1.Effectiveness of an intervention to increase the knowledge, attitude, and practice regarding the return and disposal of unused medications
Pauline Lai Siew Mei ; Tan Kit Mun ; Lee Hong Gee ; Wong Yin Yen
Malaysian Family Physician 2021;16(1):56-63
This study aimed to evaluate the effectiveness of an educational intervention (Safe D.U.M.P)
to improve the knowledge, attitude, and practice regarding the return and disposal of unused
medications. Community-dwelling adults in Malaysia who could understand English were recruited
from two healthcare events. Participants were asked to fill out the validated Return and Disposal of
Unused Medications (ReDiUM) questionnaire (pre-intervention), view six educational intervention
posters on how to dispose of unused medications (Safe D.U.M.P), then answer the ReDiUM
questionnaire immediately after viewing the posters (post-intervention). A total of 390 out of 456
participants participated (response rate=85.5%). Most were female (71%) with a median age of 42
years. The overall knowledge of participants significantly increased from 60% to 80% (p<0.001).
However, no improvement was seen regarding their overall attitude and practice. This outcome was as
expected as it may be more difficult to improve attitude and practice (when compared to knowledge)
with a single educational session.
2.Medication Appropriateness among Older Persons Admitted to a General Hospital in Malaysia
Heng Ker Sin ; Tan Kit Mun ; Khor Hui Min ; Noor Azleen Ahmad Tarmizi ; Renukha Sellappans
Malaysian Journal of Medicine and Health Sciences 2022;18(No.5):122-129
Introduction: Many tools have been developed to determine medication appropriateness in older persons including
the 2015 American Geriatric Society (AGS) Beers criteria and the Screening Tool of Older People’s Prescriptions
(STOPP) criteria. We aimed to determine and compare the prevalence of potentially inappropriate medications
(PIMs) based on the Beers criteria 2015 and the STOPP criteria v2 among older persons admitted to a general hospital in Malaysia. Methods: A cross-sectional study comprising of 160 patients aged 65 years old and above admitted
to the general medical wards of a tertiary teaching hospital were recruited. Beers criteria 2015 and the STOPP criteria v2 were used to evaluate participants’ medication list on admission, during hospitalisation and on discharge
for PIMs. Prevalence of PIMs which was calculated as the total number of patients with one or more PIMs over the
total number of patients. Results: The prevalence of PIMs identified by Beers criteria 2015 on admission, during
hospitalisation and on discharge were 54.85%, 64.40% and 48.80% respectively. The prevalence of PIM based on
STOPP criteria v2 were 33.08%, 47.50% and 42.50% respectively. The most prevalent PIMs according to Beers
criteria 2015 and STOPP criteria v2 were diuretics, tramadol, ticlopidine, proton pump inhibitor, benzodiazepines
and antipsychotics. Conclusion: The prevalence of PIMs use is high among hospitalised older persons in Malaysia.
While it is not possible to avoid all PIMs listed in the Beers and STOPP criteria, clinicians should exercise caution in
prescribing drugs such as benzodiazepines, antipsychotics and proton pump inhibitors for older persons weighing
the risk versus benefit of the drugs.
3.Exploration of non-pharmacological interventions in the management of behavioural and psychological symptoms of dementia.
Nur Sabiha MD HUSSIN ; Mahmathi KARUPPANNAN ; Yogheswaran GOPALAN ; Kit Mun TAN ; Shubashini GNANASAN
Singapore medical journal 2023;64(8):497-502
INTRODUCTION:
Behavioural and psychological symptoms of dementia (BPSD) are considered integral parts of dementia. While pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended as the first line of treatment in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD and the strategies and barriers to implementing them in secondary care facilities in Malaysia.
METHODS:
A qualitative study design was employed. Data were collected through observations and semi-structured interviews of 12 caregivers and 11 people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes, and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis.
RESULTS:
Some personalised non-pharmacological interventions, such as physical exercise, music therapy, reminiscence therapy and pet therapy, were conducted in several nursing care centres. Collaborative care from the care providers and family members was found to be an important facilitating factor. The lack of family support led to care providers carrying additional workload beyond their job scope. Other barriers to non-pharmacological interventions were cultural and language differences between the care providers and PWD, inadequate staff numbers and training, and time constraints.
CONCLUSION
Although non-pharmacological approaches have been used to some extent in Malaysia, continuous education and training of healthcare providers and the family members of PWD is needed to overcome the challenges to their successful implementation.
Humans
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Dementia/diagnosis*
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Psychotherapy
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Qualitative Research
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Health Personnel
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Caregivers