee-paying, or particularly those doctors involved with welfare and health of factory workers and the other forms of the main work force should well arm themselves with updates in HIV and AIDS.
    Matched MeSH terms: Primary Health Care
  7. Balasundaram R
    Family Practitioner, 1973;1(1):8.
    Matched MeSH terms: Primary Health Care
  8. Kumara Deva M
    Family Practitioner, 1977;2(7):11-13.
    Matched MeSH terms: Primary Health Care
  9. Param Palam S
    Family Practitioner, 1977;2:32-35.
    Matched MeSH terms: Primary Health Care
  10. Khoo EM
    Family Physician, 1996;8:8-10.
    Matched MeSH terms: Primary Health Care
  11. Ng CW, Md Hairi NN, Ng CJ, Kamarulzaman A
    Socioeconomic development in Malaysia, over the past few decades, has led to the improvement and expansion of the public healthcare system. This system has provided universal access to a low-priced package of comprehensive health care leading Malaysia to claim to have achieved universal health coverage (UHC). However, the Malaysian health landscape is changing rapidly. Provision of private care has grown especially in large urban towns, mainly in response to public demand. Thus far, private care has been predominantly bought and utilised by the rich but because of differentials in quality of care between the public and private sector, unabated expansion of the private health sector has the potential to adversely affect universal access to care. This effect may be accentuated in the coming years by demographic changes in the country specifically by the ageing of the population. This paper is intended to highlight challenges to UHC in Malaysia in the face of the changing health landscape in the country and to offer some suggestions as to how these challenges can be met.
    Matched MeSH terms: Primary Health Care
  12. Khoo CM, Lim YL, Abdul H, Zaharudin R, Sharipah A, Azirawati J, et al.
    JUMMEC, 1997;2:107-110.
    The Patient's Charter tells about the rights and standard of service a patient can expect. However, little information is available to gauge the reality of the charter in real practice. This survey was performed to determine the validity of the charter to the services provided and to identify areas of improvement if the charter is to be revised. A questionnaire-based survey was used to seek information from 196 patients who attended the Outpatient Department in Banting District Hospital over a period of four days. The overall waiting time for registration, to be seen by a doctor and for medication were 17.4 ± 2.0 minutes, 25.3 ± 2.6 minutes and 15.8 ± 1.3 minutes respectively. The overall waiting time for the whole consultation was 61.4 ± 4.9 minutes. Only 30.8% respondents knew about the Patient's Charter. The Patient's Charter appears to be valid for the actual services provided. There have to be measures to increase the awareness of the charter to the public perhaps via pamphlets and to provide a multi-linguistic charter.
    Matched MeSH terms: Primary Health Care
  13. Koh WM, Abu Bakar AI, Hussein N, Pinnock H, Liew SM, Hanafi NS, et al.
    Health Expect, 2021 12;24(6):2078-2086.
    PMID: 34449970 DOI: 10.1111/hex.13352
    BACKGROUND: Supported self-management improves asthma outcomes, but implementation requires adaptation to the local context. Barriers reported in Western cultures may not resonate in other cultural contexts. We explored the views, experiences and beliefs that influenced self-management among adults with asthma in multicultural Malaysia.

    METHODS: Adults with asthma were purposively recruited from an urban primary healthcare clinic for in-depth interviews. Audio-recordings were transcribed verbatim and analysed thematically.

    RESULTS: We interviewed 24 adults. Four themes emerged: (1) Participants believed in the 'hot and cold' concept of illness either as an inherent hot/cold body constitution or the ambient temperature. Hence, participants tried to 'neutralize' body constitution or to 'warm up' the cold temperature that was believed to trigger acute attacks. (2) Participants managed asthma based on past experiences and personal health beliefs as they lacked formal information about asthma and its treatment. (3) Poor communication and variable advice from healthcare practitioners on how to manage their asthma contributed to poor self-management skills. (4) Embarrassment about using inhalers in public and advice from family and friends resulted in a focus on nonpharmacological approaches to asthma self-management practice.

    CONCLUSIONS: Asthma self-management practices were learnt experientially and were strongly influenced by sociocultural beliefs and advice from family and friends. Effective self-management needs to be tailored to cultural norms, personalized to the individuals' preferences and clinical needs, adapted to their level of health literacy and underpinned by patient-practitioner partnerships.

