Displaying all 12 publications

Abstract:
Sort:
  1. Khong MJ, Chong CP
    Neth J Med, 2014 Apr;72(3):127-34.
    PMID: 24846925
    New-onset diabetes mellitus after transplantation (NODAT) is one of the complications that is increasingly occurring among kidney transplanted patients. It is associated with the risk of cardiovascular disease, graft failure and mortality. The risk of NODAT development increases with time from transplantation. Therefore, early detection and prompt action are essential in reducing the risk of NODAT and its complications. This paper aims to review the screening parameters, prevention and management strategies for NODAT in both pre- and post-transplantation conditions. The pre-transplant patient should be screened for diabetes and cardiometabolic risk factors. Blood glucose evaluation for the pre-transplantation period is important for early detection of impaired glucose tolerance (IGT) and impaired fasting glucose (IFG), which are highly associated with the incidence of NODAT. Post-kidney transplant patients should have periodical blood glucose monitoring with more frequent assessment in the initial phase. As early hyperglycaemia development is a strong predictor for NODAT, prompt intervention is needed. When NODAT develops, monitoring and control of blood glucose profile, lipid profile, microalbuminuria, diabetic complications and comorbid conditions is recommended. Immunosuppressive regimen modification may be considered as suggested by the Kidney Disease: Improving Global Outcomes (KDIGO) guideline to reverse or to improve the diabetes after weighing the risk of rejection and other potential adverse effects. Strategies for modifying immunosuppressive agents include dose reduction, discontinuation, and selection of calcineurin inhibitor (CNI), anti-metabolite agents, mammalian target of rapamycin inhibitors (mTORi), belatacept and corticosteroids. Lifestyle modification and a conventional anti-diabetic approach, as in the type 2 diabetes mellitus guidelines, are also recommended in NODAT management.
  2. Ng RS, Chong CP
    Australas Med J, 2012;5(10):534-40.
    PMID: 23173017 DOI: 10.4066/AMJ.2012.1312
    Surgical site infections are the most common nosocomial infection among surgical patients. Patients who experience surgical site infections are associated with prolonged hospital stay, rehospitalisation, increased morbidity and mortality, and costs. Consequently, surgical antimicrobial prophylaxis (SAP), which is a very brief course of antibiotic given just before the surgery, has been introduced to prevent the occurrence of surgical site infections. The efficacy of SAP depends on several factors, including selection of appropriate antibiotic, timing of administration, dosage, duration of prophylaxis and route of administration. In many institutions around the globe, evidence-based guidelines have been developed to advance the proper use of SAP. This paper aims to review the studies on surgeons' adherence to SAP guidelines and factors influencing their adherence. A wide variation of overall compliance towards SAP guidelines was noted, ranging from 0% to 71.9%. The misuses of prophylactic antibiotics are commonly seen, particularly inappropriate choice and prolonged duration of administration. Lack of awareness of the available SAP guidelines, influence of initial training, personal preference and influence from colleagues were among the factors which hindered the surgeons' adherence to SAP guidelines. Immediate actions are needed to improve the adherence rate as inappropriate use of SAP can lead to the emergence of a strain of resistant bacteria resulting in a number of costs to the healthcare system. Corrective measures to improve SAP adherence include development of guidelines, education and effective dissemination of guidelines to targeted surgeons and routine audit of antibiotic utilisation by a dedicated infection control team.
  3. Lim PC, Chong CP
    Pharm Pract (Granada), 2015 Apr-Jun;13(3):606.
    PMID: 26445623 DOI: 10.18549/PharmPract.2015.03.606
    The pathophysiology of type 2 diabetes (T2DM) mainly focused on insulin resistance and insulin deficiency over the past decades. Currently, the pathophysiologies expanded to ominous octet and guidelines were updated with newer generation of antidiabetic drug classes. However, many patients had yet to achieve their target glycaemic control. Although all the guidelines suggested metformin as first line, there was no definite consensus on the second line drug agents as variety of drug classes were recommended.
  4. Lim PP, Chong CP, Aziz NA
    Int J Clin Pharm, 2011 Dec;33(6):902-4.
    PMID: 21986835 DOI: 10.1007/s11096-011-9571-5
    CASE: Cefepime-induced thrombocytopenia is a rare adverse event (incidence <1.0%), based on data from clinical trials. However, there is limited post-marketing surveillance documentation on thrombocytopenia associated with cefepime. We describe a 45-year-old male who was admitted to the intensive care unit after allegedly being hit by a large metal bar in the right upper chest and shoulder. Rhabdomyolysis secondary to the trauma, pneumothorax, acute renal failure, and nosocomial sepsis were subsequently diagnosed. Four days after intravenous cefepime initiation, the patient developed thrombocytopenia with platelet count dropping from 102 × 10(3)/μL to 15 × 10(3)/μL. Cefepime was discontinued and the platelet count normalized to 140 × 10(3)/μL after 6 days. Use of the Naranjo adverse drug reaction probability scale indicated a possible relationship between the patient's thrombocytopenia and cefepime therapy.

