1.Barriers to implementing a national health screening program for men in Malaysia: An online survey of healthcare providers
Chirk Jenn Ng ; Chin Hai Teo ; Kar Mun Ang ; Yong Leng Kok ; Khalid Ashraf ; Hui Ling Leong ; Sri Wahyu Taher ; Zakiah Mohd Said ; Zainal Fitri Zakaria ; Ping Foo Wong ; Chee Peng Hor ; Teng Aik Ong ; Husni Hussain ; V Paranthaman P Vengadasalam ; Chiu Wan Ng ; Kavitha Agamutu ; Mohamad Aznuddin Abd Razak
Malaysian Family Physician 2020;15(1):6-14
Introduction: This study aimed to determine the views and practices of healthcare providers and
barriers they encountered when implementing the national health screening program for men in a
public primary care setting in Malaysia.
Methods: An online survey was conducted among healthcare providers across public health clinics in
Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants’ socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool.
Results: A total of 231 healthcare providers from 129 health clinics participated in this survey.
Among them, 37.44% perceived the implementation of the screening program as a “top-down
decision.” Although 37.44% found the screening tool for adult men “useful,” some felt that it was
“time consuming” to fill out (38.2%) and “lengthy” (28.3%). In addition, ‘adult men refuse to answer’
(24.1%) was cited as the most common patient-related barrier.
Conclusions: This study provided useful insights into the challenges encountered by the public
healthcare providers when implementing a national screening program for men. The screening tool for
adult men should be revised to make it more user-friendly. Further studies should explore the reasons
why men were reluctant to participate in health screenings, thus enhancing the implementation of
screening programs in primary care.
2.Impact of Diabetes Medication Therapy Adherence Clinic (DMTAC) appointment intervals on glycemic control in public health clinics across Perak, Malaysia
Ying Shan Beh ; Keshamalini Gopalsamy ; Sabrina Lai Fong Lee ; V Paranthaman P. Vengadasalam
Malaysian Family Physician 2022;17(3):105-113
Introduction:
Frequent diabetes medication therapy adherence clinic (DMTAC) appointments may lead to more rapid glycaemic control. This study aimed to evaluate the association between appointment intervals and glycaemic control (haemoglobin A1c [HbA1c] level) along with blood pressure (BP) and lipid profile (LP) during DMTAC appointments.
Methods:
This study retrospectively reviewed all recorded baseline and completed DMTAC data, including HbA1c level, LP and BP, of 318 eligible participants from 29 DMTACs across Perak. The participants were divided into shorter appointment interval (SAI) (≤30 days) and longer appointment interval (LAI) groups.
Results:
The majority of the baseline socio-demographic and clinical characteristics did not significantly differ between the SAI and LAI groups (p>0.05). Ischaemic heart disease (Odds ratio, OR=3.457; 95% CI=1.354–8.826; p=0.009) and hypertension (OR=0.521; 95% CI=0.276–0.992; p=0.044) were significantly associated with the appointment intervals. Upon completion of eight DMTAC visits, the HbA1c and FBS levels and DBP significantly improved (p<0.05). However, the mean HbA1c level (1.35±2.18% vs 0.87±2.11%, p=0.548), FBS level (1.25±4.82mmol/L vs 2.29±6.23mmol/L, p=0.538), SBP (3.28±21.82mmHg vs 3.65±18.35mmHg, p=0.343) and LDL level (0.09±0.98mmol/L vs 0.07±1.13mmol/L,
p=0.246) did not significantly differ between the SAI and LAI groups.
Conclusion
Longer DMTAC appointment intervals had similar improvement in glycaemic controls, blood pressure and lipid profiles as compared to shorter appointment intervals. A longer interval can be scheduled for lower-risk patients to optimise the use of human resources and minimise costs.
Appointments and Schedules
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Diabetes
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Pharmacists