A COMPARATIVE REVIEW OF CURRENT INTERNATIONAL ATRIAL FIBRILLATION GUIDELINES FROM A PRIMARY CARE PERSPECTIVE Atrial fibrillation (AF) is the most frequent sustained arrhythmia globally with significant morbidity and mortality. A local guideline has been created to help physicians in clinical decision-making by outlining various generally accepted approaches for the diagnosis, management and prevention of AF. This guideline was published 10 years ago, and it is imperative that new guidelines based on the latest consensus be renewed. Since then, various clinical guidelines have been issued in the past 5 years to standardise the management of AF, including the American College of Cardiology, European Society of Cardiology, National Institute for Health and Care Excellence and Asia Pacific Heart Rhythm Society guidelines. This review aims to provide a comprehensive comparison of these guidelines across multiple aspects of clinical management, including management frameworks, screening, anticoagulation, stroke and bleeding risk assessments, rate and rhythm control, follow-up, comorbidity management and technology usage.

FEASIBILITY OF QUICK RESPONSE-BASED QUALITY IMPROVEMENT PROJECTS IN AN URBAN PRIMARY CARE SETTING: A CROSS-SECTIONAL SURVEY Introduction: Using quick response (QR) codes to disseminate information has become increasingly popular since the declaration of COVID-19 as a pandemic. We aimed to investigate the feasibility of implementing QR-based quality improvement projects in our clinic to improve patients’ medical knowledge, experience and access to care. Methods: We utilised systematic random sampling by recruiting every 25th patient registered in our clinic during data collection. Participants answered a self-administered printed questionnaire regarding their smartphone usage and familiarity with QR code scanning at the patients’ waiting area. Data were analysed using the Statistical Package for the Social Sciences version 26. Results: A total of 323 patients participated (response rate=100%). The participants’ median age was 57 years (interquartile range=41–67). Most participants were women (63.1%). Approximately 90.4% (n=282) used smartphones, with 83.7% (n=261) reporting average or good usage proficiency. More than half (58.0%) accessed medical information via their smartphones, and 67.0% were familiar with QR codes. Multiple logistic regression analyses revealed that familiarity with QR codes was linked to age of <65 years [adjusted odds ratio (AOR)=4.593, 95% confidence interval (CI)=2.351–8.976, P<0.001], tertiary education (AOR=2.385, 95% CI=1.170–4.863, P=0.017), smartphone proficiency (AOR=4.703, 95% CI=1.624–13.623, P=0.004) and prior smartphone usage to access medical information (AOR=5.472, 95% CI=2.790–10.732, P<0.001). Conclusion: Since smartphones were accessible to most primary care patients, and more than half of the patients were familiar with QR code scanning, QR code-based quality improvement projects can be used to improve services in our setting.

Objectives: This study aimed to assess menopause symptoms, treatment-seeking behaviors, treatments received, and factors associated with seeking consultation from healthcare providers (HCPs). Methods: Using a self-administered Menopause Quick-6 in the Malay language (MQ6[M]) questionnaire, we surveyed 349 women aged 40–60 years attending primary healthcare clinics in four states in Malaysia for their menopause symptoms. Health-seeking behaviors for menopause symptoms were assessed using questions regarding HCPs consulted and treatments prescribed. Binary logistic regression was employed on factors associated with seeking consultation for menopause symptoms. Results: Using MQ6(M), we observed that 125 (31.3%) women reported at least one menopause symptom, with joint pains (42.8%), menstrual changes (39.5%), and hot flashes (29.3%) being the most frequent symptoms. Furthermore, 60% of the women were prescribed vitamins, and only 13% were administered Hormone Replacement Therapy (HRT). Medical comorbidities, the presence of at least one gynecological condition, menopause status, and MQ6(M) score were associated with seeking consultation with an HCP. For women with medical conditions, the odds of seeking consultation increased by a factor of 1.34 (adjusted odds ratio [AOR], 1.34; 95% confidence interval [CI], 1.11–1.76) for every additional comorbidity. The odds of seeking consultation from an HCP increased by a factor of 1.26 (AOR, 1.26; 95% CI, 1.04–1.47) with a unit increase in MQ6(M) score. Conclusions Most women had menopause symptoms but favored the use of complementary and alternative medicine over HRT. Screening and awareness of menopause treatments need to be improved at primary healthcare clinics.