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Ramdzan SN, Khoo EM, Cunningham S, Hussein N, Ramli R, Senawi SA, Sukri N, Nathan JJ, Kassim A, Ahad AM, Pinnock H. Qualitative research influencing guideline and policy: An exemplar of the development of a national school asthma guideline in Malaysia. J Glob Health 2024; 14:03027. [PMID: 38751315 PMCID: PMC11096774 DOI: 10.7189/jogh.14.03027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Affiliation(s)
- Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Steve Cunningham
- NIHR Global Health Research Unit of Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, UK
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Rizawati Ramli
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Siti Aishah Senawi
- Sektor Pengurusan Pembelajaran, Bahagian Pengurusan Sekolah Harian, Ministry of Education, Putrajaya, Malaysia
| | - Nursyuhada Sukri
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Asiah Kassim
- Paediatric Department, Hospital Tunku Azizah Kuala Lumpur, Malaysia
| | | | - Hilary Pinnock
- NIHR Global Health Research Unit of Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, UK
| | - RESPIRE collaborators
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- NIHR Global Health Research Unit of Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, UK
- Sektor Pengurusan Pembelajaran, Bahagian Pengurusan Sekolah Harian, Ministry of Education, Putrajaya, Malaysia
- Paediatric Department, Hospital Tunku Azizah Kuala Lumpur, Malaysia
- Port Dickson Health Clinic, Ministry of Health, Malaysia
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Hussein N, Ng CW, Ramli R, Liew SM, Hanafi NS, Lee PY, Cheong AT, Ghazali SS, Pinnock H, Stoddart A, Schwarze J, Khoo EM. Assessing catastrophic health expenditure and impoverishment in adult asthma care: a cross-sectional study of patients attending six public health clinics in Klang District, Malaysia. BMC Health Serv Res 2024; 24:327. [PMID: 38475801 DOI: 10.1186/s12913-024-10731-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND In Malaysia, asthma is a common chronic respiratory illness. Poor asthma control may increase out-of-pocket payment for asthma care, leading to financial hardships Malaysia provides Universal Health Coverage for the population with low user fees in the public health system to reduce financial hardship. We aimed to determine out-of-pocket expenditure on outpatient care for adult patients with asthma visiting government-funded public health clinics. We examined the catastrophic impact and medical impoverishment of these expenses on patients and households in Klang District, Malaysia. METHODS This is a cross-sectional face-to-face questionnaire survey carried out in six government-funded public health clinics in Klang District, Malaysia. We collected demographic, socio-economic profile, and outpatient asthma-related out-of-pocket payments from 1003 adult patients between July 2019 and January 2020. Incidence of catastrophic health expenditure was estimated as the proportion of patients whose monthly out-of-pocket payments exceeded 10% of their monthly household income. Incidence of poverty was calculated as the proportion of patients whose monthly household income fell below the poverty line stratified for the population of the Klang District. The incidence of medical impoverishment was estimated by the change in the incidence of poverty after out-of-pocket payments were deducted from household income. Predictors of catastrophic health expenditure were determined using multivariate regression analysis. RESULTS We found the majority (80%) of the public health clinic attendees were from low-income groups, with 41.6% of households living below the poverty line. About two-thirds of the attendees reported personal savings as the main source of health payment. The cost of transportation and complementary-alternative medicine for asthma were the main costs incurred. The incidences of catastrophic expenditure and impoverishment were 1.69% and 0.34% respectively. The only significant predictor of catastrophic health expenditure was household income. Patients in the higher income quintiles (Q2, Q3, Q4) had lower odds of catastrophic risk than the lowest quintile (Q1). Age, gender, ethnicity, and poor asthma control were not significant predictors. CONCLUSION The public health system in Malaysia provides financial risk protection for adult patients with asthma. Although patients benefited from the heavily subsidised public health services, this study highlighted those in the lowest income quintile still experienced financial catastrophe and impoverishment, and the risk of financial catastrophe was significantly greater in this group. It is crucial to ensure health equity and protect patients of low socio-economic groups from financial hardship.
