Tertiary Care Hospital In Malaysia Research Articles

Age at autism spectrum disorder diagnosis and its association with child and family characteristics in a tertiary care hospital in Malaysia.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Despite the absence of a cure, early diagnosis and intensive early intervention can improve the outcomes. However, little is known about the median age at ASD diagnosis in Malaysia or the child/family characteristics associated with early diagnosis. Therefore, this study aimed to determine the median age at ASD diagnosis among Malaysian children presenting to the country's largest public tertiary neurodevelopmental center and to investigate the possible demographic, child, and family characteristics associated with an early age at diagnosis. Data were collected between February 2017 and February 2019 from a database maintained by the child development unit of the country's largest publicly funded tertiary hospital, containing data from an ethnically diverse population. Among Malaysian children attending the clinic, the median age at ASD diagnosis was 48 months. Early autism diagnosis (<36 months of age) was associated with increased severity of social communication and interaction impairments, coexisting intellectual impairment, children from high socioeconomic status families, and children who receive joint care from their families and a maid or babysitter. The study findings highlight the socioeconomic inequalities in the country, a lack of parental awareness of early ASD signs, and the presence of cultural influences on the age at diagnosis of ASD.

High Risk of Obstructive Sleep Apnea Among Hypertensive Patients at a Selected Tertiary Care Hospital

Introduction: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by partial or complete obstruction of the upper airway, which causes desaturations and arousal. Various studies have shown that OSA is a major modifiable risk factor for hypertension. Untreated OSA is increasingly associated with cardiovascular and neurocognitive sequela. Thus, our study aims to determine the high-risk of obstructive sleep apnea among hypertensive patients at a tertiary care hospital in Malaysia. Methods: A cross-sectional study was conducted among hypertensive patients at a tertiary hospital in Malaysia. A validated Malay version of the Berlin Questionnaire was utilized along with other questions on sociodemographic characteristics and diabetes mellitus. Results: A total of 161 respondents were involved in the study. The mean age was 48.35 years and among these 75% were males and 25 % were females. The majority of respondents were of Malay ethnicity (78%), followed by Chinese (11%) and Indians (10%). Of these,18 % comprised of obese patients and 29.8% had diabetes mellitus. The prevalence of high-risk OSA among hypertensive patients was 18.0% (95% CI). High risk of OSA was found to be prevalent in the elderly age group (p&lt;0.001), female gender (p&lt;0.001), Indian ethnicity (p&lt;0.001) and among diabetes mellitus patients (p&lt;0.001). Conclusion: The study results illustrate the high risk of OSA among hypertensive patients with advancing age and diabetes mellitus. This study finding mandates these high-risk hypertensive patients should be screened for early diagnosis and timely treatment of OSA to prevent further cardiovascular risk, morbidity and mortality.

30-Day Readmission Rate of Patients with COPD and Its Associated Factors: A Retrospective Cohort Study from a Tertiary Care Hospital.

Readmission of chronic obstructive pulmonary disease (COPD) has been used as a measure of performance for COPD care. This study aimed to determine the rate of readmission of COPD in tertiary care hospital in Malaysia and its associated factors. A retrospective cohort study was conducted at a tertiary care hospital in Malaysia from 1st January to 21st May 2019. Seventy admissions for COPD exacerbation involving 58 patients were analyzed. The majority of the patients were male (89.8%), had a mean age of 71.95 ± 7.24 years and a median smoking history of 40 (IQR = 25) pack-years, 84.5% were in GOLD group D and 91.4% had a mMRC grading of 2 or greater. Approximately 60.3% had upper or lower respiratory tract infection as the cause of exacerbation; one in five patients had uncompensated hypercapnic respiratory failure at presentation, and 27.6% needed mechanical ventilatory support. Approximately 43.1% of patients had a history of exacerbation that required hospitalisation in the past year. The mean blood eosinophil concentration was 0.38 ± 0.46 x109 cells/L. The 30-day readmission rate was 20.3%, revisit rate to the emergency room within 30 days after discharge was 3.4%, and in-hospital mortality rate was 1.7%. Among all characteristics, a higher baseline mMRC grade (p = 0.038) and history of exacerbation in the past 1 year (p < 0.001) were statistically associated with 30-day readmission. The 30-day readmission rate for COPD exacerbation in a Malaysian tertiary hospital is similar to the rates in high-income countries. Exacerbation in the previous year and a higher baseline mMRC grading were significant risk factors for 30-day readmission in patients with COPD. Strategies of COPD management should concentrate on improvement of symptoms control by optimisation of pharmacotherapy, and early initiation of pulmonary rehabilitation, and structured integrated care programs to reduce readmission rates.