    PATIENT AND PUBLIC CONTRIBUTIONS: Patients contributed to data. Members of the public were involved in the discussion of the results.

    Matched MeSH terms: Primary Health Care
  14. Rossaki FM, Hurst JR, van Gemert F, Kirenga BJ, Williams S, Khoo EM, et al.
    Expert Rev Respir Med, 2021 12;15(12):1563-1577.
    PMID: 34595990 DOI: 10.1080/17476348.2021.1985762
    INTRODUCTION: Low- and middle-income countries (LMICs) bear a high proportion of the global morbidity and mortality caused by COPD. Increased exposure to risk factors throughout life (e.g. malnutrition, indoor and outdoor air pollution, and smoking) is associated with higher COPD prevalence in LMICs and the lack of treatment availability increases avoidable harm.

    AREAS COVERED: This review covers the epidemiology and burden of COPD in LMICs, and challenges and recommendations related to health-care systems, prevention, diagnosis, and treatment. Main challenges are related to under-resourced health-care systems (such as limited availability of spirometry, rehabilitation, and medicines). Lack of policy and practical local guidelines on COPD diagnosis and management further contribute to the low diagnostic and treatment rates. In the absence of, or limited number of respiratory specialists, primary care practitioners (general practitioners, nurses, pharmacists, physiotherapists, and community health workers) play an even more pivotal role in COPD management in LMICs.

    EXPERT OPINION: Raising awareness on COPD, educating health-care workers, patients, and communities on cost-effective preventive measures as well as improving availability, affordability and proper use of diagnostic and pharmacological and non-pharmacologic treatment in primary care are the key interventions needed to improve COPD prevention, diagnosis, and care in LMICs.

    Matched MeSH terms: Primary Health Care
  15. Lim HM, Abdullah A, Ng CJ, Teo CH, Valliyappan IG, Abdul Hadi H, et al.
    Int J Med Inform, 2021 Nov;155:104567.
    PMID: 34536808 DOI: 10.1016/j.ijmedinf.2021.104567
    BACKGROUND: COVID-19 telemonitoring applications have been developed and used in primary care to monitor patients quarantined at home. There is a lack of evidence on the utility and usability of telemonitoring applications from end-users' perspective.

    OBJECTIVES: This study aimed to evaluate the feasibility of a COVID-19 symptom monitoring system (CoSMoS) by exploring its utility and usability with end-users.

    METHODS: This was a qualitative study using in-depth interviews. Patients with suspected COVID-19 infection who used CoSMoS Telegram bot to monitor their COVID-19 symptoms and doctors who conducted the telemonitoring via CoSMoS dashboard were recruited. Universal sampling was used in this study. We stopped the recruitment when data saturation was reached. Patients and doctors shared their experiences using CoSMoS, its utility and usability for COVID-19 symptoms monitoring. Data were coded and analysed using thematic analysis.

    RESULTS: A total of 11 patients and 4 doctors were recruited into this study. For utility, CoSMoS was useful in providing close monitoring and continuity of care, supporting patients' decision making, ensuring adherence to reporting, and reducing healthcare workers' burden during the pandemic. In terms of usability, patients expressed that CoSMoS was convenient and easy to use. The use of the existing social media application for symptom monitoring was acceptable for the patients. The content in the Telegram bot was easy to understand, although revision was needed to keep the content updated. Doctors preferred to integrate CoSMoS into the electronic medical record.

    CONCLUSION: CoSMoS is feasible and useful to patients and doctors in providing remote monitoring and teleconsultation during the COVID-19 pandemic. The utility and usability evaluation enables the refinement of CoSMoS to be a patient-centred monitoring system.