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Affiliation(s)
- Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Chiu Wan Ng
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Rizawati Ramli
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Ping Yein Lee
- UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
| | - Hilary Pinnock
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Andrew Stoddart
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Jürgen Schwarze
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, Usher Institute, The University of Edinburgh, Edinburgh, UK
- Child Life and Health, Centre for Inflammation Research, The University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
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Lee B, Kwon CY, Kim YJ, Kim JH, Kim KI, Lee BJ, Lee JH. Research status of east Asian traditional medicine treatment for chronic cough: A scoping review. PLoS One 2024; 19:e0296898. [PMID: 38330020 PMCID: PMC10852285 DOI: 10.1371/journal.pone.0296898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/13/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND When patients continue to experience cough despite conventional treatment, East Asian traditional medicine (EATM) including herbal medicine and/or acupuncture has been frequently used. Previous systematic reviews of EATM treatment for chronic cough have been conducted mainly on herbal medicine, targeting patients with conditions that cause cough. In clinical practice, EATM interventions are not limited to herbal medicine, and considering that chronic cough is often caused by two or more conditions or unspecific causes, a comprehensive investigation is clinically relevant. We examined the current research status of EATM for chronic cough. METHODS Based on Arksey and O'Malley's scoping review methodological framework, a total of six English, Chinese, Korean, and Japanese electronic databases were searched on August 2022. Any clinical studies on EATM targeting chronic cough patients (regardless of their cause) were included. RESULTS Among 474 included studies, the study designs were mainly randomized controlled trials (72.4%), and the population was evenly distributed between children and adults. The cause of cough was not reported in most studies (56.1%). The common cause of cough was upper airway cough syndrome and post-respiratory infection (9.5%, each), followed by mixed cause (7.6%), nonspecific cause (5.9%), and gastroesophageal reflux disease (4.0%). EATM was conducted for a mean of 19.1 days, and herbal medicine was the most common (80.6%). Conventional medication was frequently used as a control (81.2%). For outcomes, the total effective rate was the most frequently utilized (94.3%), followed by cough severity (53.8%). EATM treatment showed positive outcomes in most studies. CONCLUSIONS In future EATM studies, it is necessary to either specify the cause of chronic cough or to report that the study was targeting nonspecific chronic cough. In addition, high-quality studies assessing the efficacy of EATM with placebo control treatment should be conducted, using validated evaluation tools.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, South Korea
| | - Ye Ji Kim
- Department of Korean Pediatrics, Kyung Hee University Medical Center, Seoul, South Korea
| | - Jae Hyun Kim
- Department of Korean Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Kwan-Il Kim
- Department of Internal Medicine, Division of Allergy, Immune and Respiratory System, College of Korean Medicine, Kyung Hee Medical Center, Kyung Hee University, Seoul, South Korea
| | - Beom-Joon Lee
- Department of Internal Medicine, Division of Allergy, Immune and Respiratory System, College of Korean Medicine, Kyung Hee Medical Center, Kyung Hee University, Seoul, South Korea
| | - Jun-Hwan Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Department of Korean Convergence Medical Science, KIOM School, University of Science & Technology (UST), Daejeon, South Korea
- Department of Radiology, Athinoula A. Martinos Center for Biomedical imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
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So WL, Chong TK, Lee IHT, So MTW, Liu AMY, Leung STC, Ching W, Yip HY, Shaw PC, Hui JHL. Cytochrome oxidase I DNA barcodes of crocodilians meat selling in Hong Kong. Sci Data 2024; 11:46. [PMID: 38184675 PMCID: PMC10771468 DOI: 10.1038/s41597-023-02889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024] Open
Abstract
The crocodilians include true crocodiles, alligators, caimans, and gharial, and the trade of crocodilian products is regulated in accordance with the Convention of Wild Fauna and Flora (CITES). Hong Kong does not have her own wild crocodilians; thus, all crocodilians meat available is presumably imported with proper license. Here, we obtained a dataset of cytochrome oxidase I (COI) gene markers of 114 crocodilian meat samples (including frozen and dried crocodilian meat products) available in the contemporary market. We have also validated these barcodes in a phylogenetic approach with other data deposited on the GenBank, and detected 112 samples belonging to four crocodile species Crocodylus siamensis, C. porosus, C. niloticus and Alligator mississippiensis, and 2 samples belonging to snake Malayopython reticulatus. The dataset generated in this study will be useful for further studies including meat inspection, illegal trading, and enhancement of international and local legislations on illegal reptile importation.
