A Systematic Review of Health-Related Quality of Life Assessment Instruments for Cancer Patients: A Malaysian Perspective Introduction The absence of a review of health-related quality of life (HRQoL) assessment tools has led to inconsistencies in the use of HRQoL instruments across different cancer populations, such as adults, pediatric patients, and caregivers, limiting the comparability of findings and hindering the accurate evaluation of cancer care outcomes. With that, this study aimed to investigate how Malaysian cancer patients’ and other sub-population’s HRQoL is measured and quantified through HRQoL assessment instrument. Methods From 2013 to 2023, a literature search was conducted on Scopus, PubMed, Cochrane Library, and ClinicalTrials.gov. The included studies and previously published review papers were also cited backward. For each HRQoL assessment instrument, attributes such as author(s), year of publication, study site, study design, target population, cancer types, study purpose, sample size, and instrument languages were extracted and compared. Results In this systematic review encompassing 88 studies, a variety of HRQoL assessment tools were employed, including both generic and cancer-type specific instruments. Distinct HRQoL assessment tools were identified for different populations, including pediatric, adolescent, and caregiver groups. The findings underscore the wide variety of instruments used across different cancer populations and age groups, highlighting the need for tailored assessments that consider specific demographic and clinical contexts. While generic HRQoL tools were the most commonly used across studies, disease-specific instruments for various cancer types were also frequently employed as supplementary measures. Conclusion Moving forward, it is essential for stakeholders to collaborate in addressing the gaps in HRQoL research and to work towards the standardization of HRQoL assessment tools to ensure consistency and comparability in future studies.

Introduction: Home medication review (HMR) involves a patient-centered approach, extending continuity of care to the community setting with the intention of improving medication use and health outcome. The delivery of HMR services in Malaysia remains limited to urban hospitals and clinics. Current study aimed to explore the perception and acceptability of HMR in older adults. Methods: In-depth individual interviews were conducted among adults aged ≥65 years old, taking ≥5 medications, recruited from geriatrics clinics at a tertiary teaching hospital. Home interviews were conducted among 12 older adults and care givers between April to June 2019. Interviews were audio-taped, transcribed verbatim and analysed through descriptive interpretive approach of qualitative data analysis. Results: HMR provided participants with opportunities to discuss medication-related issues with pharmacists in conducive environments. Pharmacists provided information which improved knowledge on indications, dosages and safe storage of medications through HMR. Participants experienced relief and developed confidence in medication self-management. Conclusion: The importance of follow-up visits to ensure adequate monitoring and continuity of care were emphasized. Larger quantitative studies are required to determine the clinical impact and cost-effectiveness of HMR to justify the implementation and expansion of this service

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.

Introduction: The population of Malaysia is ageing rapidly. Due to the relatively greater incidence of noncommunicable diseases among older adults, polypharmacy is highly prevalent in this population. This polypharmacy along with other age-related factors increases the risk of drug-related problems to several folds. Currently, no study in Malaysia or even Asia has determined the type and nature of drug-related problems among non-institutionalised older adults. Therefore, this study aims to highlight common drug-related problems among community-dwelling older persons (≥ 65 years) with polypharmacy. Materials and Methods: A cross-sectional exploratory study was carried out where in-depth home medication reviews were carried out by two pharmacists. Participants were recruited from geriatric and fall clinics of the University of Malaya Medical Centre located in the urban area of the Federal Territory of Malaysia. The total numbers of drug-related problems were classified using the Pharmaceutical Care Network Europe (PCNE) classification V9.0. Recommendations and referral letters were provided based on the pharmaceutical care issues identified. Results: Thirty participants were recruited, among whom 178 drug-related problems were identified with a median value of six [range 1-11] drug-related problems per participant. The majority of problems were related to the effectiveness of prescribed treatment (69.1 %), followed by the possibility of adverse effects (28.7 %). Conclusion Home medication review identifies numerous medication-related issues and allows for patient education and detailed counselling in an informal and patient-friendly manner. Future studies to determine the longitudinal effect of home medication review on patient outcome, cost implications, and overall healthcare utilization are now indicated.
Medication Review ; Aged ; Pharmacist