Practice of dietary supplements and its influence towards treatment adherence among chronic disease patients

Introduction The use of dietary supplements had risen over the years among chronic disease patients with most of it were of patients' own initiative. This study aimed to describe the supplements use, assess the knowledge and attitude towards supplements and its interaction with prescribed medication, and determine whether knowledge and attitude towards supplements could influence treatment adherence in chronic disease patients. Methods A cross-sectional study was conducted among chronic disease patients in Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur from September to November 2016 upon their written informed consent. This study consists of a collection of validated instruments that measured the use of dietary supplements and its reason; the knowledge and attitude on dietary supplements and supplements-drug interaction and medication adherence. Results A total number of 250 respondents were interviewed and 72.4% was found to use supplements of own initiatives. Most of the respondents were using supplements to maintain health (78.8%), prevent health problems (72.4%) and improve overall health (63.2%). It was found that respondents' knowledge on supplement-drug interactions were not at the satisfactory level. The treatment adherence was found not to be associated with knowledge and attitude towards supplements nor numbers of supplements use. Conclusions Chronic disease patients mainly knew on the purpose of supplements for health and wellness, but had less knowledge on supplement-drug interactions, warranting patients' education on that particular field

Healthy ageing conceptualisations: older Malays in Malaysia

Population ageing is a worldwide phenomenon. Promoting healthy ageing is now firmly in the policy agenda of many countries.This thesis aimed to explore healthy ageing conceptualisations among older Malays in Malaysia. The thesis addresses two broad questions: What factors are important in conceptualising healthy ageing from the perspective of older Malays and how are the factors being expressed? What are the barriers to and facilitators of healthy ageing in the community studied? This thesis comprises two consecutive studies. Study 1 involves focus group interviews to explore healthy ageing conceptualisations and facilitators of and barriers to the healthy ageing experience in older Malays. To further explore these issues, Study 2 examines six case studies, selected from Study 1 on the basis of a quantitative screening tool that identified participants as healthy and unhealthy agers. Study 2 focussed on the role of spirituality in healthy ageing. The cases were used to construct individual perspectives of healthy ageing using data from a structured interview and open ended qualitative responses, focus group interviews (Study 1), observation and reflections of the interaction with the participants throughout the study period. Eight focus groups consisted of 38 older Malays aged 60 to 95 years participated in Study 1. In Study 2, six cases were selected via maximal variation sampling. Six interconnected themes captured the healthy ageing concepts in Study 1. Firstly, spirituality was the driving force followed by peace of mind as the ultimate aim for healthy ageing. Physical health and function, family relationships, financial independence, and living environment greatly affected the lives of older Malays in this study. The six themes were used as a framework to address facilitators of and barriers to healthy ageing in Study 2, in particular the role of spirituality in healthy ageing. The older individuals have their own perception of their healthy ageing status and healthy ageing was seen as a process in balancing the facilitators and barriers to it. In Study 2, the sprirituality was mainly experienced as connectedness to God (intrinsic spirituality) and as mutual responsibility in their relationship with others (extrinsic spirituality). The role of spirituality was not limited as a facilitator for healthy ageing; unfulfilled intrinsic and/or extrinsic spirituality can be barriers to healthy ageing. More importantly, Study 2 identified the need to listen to the perspectives of older people to address healthy ageing in a bio-psycho-social-spiritual framework. Based on the thesis findings a model of healthy ageing was developed: the Dynamic Adaptation, Prioritisation and Transcendent Acceptance (aDAPTA) model. Older people used the processes outlined in the model in balancing the barriers and facilitators to achieving healthy ageing. In conclusion, the different cultural values explored in this thesis provided an avenue to expand healthy ageing concepts and make them relevant to the local context in Malaysia. Healthy ageing should not be restricted to a biomedical or a psychological model, the lay multidimensional bio-psycho-social-spiritual approach should be considered, particularly in addressing the needs and the adaptation experiences of older people in the local community

