OBJECTIVES: This study aims to identify the prevalence and nature of pre-admission inappropriate prescribing by using the STOPP (screening tool of older people's prescriptions) criteria amongst a sample of hospitalised elderly inpatients in South Australia.
SETTING: Medical, surgical and rehabilitation wards of a public teaching hospital in Adelaide, South Australia.
MAIN OUTCOME MEASURE: Pre-admission prevalence of PIM.
METHOD: Medication management plans of 100 patients of ≥65 years old were prospectively studied to determine the prevalence of pre-admission PIM use. Sixty-five criteria of STOPP were applied to identify PIMs.
RESULTS: The total number of pre-admission medications screened during the study period was 949; the median number of medicines per patient was nine (range 2-28). Overall the STOPP criteria identified 138 PIMs in 60 % of patients. The most frequently encountered PIM was opiates prescribed in patients with recurrent falls (12.3 %), followed by benzodiazepines in fallers (10.1 %) and proton pump inhibitors when prescribed for peptic ulcer disease for long-term at maximum doses (9.4 %). The number of medications were found to have a positive correlation with pre-admission PIM use (r(s) = 0.49, P < 0.01).
CONCLUSIONS: Pre-admission PIM use is highly prevalent among the studied population. Strategies to reduce PIM use should be undertaken by physicians and pharmacists. The use of the STOPP criteria in clinical practice to reduce prescriptions of inappropriate medications requires further investigation.
METHODS: This study was a cross-sectional nationwide survey targeting physicians from private medical centres in Malaysia. The survey was conducted using questionnaire having (i) background and demographic data of the physicians, volume of prescription in a day, stock of generic medicines in their hospital pharmacy etc. (ii) their knowledge about bioequivalence (iii) prescribing behavior (iv) physicians' knowledge of quality, safety and efficacy of generic medicines, and their cost (v) perceptions of physicians towards issues pertaining to generic medicines utilization.
RESULTS: A total of 263 questionnaires out of 735 were received, giving a response rate of 35.8%. Of the respondents, 214 (81.4%) were male and 49 (18.6%) were females. The majority of the participants were in the age range of 41-50 years and comprised 49.0% of the respondents. Only 2.3% of physicians were aware of the regulatory limits of bioequivalence standards in Malaysia. Of the respondents, 23.2% agreed that they 'always' write their prescriptions using originator product name whereas 50.2% do it 'usually'. A number of significant associations were found between their knowledge, perceptions about generic medicines and their demographic characteristics.
CONCLUSIONS: The majority of the physicians from private medical centres in Malaysia had negative perceptions about safety, quality and the efficacy of generic medicines. These negative perceptions could be the cause of the limited use of generic medicines in the private medical centres. Therefore, in order to facilitate their use, it is recommended that the physicians need to be reassured and educated about the drug regulatory authority approval system of generic medicines with regard to their bioequivalence, quality, efficacy and safety. Apart from the policy on generic substitution, it would also be recommended to have a national medicine pricing policy, which controls drug prices, in both the public and private sector. These efforts are worthwhile to reduce the drug expenditure and improve the medicine affordability in Malaysia.
METHODS: This is a pragmatic randomized control trial study where elective admitted patients will be randomly divided into the intervention (SS) or control (NN) group. All data will be collected during a face-to-face interview, anthropometric measurement, blood sampling (albumin, white blood count, hemoglobin, and c-reactive protein), handgrip strength, and postoperative complications. Group SS will be receiving a tailored lifestyle and intensively supplemented with oral nutrition support as compared to Group NN that will receive standard medical care. The primary outcome for this study is the length of stay in the hospital. Additional outcome measures are changes in biochemical profile and nutritional and functional status. The effects of intervention between groups on the outcome parameters will be analyzed by using the SPSS General Linear Model (GLM) for the repeated measure procedure.
DISCUSSION: The intervention implemented in this study will serve as baseline data in providing appropriate nutritional management in patients undergoing gastrointestinal and oncological surgery.
TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration and Results System (PRS) NCT04347772 . Registered on 20 November 2019.
MATERIALS AND METHODS: The Second Victim Experience and Support Tool for Recovery (SVEST-R) questionnaire was utilized to conduct an anonymous survey on the healthcare providers in Sarawak General Hospital (SGH) from August to October 2018.
RESULTS: A total of 482 respondents participated in the survey and 46.1% of the respondents reported SVE following their involvement in PSIs. Notably, symptoms such as flashbacks, fear, and stress tend to persist for longer durations compared to other symptoms. It is worth noting that non-work-related support received the highest mean (medical doctors = 3.83; nurses = 3.70), indicating that respondents preferred to seek emotional support from their friends and families. Furthermore, nurses reported a significantly higher experience of absenteeism following PSIs than doctors (p=0.003). In addition, most respondents expressed a desire for discussion or counselling with a respected peer or supervisor following their involvement in PSIs.
CONCLUSION: Present study reported a relatively high prevalence of SVE among healthcare providers at SGH. Hence, proactive measures, including non-work related and supervisor support, are essential in facilitating their overall well-being and successful recovery.