    CONCLUSION: Although cefepime-induced thrombocytopenia is rare, clinicians should be alert to this potential adverse effect among critically ill patients.

  5. Chong CP, Shahar S, Haron H, Din NC
    Clin Interv Aging, 2019;14:1331-1342.
    PMID: 31413554 DOI: 10.2147/CIA.S211534
    Background: Sugar is widely consumed in Malaysia, and the excessive intake of sugar has been associated with cognitive functions. However, the association between sugar intake and cognitive impairment among Malaysian older adults is yet to be determined. Purpose: The objective of this study was to evaluate the associations between types and sources of sugar intake and cognitive functions and to identify their risk in predicting cognitive impairment (MMSE score <24). Subjects and methods: A total of 1,209 subjects aged ≥60 years were recruited through multi-stage random sampling from selected states in Malaysia. Dietary intake was derived using a 7-day dietary history questionnaire and supplemented with a quantitative food frequency questionnaire for added sugar intake. Results: The prevalence of cognitive impairment as defined by Mini-Mental State Examination (MMSE) less than 24 was 31.9%, while the prevalence of mild cognitive impairment was 13.1%. The median (IQR) for total sugar intake was 44.60 g/day (26.21-68.81) or 8 tsp, and free sugar intake was 33.08 g/day (17.48-57.26) or 6 tsp. The higher intake of total sugars, free sugars, sucrose, lactose, sugar-sweetened beverages, sugar-sweetened cakes, and dessert was found to be significantly associated with a lower MMSE score, after adjusting for covariates. On the other hand, the consumption of cooked dishes and fruits was significantly associated with a better MMSE score. The adjusted OR for risk of cognitive impairment (MMSE score <24) was 3.30 (95% CI 2.15-5.08) for total sugars and 3.58 (95% CI 2.32-5.52) for free sugars, comparing the highest with the lowest intake percentiles. Conclusion: Excessive sugar consumption among older adults showed a notable association with poor cognitive functions, but longitudinal studies and clinical trials are further needed to clarify the direction of causality and to investigate the underlying mechanism.
  6. Tan SF, Chong CP, Chooi WT
    MyJurnal
    An assessment on the use of acetaminophen (paracetamol) among consumers would
    provide guidance for implementing strategies to overcome the misuse of acetaminophencontaining
    products. This study aims to evaluate Malaysian consumers’ practices,
    perceptions and understanding regarding the use of acetaminophen. A semi-structured
    qualitative study utilising face-to-face interviews was conducted among 14 consumers
    aged 24 to 82 years old who live in Pulau Pinang, Malaysia. Transcripts of all the
    interviews were generated from audio tapes and were analysed for the issues and themes
    emerging from the text; the transcripts were independently coded and verified by experts.
    The consumers had a positive attitude towards the popularity, safety and efficacy of
    acetaminophen. The consumers predominantly used acetaminophen for pain and fever.
    Some consumers tended to increase the frequency and dosage of acetaminophen
    consumption if their condition persisted. Consumers had difficulty recognising the generic
    acetaminophen-containing products available in the market. Health literacy investigations
    have found that consumers have a lack of knowledge regarding the correct dosing
    regimen for acetaminophen in adults and children. The consumers were not aware of the
    precautions and toxicities of acetaminophen. To increase awareness of acetaminophen
    poisoning in Malaysia, the consumers suggested that educational tools regarding the
    proper use of acetaminophen are needed from the Ministry of Health and policy-makers.
    The information gained from this study emphasises the importance of educational
    interventions to educate the public on the proper use of acetaminophen in Malaysia.
  7. Chong CP, Hassali MA, Bahari MB, Shafie AA
    Int J Clin Pharm, 2011 Feb;33(1):124-31.
    PMID: 21365404 DOI: 10.1007/s11096-010-9470-1
    OBJECTIVE: To evaluate the Malaysian community pharmacists' views on generic medicines.

    SETTING: A sample of 1419 Malaysian community pharmacies with resident pharmacists.

    METHOD: A cross-sectional nationwide survey using a self-completed mailing questionnaire.

    MAIN OUTCOME MEASURE: Pharmacists' views on generic medicines including issues surrounding efficacy, safety, quality and bioequivalence.

