Nirmatrelvir/ritonavir treatment and the risk of post-COVID condition over 180 days in Malaysia.

Background: The effect of nirmatrelvir/ritonavir on preventing post-COVID condition (PCC) in the BA4, BA5, and XBB Omicron predominant periods is not well understood. The purpose of this study was to assess how nirmatrelvir/ritonavir treatment affected both PCC and health-related quality of life.

Methods: This retrospective cohort study enrolled 2,524 adults aged 18 years and older who were eligible for nirmatrelvir/ritonavir between July 14 to November 14, 2022.

Impact evaluation of guidelines on antibiotic utilisation & appropriateness in Malaysian public primary care: an interrupted time series analysis.

Background: The National Antimicrobial Guidelines (NAG) 2014 and NAG2019 in Malaysia targeted rational and judicious use of antimicrobials. In this study, we assessed the change in antibiotic utilisation and appropriateness due to the guidelines that were implemented from 2011 to 2019.

Methods: Interrupted time series analyses on rates of antibiotic appropriateness and utilisation were performed using prescription data from public primary care clinics in Malaysia between January 2011 and December 2019.

Treatment intensification and therapeutic inertia of antihypertensive therapy among patients with type 2 diabetes and hypertension with uncontrolled blood pressure.

Treatment intensification is essential to ensure guideline targets are attained in diabetes patients. The failure to intensify treatment when the targets are not achieved is therapeutic inertia. This study aimed to determine the proportions and factors associated with treatment intensification and therapeutic inertia of antihypertensive therapy in type 2 diabetes patients with uncontrolled hypertension in Malaysia.

Economic Evaluation of Nirmatrelvir/Ritonavir Among Adults Against Hospitalization During the Omicron Dominated Period in Malaysia: A Real-World Evidence Perspective.

Background And Objectives: Nirmatrelvir/ritonavir was administered orally to manage mild to moderate symptoms of COVID-19 in adult patients. The objectives of this study were to (i) evaluate the cost-effectiveness of prescribing nirmatrelvir/ritonavir within 5 days of a COVID-19 illness in order to avert hospitalization within a 30-day period in the Malaysia setting; (ii) determine how variations in pricing and hospitalization rates will affect the cost-effectiveness of nirmatrelvir/ritonavir.

Methods: The 30-day hospitalization related to COVID-19 was determined using 1 to 1 propensity score-matched real-world data in Malaysia from 14 July 2022 to 14 November 2022.

Prevalence of diabetic kidney disease and the associated factors among patients with type 2 diabetes in a multi-ethnic Asian country.

The actual prevalence of diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D) in Malaysia is unknown. We aimed to determine the prevalence of DKD and its associated risk factors among T2D patients in Malaysia. An analytical cross-sectional study was conducted using the year 2022 clinical audit dataset from the National Diabetes Registry.

Real-world nirmatrelvir-ritonavir outpatient treatment in reducing hospitalization for high-risk patients with COVID-19 during Omicron BA.4, BA.5 and XBB subvariants dominance in Malaysia: A retrospective cohort study.

Objective: To determine if nirmatrelvir-ritonavir 300mg/100mg treatment for 5 days in high-risk outpatients with mild to moderate COVID-19 symptoms was associated with a reduction in hospitalization, intensive care unit (ICU) admission, and death.

Methods: This 1:1 propensity score matched cohort study from 647 public health clinics in Malaysia included all patients with COVID-19 with positive tests aged 18 years and older, who were eligible for nirmatrelvir-ritonavir treatment within 5 days of illness from July 14, 2022, to November 14, 2022. The exposed group was patients with COVID-19 initiated with nirmatrelvir-ritonavir treatment, whereas those not initiated with the drug served as the control group.

Labisia pumila standardized extract (SKF7®) reduces percentage of waist circumference and waist-to-height ratio in individuals with obesity.

Aim: Evidence from the literature points towards a viable choice of utilizing Labisia pumila to improve the metabolic profile in animal studies. To that end, this prospective study was designed to assess the health impact of the consumption of L. pumila standardized extract (SKF7®) on key parameters of obesity in humans such as body weight (BW), body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR).

Five-year LDL-cholesterol trend and its predictors among type 2 diabetes patients in an upper-middle-income country: a retrospective open cohort study.

