Publications by authors named "Huan-Keat Chan"

Background: Substance abuse admission to health facilities following the pandemic is often met with challenges. COVID-19 is causing an insurmountable psychosocial impact on the whole of mankind. Marginalized communities, particularly those with substance use disorders (SUDs), are also likely to suffer from greater psychosocial burden.

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Introduction: Deprescribing serves as a pivotal measure to mitigate the drug-related problem due to polypharmacy. This study aimed to map the factors influencing healthcare providers' deprescribing decision using the Behaviour Change Wheel framework and develop an innovative conceptual model to support deprescribing practice.

Methods: A cross-sectional online survey targeting doctors and pharmacists was conducted to assess the influence of various factors on healthcare providers' comfort in recommending deprescribing.

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Background: Children with intravenous immunoglobulin (IVIG) resistant Kawasaki disease (KD) are at higher risk of developing coronary artery (CA) aneurysm. Early identification of high-risk patients using a predictive tool would allow for earlier interventions to prevent cardiac complications.

Methods: Children with KD who were admitted to five selected hospitals in Malaysia between 2008 and 2018 and received 2 g/kg of IVIG within 10 days from the onset of illness were included.

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COVID-19 self-testing is essential for enabling individuals to self-care, screen themselves and, if positive, isolate themselves. Since 2021, COVID-19 self-tests have been extensively used in high-income countries, however, their programmatic implementation in low- and middle-income countries has been delayed. An implementation pilot, mixed-methods study, was conducted in four industrial manufacturing companies, in Kedah State between November 2022 and May 2023.

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Article Synopsis
  • The study investigates public knowledge and attitudes towards home quarantine measures in Malaysia post-COVID-19, focusing on their ability to contain potential outbreaks.
  • Conducted online among Malaysian adults from August to October 2022, the study used a validated questionnaire to assess knowledge of quarantine instructions and COVID-19 warning signs.
  • Findings revealed over 80% of respondents were knowledgeable about most quarantine guidelines; however, many struggled with recognizing uncommon warning signs, while those with previous COVID-19 infections displayed better knowledge than those without.
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Hepatitis C self-testing (HCVST) is emerging as an additional strategy that could help to expand access to HCV testing. We conducted a study to assess the usability and acceptability of two types of HCVST, oral fluid- and blood-based, among the general population and men who have sex with men (MSM) in Malaysia. An observational study was conducted in three primary care centres in Malaysia.

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Background: Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Malaysia and poses a major burden on society.

Aims: To determine the overall survival rate of patients diagnosed with CRC and factors contributing to survival.

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Introduction: Polypharmacy and potentially inappropriate medications (PIM) are common among older adults. To guide appropriate prescribing, healthcare professionals often rely on explicit criteria to identify and deprescribe inappropriate medications, or to start medications due to prescribing omission. However, most explicit PIM criteria were developed with inadequate guidance from quality metrics or integrating real-world data, which are rich and valuable data source.

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Background: Polypharmacy and the use of potentially inappropriate medications (PIMs) are prevalent among older patients admitted to hospitals, posing a heightened risk of adverse drug events. This trial aims to evaluate the effectiveness of a pharmacist-led deprescribing intervention in reducing medications, PIM and improving clinical outcomes, using the locally developed Malaysian Potentially Inappropriate Prescribing Screening tool in Older Adults (MALPIP).

Methods: This is an 18-month cluster-randomized, open-label, parallel-arm controlled trial conducted at 14 public hospitals in the Perak state of Malaysia.

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Background: Colorectal neoplasia is a multistep process that can lead to the development of colorectal cancer. Colonoscopy is the gold standard for diagnosis and screening of colorectal cancer, but its uptake is often hindered by unpleasant experiences and logistic obstacles. Therefore, non-invasive biomarker tests such as the M2-pyruvate kinase (M2PK) test have been explored as a potential screening tool.

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Article Synopsis
  • Pain management in advanced cancer patients is often inadequate, highlighting the need for better education among healthcare providers in Malaysia.
  • A study involving doctors revealed many had insufficient training in palliative care, with only a minority aware of proper morphine use protocols for cancer pain.
  • Significant misconceptions about morphine, such as fears of addiction and respiratory depression, hinder effective pain management and indicate a need for improved training and resources.
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Background and Purpose: and purpose: Non-alcoholic fatty liver disease (NAFLD) is a significant global health concern with limited pharmacotherapy options. This study aimed to evaluate the effectiveness of a standardized extract of in mild-to-moderate NAFLD.