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Affiliation(s)
- Wai Lok So
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tze Kiu Chong
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ivy Hoi Ting Lee
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Miu Tsz Wai So
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Avis Mang Yi Liu
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sam Tsz Chung Leung
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wai Ching
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ho Yin Yip
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Pang Chui Shaw
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Dak Sum Yip Yio Chin R&D Centre for Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jerome Ho Lam Hui
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Simon F.S. Li Marine Science Laboratory, Institute of Environment, Energy and Sustainability, State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Li Dak Sum Yip Yio Chin R&D Centre for Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Wardani RS, Schellack N, Govender T, Dhulap AN, Utami P, Malve V, Wong YC. Treatment of the common cold with herbs used in Ayurveda and Jamu: monograph review and the science of ginger, liquorice, turmeric and peppermint. Drugs Context 2023; 12:2023-2-12. [PMID: 37342461 PMCID: PMC10278442 DOI: 10.7573/dic.2023-2-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/25/2023] [Indexed: 06/23/2023] Open
Abstract
Background The common cold is typically managed with decongestants, antihistamines, antitussives and antipyretics. In addition to these established medications, herbal ingredients have been used over centuries to help treat common cold symptoms. The Ayurveda and Jamu systems of medicine, originating from India and Indonesia, respectively, have leveraged herbal therapies to treat many illnesses. Method An expert roundtable discussion comprising specialists in Ayurveda, Jamu, pharmacology and surgery along with a literature review was conducted to evaluate the use of four herbs - ginger, liquorice, turmeric and peppermint - for common cold symptom management in Ayurvedic texts, Jamu publications and monographs from the World Health Organization, Health Canada and various European guidelines. Discussion Due to a lack of antivirals, common cold management revolves around maintaining personal hygiene and symptom management. Herbal medicines have been an integral part of many cultures worldwide. Despite its growing acceptance, there is a perception that healthcare providers lack interest and may prevent patients from discussing the use of herbal medicines. Limited education and training may also widen the communication gap between patients and healthcare providers, hindering effective management. Conclusion Evaluation of scientific evidence and the standing in international monographs can offer perspectives on the use of herbal medicines for common cold management.
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Affiliation(s)
- Retno S Wardani
- Otorhinolaryngology Head and Neck Surgery Department, Academic Health System Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Natalie Schellack
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | | | | | - Vinod Malve
- Procter & Gamble Health Limited, Mumbai, India
| | - Yong Chiat Wong
- Personal Health Care, Procter & Gamble International Operations SA Singapore Branch, Singapore
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Hussein N, Liew SM, Hanafi NS, Lee PY, Cheong AT, Ghazali SS, Chinna K, Pang YK, Kassim A, Parker RA, Schwarze J, Sheikh A, Pinnock H, Khoo EM. Asthma control and care among six public health clinic attenders in Malaysia: A cross-sectional study. Health Sci Rep 2023; 6:e1021. [PMID: 37152232 PMCID: PMC10154831 DOI: 10.1002/hsr2.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 05/09/2023] Open
Abstract
Background and Aims Asthma is common in Malaysia but neglected. Achieving optimal asthma control and care is a challenge in the primary care setting. In this study, we aimed to identify the risk factors for poor asthma control and pattern of care among adults and children (5-17 years old) with asthma attending six public health clinics in Klang District, Malaysia. Methods We conducted a cross-sectional study collecting patients' sociodemographic characteristics, asthma control, trigger factors, healthcare use, asthma treatment, and monitoring and use of asthma action plan. Descriptive statistics and stepwise logistic regression were used in data analysis. Results A total of 1280 patients were recruited; 85.3% adults and 14.7% children aged 5-17 years old. Only 34.1% of adults had well-controlled asthma, 36.5% had partly controlled asthma, and 29.4% had uncontrolled asthma. In children, 54.3% had well-controlled asthma, 31.9% had partly controlled, and 13.8% had uncontrolled asthma. More than half had experienced one or more exacerbations in the last 1 year, with a mean of six exacerbations in adults and three in children. Main triggers for poor control in adults were haze (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.13-2.01); cold food (OR 1.54; 95% CI 1.15-2.07), extreme emotion (OR 1.90; 95% CI 1.26-2.89); air-conditioning (OR 1.63; 95% CI 1.20-2.22); and physical activity (OR 2.85; 95% CI 2.13-3.82). In children, hot weather (OR 3.14; 95% CI 1.22-8.11), and allergic rhinitis (OR 2.57; 95% CI 1.13-5.82) contributed to poor control. The majority (81.7% of adults and 64.4% of children) were prescribed controller medications, but only 42.4% and 29.8% of the respective groups were compliant with the treatment. The importance of an asthma action plan was reported less emphasized in asthma education. Conclusion Asthma control remains suboptimal. Several triggers, compliance to controller medications, and asthma action plan use require attention during asthma reviews for better asthma outcomes.
