Introduction: The impact of irrational use of drug is reduction in the quality of drug therapy leading to increased morbidity and mortality. The main objective was to obtain baseline information regarding the prescribing pattern for non-steroidal anti-inflammatory drugs (NSAIDs) by physicians in the outpatient departments (OPDs) of two selected polyclinics in Kota Kinabalu, Sabah. Methods: Four hundred (200 from each polyclinic) prescriptions containing NSAIDs were collected, photocopied and later analyzed. Two hundred selected patients (100 from each polyclinic) attending the OPDs were interviewed using a questionnaire. Results: Educated and higher income group of patients mostly attended in private polyclinic (PPC) whereas comparatively less educated and lower income group of patients generally attended government UMS polyclinic (UPC). Analgesics with no or minimal anti-inflammatory effects were the most commonly prescribed NSAIDs in the OPD of UPC. On the contrary, analgesics with potent anti-inflam-matory effects were the most commonly prescribed NSAIDs in PPC. Due to the nature of potent drugs, socioeco-nomically advantaged patients attending PPC is more likely to develop adverse effects. Therefore, the prescribers in PPC had to prescribe additional drugs to counter the adverse effects of NSAIDs, hence increasing the cost of drugs prescribed compared to UPC. The patients taking NSAIDs before coming to hospital were influenced by pharmacists, friends and doctor’s advice given previously. Conclusions: The overall prescribing pattern of NSAIDs among two polyclinics is satisfactory, although there may be scopes for improvement. Educational intervention can be designed for rational prescribing to improve the quality of health care.
Introduction:Malaysia has the highest prevalence of obesity among the Southeast Asian nations which increases the risk for non-communicable diseases such as diabetes mellitus and hypertension. Since rural communities regularly face challenges in receiving medical services, regular health screening programs targeting these communities are necessary for early diagnosis and intervention to prevent complications as well as preserve the patients’ quality of life. Methods: A community health screening program was performed in the Inanam sub-district of Kota Kinabalu, Sa-bah, Malaysia. A total of 50 participants via convenience sampling were examined for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) to determine their general and central obesity status. Estimation of body fat percentage (Fat%) and body fat mass was conducted by using bioelectrical impedance analysis. Addition-ally, systolic blood pressure (SBP), diastolic blood pressure (DBP), and capillary blood glucose were also measured. Results: The participants had a median age of 39.50 years. The prevalence of general obesity was 28%, while the prevalence of central obesity was 78% (based on WC) and 74% (according to WHR). Hypertension and hyperglyce-mia prevalence was reported at 24% and 20%, respectively. BIA showed that both Fat% and fat mass had positive associations with BMI (r=0.656, p=0.001 for Fat%; r=0.868, p=0.001 for fat mass) and WC (r=0.505, p=0.001 for Fat%; r=0.761, p=0.001 for fat mass). The DBP had positive associations with the BMI (r=0.390, p=0.005), WC (r=0.467, p=0.001), and WHR (r=0.331, p=0.019), while the SBP had a positive association with the WC alone (r=0.341, p=0.015). Conversely, there were no significant associations between capillary blood glucose and BMI, WC, or WHR. Conclusion: The rural community of Inanam sub-district had a higher prevalence of central obesity than the national level. This should raise concern among healthcare professionals regarding future hypertension and hyperglycemia risk in this community.
Obesity is a known risk factor for non-communicable diseases, including hypertension and diabetes mellitus, with Malaysia having the highest prevalence of obesity among Southeast Asian countries. Additionally, the delivery of medical services to the rural communities remains challenging despite efforts to increase accessibilities to the healthcare facilities. Therefore, regular health screening programmes specifically aiming at these communities are necessary for early diagnosis and intervention to prevent complications while improving the patients’ quality of life. A health screening programme was conducted in a sub-district of Kota Kinabalu, Sabah, Malaysia, where 50 participants were examined for general obesity based on body mass index (BMI) together with central obesity according to waist circumference (WC) and waist-to-hip ratio (WHR). Bioelectrical impedance analysis was performed to estimate body fat percentage (fat%) and body fat mass, along with the measurement of systolic blood pressure (SBP), diastolic blood pressure (DBP), and capillary blood glucose. The median age of the participants was 39.50 years. The prevalence of general obesity, central obesity based on WC and WHR, hypertension, and hyperglycaemia was 28%, 78%, 74%, 24%, and 20%, respectively. Both fat% and fat mass had positive correlations to the BMI (fat%: r = 0.656, p = 0.001; fat mass: r = 0.868, p = 0.001) and WC (fat%: r = 0.505, p = 0.001; fat mass: r = 0.761, p = 0.001). DBP had positive correlations with the BMI (r = 0.390, p = 0.005), WC (r = 0.467, p = 0.001), and WHR (r = 0.331, p = 0.019), while SBP had a positive correlation only with WC (r = 0.341, p = 0.015). Conversely, capillary blood glucose had no significant correlation with either BMI, WC, or WHR. The higher prevalence of central obesity among participants of the health screening program compared to the national level should raise concern among the healthcare providers regarding the future risk for hypertension and hyperglycaemia in this community
Irrational use of drugs could be detrimental issues in the practices of healthcare communities. This problem arises either because of the wrong prescription or inappropriate self-medication. Faulty prescribing practices and incorrect self-medication will lead to an ineffective treatment regime. Still, they can also be unsafe as these may exacerbate or prolong the illness and distress the patients. In turn, these will incur unnecessary treatment costs. The most typical issues in the irrational use of drugs are the patient’s lack of information about the medicine and inadequate proper consultation from physicians. Lack of regulation in the appropriate use and supply of drugs by the relevant enforcement agencies could also be the problem in the irrational use of drugs. Ulceration and inflammation due to the irrational use of NSAIDs, antibiotics, and unhealthy lifestyle may contribute to the novel therapeutic strategy challenges. The ability to purchase the drugs without a doctor’s prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) was also the landmark event that became the most widely used medications for the anti-inflammatory, analgesic, and antipyretic effects. Inadequate knowledge from both drug providers and patients may contribute to the most recognized influential factors in the irrational use of drugs in various countries. The recommendation should introduce an appropriate educational intervention that can be designed to promote rational prescribing. Proper regulation on prescription practices by policymakers and physicians could be the way to ensure the standard of rational usage of drugs have compliant with the healthcare communities.