Materials And Methods: This was a 12-month randomized controlled trial, in which adults with a controlled attenuation parameter (CAP) score >250 dB/m and a fibrosis score <10 kPa were randomly assigned to receive a standardized extract at a dose of 3,000 mg daily (n = 112) or a placebo (n = 114).

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Introduction: The rise in colorectal cancer (CRC) incidence becomes a global concern. As geographical variations in the CRC incidence suggests the role of area-level determinants, the current study was designed to identify the spatial distribution pattern of CRC at the neighbourhood level in Malaysia.

Method: Newly diagnosed CRC cases between 2010 and 2016 in Malaysia were identified from the National Cancer Registry.

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Background: Despite advancements in hepatitis C virus (HCV) treatment, low uptake among hard-to-reach populations remains a global issue. The current study aimed to assess the feasibility of a modified same-day test-and-treat model in improving HCV care for people who inject drugs (PWID) living in resource-constrained rural areas.

Methods: A pilot study was conducted in four primary healthcare (PHC) centers in Malaysia.

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Introduction: Upper respiratory tract infection (URTI) is commonly encountered at the primary care level. Its management is particularly challenging due to the similarity of its symptoms to coronavirus disease 2019 (COVID-19) infection. Our study evaluated the profiles and antibiotic use of patients seeking care from a dedicated community-based URTI clinic during the COVID-19 pandemic.

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Article Synopsis
  • The study evaluated the effectiveness of the APRI and FIB-4 indices in diagnosing cirrhosis caused by hepatitis C, involving 906 participants.
  • Individual scores from both indices were tested against standardized cut-off levels, with APRI and FIB-4 showing varying levels of sensitivity and specificity.
  • Combining the two methods in a sequential approach improved diagnostic performance, highlighting that using both tools together is more effective for diagnosing cirrhosis than using either one alone.
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The recent wave of COVID-19 cases has led to the potential need for booster doses. We surveyed 6,294 people and found that 87.6% reported willingness to take a booster dose, with vaccine efficacy rate being the most common reason cited to accept booster dose.

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Introduction: Colorectal cancer (CRC) is the third most common cancer globally. This study aimed to determine the incidence, mortality, and survival rates of CRC in northern Malaysia over the last decade.

Materials And Methods: This was a registry-based, cross-sectional study.

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Article Synopsis
  • - The systematic review investigates the global disparities in colorectal cancer (CRC) screening recommendations for average-risk individuals by analyzing guidelines published from 2011 to 2021 using an ecobiosocial approach.
  • - Fourteen guidelines were included after a thorough search across multiple databases, and their quality was assessed using the AGREE II instrument, highlighting inconsistencies in CRC screening practices.
  • - Key disparities identified were categorized into ecological, biological, and social factors, emphasizing the need for standardized practices in CRC screening to improve public health outcomes.
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Background: Chronic pain has a major impact on a patient's quality of life, affecting physical and psychological functioning. It has debilitating consequences on social and economic aspects too. This study aimed to explore the status of health-related quality of life (HRQoL) of Malaysian patients suffering from chronic non-malignant pain.

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The Dietary Inflammatory Index (DII) was extensively used to examine the inflammatory potential of diet related to colorectal cancer (CRC). This meta-analysis aimed to update the evidence of the association between the DII and CRC across various culture-specific dietary patterns. Literature search was performed through online databases (, and ).

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Background: Malaysia has an estimated hepatitis C virus (HCV) prevalence of 1.9% among its adult population and a history of providing HCV treatment in the public sector. In 2019, Malaysia launched a 5-year national strategic plan for viral hepatitis control and has been expanding HCV testing and treatment to the primary care and community levels, while actively engaging key populations in services for hepatitis care.

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Background: While the availability of generic direct-acting antivirals (DAAs) opens the door for large-scale treatment, the care for people living with hepatitis C virus (HCV) in Malaysia is shifting toward a tripartite partnership between the public health system, correctional settings and civil society organizations (CSOs). This study aimed to explore the barriers to scaling up HCV treatment in Malaysia from the perspective of key stakeholders.

Methods: Eighteen focus-group discussions (FGDs) were conducted with 180 individuals, who actively engaged in coordinating, executing or supporting the implementation of the national strategic plan for HCV.

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