Background: Patients with diabetes have increased risks of cardiovascular diseases (CVD), and their LDL-cholesterol (LDL-C) has to be treated to target to prevent complications. We aim to determine the LDL-C trend and its predictors among patients with type 2 diabetes (T2D) in Malaysia.

Methods: This was a retrospective open cohort study from 2013 to 2017 among T2D patients in public primary health care clinics in Negeri Sembilan state, Malaysia.

Changes in body mass index, glycosylated hemoglobin A1C, blood pressure, and LDL-cholesterol among type 2 diabetes patients in Malaysia: A population-based longitudinal study.

Background: This study aimed to describe changes in body mass index, glycosylated hemoglobin A1C, blood pressure, and low-density lipoprotein (LDL)-cholesterol among type 2 diabetes patients in Malaysia.

Methods: A five-year retrospective cohort study was conducted using data from the National Diabetes Registry. Type 2 diabetes patients aged ≥18 years and had ≥2 clinical audits between 2013 and 2017 were included in the analysis.

The effectiveness of an emotion-focused educational programme in reducing diabetes distress in adults with type 2 diabetes mellitus at 12-month follow-up: a cluster randomized controlled trial.

Background: Diabetes distress (DD) is an increasingly important part of clinical medicine, diabetes self-management and research topic in people with diabetes mellitus. The present study evaluated the effectiveness of a value-based emotion-focused educational program in Malay adults with type 2 diabetes (VEMOFIT) at 12-month follow-up compared with a program with systematic attention to participants' emotions (attention-control).

Methods: VEMOFIT consisted of four biweekly group sessions and a booster session after 3 months; the attention-control program consisted of three sessions over the same period.

A Revised Version of Diabetes Quality of Life Instrument Maintaining Domains for Satisfaction, Impact, and Worry.

Background: Diabetes quality of life (DQoL) instrument has been widely used to measure quality of life among diabetes patients. This study aimed to develop a revised version of DQoL instrument that incorporated issues of redundancies in the items and strengthen the basis of validity of the instrument.

Methods: This was a cross-sectional study where diabetes patients were recruited from December 1, 2014, until end of March 2015 at a public health clinic in Peninsular Malaysia.

The All-Cause Mortality and a Screening Tool to Determine High-Risk Patients among Prevalent Type 2 Diabetes Mellitus Patients.

Aims: This study aims to determine the all-cause mortality and the associated risk factors for all-cause mortality among the prevalent type 2 diabetes mellitus (T2DM) patients within five years' period and to develop a screening tool to determine high-risk patients.

Methods: This is a cohort study of T2DM patients in the national diabetes registry, Malaysia. Patients' particulars were derived from the database between 1st January 2009 and 31st December 2009.

Decision making process and factors contributing to research participation among general practitioners: A grounded theory study.

Introduction: The participation of general practitioners (GPs) in primary care research is variable and often poor. We aimed to develop a substantive and empirical theoretical framework to explain GPs' decision-making process to participate in research.

Methods: We used the grounded theory approach to construct a substantive theory to explain the decision-making process of GPs to participate in research activities.

Validation of the Malay version of Diabetes Quality of Life (DQOL) Questionnaire for Adult Population with Type 2 Diabetes Mellitus.

Objective: We aimed to validate the Malay version of Diabetes Quality of Life (DQOL) questionnaire for Malaysian adult population with type 2 diabetes mellitus (DM).

Methods: This is a cross-sectional study to validate Malay version of DQOL among the adult diabetic patients. DQOL questionnaire has 46 items consist of three domains, namely Satisfaction Domain, Impact Domain and Worry Domain.

The effectiveness of a value-based EMOtion-cognition-Focused educatIonal programme to reduce diabetes-related distress in Malay adults with Type 2 diabetes (VEMOFIT): study protocol for a cluster randomised controlled trial.

Background: Type 2 diabetes mellitus (T2DM) patients experience many psychosocial problems related to their diabetes. These often lead to emotional disorders such as distress, stress, anxiety and depression, resulting in decreased self-care, quality of life and disease control. The purpose of the current study is to evaluate the effectiveness of a brief value-based emotion-focused educational programme in adults with T2DM on diabetes-related distress (DRD), depressive symptoms, illness perceptions, quality of life, diabetes self-efficacy, self-care and clinical outcomes.

Effectiveness of the EMPOWER-PAR Intervention in Improving Clinical Outcomes of Type 2 Diabetes Mellitus in Primary Care: A Pragmatic Cluster Randomised Controlled Trial.