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Affiliation(s)
- Norita Hussein
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Ping Yein Lee
- UM eHealth Unit, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health SciencesUniversiti Putra MalaysiaSeri KembanganMalaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health SciencesUniversiti Putra MalaysiaSeri KembanganMalaysia
| | - Karuthan Chinna
- Faculty of Business and ManagementUCSI UniversityKuala LumpurMalaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Asiah Kassim
- Kuala Lumpur Women and Children Hospital, Ministry of HealthKuala LumpurMalaysia
| | - Richard A. Parker
- Edinburgh Clinical Trials Unit, Usher InstituteThe University of EdinburghEdinburghUK
| | - Jürgen Schwarze
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteThe University of EdinburghEdinburghUK
- Child Life and Health, Centre for Inflammation ResearchThe University of EdinburghEdinburghUK
| | - Aziz Sheikh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteThe University of EdinburghEdinburghUK
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteThe University of EdinburghEdinburghUK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
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Lee B, Park HJ, Jung SY, Kwon OJ, Park YC, Yang C. Herbal Medicine Maekmundong-Tang on Patients with Nonspecific Chronic Cough: Study Protocol for a Double-Blind, Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4164. [PMID: 36901170 PMCID: PMC10002217 DOI: 10.3390/ijerph20054164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
As the treatment of nonspecific chronic cough with conventional medications that treat cough according to the cause is limited, Maekmundong-tang (comprising Liriopis seu Ophiopogonis Tuber, Pinelliae Tuber, Oryzae Semen, Zizyphi Fructus, Ginseng Radix, and Glycyrrhizae Radix et Rhizoma) has been used empirically in the clinical setting of East Asian traditional medicine. This study is the first to explore the feasibility, preliminary effect, safety, and cost-effectiveness of Maekmundong-tang for nonspecific chronic cough. This study protocol is that of a double-blind, randomized, active-controlled, parallel-group clinical trial for comparing Maekmundong-tang with Saengmaek-san (comprising Liriopis seu Ophiopogonis Tuber, Ginseng Radix, and Schisandrae Fructus), a Korean national health insurance-covered herbal medicine for cough. A total of 30 nonspecific chronic cough patients will participate and receive the assigned herbal medicine for 6 weeks, and clinical parameters will be assessed at weeks 0 (baseline), 3 (midterm assessment), 6 (primary endpoint), 9, and 24 (follow-up). Study feasibility outcomes, including recruitment, adherence, and completion rates, will be assessed. Preliminary effects on cough severity, frequency, and quality of life will be evaluated using outcome measures, such as the Cough Symptom Score, Cough Visual Analog Scale, and the Leicester Cough Questionnaire. Adverse events and laboratory tests will be monitored for safety evaluation, and exploratory economic evaluations will be conducted. The results will provide evidence of Maekmundong-tang in the treatment of nonspecific chronic cough.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Hyo-Ju Park
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - So-Young Jung
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - O-Jin Kwon
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Yang-Chun Park
- Division of Respiratory Medicine, Department of Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon 34520, Republic of Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
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Kassa E, Kebede RA, Habte BM. Perceptions towards childhood asthma and barriers to its management among patients, caregivers and healthcare providers: a qualitative study from Ethiopia. BMC Pulm Med 2022; 22:184. [PMID: 35527248 PMCID: PMC9080199 DOI: 10.1186/s12890-022-01984-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/05/2022] [Indexed: 11/27/2022] Open
Abstract
Background The management of asthma, which is one of the major causes of childhood morbidity and mortality has been affected by non-adherence to recommended treatment regimens with severe consequences. The aim of the present study was therefore to explore the perceptions of the children with asthma, their caregivers and their healthcare providers towards asthma and barriers to long term childhood asthma management in an institutional setting in Addis Ababa, Ethiopia. Methods A qualitative descriptive design was followed for the present study that used individual interviews as a data collection method. The study participants were 23 pairs of children with asthma that had treatment follow-ups in two tertiary hospitals and their caregivers and eight healthcare providers who cared for these children. The data was analyzed using thematic analysis approach. Results The study findings revealed that the children’s reported adherence to the recommended treatment regimens was low and they along with their caregivers were facing physical, emotional and social burdens related to asthma. Some of the influencing factors affecting childhood asthma management were found to be the low-level implementation of the asthma management guidelines by the healthcare providers, limited awareness about asthma and its management by the children and their caregivers, use of traditional home remedies and religious healing on a complementary and alternative basis and inadequate education received from healthcare professionals. Further identified barriers to the adherence of especially inhaled corticosteroids appear to be the low necessity beliefs towards chronic administration of treatment regimens and concerns related with difficulty of administration, fear of side effects and general negative attitude towards it, in addition to their low availability and affordability. Conclusions Low awareness of the biomedical treatment regimens and use of traditional home remedies and religious healing by the children with asthma and their caregivers, the low-level implementation of the asthma management guidelines as well as low access to medications may among other things contribute to the low adherence of the children to their recommended regimens. The findings support the need for implementation of asthma management guidelines, institution of strong asthma care and education programs that are sensitive to local and individual patients’ and caregiver perceptions and experiences including emotional distress, the need to institute chronic care approach and ways to address patients’ medication access issues. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01984-2.
