ABSTRACT
@#Garlic has gained popularity worldwide as a non-pharmacological treatment for hypertension but its use in Malaysia is still moderate. This study was undertaken among Malaysian urban population to assess their knowledge, awareness and attitude towards garlic supplement. This study is a cross sectional study and was carried out from February to May 2015. A total of 202 respondents took part in the study with 45% (n=91) taking garlic supplement. The result demonstrated that there was a significant negative correlation with age and knowledge score (r=-0.15, p=0.03). Majority of the respondents were unaware (n=61/202, 69.8%) that garlic has blood pressure lowering properties. Most preferred conventional medicines (n=119/202, 58.9%) over garlic supplement (n=83/202, 41.1%). However, most of the respondents (n=176/202, 87.1%) were interested to know more about the use of garlic for hypertension. There is no significant correlation between knowledge, awareness and attitude of respondents towards garlic supplement.
ABSTRACT
@#Background: Limited efforts have been made to evaluate medication adherence among subsidized and self-paying patients. Objective: To investigate medication adherence among patients with and without medication subsidies and to identify factors that may influence patients’ adherence to medication. Setting: Government healthcare institutions in Kuala Lumpur, Selangor, and Negeri Sembilan and private healthcare institutions in Selangor and Negeri Sembilan, Malaysia. Methods: This cross-sectional study sampled patients with and without medication subsidies (self-paying patients). Only one of the patient’s medications was re-packed into Medication Event Monitoring Systems (MEMS) bottles, which were returned after four weeks. Adherence was defined as the dose regimen being executed as prescribed on 80% or more of the days. The factors that may influence patients’ adherence were modelled using binary logistic regression. Main outcome measure: Percentage of medication adherence. Results: A total of 97 patients, 50 subsidized and 47 self-paying, were included in the study. Medication adherence was observed in 50% of the subsidized patients and 63.8% of the self-paying patients (χ²=1.887, df=1, p=0.219). None of the evaluated variables had a significant influence on patients’ medication adherence, with the exception of attending drug counselling. Patients who attended drug counselling were found to be 3.3 times more likely to adhere to medication than those who did not (adjusted odds ratio of 3.29, 95% CI was 1.42 to7.62, p = 0.006). Conclusion: There is no significant difference in terms of medication adherence between subsidized and self-paying patients. Future studies may wish to consider evaluating modifiable risk factors in the examination of non-adherence among subsidized and self-paying patients in Malaysia.
ABSTRACT
Falls are a major problem among the elderly and can lead to serious injury. Adults older than 65 years suffer the greatest number of severe falls. This study aims to evaluate the knowledge and perception of medication related falls as well as preferred medication related fall prevention programs in the local population. A cross-sectional survey was conducted among the elderly patients in a tertiary hospital. A total of 86 patients [n=86] were interviewed. Approximately 23.3% [20 patients] of the elderly had a history of falls over the past 6 months. Majority of the elderly considered falls as a major concern [80 patients, 93%] and is preventable [55 patients, 64%]. Patients with a medical condition reported a significantly greater number of falls within the past 6 months [p<0.001]. Approximately 69% [59 patients] of the elderly were aware of their medication and associated risk of falls. In patients that were unaware of medication associated risk of falls, 81.5% [22 patients] had a potentially inappropriate medication preferred preventive interventions for medication related falls were related to strength and training programs [37 patients, 43%]. The knowledge of falls, medication related falls and intervention strategies in the elderly were minimal
ABSTRACT
Anticoagulant responses to warfarin vary among patients, based on genetic factors, diet, concomitant medications, and disease state. We evaluated the effectiveness and safety of a 10mg warfarin initiation nomogram in anAsian population. Retrospective cross-sectional audit studies were conducted from March 2009 to March 2010. The use of a 10mg-loading dose to initiate warfarin treatment resulted in 33[84.6%] patients attaining a therapeutic INR within four days [mean time, 2.6 days]. There was no significant correlation between age, gender, race, and serum albumin for the time to reach a therapeutic INR. A significant correlation was noted for patient's baseline INR and time to reach a therapeutic INR [P<0.05]. No significant differences were observed in time to reach a therapeutic INR in patients treated with specific class of concomitant drugs or patients with specific disease states.The overall incidence of over-anticoagulation was 35.9%; however, no bleeding episodes were encountered. In conclusion, the use of a 10mg warfarin nomogram was effective in rapidly achieving a therapeutic INR. However, the nomogram's safety is debatable owing to the high over-anticoagulation rate warfarin-administered patients. Caution is recommended in the initiation of warfarin reatment using the 10mg nomogram