Background: The chronic care model was proven effective in improving clinical outcomes of diabetes in developed countries. However, evidence in developing countries is scarce. The objective of this study was to evaluate the effectiveness of EMPOWER-PAR intervention (based on the chronic care model) in improving clinical outcomes for type 2 diabetes mellitus using readily available resources in the Malaysian public primary care setting.

Messages from the Malaysian Diabetes Registries on Diabetes Care in Malaysian public healthcare facilities.

A persistent and increasing prevalence of diagnosed and undiagnosed diabetes mellitus has recently been reported in the National Health and Morbidity Survey 2015. This commentary recapitulates the relevant and valuable lessons in the Malaysian national diabetes registries to inform the healthcare stakeholders and policy makers on potential areas of clinical practice improvement and future researches. Under performance of the process measures and sub-optimal control of HbA1c, blood pressure and lipids profile were prevalent (<40% achieved treatment targets).

A nationwide survey of public healthcare providers' impressions of family medicine specialists in Malaysia: a qualitative analysis of written comments.

Objective: To examine impressions of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics.

Design: Cross-sectional study.

Setting: This study is part of a larger national study on the perception of Malaysian public healthcare professionals on FMSs (PERMFAMS).

A nationwide postal survey on the perception of Malaysian public healthcare providers on family medicine specialists' (PERMFAMS) clinical performance, professional attitudes and research visibility.

Perception of healthcare providers who worked with family medicine specialists (FMSs) could translate into the effectiveness of primary healthcare delivery in daily practices. This study examined perceptions of public healthcare providers/professionals (PHCPs) on FMSs at public health clinics throughout Malaysia. This was a cross-sectional study in 2012-2013 using postal method targeting PHCPs from three categories of health facilities, namely health clinics, health offices and hospitals.

Predictors of poor glycaemic control in older patients with type 2 diabetes mellitus.

Introduction: We assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia.

Methods: This cross-sectional study used the data of 21,336 patients aged ≥ 60 years with T2DM from the Adult Diabetes Control and Management Registry 2008-2009.

Results: Predictors of poor glycaemic control were: age groups 60-69 years (odds ratio [OR] 1.

Predictive factors of follow-up non-attendance and mortality among adults with type 2 diabetes mellitus- an analysis of the Malaysian diabetes registry 2009.

This study examined the factors associated with follow-up non-attendance (FUNA) and mortality among the adult patients with type 2 diabetes mellitus (T2DM). Data on 57780 T2DM patients from the 2009 diabetes registry were analyzed using multinomial logistic mixed model. Out of 57780 patients, 3140 (5.

Study protocol of EMPOWER participatory action research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hypertension outcomes in primary care.

Background: Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of its effectiveness in developing countries. The aim of this study was to evaluate the effectiveness of the EMPOWER-PAR intervention (multifaceted chronic disease management strategies based on the chronic care model) in improving outcomes for type 2 diabetes mellitus and hypertension using readily available resources in the Malaysian public primary care setting.

A nationwide survey on the expectation of public healthcare providers on family medicine specialists in Malaysia-a qualitative analysis of 623 written comments.

Objective: To examine the expectation of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics.

Design: Cross-sectional study.

Setting: This study is part of a larger national study on the perception of the Malaysian public healthcare professionals on FMSs.

Poor glycemic control in younger women attending Malaysian public primary care clinics: findings from adults diabetes control and management registry.

Background: Women of reproductive age are a group of particular concern as diabetes may affect their pregnancy outcome as well as long-term morbidity and mortality. This study aimed to compare the clinical profiles and glycemic control of reproductive and non-reproductive age women with type 2 diabetes (T2D) in primary care settings, and to determine the associated factors of poor glycemic control in the reproductive age group women.

Methods: This was a cross-sectional study using cases reported by public primary care clinics to the Adult Diabetes Control and Management registry from 1st January to 31st December 2009.

Usage of glucometer is associated with improved glycaemic control in type 2 diabetes mellitus patients in Malaysian public primary care clinics: an open-label, randomised controlled trial.

Introduction: Self-monitoring of blood glucose (SMBG) has been underutilised. We conducted an open-label, randomised controlled trial to assess the feasibility of introducing SMBG in primary care clinics in Malaysia.

Methods: This was an open-label, randomised controlled trial conducted in five public primary care clinics in Malaysia.