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  1. Lo, Adeline Li Ching, Muhammad Rabbani Abdul Malek, Nurshahirah Zulkifli, Siti Nur Fatihah Shaifol Akmar, Suzana Shahar, Chong, Elizabeth Gar Mit, et al.
    Jurnal Sains Kesihatan Malaysia, 2019;17(1):115-124.
    MyJurnal
    Compliance rate towards consumption of oral nutritional supplement (ONS) is low among geriatric patients. Thus, this study aimed to examine factors affecting low compliance of ONS intake among a sample of geriatric patients. A cross-sectional survey was carried out involving 30 geriatric patients being prescribed with ONS during their stay in Hospital Kuala Lumpur. Information on compliance rate and influencing factors were collected through interview and observation. Nutritional status was assessed using anthropometry and Patient Generated Subjective Global Assessment (PG-SGA). 50.0% subjects were underweight and 70.0% and 30.0% were moderate and severely malnourished, respectively. A total of 43.3% were categorised as low, 53.4% medium and 3.3% high compliance towards consumption of ONS. Most of the subjects with low compliance agreed expressed that they need more nursing support (53.8%). Less than half perceived they had been given the needed nursing support (44.4%), and with respect to ONS: knowledgeable (38.5%), timely given (37.5%), understood the importance (35.7%), were able to finish it (35.0%), well-aware of the reasons of prescription (33.3%), satisfied with its taste (33.3%), received suitable volume (33.3%), satisfied with the texture (31.6%), and received suitable frequency (28.6%). In conclusion, approximately 40% of subjects had low compliance towards ONS. Awareness and nursing support were important factors associated with low compliance. There is a need to ensure adequate nursing support and education been given to patients prescribed with ONS in order to increase the compliance rate.
  2. Ong TIW, Lim LL, Chan SP, Chee WSS, Ch'ng ASH, Chong EGM, et al.
    Osteoporos Sarcopenia, 2023 Jun;9(2):60-69.
    PMID: 37496985 DOI: 10.1016/j.afos.2023.06.002
    OBJECTIVES: The aim of these Clinical Practice Guidelines is to provide evidence-based recommendations to assist healthcare providers in the screening, diagnosis and management of patients with postmenopausal osteoporosis (OP).

    METHODS: A list of key clinical questions on the assessment, diagnosis and treatment of OP was formulated. A literature search using the PubMed, Medline, Cochrane Databases of Systematic Reviews, and OVID electronic databases identified all relevant articles on OP based on the key clinical questions, from 2014 onwards, to update from the 2015 edition. The articles were graded using the SIGN50 format. For each statement, studies with the highest level of evidence were used to frame the recommendation.

    RESULTS: This article summarizes the diagnostic and treatment pathways for postmenopausal OP. Risk stratification of patients with OP encompasses clinical risk factors, bone mineral density measurements and FRAX risk estimates. Non-pharmacological measures including adequate calcium and vitamin D, regular exercise and falls prevention are recommended. Pharmacological measures depend on patients' fracture risk status. Very high-risk individuals are recommended for treatment with an anabolic agent, if available, followed by an anti-resorptive agent. Alternatively, parenteral anti-resorptive agents can be used. High-risk individuals should be treated with anti-resorptive agents. In low-risk individuals, menopausal hormone replacement or selective estrogen receptor modulators can be used, if indicated. Patients should be assessed regularly to monitor treatment response and treatment adjusted, as appropriate.

    CONCLUSIONS: The pathways for the management of postmenopausal OP in Malaysia have been updated. Incorporation of fracture risk stratification can guide appropriate treatment.

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