Healthy ageing conceptualisations: older Malays in Malaysia

Population ageing is a worldwide phenomenon. Promoting healthy ageing is now firmly in the policy agenda of many countries.This thesis aimed to explore healthy ageing conceptualisations among older Malays in Malaysia. The thesis addresses two broad questions: What factors are important in conceptualising healthy ageing from the perspective of older Malays and how are the factors being expressed? What are the barriers to and facilitators of healthy ageing in the community studied? This thesis comprises two consecutive studies. Study 1 involves focus group interviews to explore healthy ageing conceptualisations and facilitators of and barriers to the healthy ageing experience in older Malays. To further explore these issues, Study 2 examines six case studies, selected from Study 1 on the basis of a quantitative screening tool that identified participants as healthy and unhealthy agers. Study 2 focussed on the role of spirituality in healthy ageing. The cases were used to construct individual perspectives of healthy ageing using data from a structured interview and open ended qualitative responses, focus group interviews (Study 1), observation and reflections of the interaction with the participants throughout the study period. Eight focus groups consisted of 38 older Malays aged 60 to 95 years participated in Study 1. In Study 2, six cases were selected via maximal variation sampling. Six interconnected themes captured the healthy ageing concepts in Study 1. Firstly, spirituality was the driving force followed by peace of mind as the ultimate aim for healthy ageing. Physical health and function, family relationships, financial independence, and living environment greatly affected the lives of older Malays in this study. The six themes were used as a framework to address facilitators of and barriers to healthy ageing in Study 2, in particular the role of spirituality in healthy ageing. The older individuals have their own perception of their healthy ageing status and healthy ageing was seen as a process in balancing the facilitators and barriers to it. In Study 2, the sprirituality was mainly experienced as connectedness to God (intrinsic spirituality) and as mutual responsibility in their relationship with others (extrinsic spirituality). The role of spirituality was not limited as a facilitator for healthy ageing; unfulfilled intrinsic and/or extrinsic spirituality can be barriers to healthy ageing. More importantly, Study 2 identified the need to listen to the perspectives of older people to address healthy ageing in a bio-psycho-social-spiritual framework. Based on the thesis findings a model of healthy ageing was developed: the Dynamic Adaptation, Prioritisation and Transcendent Acceptance (aDAPTA) model. Older people used the processes outlined in the model in balancing the barriers and facilitators to achieving healthy ageing. In conclusion, the different cultural values explored in this thesis provided an avenue to expand healthy ageing concepts and make them relevant to the local context in Malaysia. Healthy ageing should not be restricted to a biomedical or a psychological model, the lay multidimensional bio-psycho-social-spiritual approach should be considered, particularly in addressing the needs and the adaptation experiences of older people in the local community

Efficacy and Sustainability of Diabetes-Specific Meal Replacement on Obese and Overweight Type-2 Diabetes Mellitus Patients: Study Approaches for a Randomised Controlled Trial and Impact of COVID-19 on Trial Progress

Meal replacement (MR) is widely used in weight and diabetes management programs due to its ease of compliance and handling. However, little is known about its impact on outcomes other than glycaemic control and weight loss. Furthermore, not many studies evaluate its cost-effectiveness and sustainability. This study aimed to evaluate the efficacy of a diabetes-specific MR for the weight reduction and glycaemic controls of overweight and obese T2DM patients, as compared to routine dietary consultation. Other health outcomes, the cost effectiveness, and the sustainability of the MR will also be evaluated. Materials and Methods: This randomised controlled clinical trial will involve 156 participants who have been randomised equally into the intervention and control groups. As a baseline, both groups will receive diet consultation. Additionally, the intervention group will receive an MR to replace one meal for 5 days a week. The duration of intervention will be 12 weeks, with 36 weeks of follow-up to monitor the sustainability of the MR. The primary endpoints are weight and Hemoglobin A1c (HbA1c) reduction, while the secondary endpoints are anthropometry, biochemical measurements, satiety, hormone changes, quality of life, and cost-effectiveness. The impact of the COVID-19 pandemic on study design is also discussed in this paper. This study has obtained human ethics approval from RECUKM (JEP-2019-566) and is registered at the Thai Clinical Trials Registry (TCTR ID: TCTR20210921004)

Telephone intervention to reduce burden and improve quality of life among dementia caregivers: a bibliometric analysis from 2017 to 2022

