Study investigating the impact of pharmacist involvement on the outcomes of diabetes medication therapy adherence program Malaysia

Involvement of pharmacists in improving medication adherence among diabetic patients is recognized globally. In Malaysian healthcare system, pharmacists are also operating health services i.e. Diabetes Medication Therapy Adherence Clinic [DMTAC]. This study aimed to assess the clinical outcomes of patients managed by pharmacists [DMTAC], in a Malaysian hospital setting. This was an open labelled randomised study. Type 2 diabetes patients with HbA1c >/=8% were recruited and arbitrarily divided into the intervention group [usual care plus DMTAC] and the non-intervention group [usual care only]. Those enrolled in the intervention group were scheduled for follow-up for eight consecutive visits. Improvements in lab results were compared longitudinally [pre and post analysis] between the groups. Data analysis was done using PASW 18[registered] version. A total of 76 patients were enrolled, with 39 patients in the intervention group and 37 patients in the non-intervention group. Mean HbA1c [-0.90% vs. -0.08%, p=0.011] and fasting blood glucose levels [-3.45mmol.l vs. +0.79mmol/l, p=0.002] reduced significantly between the intervention group vs. non-intervention group. Total cholesterol and low-density lipoprotein cholesterol [LDL-C] were also significantly reduced in the intervention group [TC -0.34mmol/l, p=0.018] [LDL -0.45mmol/l, p=0.001]. In conclusion, pharmacists managed DMTAC significantly improved glycaemic control and lipid profile of diabetic patients

Malay version of the brief questionnaire on smoking urge: translation and psychometric properties of the questionnaire

This study aimed to evaluate the psychometric properties of Malay translated version of the brief questionnaire of smoking urges [QSU-Brief]. The translation procedure was done following the standard guidelines. The reliability and validity of the Malaysian version scale were evaluated based on the data collected from 133 Malaysian smokers. The internal consistency was calculated to assess the reliability. Factor analysis and construct validity were performed to validate psychometric properties of the scale. Total Cronbach's alpha of the scale was 0.806. The exploratory factor analysis revealed two factors that accounted for 66.15% of the explained total variance. The first component consisted of items 1, 3, 6, 7, and 10, while the second component included the rest. The QSU-Brief total score had a significant positive relationship with exhaled CO level [r = 0.24; P = 0.005], number of cigarettes smoked per day [r = 0.30; P < 0.001] and other clinical factors. Items 2 and 5 loaded strongly on factor 2, whereas both items loaded ambivalently on two factors in the previous studies. This discrepancy might be clarified by language differences. The Malaysian QSU-Brief is a good candidate for evaluating urge to smoke in both clinical practice and clinical trials

Use of mind body complementary therapies (MBCTs) and health related quality of life (HRQoL) of cancer patients

Prayers, spiritual healing, yoga, meditation, t’ai chi, qigong and support groups are classified as mind body complementary therapies (MBCTs). The study aimed to examine the prevalence of MBCTs use and the Health Related Quality of Life (HRQoL) in a group of Malaysian cancer patients. Methods: This crosssectional study was conducted on 184 cancer patients at the oncology clinic of Penang general hospital, Malaysia. MBCTs was assessed using a self- administered questionnaire while the HRQoL of the participants was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Among the complementary and alternative medicines (CAM) users, 75(40.7%) patients self-reported using MBCTs while having cancer. Majority of MBCTs users were female 60(80%, p=0.01), aged between 38 and 57 (58%), and were of Malay ethnicity (61%). Socio-demographic factors including age (r=0.15, p=0.03) and monthly house-hold income (r= -0.25, p<0.001) were significantly correlated with MBCTs use. Prayers for health reasons was the most frequently practised MBCTs modality, followed by spiritual practices 20(10.8%), meditation 7(5.9%), t’ai chi 7(3.8%), music therapy 4(2.1%), qigong 1(0.5%), hypnotherapy 1(0.5%), and reiki 1(0.5%). Recommendations from friends and family members 53(70%) were the most common reasons of MBCTs use followed by patient’s own will 22(29.3%). Health related Quality of Life (HRQoL) scores showed significant difference in all functional and symptoms scores among MBCTs users and non-users (p<0.05). Conclusion: The study helps to identify numerous MBCTs commonly practised by a group of Malaysian cancer patients. Prayers specifically for health reasons and spiritual practices were somewhat common among patients. Viewing MBCTs, not as alternative but to complement conventional cancer therapies may help to address cancer patients’ emotional and psychological needs.

Tuberculous lymphadenitis at Penang general hospital, Malaysia

To evaluate the incidence, treatment and clinical outcomes of tuberculous [TB] lymphadenitis at Penang General Hospital, Malaysia. Penang General Hospital is the referral center for all tuberculosis patients in the state of Penang. Patient records were reviewed to identify patients with confirmed diagnosis of TB lymphadenitis between January 2006 and December 2008. Data were analyzed using SPSS version 15. Of 1,548 tuberculosis cases, 109 [7.0%] patients had TB lymphadenitis. The mean age was 36.4 +/- 12.87 years and of the 109 patients with TB lymphadenitis, 35 [33.0%], 37 [34.0%] and 36 [33.0%] were observed for 2006, 2007 and 2008, respectively. Ethnically, 45 [41.3%] were Malay followed by 37 Chinese [33.9%]. Among risk factors for TB lymphadenitis, HIV and diabetes mellitus were seen in 17 [15.6%] and 11 [10.0%] patients, respectively. Cough and fever were the most frequently reported symptoms. In a majority of cases [n = 90, 82.5%] positive results were obtained for fine-needle aspiration [FNA]. Directly observed therapy was given to all patients. Sixty-two [56.9%] patients were successfully treated, and 5 [4.6%] patients died during the treatment. There was no increase in the incidence of TB lymphadenitis over the 3-year study period. The incidence was slightly higher in male than female gender and in Malay [ethnic group]. Diabetes mellitus and HIV were the most commonly reported risk factors. FNA is the most reliable diagnostic test

Knowledge and perception of breast cancer among women of various ethnic groups in the state of Penang: a cross-sectional survey

The objective of this study was to assess and compare the knowledge and perception of breast cancer among women of various ethnic groups in the state of Penang. A cross-sectional survey was conducted from February 5 to March 15, 2008. 384 participants were conveniently selected and interviewed face to face by a trained researcher [M.A.H.] using a validated questionnaire. Participants were required to answer 22 questions concerning knowledge of breast cancer and 5 questions on the perception of breast cancer management and treatment outcomes. The mean total score of knowledge was 59.1%, with Indian women having significantly less knowledge than the Chinese and Malay women [P< 0.001]. Only 117 [32.3%] and 120 [33.0%] women were aware of the recommended breast self-examination [BSE] and clinical breast examination [CBE] guidelines, respectively. Multiple regression analysis showed that ethnicity, age, level of education and employment status were major determinants of breast cancer knowledge. The current study has demonstrated that women in the state of Penang have serious knowledge deficits about breast cancer and poor awareness of BSE and CBE guidelines. This study has highlighted the need of an intensive breast cancer awareness campaign which should also stress the importance of early detection and reporting of breast cancer