7 research outputs found
Development and novel therapeutics in hepatocellular carcinoma: a review
No full textPravinkumar Vishwanath Ingle, Sarah Zakiah Samsudin, Pei Qi Chan, Mei Kei Ng, Li Xuan Heng, Siu Ching Yap, Amy Siaw Hui Chai, Audrey San Ying WongDepartment of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, MalaysiaAbstract: This review summarizes the epidemiological trend, risk factors, prevention strategies such as vaccination, staging, current novel therapeutics, including the drugs under clinical trials, and future therapeutic trends for hepatocellular carcinoma (HCC). As HCC is the third most common cause of cancer-related death worldwide, its overall incidence remains alarmingly high in the developing world and is steadily rising across most of the developed and developing world. Over the past 15 years, the incidence of HCC has more than doubled and it increases with advancing age. Chronic infection with hepatitis B virus is the leading cause of HCC, closely followed by infection with hepatitis C virus. Other factors contributing to the development of HCC include alcohol abuse, tobacco smoking, and metabolic syndrome (including obesity, diabetes, and fatty liver disease). Treatment options have improved in the past few years, particularly with the approval of several molecular-targeted therapies. The researchers are actively pursuing novel therapeutic targets as well as predictive biomarker for treatment of HCC. Advances are being made in understanding the mechanisms underlying HCC, which in turn could lead to novel therapeutics. Nevertheless, there are many emerging agents still under clinical trials and yet to show promising results. Hence, future therapeutic options may include different combination of novel therapeutic interventions.Keywords: hepatocellular carcinoma, HCC, novel therapeutics, treatment, management, molecular targeted therapies, clinical drug tria
Relationship between Treatment Burden, Health Literacy, and Medication Adherence in Older Adults Coping with Multiple Chronic Conditions
No full textA prospective study was conducted to investigate the impact of treatment burden and health literacy on medication adherence among older adults with multiple chronic conditions (MCC) and to explore the potential moderating effects of demographic and clinical factors. Face-to-face structured interviews were conducted among older adults aged 60 and above using the Burden of Treatment Questionnaire (TBQ-15), Short Form Health Literacy Questionnaire (HLS-SF12), and Malaysia Medication Adherence Assessment Tool (MyMAAT). This study included 346 older adults aged 60 years and above with two or more chronic conditions (n = 346). Hypertension (30.2%), hyperlipidemia (24.0%), and diabetes (18.0%) were the most reported chronic conditions among participants. The mean score of treatment burden was 53.4 (SD = 28.2), indicating an acceptable burden of treatment. The mean score of health literacy was 16.4 (SD = 12.6), indicating a limited health literacy level among participants; meanwhile, the mean score of medication adherence was 32.6 (SD = 12.3), indicating medication non-adherence among participants. Medication adherence was significantly correlated with treatment burden (r = −0.22, p p p p < 0.05). The study findings emphasize that multimorbid older adults with high treatment burdens and low health literacy are more likely to have poor medication adherence. This underscores the importance for clinicians to address these factors in order to improve medication adherence among older adults with multiple chronic conditions (MCC)
Assessment of non-steroidal anti-inflammatory drugs use and its complications among pediatric patients at a private tertiary care hospital in Malaysia
No full textAbstract Background Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to pediatric patients, but inappropriate use can lead to adverse health outcomes. Therefore, a study was conducted to analyse the prescribing patterns and drug-related problems (DRPs) associated with NSAIDs among pediatric patients at a private tertiary care hospital in Malaysia. Methods This single-centre, ambidirectional cohort study was conducted at a private tertiary care hospital in Kuala Lumpur, Malaysia, from January 2024 to March 2025. Pediatric patients under 18 years old who were prescribed NSAIDs were included in the study. Data was collected from the patient’s prescriptions and clinical progress notes. Results A total of 1958 pediatric prescriptions were analysed. The mean age of patients prescribed NSAIDs was 8.26 ± 5.08 years (Median: 8 years, IQR: 8.75). Of the 1958 patient visits, 882 (45.05%) were