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  1. Article ; Online: Screening and management of osteoporosis: a survey of knowledge, attitude and practice among primary care physicians in Malaysia

    Tay, Chai Li / Ng, Wei Leik / Beh, Hooi Chin / Lim, Wan Chieh / Hussin, Narwani

    Arch Osteoporos. 2022 Dec., v. 17, no. 1, p. 72

    2022  , Page(s) 72

    Abstract: We surveyed primary care physicians in Malaysia for their knowledge, attitude and practice in screening and managing osteoporosis. We found a low level of screening and active management of osteoporosis in the primary care setting despite positive ... ...

    Abstract We surveyed primary care physicians in Malaysia for their knowledge, attitude and practice in screening and managing osteoporosis. We found a low level of screening and active management of osteoporosis in the primary care setting despite positive attitudes towards them. We advocate for the active management of osteoporosis at the primary care level. INTRODUCTION: Prevention of osteoporotic fracture is important in primary healthcare for healthy ageing. Little is known about the knowledge, attitude, practice and barriers in the screening and managing osteoporosis among primary care doctors. METHODS: A cross-sectional study, using an online pre-tested questionnaire after face and content validation, was conducted for primary care doctors from 1 June to 30 July 2021 across Malaysia. Pearson’s chi-square test and logistic regression were employed. RESULTS: A total of 350 primary care doctors in Malaysia, consisting of 113 (32.3%) family medicine specialists (FMS) and 237 (67.7%) medical officers, participated in this study. The mean ± SD score of osteoporosis knowledge was 50.46 ± 15.09 with minimum and maximum values of 0 and 83.64%, respectively. One hundred and ten (31.4%) respondents achieved a satisfactory overall knowledge score of ≥ 60%, 156 (44.6%) were confident in advising patients for initiation of anti-osteoporotic medication, and 243 (69.4%) perceived that bisphosphonate should be made available in health clinics. Only 97 (27.7%) practised osteoporosis screening. Inaccessibility of bone mineral densitometry (BMD) (90.6%), inadequate knowledge (87.7%) and inaccessibility of pharmacotherapy (87.1%) are perceived modifiable barriers to osteoporosis screening and management. Factors associated with a satisfactory knowledge of osteoporosis are designation as a family medicine specialist (AOR 3.034, p = 0.002), attendance at an osteoporosis management update course (AOR 2.095, p = 0.034) and the practice of osteoporosis screening for the elderly (AOR 2.767, p = 0.001). CONCLUSION: Given the insufficient knowledge and low level of osteoporosis screening, there is a need for a national structured health programme to address the knowledge gap, increase screening practices and enhance accessibility to BMD and anti-osteoporosis medication in primary care.
    Keywords bone fractures ; chi-square distribution ; cross-sectional studies ; densitometry ; drug therapy ; elderly ; face ; health programs ; medicine ; osteoporosis ; questionnaires ; regression analysis ; surveys ; Malaysia
    Language English
    Dates of publication 2022-12
    Size p. 72
    Publishing place Springer London
    Document type Article ; Online
    ZDB-ID 2253231-6
    ISSN 1862-3514 ; 1862-3522
    ISSN (online) 1862-3514
    ISSN 1862-3522
    DOI 10.1007/s11657-022-01111-y
    Database NAL-Catalogue (AGRICOLA)

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  2. Article ; Online: Screening and management of osteoporosis: a survey of knowledge, attitude and practice among primary care physicians in Malaysia.

    Tay, Chai Li / Ng, Wei Leik / Beh, Hooi Chin / Lim, Wan Chieh / Hussin, Narwani

    Archives of osteoporosis

    2022  Volume 17, Issue 1, Page(s) 72

    Abstract: We surveyed primary care physicians in Malaysia for their knowledge, attitude and practice in screening and managing osteoporosis. We found a low level of screening and active management of osteoporosis in the primary care setting despite positive ... ...

