1.Prevalence, factors influencing and knowledge about adherence to lipid-lowering therapy among hyperlipidemia patients
Navin Kumar Devaraj ; Mohazmi Mohamed ; Norita Hussein
The Medical Journal of Malaysia 2017;72(3):157-164
background: Hyperlipidaemia is a significant risk factor for
cardiovascular disease. However, adherence to lipidlowering
therapy is often unsatisfactory due to a
combination of patient factors, therapy, socio-economic and
health system-related factors.
Aims: to identify the prevalence of adherence to lipidlowering
therapy, the factors contributing to non-adherence
and knowledge regarding hyperlipidaemia and its’ treatment
among Malaysian patients with hyperlipidemia.
Methods: A quantitative study using a cross-sectional
survey was carried out in an urban primary care clinic in
August 2015. Patients on lipid-lowering therapy for ≥ 1 year
aged ≥ 18 years were selected using simple random
sampling. consenting patients answered a selfadministered
questionnaire (in Malay/English) which
included socio-demographic profile, hyperlipidaemia profile,
adherence to lipid-lowering therapy (using the Morisky
Medication Adherence scale-8; score ≥ 6 taken as adherent),
reasons leading to non-adherence, knowledge regarding
hyperlipidaemia and its’ treatment, and use of non-allopathic
medicine.
results: the response rate was 90.7%. the prevalence of
adherence to lipid-lowering therapy was 82.4%. “the most
common reasons for non-adherence was being worried
about side effect of lipid-lowering agent (71.4%), followed by
the need to take too many drugs in a day (61.4%) and
negative influences by friends, relative and mass media
(60%)”. Factors associated with non-adherence include male
gender, on longer duration of therapy, less frequency of
follow-up, less number of follow-up clinics, taking
medication at night/random timing and having lower
knowledge scores.
conclusion: Overall the prevalence of adherence was high
in patients with hyperlipidaemia. Interventions to boost
adherence should target those who were identified as non-adherent.
2.Nurses’ knowledge, beliefs and practices regarding the screening and treatment of postpartum depression in maternal and child health clinics: A cross-sectional survey
Kang Pei San ; Mohazmi bin Mohamed ; Ng Yong Muh ; Liew Su-May
Malaysian Family Physician 2019;14(1):18-25
Background: Postpartum depression (PPD) affects 10-15% of women worldwide, and screening
is recommended by clinical guidelines. In Malaysia, nurses in maternal and child health (MCH)
clinics provide postpartum care.
Aim: To determine nurses’ level of knowledge, beliefs and practices regarding PPD and factors
associated with screening practices.
Methods: A cross-sectional study using universal sampling was conducted on nurses from seven
government MCH clinics in Malaysia. Data was collected from March until April 2016 through a
self-reported questionnaire. Univariate and multivariate analyses were performed to identify factors
associated with having ever performed PPD screening.
Results: Of the 108 nurses, 55.6% scored above the median total knowledge score (17 out of 24
points). Despite a high proportion of nurses believing that they were responsible for PPD screening
(72.2%), counselling depressed mothers (72.2%) and referring mothers for further treatment
(87.0%), only 64.8% and 51.9% were confident in recognizing PPD and counselling depressed
mothers, respectively. Only 25.9% had ever practiced PPD screening, which was associated
with beliefs concerning screening taking too much time (adjusted odds ratio [AOR]=0.13,
95% confidence interval [CI]= 0.02–0.74, P=0.022) and that screening is their responsibility
(AOR=14.12, 95%CI=1.65-120.75, P=0.016).
Conclusion: More than half of the nurses scored above the median total knowledge score and
had positive beliefs towards PPD screening. However, PPD screening practices were poor, and this
outcome was associated with their beliefs regarding time and responsibility.
3.Prevalence and documented causes of hyponatraemia among geriatric patients attending a primary care clinic
Chai Li Tay ; Phyo Kyaw Myint ; Mohazmi Mohamed ; Roy L Soiza ; Maw Pin Tan
The Medical Journal of Malaysia 2019;74(2):121-127
Introduction: Hyponatraemia is the commonest electrolyte
abnormality and has major clinical implications. However,
few studies of hyponatraemia in the primary care setting has
been published to date. OBJECTIVES: To determine the
prevalence, potential causes and management of
hyponatraemia and to identify factors associated with
severity of hyponatraemia among older persons in a primary
care setting.
Methods: Electronic records were searched to identify all
cases aged ≥60 years with a serum sodium <135mmol/l,
attending outpatient clinic in 2014. Patients’ medical records
with the available blood test results of glucose, potassium,
urea and creatinine were reviewed.
Results: Of the 21,544 elderly, 5873 patients (27.3%) had
electrolyte profile tests. 403 (6.9%) had hyponatraemia in at
least one blood test. Medical records were available for 253,
mean age 72.9±7.3 years, 178 (70.4%) had mild
hyponatraemia, 75 (29.6%) had moderate to severe
hyponatraemia. Potential causes were documented in 101
(40%). Patients with moderate to severe hyponatraemia were
five times more likely to have a cause of hyponatraemia
documented (p<0.01). Medications were the commonest
documented cause of hyponatraemia (31.7%).
Hydrochlorothiazide use was attributed in 25 (78.1%) of 32
with medication-associated hyponatraemia. Repeat renal
profile (89%) was the commonest management of hypotonic
hyponatraemia.