to pediatricians, and 803 (41.01%) were to the emergency department. A total of 2072 NSAIDs were prescribed, with the majority (94.48%; p < 0.001) of prescriptions containing only one NSAID. The most common reason for prescribing NSAIDs was pain (63.18%). Ibuprofen was the most commonly prescribed NSAID for both male and female patients (n = 1216, 58.94%), followed by Diclofenac (n = 270, 12.75%) and Celecoxib (n = 218, 10.57%). Age was significantly associated with the type of NSAID prescribed (p < 0.001). A total of 405 potential DRPs were identified. Ibuprofen had the highest number of potential DRPs (n = 193, p < 0.001) due to its high usage, followed by Diclofenac (n = 142) and Celecoxib (n = 16). Conclusion Ibuprofen was the most commonly prescribed NSAID for pediatric patients, primarily for painful inflammatory conditions, leading to an increase in drug-related complications. While the prescribing pattern of NSAIDs appears appropriate, there is a rising trend in drug-related complications. Structured educational intervention programmes are needed to improve the prescribing pattern of NSAIDs in healthcare settings and ensure the safety of pediatric patients
Table_2_Effectiveness of educational intervention in improving medication adherence among patients with diabetes in Klang Valley, Malaysia.docx
No full textBackgroundThe diabetes patients’ adherence to prescription medication is 67.5%, which is lower than that of patients with any other medical conditions. Patients with low medication adherence are more likely to experience clinical complications, repeated hospitalizations, increased mortality, and increased healthcare costs, hence, education on disease and medication adherence is vital now. This study aimed to assess the level of medication adherence, medicine and information-seeking behaviour, and the effectiveness of online educational intervention in improving medication adherence and medicine and information-seeking behaviours among patients with diabetes in Klang Valley, Malaysia.MethodsIndividuals aged 12 years and above with a prior diagnosis of diabetes were identified and randomly divided into (control (n=183), and intervention groups (n = 206). Data about their medication adherence and information-seeking behaviour were obtained. As part of the online educational intervention, a month of daily general reminders to take their medications and educational materials about diabetes had provided to them via WhatsApp groups. After a month, the groups were reassessed, and the data were compared.ResultsThe results showed that, at baseline, most of the respondents in the control (58.8% females and 53.08% males) and intervention (65.52% females and 85.12% males) groups had a low level of medication adherence. After a month of intervention, medication adherence was significantly improved in the intervention group (91.4% females and 71.28% males) compared to the control group (38.23% females and 44.44% males). At baseline, only 96 (52.45%) respondents in the control group and 110 (52.38%) in the intervention group preferred to read online educational materials to know more about their condition(s), it was improved after a month of intervention in the intervention group where 204 (99.02%) respondents prefer online materials, however no change in the control group response.ConclusionThe study concludes that medication adherence and information-seeking behaviours among the study population have been significantly improved after a month of structured intervention. Medication adherence plays a crucial role in risk reduction strategies subsequently it improves the patient’s quality of life. Thus, well-planned more robust educational interventions on chronic diseases are warranted to improve the health outcomes of the patients.</p
Table_1_Effectiveness of educational intervention in improving medication adherence among patients with diabetes in Klang Valley, Malaysia.docx
No full textBackgroundThe diabetes patients’ adherence to prescription medication is 67.5%, which is lower than that of patients with any other medical conditions. Patients with low medication adherence are more likely to experience clinical complications, repeated hospitalizations, increased mortality, and increased healthcare costs, hence, education on disease and medication adherence is vital now. This study aimed to assess the level of medication adherence, medicine and information-seeking behaviour, and the effectiveness of online educational intervention in improving medication adherence and medicine and information-seeking behaviours among patients with diabetes in Klang Valley, Malaysia.MethodsIndividuals