    Matched MeSH terms: Primary Health Care
  16. Abdullah B, Snidvongs K, Poerbonegoro NL, Sutikno B
    Int J Environ Res Public Health, 2022 Oct 20;19(20).
    PMID: 36294211 DOI: 10.3390/ijerph192013632
    The COVID-19 pandemic presented unique challenges to the delivery of healthcare for patients with allergic rhinitis (AR) following its disruption and impact on the healthcare system with profound implications. Reliance on self-care for AR symptom management was substantial during the pandemic with many patients encouraged to only seek in-person medical care when necessary. The advantage of digital technology becomes apparent when patients and healthcare providers had to change and adapt their method of interaction from the regular physical face-to-face consultation to telehealth and mobile health in the provision of care. Despite the pandemic and the ever-evolving post pandemic situation, optimal management of AR remains paramount for both patients and healthcare professionals. A reshaping of the delivery of care is essential to accomplish this goal. In this paper, we present what we have learned about AR management during the COVID-19 pandemic, the role of digital technology in revolutionizing AR healthcare, screening assessment in the identification and differentiation of common upper respiratory conditions, and a framework to facilitate the management of AR in primary care.
    Matched MeSH terms: Primary Health Care
  17. Qureshi N, Da Silva MLR, Abdul-Hamid H, Weng SF, Kai J, Leonardi-Bee J
    Cochrane Database Syst Rev, 2021 Oct 07;10(10):CD012985.
    PMID: 34617591 DOI: 10.1002/14651858.CD012985.pub2
    BACKGROUND: Familial hypercholesterolaemia is a common inherited condition that is associated with premature cardiovascular disease. The increased cardiovascular morbidity and mortality, resulting from high levels of cholesterol since birth, can be prevented by starting lipid-lowering therapy. However, the majority of patients in the UK and worldwide remain undiagnosed. Established diagnostic criteria in current clinical practice are the Simon-Broome and Dutch Lipid Clinical network criteria and patients are classified as having probable, possible or definite familial hypercholesterolaemia.

    OBJECTIVES: To assess the effectiveness of healthcare interventions strategies to systematically improve identification of familial hypercholesterolaemia in primary care and other community settings compared to usual care (incidental approaches to identify familial hypercholesterolaemia in primary care and other community settings).

    SEARCH METHODS: We searched the Cochrane Inborn Errors of Metabolism Trials Register. Date of last search: 13 September 2021. We also searched databases (Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, PubMed, Embase, CINAHL, Web of Science, and SCOPUS) as well as handsearching relevant conference proceedings, reference lists of included articles, and the grey literature. Date of last searches: 05 March 2020.  SELECTION CRITERIA: As per the Effective Practice and Organisation of Care (EPOC) Group guidelines, we planned to include randomised controlled trials (RCTs), cluster-RCTs and non-randomised studies of interventions (NRSI). Eligible NRSI were non-randomised controlled trials, prospective cohort studies, controlled before-and-after studies, and interrupted-time-series studies. We planned to selected studies with healthcare interventions strategies that aimed to systematically identify people with possible or definite clinical familial hypercholesterolaemia, in primary care and other community settings. These strategies would be compared with usual care or no intervention. We considered participants of any age from the general population who access primary care and other community settings.

    DATA COLLECTION AND ANALYSIS: Two authors planned to independently select studies according to the inclusion criteria, to extract data and assess for risk of bias and the certainty of the evidence (according to the GRADE criteria). We contacted corresponding study authors in order to obtain further information for all the studies considered in the review.

    MAIN RESULTS: No eligible RCTs or NRSIs were identified for inclusion, however, we excluded 28 studies.

    AUTHORS' CONCLUSIONS: Currently, there are no RCTs or controlled NRSI evidence to determine the most appropriate healthcare strategy to systematically identify possible or definite clinical familial hypercholesterolaemia in primary care or other community settings. Uncontrolled before-and-after studies were identified, but were not eligible for inclusion. Further studies assessing healthcare strategies of systematic identification of familial hypercholesterolaemia need to be conducted with diagnosis confirmed by genetic testing or validated through clinical phenotype (or both).