METHODS: A cross-sectional study of 255 adult outpatients was conducted at a public tertiary hospital in North-East Malaysia, focusing on those who visited the family medicine, medical, orthopedic, and surgical outpatient clinics. Systematic random sampling was used to select participants. The study utilized a validated Bahasa Malaysia questionnaire to assess patients' knowledge, attitudes, and practices regarding telemedicine. Multivariable logistic regression analysis was conducted to identify sociodemographic factors predicting each readiness domain.
RESULTS: While 60.4% of participants demonstrated good knowledge and 75.7% held favorable attitudes, understanding how these readiness levels can guide targeted interventions remains limited. Only 16.9% had prior telemedicine experience, and 52.2% showed adequate practice readiness based on the composite score. Younger age was independently associated with greater knowledge (adjusted odds ratio [AOR] 0.95; 95% confidence interval [CI] 0.93-0.98), more favorable attitudes (AOR 0.95; 95% CI 0.92-0.97), and greater practice readiness (AOR 0.97; 95% CI 0.95-0.99). The strongest predictor of practice readiness was prior telemedicine exposure (AOR 3.11; 95% CI 1.42-7.43).
DISCUSSION: Our population faces a significant readiness-to-practice gap, mainly due to age-related digital barriers and limited experience. Addressing these challenges through structured onboarding can help ensure equitable access to health care for all, thereby encouraging collective action.
METHODS: This cross-sectional study was conducted from July to August 2023 at four public hospitals in Sarawak, Malaysia. Universal sampling was used to recruit nurses from various critical care units managing patients requiring ventilator support. A self-administered questionnaire, consisting of four sections, was employed to gather background information from nurses, assess their knowledge, self-reported practices, and identify barriers related to VAP prevention.
RESULTS: A total of 298 critical care nurses participated in the study. Of these, 66.8% demonstrated poor knowledge of ventilator-associated pneumonia (VAP) prevention; however, self-reported practices with VAP prevention were significantly high at 76.5%. A Pearson's correlation test revealed a significant association between the nurses' knowledge and their self-reported practices related to VAP prevention (p
METHODS: We used the methodology employed by the European Centre for Disease Prevention and Control to assess the prevalence of HAIs in Punjab Province, Pakistan. Data were collected from 13 hospitals using a structured data collection tool.
RESULTS: Out of 1,553 hospitalized patients, 130 (8.4%) had symptoms of HAIs. The most common HAI was surgical site infection (40.0%), followed by bloodstream infection (21.5%), and lower respiratory tract infection (14.6%). The prevalence of HAI was higher in private sector hospitals (25.0%) and among neonates (23.8%) and patients admitted to intensive care units (33.3%). Patients without HAIs were admitted mainly to public sector hospitals and adult medical and surgical wards.
CONCLUSIONS: The study found a high rate of HAIs among hospitals in Pakistan, especially surgical site infections, bloodstream infections, and lower respiratory tract infections. This needs to be addressed to reduce morbidity, mortality, and costs in the future, and further research is planned.
METHOD: A cross-sectional study was conducted, using questionnaires sent to selected medical staff in a public hospital in Shandong, China (N = 1012). Multiple regression analysis was used to investigate how psychological strains influencing life satisfactions among medical staff.
RESULTS: The findings indicate that aspiration strain and deprivation strain have significantly negative impact on medical staff's life satisfaction even with other variables controlled for. Weekly working hour was a significant predictor for life satisfaction. Family factors, such as marital status and kids in the family as well as social support were important factors in influencing individuals' life satisfaction.
CONCLUSION: The current study highlights the negative associations between aspiration strain, deprivation strain and life satisfaction. The result underlines the importance of actions taken to prevent and combat psychological strains. It also provides some evidence for policy makers to improve the work environment for medical staff, such as reduce weekly working hours and enhance social support in order to increase medical staff's life satisfaction.
Methods: A cross-sectional study, using a validated 23-item self-administered questionnaire, was conducted among pharmacists from 11 public hospitals in the State of Selangor, Malaysia, from December 2016 to January 2017. All public hospital pharmacists (n=432) were invited to participate in the survey. A 5-point Likert scale was employed in the questionnaire; the perception section was scored from 1 (strongly disagree) to 5 (strongly agree) while the practice section was scored from 1 (never) to 5 (always). Both descriptive and inferential statistical analyses were used to analyse data.
Results: Of the 432 pharmacists surveyed, 199 responded, giving a response rate of 46.0%. The majority of the respondents agreed (n=190, 95.5%) that the AMS programme improves patient care at their hospitals (median=5; IQR=1). Slightly less than half of the respondents indicated that a local antibiotic guideline was established in their hospitals (median=3, IQR=2.5), and had taken part in antimicrobial awareness campaigns to promote optimal use of antimicrobials in hospitals (median=3, IQR=1).
Conclusions: Overall, the perception and practices of the surveyed hospital pharmacists towards AMS programme were positive. National antibiotic guidelines, which take into consideration local antimicrobial resistance patterns, should be used fully to improve antimicrobial usage and to reduce practice variation. Collaboration among healthcare professionals should be strengthened to minimise the unfavourable consequences of unintended use of antimicrobial agents while optimising clinical outcomes.