aged 12 years and above with a prior diagnosis of diabetes were identified and randomly divided into (control (n=183), and intervention groups (n = 206). Data about their medication adherence and information-seeking behaviour were obtained. As part of the online educational intervention, a month of daily general reminders to take their medications and educational materials about diabetes had provided to them via WhatsApp groups. After a month, the groups were reassessed, and the data were compared.ResultsThe results showed that, at baseline, most of the respondents in the control (58.8% females and 53.08% males) and intervention (65.52% females and 85.12% males) groups had a low level of medication adherence. After a month of intervention, medication adherence was significantly improved in the intervention group (91.4% females and 71.28% males) compared to the control group (38.23% females and 44.44% males). At baseline, only 96 (52.45%) respondents in the control group and 110 (52.38%) in the intervention group preferred to read online educational materials to know more about their condition(s), it was improved after a month of intervention in the intervention group where 204 (99.02%) respondents prefer online materials, however no change in the control group response.ConclusionThe study concludes that medication adherence and information-seeking behaviours among the study population have been significantly improved after a month of structured intervention. Medication adherence plays a crucial role in risk reduction strategies subsequently it improves the patient’s quality of life. Thus, well-planned more robust educational interventions on chronic diseases are warranted to improve the health outcomes of the patients.</p
Probiotics for the prevention of antibiotic-associated diarrhea – an umbrella review of meta-analyses of randomized controlled trials
No full textIntroduction and aim. Antibiotic therapies induce diarrhea by disrupting the intestinal microbiota, prompting research into probiotics to prevent antibiotic-associated diarrhea (AAD). The aim of this study was to systematically identify and summarize meta-analyses of randomized controlled trials (RCT) on probiotics for AAD prevention.
Material and methods. Databases including PubMed, EMBASE, Epistemonikos, and the Cochrane Database were searched up to December 11, 2023. Systematic reviews and meta-analyses of RCTs on probiotics for AAD prevention in any age group were included. Meta-analyses were re-performed to calculate pooled risk ratios (RR) with 95% confidence intervals (CI). Evidence quality was assessed using GRADE criteria.
Analysis of the literature. The review included 16 articles with 39 unique meta-analyses. Probiotics reduced AAD risk across various groups: adults (RR 0.47, 95% CI 0.40–0.56), all ages (RR 0.58, 95% CI 0.50–0.68), and outpatients (RR 0.49, 95% CI 0.36 0.66) with a moderate level of evidence. For the use of any probiotics in pediatrics, the initial high-quality evidence (RR 0.48, 95% CI 0.44–0.63) was downgraded to moderate after a sensitivity analysis excluding small studies.
Conclusion. Probiotics are beneficial in preventing AAD, but evidence quality varies from low to moderate. High-quality trials are needed to identify the most effective probiotic species and strains, dosages, and target patient populations
Treatment Strategies and Challenges in the Co-Management of Type 2 Diabetes and Tuberculosis
No full textDespite rapid advances in the healthcare field, diabetes mellitus (DM) and tuberculosis (TB) continues to be a global burden that affects millions of people every year. The association between DM and TB has been known for an extended period. The last 15 years, however, have seen an increased number of studies showing that diabetes (both type 1 and type 2) increases the risk of tuberculosis because of impaired immune defences and likewise, TB may induce hyperglycemia and therefore increase the risk of DM. When DM and TB co-exist as dual diseases, it complicates management strategies as treatment outcomes are affected. In developing countries where the epidemic of DM and TB is rapidly growing, the presence of a concomitant disease becomes a challenge to the affected nation and could also impact DM and TB control on a global scale. This review brings together information on what is currently known about T2DM and TB as a double epidemic, the recommended treatment strategies, and the challenges involved in disease management. Furthermore, we address the future perspectives of the co-management of T2DM and TB and what can be done to overcome the shortcomings of currently available guidelines
