Medication adherence, its associated factors and implication on glycaemic control in patients with type 2 diabetes mellitus: A cross-sectional study in a Malaysian primary care clinic.

Introduction: Medication adherence and metabolic control remain suboptimal among patients with diabetes mellitus in Malaysia despite the clear benefits of reduced vascular complications and mortality risk. This study examined the factors associated with medication adherence and glycaemic control in patients with type 2 diabetes mellitus in a primary care clinic. Method: This cross-sectional study was conducted in a public health clinic in Pagoh, Johor, among 386 patients recruited via systematic random sampling. Data were obtained using a validated 7-item structured questionnaire, glycated haemoglobin (HbA1c) test and medical record review. Logistic regression analysis was performed to determine the factors associated with medication adherence. Results: The mean patient age was 60.04± 10.75 years, and the mean HbA1c level was 8.3±2.0%. Approximately 60.3% of the participants were adherent to their medication, and an increasing age was significantly associated with medication nonadherence (adjusted odds ratio [OR]: 0.959; confidence interval [CI]: 0.934-0.985). Medication adherence (adjusted OR: 2.688; CI: 1.534- 4.708) and use of combined oral medications (adjusted OR: 5.604; CI: 3.078-10.203), combined oral medications with insulin (adjusted OR: 23.466; CI: 8.208-67.085) and insulin only (adjusted OR: 6.528; CI: 1.876-22.717) were associated with good glycaemic control. Older age (adjusted OR: 0.954; CI: 0.923-0.986) and Malay ethnicity (adjusted OR: 0.284; CI: 0.101-0.794) were associated with poor glycaemic control. Conclusion: Suboptimal medication adherence and glycaemic control are prevalent in primary care settings, especially among elderly patients. Counselling should be targeted to patients and their caretakers to improve medication adherence and optimise metabolic control.

Factors Influencing Pap Smear Screening Uptake among Women Visiting Outpatient Clinics in Johor.

Introduction: Despite the benefits of cervical cancer screening, Pap smear uptake remains variable in Malaysia, with Johor previously reported as the state with the lowest uptake. This study aims to fill the gap in epidemiological knowledge and assess factors affecting the uptake of Pap smear screening among women in Johor. Methods: A cross-sectional study was conducted in several government and private clinics across Johor, including Pagoh, Muar, Batu Pahat, Kulai, and Johor Bahru districts. Data was collected from 452 women using self-administered questionnaires, and logistic regression was performed to determine factors associated with Pap smear uptake. Results: Findings showed that 48.5% of the women reported having undergone Pap smear screening in the previous 3 years, and 40.0% and 51.3% of respondents accurately answered questions on symptoms and risk factors of cervical cancer, respectively. Increasing age (ORad. 2.322, 95% CI 1.708-3.158), being married (ORadj 4.860, 95% CI 1.100-21.476), parity of ≥5 (ORadj 8.381, 95% CI 1.326-52.958), young age at first pregnancy (ORadj 0.932, 95% CI 0.877-0.991), knowledge of cervical cancer symptoms (ORadj. 1.745, 95% CI 1.065-2.857), support from family (ORadj 3.620, 95% CI 2.081-6.298), and contraception use (ORadj 2.220, 95% CI 1.314-3.750) were significantly associated with increased Pap smear uptake among women visiting outpatient clinics in Johor. Conclusion: Pap smear uptake remains suboptimal in Johor, and broad-based awareness campaigns tailored towards improving knowledge of cervical cancer with family involvement are crucial to improving uptake among women in Johor.