risk factors - Malaysian Journal of Pharmacy (MJP)

Cost-Effectiveness Analysis of a Behavioral Risk Factor Reduction Program at a Worksite: Experience From a Public University in Malaysia

by Siow Yen Liau, Asrul A Shafie, Mohamed Azmi A Hassali and Mohamed Izham Mohamed Ibrahim.

Vol. 1 No. 11 (2014): Malaysian Journal of Pharmacy / Published: October 1, 2014

Abstract

Objectives: The objectives of this study were to determine the cost of a behavioral risk factor reduction program at the worksite and to compare the cost-effectiveness of the program with a control group. Methodology: This was a quasi-experimental study conducted among employees of Universiti Sains Malaysia. The program targeted five primary risk factors (RF). Participants in the intervention program were subjected to schedule individualized counseling and seminars during the 6- month follow-up. Participants in the control group underwent health screening. Cost-effectiveness analysis was conducted from the payer’s perspective to determine the cost of 1% increase in proportion of participants who reach ideal targets for the RF. One-way sensitivity analysis was also conducted. Results: A total 136 participants were recruited in this study. At 6-month follow-up, significantly higher proportion of participants in the intervention group reached target for fruit and vegetable intake (P < 0.001) and physical activity (P = 0.017). The costs of the intervention program and control group were estimated to be MYR304.52 (USD92.28) and MYR169.90 (USD51.48) per participant respectively. The incremental cost-effectiveness ratio (ICER) of all the RF were lower than the World Health Organization recommendation based on the CHOICE analyses for relative cost-effectiveness of an intervention. Body mass index and alcohol consumption reported negative ICER which indicated control dominant. Sensitivity analyses showed that ICER was reported to be most sensitive to the change in participants’ salary. Conclusion: The proposed health promotion program was shown to be cost-effective in modifying most of the behavioral RF.

Calculated 10 Years Risk of CHD: Primary Preventive Measures in Medical Ward PPUKM (University Kebangsaan Malaysia Medical Centre)

DOI: 10.52494/RRJX5324

by Semira Abdi Beshir and Rosnani Hashim.

Vol. 1 No. 9 (2011): Malaysian Journal of Pharmacy / Published: October 1, 2011

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Abstract

Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally. Identification of common risk factors and risk stratification helps to prioritize primary preventive measures and hence can reduce this epidemic. This retrospective cross sectional study was carried out to assess the primary preventive measures according to 10 years CHD risk stratification. One hundred thirty (67 female and 63 female) middle aged (40-65 years) patients admitted to PPUKM’s medical ward with no prior diagnosis of CHD were selected. Patient diagnosed with diabetes or hypertension related to pregnancy was excluded. The patients’ medical record and order management system (OMS) were screened to obtain relevant demographic information, medical and medication history and related laboratory results. The Joint British Societies CHD risk prediction chart was used to calculate the 10 years CHD risk. Gender specific differences of 10 years calculated CHD risk, baseline measure of BP, cholesterol, weight, BMI, HbA1C level and number of patients who received primary preventive measures were used as outcome measures. Results showed that male patients had a significantly higher 10 years CHD risk than female (P < 0.05). Hypertension was the most prevalent risk factor followed by diabetes and dyslipidemia. About10% (n=6) of hypertensive patients with SBP≥160 mmHg and 32 (37%) diabetic patients did not receive antihypertensive therapy and lipid lowering therapy respectively. Hence, there is a need for further improvement in primary preventive measures for CHD.