    RESULTS: Responses were received from 219 pharmacies (response rate 15.4%). Only 50.2% of the surveyed pharmacists agreed that all products that are approved as generic equivalents can be considered therapeutically equivalent with the innovator medicines. Around 76% of respondents indicated that generic substitution of narrow therapeutic index medicines is inappropriate. The majority of the pharmacists understood that a generic medicine must contain the same amount of active ingredient (84.5%) and must be in the same dosage form as the innovator brand (71.7%). About 21% of respondents though that generic medicines are of inferior quality compared to innovator medicines. Most of the pharmacists (61.6%) disagreed that generic medicines produce more side-effects than innovator brand. Pharmacists graduated from Malaysian universities, twinning program and overseas universities were not differed significantly in their views on generic medicines. Additionally, the respondents appeared to have difficulty in ascertaining the bioequivalent status of the marketed generic products in Malaysia.

    CONCLUSION: The Malaysian pharmacists' have lack of information and/or trust in the generic manufacturing and/or approval system in Malaysia. This issue should be addressed by pharmacy educators and relevant government agencies.

  8. Chong CP, Hassali MA, Bahari MB, Shafie AA
    Health Policy, 2010 Jan;94(1):68-75.
    PMID: 19762106 DOI: 10.1016/j.healthpol.2009.08.011
    This study aims to provide baseline data to support the implementation of generic substitution policy in Malaysia by evaluating the community pharmacists' perceptions and opinions on generic substitution and current substitution practices.
  9. Chong CP, March G, Clark A, Gilbert A, Hassali MA, Bahari MB
    Health Policy, 2011 Feb;99(2):139-48.
    PMID: 20732723 DOI: 10.1016/j.healthpol.2010.08.002
    This study evaluated Australian community pharmacists' rate of generic medicine substitution, patient acceptance of generic substitution and cost-savings achieved for patients from substitution.
  10. Chew CC, Lim XJ, Letchumanan P, Narayanan MS, Rajan P, Chong CP
    J Pharm Policy Pract, 2023 Oct 04;16(1):116.
    PMID: 37794504 DOI: 10.1186/s40545-023-00625-1
    BACKGROUND: Patient education is identified as one of the core and fundamental management strategies in the management of allergic rhinitis. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines developed guidance for the management of allergic respiratory disease, and the guidelines are applicable to the international context. The ARIA guidelines for the pharmacy have specifically encouraged the creation of local pharmacist-led intervention in allergic rhinitis management. This study aims to develop a pharmacist-led educational model using a multi-phase study approach.

    METHOD: In phase one, we conducted a literature review using four databases to extract relevant articles and clinical practice guidelines published between 2017 and 2022. The information was structured into a questionnaire consisting of patient education material (10 domains with 130 items) and pharmacist counseling scopes (15 domains with 43 items), with each item having a rating scale ranging from 1 (lowest) to 9 (highest) level of agreement. Fifty-two panellists, including otorhinolaryngologists and pharmacists, were invited to complete the questionnaire. A consensus agreement was considered when at least 70% of panellists scored 7 to 9 (critically important). A two-round survey was conducted, and descriptive analysis, inter-rater reliability (≥ 0.5-1 indicate moderate to excellent reliability), variation in the relative interquartile (VRIR 

  11. Chew CC, Lim XJ, Narayanan MS, Letchumanan P, Rajan P, Chong CP
    PMID: 37362103 DOI: 10.1007/s12070-023-03896-x
    AIMS: This study aims to determine the trend of allergic rhinitis (AR) prevalence in a tertiary hospital between 2017 and 2022, and to compare its prevalence pre- and post-COVID-19 pandemic.

    METHODS: This was a cross-sectional study involving the extraction of all Malaysian patients' medical records who were diagnosed with AR and attended the otorhinolaryngology outpatient clinic of a government-funded tertiary hospital in Malaysia between 2017 and 2022.

    RESULTS: 3,744 cases out of the 57,968 first-encounter outpatient visits to the otorhinolaryngology clinic were extracted for analysis. Overall, the prevalence of AR cases ranged from 1.83 to 9.23% between 2017 and 2022. There was a significant drop of 21.38 to 70.22% between the pre- and post-COVID-19 pandemic (p 

  12. Chew CC, Chang CT, Lim XJ, Yong WY, George D, Letchumanan P, et al.
    J Pharm Policy Pract, 2022 Nov 08;15(1):80.
    PMID: 36348443 DOI: 10.1186/s40545-022-00477-1
    Allergic rhinitis has been identified as a major respiratory disease that places a significant burden on patients and the healthcare system. Nevertheless, the management of allergic rhinitis is challenging for both patients and practitioners. Pharmacists have been recognised as strategic in providing advice for allergic avoidance, disease information, and pharmacological care for allergic rhinitis management. This role has been underutilised in the public health service sector in Malaysia due to variation in practice, regulation, and health system structures when compared to the international guidelines. This article proposed a PhaRmacISt-led Education Model (AR-PRISE) that includes explicit patient education materials and an algorithm for structured counselling by pharmacists in the management of patients with allergic rhinitis.
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links