POUR-UP: Power of Urination in Relieving Urethral Pain During Flexible Cystoscopy in Males

ABSTRACTThis study aimed to investigate the effectiveness of micturition (urination) during flexible cystoscopy in alleviating urethral pain in males. A single-blinded, randomized controlled trial was conducted with 103 male outpatients at a tertiary care hospital in Malaysia. Participants, aged 18–80, undergoing flexible cystoscopy were randomly assigned to either a control or interventional group. The interventional group was instructed to urinate during the procedure, while the control group received no such instructions. All patients received standard lidocaine gel before the examination. Patient discomfort was assessed using Visual Analogue Scores (VAS) at three points: before gel instillation (baseline), immediately after the procedure, and 15 minutes post-examination. Age, BMI, duration of the examination, and examiner experience were also recorded to explore their correlation with the immediate post-procedure pain score. The interventional group reported significantly lower pain scores immediately after the procedure (p &lt; 0.001) and 15 minutes later (p &lt; 0.005) compared to the control group. However, there was no statistically significant difference in age, BMI, examination duration, or examiner experience level between the two groups regarding the pain score immediately post-procedure. These findings suggest that urination during flexible cystoscopy can substantially alleviate urinary discomfort and lead to a significant reduction in urethral pain in males. This approach mayprovide a valuable method to improve patient comfort during the procedure.

Factors Impacting Hypertension Awareness among Hypertensive Population: A Quantitative Study in a Tertiary Care Hospital in Malaysia

There are obstacles to high levels of hypertension awareness that are embedded in gender, income and lifestyle habits which need to be addressed leading to high levels of undiagnosed and uncontrolled hypertension. This study aimed to explore the various factors which affect hypertension awareness among a hypertensive population in a tertiary care hospital. A quantitative study was conducted among hypertensive patients at a tertiary care hospital in Selangor, Malaysia. A validated and translated questionnaire was utilised as a data collection tool. Descriptive and inferential statistical analysis was done using SPSS version 25. A thousand participants (female n=621, male n= 379) were recruited, and their mean age is 48± 11.09 years old. Approximately half of respondents were not informed by their doctor that they have hypertension. More than half of respondents were unaware about the normal range of systolic and diastolic. Female gender, Chinese race, urban resident, older adults, and tertiary education level are the most significant factors that have a great influence on the level of awareness among hypertensive population. Hypertension awareness needs to be addressed from systemic point of view to solve the growing barriers to accessing correct information about the disease. Health care providers and authorities need to regulate the manner in which information on mortal diseases is presented to the public to reduce incidence of malpractice.

THE IMPACT OF ANTIMICROBIAL STEWARDSHIP ON THE PATTERNS OF ANTIBIOTICS’ PRESCRIPTION AND CLINICAL OUTCOMES IN THE MEDICAL WARD OF A MALAYSIAN TERTIARY CARE HOSPITAL

