High-risk nonsteroidal anti-inflammatory drugs prescribing in primary care: results from National Medical Care Survey Malaysia

Hwong, Wen Yea; Lim, Yvonne Mei Fong; Khoo, Ee Ming; Sivasampu, Sheamini

doi:10.1007/s11096-020-00966-w

Cited by 7 publications

(12 citation statements)

References 29 publications

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“…Due to the unavailability of data for the number of doctors per clinic, estimated numbers depending on the clinic types were used. It was estimated that the median number of doctors for public clinic was six, whereas the median number of doctors for both public mobile services and private clinics in Selangor was one [ 40 , 41 ]. Data on operating hours was used to estimate each clinic’s availability.…”

Section: Methodsmentioning

confidence: 99%

Spatial Accessibility of Primary Care in the Dual Public–Private Health System in Rural Areas, Malaysia

Hamid

Juni

Manaf

et al. 2023

IJERPH

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Disparities in access to health services in rural areas represent a global health issue. Various external factors contribute to these disparities and each root requires specific remedial action to alleviate the issue. This study elucidates an approach to assessing the spatial accessibility of primary care, considering Malaysia’s dual public–private system specifically in rural areas, and identifies its associated ecological factors. Spatial accessibility was calculated using the Enhance 2-Step Floating Catchment Area (E2SFCA) method, modified as per local context. Data were secondary sourced from Population and Housing Census data and administrative datasets pertaining to health facilities and road network. The spatial pattern of the E2SFCA scores were depicted using Hot spot Analysis. Hierarchical multiple linear regression and geographical weight regression were performed to identify factors that affect E2SFCA scores. Hot spot areas revolved near the urban agglomeration, largely contributed by the private sector. Distance to urban areas, road density, population density dependency ratios and ethnic composition were among the associated factors. Accurate conceptualization and comprehensive assessment of accessibility are crucial for evidence-based decision making by the policymakers and health authorities in identifying areas that need attention for a more specific and localized planning and development.

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Section: Methodsmentioning

confidence: 99%

Spatial Accessibility of Primary Care in the Dual Public–Private Health System in Rural Areas, Malaysia

Hamid

Juni

Manaf

et al. 2023

IJERPH

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“…Although many professional organisations and societies recommend limiting or avoiding NSAIDs in high-risk patients, potentially harmful prescribing and OTC use persist at undesirable rates 15–18. This scoping review identified 68 studies describing healthcare-based interventions to de-implement potentially harmful NSAIDs published between 1 January 2000 and 31 May 2022.…”

Section: Discussionmentioning

confidence: 99%

“…Despite numerous long-standing recommendations, potentially harmful NSAIDs prescribing and OTC use persists globally 15–18. As an example, multiple studies show that up to 30% of patients with chronic kidney disease are prescribed long-term NSAIDs 19 20.…”

Section: Introductionmentioning

confidence: 99%

Scoping review of interventions to de-implement potentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) in healthcare settings

Rockwell,

Oyese,

Singh

et al. 2024

BMJ Open

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ObjectivesPotentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) utilisation persists at undesirable rates worldwide. The purpose of this paper is to review the literature on interventions to de-implement potentially harmful NSAIDs in healthcare settings and to suggest directions for future research.DesignScoping review.Data sourcesPubMed, CINAHL, Embase, Cochrane Central and Google Scholar (1 January 2000 to 31 May 2022).Study selectionStudies reporting on the effectiveness of interventions to systematically reduce potentially harmful NSAID utilisation in healthcare settings.Data extractionUsing Covidence systematic review software, we extracted study and intervention characteristics, including the effectiveness of interventions in reducing NSAID utilisation.ResultsFrom 7818 articles initially identified, 68 were included in the review. Most studies took place in European countries (45.6%) or the USA (35.3%), with randomised controlled trial as the most common design (55.9%). Interventions were largely clinician-facing (76.2%) and delivered in primary care (60.2%) but were rarely (14.9%) guided by an implementation model, framework or theory. Academic detailing, clinical decision support or electronic medical record interventions, performance reports and pharmacist review were frequent approaches employed. NSAID use was most commonly classified as potentially harmful based on patients’ age (55.8%), history of gastrointestinal disorders (47.1%), or history of kidney disease (38.2%). Only 7.4% of interventions focused on over-the-counter (OTC) NSAIDs in addition to prescription. The majority of studies (76.2%) reported a reduction in the utilisation of potentially harmful NSAIDs. Few studies (5.9%) evaluated pain or quality of life following NSAIDs discontinuation.ConclusionMany varied interventions to de-implement potentially harmful NSAIDs have been applied in healthcare settings worldwide. Based on these findings and identified knowledge gaps, further efforts to comprehensively evaluate the effectiveness of interventions and the combination of intervention characteristics associated with effective de-implementation are needed. In addition, future work should be guided by de-implementation theory, focus on OTC NSAIDs and incorporate patient-focused strategies and outcomes, including the evaluation of unintended consequences of the intervention.

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“…While data submission for public facilities can be made compulsory by a top-down administrative circulars, there is no regulatory mechanism for mandatory data submission by private healthcare facilities. However, some limited data on private healthcare facilities are available through ad hoc primary care and hospital surveys ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

Non-communicable Disease Surveillance in Malaysia: An Overview of Existing Systems and Priorities Going Forward

Chandran

Kumar

Hairi

et al. 2021

Front. Public Health

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In 2012, the World Health Organization (WHO) set a comprehensive set of nine global voluntary targets, including the landmark “25 by 25” mortality reduction target, and 25 indicators. WHO has also highlighted the importance of Non-Communicable Disease (NCD) surveillance as a key action by Member States in addressing NCDs. This study aimed to examine the current national NCD surveillance tools, activities and performance in Malaysia based on the WHO Global Monitoring Framework for NCDs and to highlight gaps and priorities moving forward. A desk review was conducted from August to October in 2020, to examine the current national NCD surveillance activities in Malaysia from multiple sources. Policy and program documents relating to NCD surveillance in Malaysia from 2010 to 2020 were identified and analyzed. The findings of this review are presented according to the three major themes of the Global Monitoring Framework: monitoring of exposure/risk factor, monitoring of outcomes and health system capacity/response. Currently, there is a robust monitoring system for NCD Surveillance in Malaysia for indicators that are monitored by the WHO NCD Global Monitoring Framework, particularly for outcome and exposure monitoring. However, Malaysia still lacks data for the surveillance of the health system indicators of the framework. Although Malaysia has an NCD surveillance in place that is adequate for the WHO NCD Global Monitoring Framework, there are areas that require strengthening. The country must also look beyond these set of indicators in view of the increasing burden and impact of the COVID-19 pandemic. This includes incorporating mental health indicators and leveraging on alternate sources of data relating to behaviors.

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High-risk nonsteroidal anti-inflammatory drugs prescribing in primary care: results from National Medical Care Survey Malaysia

Cited by 7 publications

References 29 publications

Spatial Accessibility of Primary Care in the Dual Public–Private Health System in Rural Areas, Malaysia

Spatial Accessibility of Primary Care in the Dual Public–Private Health System in Rural Areas, Malaysia

Scoping review of interventions to de-implement potentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) in healthcare settings

Non-communicable Disease Surveillance in Malaysia: An Overview of Existing Systems and Priorities Going Forward

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