    Abstract We surveyed primary care physicians in Malaysia for their knowledge, attitude and practice in screening and managing osteoporosis. We found a low level of screening and active management of osteoporosis in the primary care setting despite positive attitudes towards them. We advocate for the active management of osteoporosis at the primary care level.
    Introduction: Prevention of osteoporotic fracture is important in primary healthcare for healthy ageing. Little is known about the knowledge, attitude, practice and barriers in the screening and managing osteoporosis among primary care doctors.
    Methods: A cross-sectional study, using an online pre-tested questionnaire after face and content validation, was conducted for primary care doctors from 1 June to 30 July 2021 across Malaysia. Pearson's chi-square test and logistic regression were employed.
    Results: A total of 350 primary care doctors in Malaysia, consisting of 113 (32.3%) family medicine specialists (FMS) and 237 (67.7%) medical officers, participated in this study. The mean ± SD score of osteoporosis knowledge was 50.46 ± 15.09 with minimum and maximum values of 0 and 83.64%, respectively. One hundred and ten (31.4%) respondents achieved a satisfactory overall knowledge score of ≥ 60%, 156 (44.6%) were confident in advising patients for initiation of anti-osteoporotic medication, and 243 (69.4%) perceived that bisphosphonate should be made available in health clinics. Only 97 (27.7%) practised osteoporosis screening. Inaccessibility of bone mineral densitometry (BMD) (90.6%), inadequate knowledge (87.7%) and inaccessibility of pharmacotherapy (87.1%) are perceived modifiable barriers to osteoporosis screening and management. Factors associated with a satisfactory knowledge of osteoporosis are designation as a family medicine specialist (AOR 3.034, p = 0.002), attendance at an osteoporosis management update course (AOR 2.095, p = 0.034) and the practice of osteoporosis screening for the elderly (AOR 2.767, p = 0.001).
    Conclusion: Given the insufficient knowledge and low level of osteoporosis screening, there is a need for a national structured health programme to address the knowledge gap, increase screening practices and enhance accessibility to BMD and anti-osteoporosis medication in primary care.
    MeSH term(s) Aged ; Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Humans ; Malaysia ; Osteoporosis/diagnosis ; Osteoporosis/drug therapy ; Physicians, Primary Care ; Surveys and Questionnaires
    Language English
    Publishing date 2022-04-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2253231-6
    ISSN 1862-3514 ; 1862-3522
    ISSN (online) 1862-3514
    ISSN 1862-3522
    DOI 10.1007/s11657-022-01111-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Is pre-stroke frailty as determined by the Clinical Frailty Scale version 2.0 associated with stroke outcomes?

    Ng, Chai Chen / Lim, Wan Chieh / Tan, Kit Mun / Wong, Kah Yan / Kanagarajah, Rajwin Raja / Singh, Harsukhpreet Singh A/L Kishore / Tan, Wei Guang

    Singapore medical journal

    2023  

    Language English
    Publishing date 2023-03-06
    Publishing country India
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 2737-5935 ; 0037-5675
    ISSN (online) 2737-5935
    ISSN 0037-5675
    DOI 10.4103/singaporemedj.SMJ-2021-187
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Hip fracture management in the emergency department and its impact on hospital outcomes: a retrospective cross-sectional analysis.

    Thiam, Chiann Ni / Khor, Hui Min / Pang, Gordon Hwa Mang / Lim, Wan Chieh / Shanmugam, Tharshne / Chandrasekaran, C Sankara Kumar / Singh, Simmrat / Zakaria, Mohd Idzwan Bin / Ong, Terence

    European geriatric medicine

    2022  Volume 13, Issue 5, Page(s) 1081–1088

    Abstract: Purpose: The emergency department (ED) plays an important role in initiating early treatment for hip fractures and ensuring prompt transfer to orthopaedic wards. This study reported on the care delivered in a tertiary centre ED in Malaysia and the ... ...