Objective: To evaluate the impact of antimicrobial stewardship (AMS) on antibiotic prescribing patterns and certain clinical outcomes, the length of stay (LOS) and the re-admission rate (RR) of the patients treated within the medical ward of a tertiary care hospital in Malaysia.&#x0D; Methods: This quasi-experimental study was conducted retrospectively. The prescriptions of the AMS included alert antibiotics (AA) such as cefepime, ceftazidime, colistin (polymyxin E), imipenem-cilastatin, meropenem, piperacillin-tazobactam and vancomycin were reviewed for the period of 24 mo before (May, 2012–April, 2014) and after (May, 2014–April, 2016) the AMS implementation for the patients who were treated within the medical ward of a Malaysian tertiary care hospital. Patterns of antibiotics prescribed were determined descriptively. The impact of the AMS on the length of stay (LOS) and readmission rate (RR) was determined by the interrupted time series (ITS) comparative analysis of the pre-and post-AMS segments segregated by the point of onset (May, 2014) of the AMS program. Data analysis was performed through autoregressive integrated moving average (ARIMA) Winter Additive model and the Games-Howell non-parametric post hoc test by using IBM Statistical Package for Social Sciences version 25.0 for Windows (SPSS Inc., Chicago, IL, USA).&#x0D; Results: A total of 1716 prescriptions of the AA included for the AMS program showed that cefepime (623, 36.3%) and piperacillin-tazobactam (424, 24.7%) were the most prescribed antibiotics from May 2012 to April 2016. A 23.6% drop in the number of the AA prescriptions was observed during the 24-month post-AMS period. The LOS of the patients using any of the AA showed a post-AMS decline by 3.5 d. The patients’ LOS showed an average reduction of 0.12 (95% CI, 0.05–0.19, P=0.001) with the level and slope change of 0.18 (95% CI, 0.04–0.32, P=0.02) and 0.074 (95% CI, 0.02–0.12, P=0.002), respectively. Similarly, the percent RR reduced from 20.0 to 9.85 during the 24-month post-AMS period. The observed post-AMS mean monthly reduction of the RR for the patients using any AA was 0.38 (95% CI, 0.23–0.53, P&lt;0.001) with the level and slope change of 0.33 (95% CI, 0.14–0.51, P=0.02) and 0.37 (95% CI, 0.16–0.58, P=0.001), respectively.&#x0D; Conclusion: The AMS program of a Malaysian tertiary care hospital was a coordinated set of interventions implemented by the AMS team of the hospital that comprised of the infectious diseases (ID) physician, clinical pharmacists and microbiologist. The successful implementation of the AMS program from May, 2014 to April, 2016 within the medical ward resulted in the drop of the number of AA prescriptions that sequentially resulted in the significant (P&lt;0.05) post-AMS reduction of the LOS and the RR.

Use of potentially inappropriate medications among older outpatients and inpatients in a tertiary care hospital in Malaysia.

Older individuals are seemingly having more medical conditions, which predispose them to a greater risk of polypharmacy. Potentially inappropriate medications (PIMs), including those having anticholinergic and sedative properties, are common in their prescriptions, often associated with functional decline and negative health outcomes. Thus, this study reports proportions of inappropriate drugs and drug burden exposures and its correlation with patient-reported outcomes (PROs) among cognitively intact older adults admitted to a ward or visiting the outpatient clinic at a tertiary care hospital in Malaysia. This cross-sectional study included data from 344 older (173 inpatients and 171 outpatients) patients, aged 60years and above, through validated questionnaires. Medication appropriateness was assessed via Medication Appropriateness Index (MAI) tool, whereas Beers and Screening Tool of Older Person's Potentially Inappropriate Prescribing (STOPP) criteria were used to evaluate PIMs and potentially inappropriate prescribing (PIP), respectively. The Drug Burden Index (DBI) and polypharmacy, as well as PROs, included Groningen Frailty Indicator (GFI), Katz Index of Independence in Activities of Daily Living (Katz ADL) and Older People's Quality of Life (OPQOL) were also evaluated. Overall, inpatients received significantly higher medications (6.90±2.70 vs 4.49±3.20) than outpatients. A significantly higher proportion of inpatients received at least one PIM (65% vs 57%) or PIP (57.4% vs 17.0%) and higher mean MAI score (1.76±1.08 and 1.10±0.34) and DBI score (2.67±1.28 vs 1.49±1.17) than outpatients. Inpatients had significantly higher total OPQOL (118.53 vs 79.95) and GFI score (5.44 vs 3.78) than outpatients. We only found significant correlations between GFI and DBI and total OPQOL and the number of PIMs. Proportions of PIMs and DBI exposure were significantly higher in an inpatient setting. No significant correlations between exposures to inappropriate medications or drug burden and PROs were observed.

Drug-related problems in a general paediatric ward of a tertiary care hospital in Malaysia