Background and Aims: Caring for a person suffering with dementia is a major public health challenge as it contributes to psychiatric and physical illness among the caregivers. The number of people living with dementia is estimated to rise to 115.4 million by 2050. This bibliometric analysis was aim to explore the trend of telephone intervention among family carers of community dwelling people living with dementia during the past five years. Methods: Using the keywords “dementia”, “carers”, and “telephone”, we retrieved publications discussing on telephone-intervention among dementia caregivers appearing in the PubMed/MEDLINE from 2017 to 2022. Results: The total number of 199 publications that discussed on telephone-intervention in analysing the burdens of dementia caregivers increased three-fold in the last five years, with Australia, China and the USA being the top three countries with the highest publications, suggesting that these countries have made many scientific contributions to this field of research. Most telephone-delivered intervention were conducted in high income countries, but only a few in middle and low income countries, such as Malaysia. Retrieved articles were published mostly in journals with impact factors ranging between 3.0 to 4.0, mainly the BMC Geriatrics, Aging & Mental Health and BMJ Open, that specialize in mental health and healthcare of older people. Over the five-year period, quality of life was consistently one of the most frequent terms discussed for this research field. Other top rankings were anxiety, neuropsychiatric symptoms, social support, dementia care, and covid-19. Conclusion: Dementia research has grown markedly in the past years, not only on the patient but the caregivers as well. The impact factor of journals and strong collaborations between highlydeveloped countries support that the quality of published research has improved. While quality of life was a consistently dominant research focus, other topics gained much attention during this time period too. These findings provide a framework for analysing the current status caregivers of person with dementia (PWD) quality of life research and establishing a complete approach for furthering the subject

Clinical profile of the study respondents (N = 200).

Clinical profile of the study respondents (N = 200).</p

The Mean Score of Mindful Eating and its’ subdomains (N = 200).

The Mean Score of Mindful Eating and its’ subdomains (N = 200).</p

Association of the level of mindful eating with sociodemographic characteristics and clinical profiles (N = 200).

Association of the level of mindful eating with sociodemographic characteristics and clinical profiles (N = 200).</p

Prevalence of obesity and its associated risk factors among the elderly in Malaysia: Findings from The National Health and Morbidity Survey (NHMS) 2015

Background: Obesity is a crucial public health problem and is rising globally. This study was conducted to determine the prevalence of obesity and its associated factors among the elderly in Malaysia. Methods: Data were obtained from the National Health and Morbidity Survey (NHMS) 2015. This was a cross sectional population-based study using a two stage stratified random sampling design. Elderly population aged 60 years and above was selected. Data were collected using pre-tested self-administered questionnaire in the form of sociodemographic profile, non-communicable diseases (NCD) comorbidities (status on hypertension, diabetes and hypercholesterolemia) and NCD risk factors (current smoker and physical activity). Obesity has been defined using the World Health Organization (WHO) Body Mass Index (BMI) guideline, 1998. A complex sampling design analysis was used for the descriptive statistics. The associated risk factors for obesity were identified using Multiple Logistic Regression analysis. Results: A total of 3794 respondents were included in this study. The prevalence of obesity among Malaysian elderly was 30.2%. The prevalence of obesity among the elderly was significantly higher in females, respondents from urban areas and Indians. Approximately one third of the elderly with non-communicable diseases such as hypertension (33.1%) and diabetes (38.8%), respectively, were obese. Among elderly who were obese, majority of them (89.8%) had at least one NCD. The prevalence of obesity was 16.8% among current smokers (aOR 0.59). Multiple logistic regression analysis revealed that elderly females (aOR [adjusted odds ratio] 1.52), having secondary education (aOR 1.96) with household income of RM 3000 and above (aOR 1.57) as well as being hypertensive (aOR 1.61) and diabetic (aOR 1.50) were more likely to be obese. In contrast, the Chinese elderly respondents (aOR 0.62) and current smokers (aOR 0.59) were less likely to be obese. There were no significant associations of obesity with hypercholesterolemia or with physical activity. Conclusions: A substantial proportion of Malaysian elderly were obese, and factors associated with obesity among them were being female, having secondary education with a household income of RM 3000 and above and being hypertensive or diabetic. Enhanced health promotion and education should be targeted at younger people in order to prevent obesity in the later years

Sociodemographic characteristics of the study respondents (N = 200).

Sociodemographic characteristics of the study respondents (N = 200).</p