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Alzayer R, Almansour HA, Basheti I, Chaar B, Al Aloola N, Saini B. Asthma patients in Saudi Arabia - preferences, health beliefs and experiences that shape asthma management. ETHNICITY & HEALTH 2022; 27:877-893. [PMID: 32931314 DOI: 10.1080/13557858.2020.1817868] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
UNLABELLED Objectives: The aim of this study was to explore the experience of Saudi participants in managing their asthma and their perspectives about using future pharmacy-based services for asthma management. METHODS Semi-structured interviews were conducted with adult Saudis with asthma or those who were a carer of a child with asthma. Participants were recruited from medical practices and community centres in Riyadh, Saudi Arabia. Verbatim transcribed interviews were inductively analysed using thematic analysis. RESULTS Twenty-three Saudi participants with asthma or caring for those with asthma took part in interviews which lasted on average for 25 min. Most participants did not have well-controlled asthma. Thematic analyses of the interview transcripts highlighted four key emergent themes: participants experience of asthma, participants' beliefs and perceptions about health and medicines, perception of health professionals and advocacy and social support. Many participants expressed an emotional burden in their lived experience of asthma. Lack of self-management skills were evident in participants' reluctance to make decisions in emergency situations. Some participants had strong beliefs about using herbal medicines rather than western medicines. Using social media or consulting with their family members with asthma was a common preference, rather than consulting healthcare professionals. Participants' were rather unclear about pharmacy asthma care services and reported not having experienced such services in their pharmacies. CONCLUSION Inadequate self-management behaviours may affect the level of asthma control in people with asthma in Saudi Arabia. Improved primary care models with extensive focus on asthma education are needed to relieve the over-reliance on tertiary care help-seeking models that are currently the norm. Current evidence-based information also needs to be prepared in patient friendly formats and disseminated widely. Community pharmacists would need to be trained and skilled inpatient engagement and would have to win the public trust for viable asthma services provision.
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Affiliation(s)
- Reem Alzayer
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Hadi A Almansour
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Iman Basheti
- Vice President and Dean of the Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Betty Chaar
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Noha Al Aloola
- College of Pharmacy, Clinical Pharmacy Department, King Saud University, Riyadh, Saudi Arabia
| | - Bandana Saini
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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Ramdzan SN, Khoo EM, Liew SM, Cunningham S, Pinnock H. Stakeholders' views of supporting asthma management in schools with a school-based asthma programme for primary school children: a qualitative study in Malaysia. BMJ Open 2022; 12:e052058. [PMID: 35131821 PMCID: PMC8823135 DOI: 10.1136/bmjopen-2021-052058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The WHO Global School Health Initiative aimed to improve child and community health through health promotion programmes in schools, though most focus on preventing communicable disease. Despite WHO recommendations, no asthma programme is included in the Malaysian national school health service guideline. Therefore, we aimed to explore the views of school staff, healthcare professionals and policy-makers about the challenges of managing asthma in schools and the potential of a school asthma programme for primary school children. DESIGN A focus group and individual interview qualitative study using purposive sampling of participants to obtain diverse views. Data collection was guided by piloted semistructured topic guides. The focus groups and interviews were audiorecorded, transcribed verbatim and analysed using inductive thematic analysis. We completed data collection once data saturation was reached. SETTING Stakeholders in education and health sectors in Malaysia. PARTICIPANTS Fifty-two participants (40 school staff, 9 healthcare professionals and 3 policy-makers) contributed to nine focus groups and eleven individual interviews. RESULTS School staff had limited awareness of asthma and what to do in emergencies. There was no guidance on asthma management in government schools, and teachers were unclear about their role in school children's health. These uncertainties led to delays in the treatment of asthma symptoms/attacks, and suggestions that an asthma education programme and a school plan would improve asthma care. Perceived challenges in conducting school health programmes included a busy school schedule and poor parental participation. A tailored asthma programme in partnerships with schools could facilitate the programme's adoption and implementation. CONCLUSIONS Identifying and addressing issues and challenges specific to the school and wider community could facilitate the delivery of a school asthma programme in line with the WHO School Health Initiative. Clarity over national policy on the roles and responsibilities of school staff could support implementation and guide appropriate and prompt response to asthma emergencies in schools.