    Matched MeSH terms: Primary Health Care
  18. Yusoff HM, Ahmad H, Ismail H, Reffin N, Chan D, Kusnin F, et al.
    Hum Resour Health, 2023 Oct 13;21(1):82.
    PMID: 37833727 DOI: 10.1186/s12960-023-00868-8
    Violence against healthcare workers recently became a growing public health concern and has been intensively investigated, particularly in the tertiary setting. Nevertheless, little is known of workplace violence against healthcare workers in the primary setting. Given the nature of primary healthcare, which delivers essential healthcare services to the community, many primary healthcare workers are vulnerable to violent events. Since the Alma-Ata Declaration of 1978, the number of epidemiological studies on workplace violence against primary healthcare workers has increased globally. Nevertheless, a comprehensive review summarising the significant results from previous studies has not been published. Thus, this systematic review was conducted to collect and analyse recent evidence from previous workplace violence studies in primary healthcare settings. Eligible articles published in 2013-2023 were searched from the Web of Science, Scopus, and PubMed literature databases. Of 23 included studies, 16 were quantitative, four were qualitative, and three were mixed method. The extracted information was analysed and grouped into four main themes: prevalence and typology, predisposing factors, implications, and coping mechanisms or preventive measures. The prevalence of violence ranged from 45.6% to 90%. The most commonly reported form of violence was verbal abuse (46.9-90.3%), while the least commonly reported was sexual assault (2-17%). Most primary healthcare workers were at higher risk of patient- and family-perpetrated violence (Type II). Three sub-themes of predisposing factors were identified: individual factors (victims' and perpetrators' characteristics), community or geographical factors, and workplace factors. There were considerable negative consequences of violence on both the victims and organisations. Under-reporting remained the key issue, which was mainly due to the negative perception of the effectiveness of existing workplace policies for managing violence. Workplace violence is a complex issue that indicates a need for more serious consideration of a resolution on par with that in other healthcare settings. Several research gaps and limitations require additional rigorous analytical and interventional research. Information pertaining to violent events must be comprehensively collected to delineate the complete scope of the issue and formulate prevention strategies based on potentially modifiable risk factors to minimise the negative implications caused by workplace violence.
    Matched MeSH terms: Primary Health Care
  19. Husin M, Teh XR, Ong SM, Lim YMF, Ang SH, Chan CL, et al.
    Prim Care Diabetes, 2023 Jun;17(3):260-266.
    PMID: 36932012 DOI: 10.1016/j.pcd.2023.03.003
    AIMS: To evaluate the effectiveness of the Enhanced Primary Healthcare (EnPHC) interventions on process of care and intermediate clinical outcomes among type 2 diabetes patients.

    METHODS: This was a quasi-experimental controlled study conducted in 20 intervention and 20 control public primary care clinics in Malaysia from November 2016 to June 2019. Type 2 diabetes patients aged 30 years and above were selected via systematic random sampling. Outcomes include process of care and intermediate clinical outcomes. Difference-in-differences analyses was conducted.

    RESULTS: We reviewed 12,017 medical records of patients with type 2 diabetes. Seven process of care measures improved: HbA1c tests (odds ratio (OR) 3.31, 95% CI 2.13, 5.13); lipid test (OR 4.59, 95% CI 2.64, 7.97), LDL (OR 4.33, 95% CI 2.16, 8.70), and urine albumin (OR 1.99, 95% CI 1.12, 3.55) tests; BMI measured (OR 15.80, 95% CI 4.78, 52.24); cardiovascular risk assessment (OR 174.65, 95% CI 16.84, 1810.80); and exercise counselling (OR 1.18, 95% CI 1.04, 1.33). We found no statistically significant changes in intermediate clinical outcomes (i.e. HbA1c, LDL, HDL and BP control).

    CONCLUSIONS: EnPHC interventions was successful in enhancing the quality of care, in terms of process of care, by changing healthcare providers behaviour.

    Matched MeSH terms: Primary Health Care
  20. Kandayah T, Safian N, Azhar Shah S, Abdul Manaf MR
    PMID: 36982085 DOI: 10.3390/ijerph20065179
    BACKGROUND: Sarcopenia is a disease associated with the loss of muscle mass, strength, and function. It affects the elderly in various ways, such as reduced mobility, compromising their daily activities, and even deteriorating metabolic health. Primary care serves as the first point of contact for patients and plays an important role in health promotion and disease prevention. Hence, this review is conducted to identify the challenges in the management of sarcopenia in the primary care setting.

    METHOD: In December 2022, a scoping review was conducted using PubMed, SCOPUS, Web of Science, and a manual search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that have been written in English, and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords challenges, management, sarcopenia, and primary care were included.

    RESULT: The initial search generated 280 publications, and 11 articles were included after inclusion and exclusion criteria for this review. In this review, challenges in the management of sarcopenia in a primary care setting are reviewed based on the screening and diagnosis.

    CONCLUSIONS: With an increasing aging population, it is important to understand the challenges in the management of sarcopenia in a primary care setting. Identification of elderly at risk of sarcopenia, followed by referring the affected elderly for confirmation of the diagnosis, is essential to preventing the adverse health effects. The initiation of treatment that comprises resistance exercise training and nutrition should not be delayed, as they are salient in the management of sarcopenia.

    Matched MeSH terms: Primary Health Care
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