Background Drug-related problems are relatively common among hospitalised patients and may be detrimental to patients and even increase healthcare costs. Characterising drug-related problems allows remedial actions to be in place to minimise the frequencyand ensure higher medication safety for the patients involved. Currently, the incidence of drug-related problems among hospitalised paediatric patients in Malaysia isunknown. Objective To determine the incidence, types and intervention acceptance, as well as the risk factors associated with drug-related problems in a Malaysian general paediatric ward. Setting General paediatric ward in Universiti Kebangsaan Malaysia Medical Centre. Method A cross-sectional observational study was conducted from March to May 2019. Data were collected from patients' medical charts, clinical notes and medical records for problem identification based on the modified Pharmaceutical Care Network Europe (PCNE) classification V 8.02. The incidence, types, causes and intervention acceptance as well as the risk factors were assessed. Main outcome measure Drug-related problemsbased on the modified PCNE classification V 8.02. Results In total, 225 paediatric patients with a total of 694 prescriptions were included in this study. The incidence of drug-related problems was 52.9% (198 prescriptions with problems in 119 patients). The main types of problemswere treatment safety (68 prescriptions, 34.3%), incomplete prescription (56 prescriptions, 28.3%) and un-optimised drug treatment (35 prescriptions, 17.7%). The main causes for the problems were necessary information not provided (n = 63, 30.1%), inappropriate dose selection (n = 47, 22.5%) and medication served without a valid prescription (n = 40, 19.1%). Of the 143 interventions proposed to prescribers by the pharmacist, 117 (81.8%) were accepted. The number of prescriptions was found to be the only risk factor associated with DRPs (odds ratio, 1.91; 95% confidence interval, 1.54-2.38; p < 0.001). Conclusion The frequency of drug-related problems among general paediatric ward patients ishigh and with each increase in prescription a patient received, the risk of aDRP doubles.

Prescribing errors in pediatric outpatient department at a tertiary care hospital in Malaysia.

Background Prescribing errors in children are common due to individualization of dosage regimen. It potentially has a great impact especially in this vulnerable population. Objective To determine the prevalence and common types of prescribing errors in a Malaysianpediatric outpatient department and to determine the factors contributing to prescribing errors. Setting Pediatric Outpatient Department and Outpatient Pharmacy at a tertiary care hospital in Malaysia. Method This is a prospective, cross sectional observational study where all new prescriptions received by the outpatient pharmacy from patients attending pediatric out-patient clinic were included for analysis. Descriptive statistics and logistic regression were used to analyze the data. Main outcome measure Frequency, types, potential clinical consequences and contributing factors of prescribing errors. Results Two hundred and fifty new prescriptions with 493 items were analyzed. There were 13 per 100 prescriptions with at least one prescribing errorand 7.3% of the total items were prescribed incorrectly. The most common types of prescribing error were, an ambiguous prescription (61.1%) followed by an unrecommended dose regimen (13.9%). Logistic regression analysis showed that the risk of aprescribing error significantly increased when the prescription was written by a house officer (OR 4.72, p = 0.029). Errors were judged to be potentially non-significant (33.3%), significant (36.1%), or serious (30.6%). Conclusion The experience of prescribers isan important factor that contributes to prescribing errors in pediatrics. Many of the errors made were potentially serious and may impact on the patients' well-being.

Hand hygiene \u2013 social network analysis of peer-identified and management-selected change agents

BackgroundHand hygiene compliance can be improved by strategies fostering collaborative efforts among healthcare workers (HCWs) through change agents. However, there is limited information about how change agents shape the social networks of work teams, and how this relates to organisational culture. The objectives of this study were to describe the influence of peer-identified change agents (PICAs) and management-selected change agents (MSCAs) on hand hygiene, perception of their leadership style by peers, and the role of the organisational culture in the process of hand hygiene promotion.MethodsThis study, stratified in pre-, during, and post-intervention periods, was conducted between February 2017 and March 2018 in two wards at a tertiary care hospital in Malaysia. Hand hygiene promotion was facilitated either by PICAs (study arm 1) or MSCAs (study arm 2), and the two wards were randomly allocated to one of the two interventions. Outcomes were: 1) perceived leadership styles of PICAs and MSCAs by staff, vocalised during question and answer sessions; 2) the social network connectedness and communication patterns between HCWs and change agents by applying social network analysis; and 3) hand hygiene leadership attributes obtained from HCWs in the post-intervention period by questionnaires.ResultsHand hygiene compliance in study arm 1 and study arm 2 improved by from 48% (95% CI: 44–53%) to 66% (63–69%), and from 50% (44–55%) to 65% (60–69%), respectively. There was no significant difference between the two arms. Healthcare workers perceived that PICAs lead by example, while MSCAs applied an authoritarian top-down leadership style. The organisational culture of both wards was hierarchical, with little social interaction, but strong team cohesion. Position and networks of both PICAs and MSCAs were similar and generally weaker compared to the leaders who were nominated by HCWs in the post-intervention period. Healthcare workers on both wards perceived authoritative leadership to be the most desirable attribute for hand hygiene improvement.ConclusionDespite experiencing successful hand hygiene improvement from PICAs, HCWs expressed a preference for the existing top-down leadership structure. This highlights the limits of applying leadership models that are not supported by the local organisational culture.