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Affiliation(s)
- Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Steve Cunningham
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
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Abstract
Asthma is a chronic airway inflammatory disease that results from a complex interplay of genetic, environmental, and lifestyle factors. There is no cure for asthma, and the management is usually as per published guidelines. As in many chronic diseases conditions, various alternative or complimentary therapies have been tried. Of these, yoga and pranayama have gained wider attention in recent years. While the term yoga is a complex term encompassing eight limbs as per Patamjai in the yoga sutras, in simple terms, yoga is described as a combination of 'asana' (physical exercises) and 'pranayama' (breathing exercise). The term "asthma" has been derived from the Greek word "panting,", which indicates a rapid and shallow breathing. The main aim of yoga and pranayama in asthma is to synchronize and control breathing, thus decreasing hyperventilation. Besides this, they also decrease the stress/strain/anxiety, change in behavior, boost immunity, and improve strength/endurance of respiratory muscles that are helpful in any subject with asthma. There have been a good number of studies including clinical trials in children with asthma that have found some beneficial effects. In the present review, the physiology of yoga and pranayama, rationale for their use in children with asthma along with a summary of various studies conducted till date, have been discussed. These are followed by recommendations regarding their incorporation in the standard of care of children with asthma.
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Shayo GA, Omary A, Mugusi F. Inhaler Non-Adherence, Associated Factors and Asthma Control among Asthma Patients in a Tertiary Level Hospital in Tanzania. East Afr Health Res J 2022; 6:78-85. [PMID: 36424951 PMCID: PMC9639640 DOI: 10.24248/eahrj.v6i1.682] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 06/29/2022] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Inhaled medications including corticosteroids are the most effective long-term controller medicines for asthma-related chronic airway inflammation. Despite this fact, 30% to 70% of the uncontrolled asthma patients report non-adherence to their inhalers. This study investigated factors affecting inhaler non-adherence among outpatient asthma patients in Muhimbili National Hospital, Dar es Salaam Tanzania and related the level of inhaler adherence to the extent of asthma control. METHODS A cross-sectional hospital-based study was conducted among patients with bronchial asthma in the pulmonology clinic of Muhimbili National Hospital in Dar-es-salaam, Tanzania. Patients' demographic, clinical and socio-economic factors were collected using a structured questionnaire. Medication adherence was self-reported using a 10-item Test of Adherence to Inhalers (TAI) questionnaire. Adherence was gauged as good when the score was 50, intermediate (score 46-49) or poor (score ≤ 45). Asthma control was assessed using a 5-question Asthma Control Test (ACT). A score of ≥20 meant well controlled asthma while a score of ≤19 meant poorly controlled asthma. Patients' inhaler use technique was assessed using a 10-step checklist. Patient's technique was regarded correct when all the steps were performed correctly. Categorical data were summarised as proportions. Binary logistic regression was performed to identify factors associated with inhaler non-adherence. Significance level was set at p-value less than .05. RESULTS A total of 385 asthma patients were enrolled in the study. Females were 206 (53.5%), 232(60.3%) were non-adherent to medications and 283(73.5%) had poorly controlled asthma. Lack of health insurance, fear of medication side effects, being too busy, having alternative medication for asthma and incorrect inhaler technique were significantly associated with non-adherence to inhalers, all p-values <.05. CONCLUSION The magnitude of inhaler non-adherence and poorly controlled asthma were very high. Promoting adherence through patients' education on asthma and its management, emphasis on patients' insurance coverage and setting aside time to care for ones' self are fundamental in optimising asthma care and treatment.
