OBJECTIVES.. To evaluate doctors’ adherence to Malaysian Clinical Practice Guideline (CPG) 2009 in the management of diabetes mellitus with co-morbidities in Malaysia.
METHODS. Cross-sectional study was done at a tertiary-care hospital in Malaysia. Total 51 physicians and 1020 patients’ prescriptions written by same physicians (20 prescriptions per physician) were analyzed. All patients had diabetes mellitus with co-morbidities. Depending on the recommendations of CPG 2009, the prescriptions were clustered as adherent and non-adherent prescriptions. All obtained data were analyzed using descriptive and inferential statistics.
RESULTS. A statistically significant negative association (Ф= 0.094, p-value=0.003) was observed between diabetes mellitus control and co-morbidities. CPG adherent had statistically weak negative association (Ф= - 0.081, p-value=0.010) with patients having co-morbidities (41.6%). No statistically significant association was observed between CPG adherence and any other co-morbidity. Majority of the patients received guidelines-compliant pharmacotherapy. The overall good level of physician adherence with CPG 2009 was observed in the management of diabetes mellitus with co-morbidities.
CONCLUSIONS. The study explored several features of prescription pattern of the physicians involved in the management of diabetes mellitus with co-morbidities and recognized the need for improvement in their prescription pattern for treating the diabetes mellitus.
Objectives: Respiratory diseases represent significant impact on health care resources. A cross-sectional, observational study, Asia-Pacific Burden of Respiratory Diseases (APBORD), was conducted to examine burden of disease in adults with respiratory diseases across 6 countries - India, Korea, Malaysia, Singapore, Taiwan, and Thailand. We examined the extent to which cough is a presenting symptom and reason for medical visits for participants with Asthma, Allergic Rhinitis (AR), COPD or Rhinosinusitis.
Methods: Participants aged ≥18 years, presenting to a physician with primary diagnosis of Asthma, AR, COPD or Rhinosinusitis were enrolled. Participants completed a survey which contained questions related to demographics, respiratory symptoms, health care resource use and quality of life.
Results: A total of 13,902 participants were screened, of which 7,030 were eligible and 5,250 enrolled. The highest percentage of participants receiving care for a respiratory disorder had primary diagnosis of AR 14.0%, (95%CI: 13.4%, 14.6%), followed by Asthma 13.5% (12.9%, 14.1%), Rhinosinusitis 5.4% (4.6%, 5.3%) and COPD 4.9%, (5.0%, 5.7%). Cough or coughing up phlegm was reported as symptom by more than half the participants. Cough or coughing up phlegm was reported as the main reason for medical visit by more than 20% of participants. Among all symptoms reported, cough was most frequently reported by participants with a primarydiagnosis of COPD (73%), followed by Asthma (61%), Rhinosinusitis (59%), and AR (47%). In addition, cough was the most frequently reported main reason for seeking medical care among participants with a primary diagnosis of COPD (43%), for Asthma (33%), for Rhinosinusitis (13%), and for AR (11%).
Conclusions: Cough is a prominent symptom and major driver of medical care for patients with Asthma, Allergic Rhinitis, COPD or Rhinosinusitis. These data suggest that patients presenting with cough should be investigated comprehensively for any underlying more serious respiratory disorders to help with appropriate disease management.