PMD41 - The Impact of Postgraduate Education on Healthcare Providers’ Awareness of Statins Therapy in Diabetic Dyslipidemia Management

To evaluate the effect of postgraduate qualification (PGQ) on the knowledge, attitude, and practice of healthcare providers toward statins utilization in outpatients with type 2 diabetes. A cross-sectional questionnaire-based study involved 200 pharmacists and physicians working in a tertiary care hospital in Malaysia, 2017. A predesigned questionnaire was prepared to suit the objectives, validated with good reliability (Cronbach's-Alpha: 0.783). It includes demographic data, knowledge, attitudes, and practice sections of statins therapy. The survey guided by the 2013 American college of cardiology/American heart association (ACC/AHA) dyslipidemia therapy guidelines. Data analysis was conducted by IBM-SPSS V23.0. A score of ≥ or < the mean score obtained from each section was classified as good or poor, respectively. Participants with PGQ (PGQP) were (20.5%) with age (38.8 ± 6.4) years, and participants with non-PGQ (non-PGQP) represent (79.5%) with age (28.4 ± 3.5) years (P-value <0.001). PGQP’ experience and non-PGQP were (12.7 ± 7.1) vs. (5.5 ± 6.1) years (P-value <0.001). The overall means of knowledge and practice were 74.8% and practice 56%. The knowledge of PGQP and non-PGQP toward statins was (81 ± 9.4%), vs. (73.2% ± 15.6%) respectively, (P-value: 0.003). PGQP and non-PGQP correctly answered the practice questions with (64.9 ± 15.2%), vs. (53.7 ± 15.8%), (P-value <0.001). Majority of the PGQP (63.4%) and non-PGQP (59.1%) have a positive attitude about statins therapy for outpatients with type 2 diabetes. Only (14.6%) of PGQP and (22%) of non-PGQP have a neutral attitude. However, (22%), and (18.9%) of PGQP and non-PGQP have a negative attitude (P-value: 0.802). There is a statistically significant difference amongst PGQP and non-PGQP in experience, knowledge, and practice respectively. PGQP have a higher level of awareness and advanced practice about statins utilization in diabetic dyslipidemia management than non-PGQP. However, there is a non-significant difference in their attitude.

Concurrent And Longitudinal Association Between Glycemic Control And Self Reported Medication Adherence Among Type 2 Diabetes Patients At A Tertiary Care Hospital In Malaysia.

This study evaluated the association between self-reported adherence with concurrent and subsequent glycemic control amongst type 2 diabetes patients at a tertiary care hospital in Malaysia. Demographic and clinical variables were assessed at baseline, after three and six months in 73 type 2 diabetes patients. Regression analysis, using SPSS, evaluated the concurrent and longitudinal association of medication adherence and glycemic control. Potential confounders of variables were identified using bi-variate correlation analyses. Concurrent Medication adherence and HbA1c association were significant after adjusting for ethnicity (P = 0.005). For longitudinal observation at 3 months, the association was significant after adjusting for ethnicity (P = 0.016); however, it became non-significant when baseline glycemic control was included in the model (P = 0.28). Easy to administer MALMAS significantly predicted concurrent glycemic control independent of potential confounders. This association persisted in longitudinal observation after 3 months when adjusted for confounders and became non-significant after adjusting for baseline glycemic control.

Association of Well-Being Index and Cognitive Impairment with Primary Open Angle Glaucoma Patients of Malaysia: A Case-Control Study.

The purpose of this study was to determine the association of well-being and cognitive impairment with primary open angle glaucoma (POAG) patients attending a tertiary care hospital in Malaysia. Fifty-four individuals were recruited for study as cases were matched with 60 individuals as the control subjects, and data were collected using the WHO well-being index and the validated 6-item cognitive impairment test dementia test. The results showed that there was no significant association between gender, ethnicity, socioeconomic status and POAG. Patients with POAG had significantly lower well-being index scores (mean 67.93) than the control group (mean 81.60) with P-value < 0.001. Similarly, patients with POAG had a significantly higher score of cognitive impairment (CIT test) (mean 6.15) compared to the control group (mean 0.40) with P-value < 0.001. Consequently, POAG is likely to be associated with higher cognitive impairment and lower well-being index.