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Affiliation(s)
- Grace A. Shayo
- Pulmonology section of the Department of internal medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam Tanzania
| | - Amina Omary
- Pulmonology section of the Department of internal medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam Tanzania
| | - Ferdinand Mugusi
- Pulmonology section of the Department of internal medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam Tanzania
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Koh WM, Abu Bakar AI, Hussein N, Pinnock H, Liew SM, Hanafi NS, Pang YK, Ho BK, Mohamed Isa S, Sheikh A, Khoo EM. Sociocultural influences on asthma self-management in a multicultural society: A qualitative study amongst Malaysian adults. Health Expect 2021; 24:2078-2086. [PMID: 34449970 PMCID: PMC8628588 DOI: 10.1111/hex.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Supported self-management improves asthma outcomes, but implementation requires adaptation to the local context. Barriers reported in Western cultures may not resonate in other cultural contexts. We explored the views, experiences and beliefs that influenced self-management among adults with asthma in multicultural Malaysia. METHODS Adults with asthma were purposively recruited from an urban primary healthcare clinic for in-depth interviews. Audio-recordings were transcribed verbatim and analysed thematically. RESULTS We interviewed 24 adults. Four themes emerged: (1) Participants believed in the 'hot and cold' concept of illness either as an inherent hot/cold body constitution or the ambient temperature. Hence, participants tried to 'neutralize' body constitution or to 'warm up' the cold temperature that was believed to trigger acute attacks. (2) Participants managed asthma based on past experiences and personal health beliefs as they lacked formal information about asthma and its treatment. (3) Poor communication and variable advice from healthcare practitioners on how to manage their asthma contributed to poor self-management skills. (4) Embarrassment about using inhalers in public and advice from family and friends resulted in a focus on nonpharmacological approaches to asthma self-management practice. CONCLUSIONS Asthma self-management practices were learnt experientially and were strongly influenced by sociocultural beliefs and advice from family and friends. Effective self-management needs to be tailored to cultural norms, personalized to the individuals' preferences and clinical needs, adapted to their level of health literacy and underpinned by patient-practitioner partnerships. PATIENT AND PUBLIC CONTRIBUTIONS Patients contributed to data. Members of the public were involved in the discussion of the results.
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Affiliation(s)
- Wen Ming Koh
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
- Rawang Health ClinicMinistry of Health of MalaysiaMalaysia
| | - Ahmad Ihsan Abu Bakar
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteUniversity of EdinburghEdinburghUK
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Bee Kiau Ho
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | | | - Aziz Sheikh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteUniversity of EdinburghEdinburghUK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
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Ma J, Liu MX, Chen LC, Shen JJ, Kuo ML. Ding Chuan Tang Attenuates Airway Inflammation and Eosinophil Infiltration in Ovalbumin-Sensitized Asthmatic Mice. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6692772. [PMID: 34595240 PMCID: PMC8478538 DOI: 10.1155/2021/6692772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 09/05/2021] [Indexed: 12/12/2022]
Abstract
Asthma is a T helper 2 (Th2) cell-associated chronic inflammatory diseases characterized with airway obstruction, increased mucus production, and eosinophil infiltration. Conventional medications for asthma treatment cannot fully control the symptoms, and potential side effects are also the concerns. Thus, complement or alternative medicine (CAM) became a new option for asthma management. Ding Chuan Tang (DCT) is a traditional Chinese herbal decoction applied mainly for patients with coughing, wheezing, chest tightness, and asthma. Previously, DCT has been proved to improve children airway hyperresponsiveness (AHR) in a randomized and double-blind clinical trial. However, the mechanisms of how DCT alleviates AHR remain unclear. Since asthmatic features such as eosinophil infiltration, IgE production, and mucus accumulation are relative with Th2 responses, we hypothesized that DCT may attenuate asthma symptoms through regulating Th2 cells. Ovalbumin (OVA) was used as a stimulant to sensitize BALB/c mice to establish an asthmatic model. AHR was detected one day before sacrifice. BALF and serum were collected for immune cell counting and antibody analysis. Splenocytes were cultured with OVA in order to determine Th2 cytokine production. Lung tissues were collected for histological and gene expression analyses. Our data reveal that DCT can attenuate AHR and eosinophil accumulation in the 30-day sensitization asthmatic model. Histological results demonstrated that DCT can reduce cell infiltration and mucus production in peribronchial and perivascular site. In OVA-stimulated splenocyte cultures, a significant reduction of IL-5 and IL-13 in DCT-treated mice suggests that DCT may alleviate Th2 responses. In conclusion, the current study demonstrates that DCT has the potential to suppress allergic responses through the reduction of mucus production, eosinophil infiltration, and Th2 activity in asthma.