    Abstract Purpose: The emergency department (ED) plays an important role in initiating early treatment for hip fractures and ensuring prompt transfer to orthopaedic wards. This study reported on the care delivered in a tertiary centre ED in Malaysia and the association between time spent in ED with hospital outcomes.
    Methods: Patients aged ≥ 65 years with fragility hip fractures and seen by the geriatric team were recruited. Data were collected on patient characteristics, key time points for treatment and hospital outcomes. Median time in ED was used to dichotomise long and short waiting time.
    Results: 447 patients were recruited. The mean (SD) age was 80.5 (7.0) years and 69.8% were women. 74.9% were prescribed analgesia within 30 min. Median (Q1,Q3) time to diagnostic imaging was 27.0 (24.0-43.0) minutes, clinician confirmation of fracture was 83.0 (49.0-129.0) minutes, and time in ED was 4.8 (3.5-6.9) h. A weekday, weekend, in-hour or out-of-hour admission did not demonstrate a difference in the time important care was delivered. Patients who spent ≥ 5 h in ED had more cardiac events (4.6 vs 10.1%, p = 0.023) and more spent ≥ 14 days in hospital (17.5 vs 29.0%, p = 0.004) compared to those < 5 h. No significant increase in inpatient complications (43.5 vs 34.6%, p = 0.054), length of stay (median, 8 vs 7 days, p = 0.119), care home discharge (5.3 vs 4.6%, p = 0.772), or in-hospital death (6.3 vs 4.2%, p = 0.313) were observed.
    Conclusion: Time to early hip fracture pain relief and diagnosis was adequate in this ED. Time ≥ 5 h in ED was associated with cardiac events and 2 weeks or more inpatient stay.
    MeSH term(s) Aged ; Cross-Sectional Studies ; Emergency Service, Hospital ; Female ; Hip Fractures/epidemiology ; Hip Fractures/therapy ; Hospital Mortality ; Hospitals ; Humans ; Male ; Retrospective Studies
    Language English
    Publishing date 2022-05-14
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2556794-9
    ISSN 1878-7657 ; 1878-7649
    ISSN (online) 1878-7657
    ISSN 1878-7649
    DOI 10.1007/s41999-022-00654-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Non-pharmacological interventions for bone health after stroke: A systematic review.

    Sallehuddin, Hakimah / Ong, Terence / Md Said, Salmiah / Ahmad Tarmizi, Noor Azleen / Loh, Siew Ping / Lim, Wan Chieh / Nadarajah, Reena / Lim, Hong Tak / Mohd Zambri, Nurul Huda / Ho, Yun Ying / Shariff Ghazali, Sazlina

    PloS one

    2022  Volume 17, Issue 2, Page(s) e0263935

    Abstract: Objective: To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients.: Data sources: Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic ... ...

    Abstract Objective: To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients.
    Data sources: Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021.
    Methods: A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWiM) was used for result synthesis.
    Results: Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported.
    Conclusion: There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required.
    MeSH term(s) Clinical Trials as Topic ; Exercise Therapy/methods ; Humans ; Osteoporosis/etiology ; Osteoporosis/prevention & control ; Osteoporosis/therapy ; Stroke/complications ; Stroke Rehabilitation/methods
    Language English
    Publishing date 2022-02-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0263935
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: COVID-19 Infection among Older People Admitted to Hospital: A Cross-Sectional Analysis.

    Thiam, Chiann Ni / Hasmukharay, Kejal / Lim, Wan Chieh / Ng, Chai Chen / Pang, Gordon Hwa Mang / Abdullah, Aimy / Saedon, Nor Izzati / Khor, Hui Min / Ong, Terence

    Geriatrics (Basel, Switzerland)

    2021  Volume 6, Issue 1

    Abstract: 1) Background: Older people with COVID-19 infection report worse clinical outcomes. There is a paucity of local data and this study aimed to describe the clinical progression of older people admitted to a university hospital in Malaysia with COVID-19 ... ...

    Abstract (1) Background: Older people with COVID-19 infection report worse clinical outcomes. There is a paucity of local data and this study aimed to describe the clinical progression of older people admitted to a university hospital in Malaysia with COVID-19 infection. (2) Methods: Older people (≥60 years) admitted with COVID-19 infection confirmed with RT-PCR from 27 February 2020-25 May 2020 were included in this study. Data on patient characteristics, hospital treatment, and inpatient outcomes were collected via hospital-held electronic medical records. Analysis was done to describe the cohort and identify factors associated with inpatient mortality. (3) Results: 26 participants were included (mean age 76.2 years, female 57.7%). All had at least one comorbid condition and half were frail. About 19.2% had non-respiratory (atypical) symptoms; 23.1% had a severe disease that required intensive care unit monitoring; 46.2% were given COVID-19 targeted therapy. Inpatient mortality and overall complication rates were 23.1% and 42.3%, respectively. Delirium on presentation and lower Ct-value were associated with mortality. (4) Conclusions: Older people with COVID-19 infection have severe infection and poor hospital outcomes. Vigilant hospital care is necessary to address their multimorbidity and frailty, along with appropriate treatment for their infection.
    Language English
    Publishing date 2021-03-08
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2308-3417
    ISSN (online) 2308-3417
    DOI 10.3390/geriatrics6010025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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