PIN8 - Determination of Predictors of Prolonged Hospitalization among Dengue Patients Attending Tertiary Care Hospital in Malaysia

PIN8 - Determination of Predictors of Prolonged Hospitalization among Dengue Patients Attending Tertiary Care Hospital in Malaysia

PHP74 - Evaluating the Relative Effectiveness of Two Malnutrition Risk Assessment Tools in Surgical Population at a Tertiary Care Hospital in Malaysia

PHP74 - Evaluating the Relative Effectiveness of Two Malnutrition Risk Assessment Tools in Surgical Population at a Tertiary Care Hospital in Malaysia

PHP36 - Cost Variations of Inpatient, Daycare and Outpatient Hysteroscopy in A Tertiary-Care Hospital in Malaysia

PHP36 - Cost Variations of Inpatient, Daycare and Outpatient Hysteroscopy in A Tertiary-Care Hospital in Malaysia

PCN11 - Patient Characteristics and Clinical Outcomes of Patients with Liver Cancer in a Tertiary-Care Hospital in Malaysia

PCN11 - Patient Characteristics and Clinical Outcomes of Patients with Liver Cancer in a Tertiary-Care Hospital in Malaysia

Extremely high prevalence of antiseptic resistant Quaternary Ammonium Compound E gene among clinical isolates of multiple drug resistant Acinetobacter baumannii in Malaysia.

BackgroundAntiseptics are commonly used for the management of MDR (multiple drug resistance) pathogens in hospitals. They play crucial roles in the infection control practices. Antiseptics are often used for skin antisepsis, gauze dressing, preparation of anatomical sites for surgical procedure, hand sterilization before in contact with an infected person, before an invasive procedure and as surgical scrub.MethodsWe screened 122 multiple drug resistant Acinetobacter baumannii (MDRAB) isolated from admitted patients in one of the tertiary care hospital in Malaysia for the presence of antiseptic resistant genes qacA and qacE (Quaternary Ammonium Compound) and susceptibility towards chlorhexidine (CLX), benzalkonium (BZK) and benzethonium (BZT).ResultsEighty-nine (73%) isolates harboured qacE gene, while none were positive for qacA. The MIC ranged from 0.2 to 0.6 for CLX, 0.02 to 0.2 for BZK and 0.04 to 0.2 μg/mL for BZT. The highest number of qacE positive isolates were obtained from surgery (n = 24; 27%; p < 0.05), followed by medical ward (n = 23; 25.8%) and ICU (n = 21; 23.6%). Majority of the isolates from wound swabs (n = 33; 37%), T/aspirate (n = 16; 18%) and tissue (n = 10; 11.2%) harboured the qacE genes.ConclusionThe present investigation showed high prevalence of qacE gene among the studied isolates. Antiseptics are important components of infection control, continuous monitoring of antiseptics use in the hospital is cautioned.

Patients' beliefs about generic medicines in Malaysia.

Acceptance of generic medicines by patients is an essential factor given that they are the end users of these medicines. In fact, adequate knowledge and positive perceptions are prerequisite to patients' acceptance and use of generic medicines. To assess the current belief and views of patients about generic medicines in Malaysia. This was a self-administered questionnaire-based study. The study was conducted with patients visiting outpatient pharmacy department at a tertiary care hospital in Malaysia. The Malaysian version of Generic Medicines Scale (GMS) was used. The GMS consists of two subscales: efficacy and similarity of generic medicines to original brand medicines. The efficacy subscale consists of 10 items while the similarity subscale consists of 6 items. The responses to the items were framed as a five-point Likert scale (1=strongly disagree to 5=strongly agree). A total of 202 out of 300 patients participated in the study, giving a response rate of 67.3%. In this study, only 49% of them (n=99) knew the term 'generic medicine'. Moreover, only 53.5% of the respondents (n=108) believed that the efficacy of generic medicines was the same as original brand medicines. In terms of quality, only 44% of the respondents (n=89) disagreed that generic medicines were of a lower quality. About one third (n=65, 32.2%) believed that generic medicines were cheaper because they were less efficacious. In terms of side effects, 44.5% of the respondents (n=90) believed that generic medicines had the same side effect profile as original brand medicines. The study finding showed that almost half of the respondents had negative belief in generic medicines. Similarly, many patients were not aware of the similarities and differences between generic and original brand medicines. Therefore, there is a need to provide patients with adequate information about generic medicines.

Guideline Adherence and Control Of Diabetes Mellitus With Co-Morbidities in a Tertiary-Care Hospital in Malaysia.

Guideline Adherence and Control Of Diabetes Mellitus With Co-Morbidities in a Tertiary-Care Hospital in Malaysia.