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Affiliation(s)
- Jason Ma
- Department of Microbiology and Immunology, Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Xun Liu
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Chen Chen
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Pediatrics, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
| | - Jiann-Jong Shen
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Ling Kuo
- Department of Microbiology and Immunology, Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Pediatrics, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
- Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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15
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Singh A, Dixit S. A study on the motivation of Indian patients to consult complementary and alternative medicine practitioners to treat coronary artery disease. Int J Health Plann Manage 2020; 36:423-441. [PMID: 33197088 DOI: 10.1002/hpm.3091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/15/2020] [Accepted: 11/01/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In India, the use of traditional medicine for health problems is a part of the cultural discourse on treatment, but the introduction of Western medicines has adversely affected their popularity. However, with the rapid spread of chronic diseases like coronary artery disease (CAD), many Indians are reverting to complementary and alternative medicine (CAM) treatments. Although previous literature has identified several motivational factors underlying CAM usage, we know little from the perspective of its practitioners. AIM The aim of the present study was to investigate the motivations behind the use of CAM treatments among Indian patients with CAD. METHOD Using semi-structured interviews, we collected data from 15 CAM practitioners and 14 CAD patients utilising CAM treatments alongside conventional biomedical (BM) treatment. We used the Clarke and Braun (2006) method of thematic analysis. RESULT AND CONCLUSION Our findings suggest that the use of CAM treatments depends on various factors working at multiple levels viz., personal factors, disease' characteristics, perceived treatment characteristics (positive attributes of CAM and negative attributes of BM) and external facilitators. Furthermore, our analysis also identifies the role of two underlining forces-push and pull-in motivating CAD patients to choose CAM treatments. The push force comprises factors that participants found to have a repelling nature, whereas pull forces were regarded as advantageous for CAM usage. Although some reasons behind the usage of CAM treatments according to patients and practitioners were overlapping, both groups also provided many distinct insights into the studied health behaviour.
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Affiliation(s)
- Arti Singh
- Department of Humanities and Social Science, Indian Institute of Technology, Kanpur, India
| | - Shikha Dixit
- Department of Humanities and Social Science, Indian Institute of Technology, Kanpur, India
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Sukri N, Ramdzan SN, Liew SM, Salim H, Khoo EM. Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study. NPJ Prim Care Respir Med 2020; 30:26. [PMID: 32513948 PMCID: PMC7280185 DOI: 10.1038/s41533-020-0185-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 05/07/2020] [Indexed: 11/12/2022] Open
Abstract
Children with poor asthma control have poor health outcomes. In Malaysia, the Malays have the highest asthma prevalence and poorest control compared to other ethnicities. We aimed to explore Malay children with asthma and their parents' perceptions on asthma and its control. We conducted focus group discussions (FGD) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Sixteen children and parents (N = 32) participated. The perception of asthma was based on personal experience, cultural and religious beliefs, and there was mismatch between children and parents. Parents perceived mild symptoms as normal, some had poor practices, raising safety concerns as children were dependent on them for self-management. Conflicting religious opinions on inhaler use during Ramadhan caused confusion in practice. Parents perceived a lack of system support towards asthma care and asthma affected quality of life. Urgent intervention is needed to address misconceptions to improve asthma care in children.
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Affiliation(s)
- Nursyuhada Sukri
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hani Salim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Ong JJ. Parental satisfaction and perception of Progress in influencing the Practice of complementary health approaches in children with autism: a cross sectional survey from Negeri Sembilan, Malaysia. Altern Ther Health Med 2019; 19:250. [PMID: 31500611 PMCID: PMC6734321 DOI: 10.1186/s12906-019-2672-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 09/03/2019] [Indexed: 11/10/2022]
Abstract
Background Parents’ use of complementary health approaches (CHA) for children with autism spectrum disorder (ASD) are common despite the uncertain evidence of its benefit. Parents often adopt CHA due to dissatisfaction with conventional treatment. This study aimed to examine parents’ satisfaction with ASD treatment and their perception of progress in their child’s development. Parents’ use of CHA among children with ASD and the factors related were also evaluated. Methods Self-administered questionnaires were completed by 48 parents of children with ASD at a single tertiary referral hospital in Malaysia. Correlation analysis was used to explore associations between parental satisfaction scores, perception of progress scores and use of CHA. Results Use of CHA was reported by parents for 35.4% of children with ASD in the sample. Parents who were less satisfied with conventional treatment and parents who perceived poorer progress in their child’s development were more likely to use CHA. Strong positive relationship was found between parent satisfaction with ASD treatment scores and parent perception of progress scores, which indicates that parents who were satisfied with treatment were more likely to perceive greater progress in their child’s development. Improvement in child’s progress was most appreciated by parents in their child’s behavior (85.5%), social skills (83.3%) and motor skills (77.1%). Conclusion The use of CHA was common among children with ASD. Parents were more likely to practice CHA when they were less satisfied with conventional treatment and perceived poorer progress. A larger multicenter study is required to further explore the practice of CHA among children with ASD throughout Malaysia.
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Affiliation(s)
- Jun Jean Ong
- Pediatric Department, Clinical Campus Seremban, International Medical University (IMU), Jalan Rasah, 70300 Seremban, Seri Menanti, Negeri Sembilan, Malaysia.
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