The original version of the International Patient Decision Aid Standards (IPDAS) recommended that patient decision aids (PtDAs) should be carefully developed, user-tested and open to scrutiny, with a well-documented and systematically applied development process. We carried out a review to check the relevance and scope of this quality dimension and, if necessary, to update it.

Background. Non-attendance is common in primary care and previous studies have reported that reminders were useful in reducing broken appointments. Objective. To determine the effectiveness of a text messaging reminder in improving attendance in primary care. Design. Multicentre three-arm randomized controlled trial. Setting. Seven primary care clinics in Malaysia. Participants. Patients (or their caregivers) who required follow-up at the clinics between 48 hours and 3 months from the recruitment date. Interventions. Two intervention arms consisted of text messaging and mobile phone reminders 24–48 hours prior to scheduled appointments. Control group did not receive any intervention. Outcome measures. Attendance rates and costs of interventions. Results. A total of 993 participants were eligible for analysis. Attendance rates of control, text messaging and mobile phone reminder groups were 48.1, 59.0 and 59.6%, respectively. The attendance rate of the text messaging reminder group was significantly higher compared with that of the control group (odds ratio 1.59, 95% confidence interval 1.17 to 2.17, P = 0.005). There was no statistically significant difference in attendance rates between text messaging and mobile phone reminder groups. The cost of text messaging reminder (RM 0.45 per attendance) was lower than mobile phone reminder (RM 0.82 per attendance). Conclusions. Text messaging reminder system was effective in improving attendance rate in primary care. It was more cost-effective compared with the mobile phone reminder.

Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness.

Background: Self-monitoring of blood glucose (SMBG) helps to improve glycemic control and empowerment of people with diabetes. It is particularly useful for people with diabetes who are using insulin as it facilitates insulin titration and detection of hypoglycemia. Despite this, the uptake of SMBG remains low in many countries, including Malaysia. Purpose: This study aimed to explore the barriers and facilitators to SMBG, in people with type 2 diabetes using insulin. Patients and methods: Qualitative methodology was employed to explore participants’ experience with SMBG. Semistructured, individual in-depth interviews were conducted on people with type 2 diabetes using insulin who had practiced SMBG, in the primary care clinic of a teaching hospital in Malaysia. Participants were purposively sampled from different age groups, ethnicity, education level, and level of glycemic control (as reflected by the glycated hemoglobin [HbA_1c]), to achieve maximum variation in sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked, and analyzed using a thematic approach. Results: A total of 15 participants were interviewed, and thematic saturation was reached. The factors that influenced SMBG were mainly related to cost, participants' emotion, and the SMBG process. The barriers identified included: frustration related to high blood glucose reading; perception that SMBG was only for insulin titration; stigma; fear of needles and pain; cost of test strips and needles; inconvenience; unconducive workplace; and lack of motivation, knowledge, and self-efficacy. The facilitators were: experiencing hypoglycemic symptoms; desire to see the effects of dietary changes; desire to please the physician; and family motivation. Conclusion: Participants’ perceptions of the purpose of SMBG, the emotions associated with SMBG, and the complexity, pain, and cost related to SMBG as well as personal and family motivation are the key factors that health care providers must consider when advising people with diabetes on SMBG.

Men have poorer health status and are less likely to attend health screening compared to women. This systematic review presents current evidence on the barriers and facilitators to engaging men in health screening. We included qualitative, quantitative and mixed-method studies identified through five electronic databases, contact with experts and reference mining. Two researchers selected and appraised the studies independently. Data extraction and synthesis were conducted using the 'best fit' framework synthesis method. 53 qualitative, 44 quantitative and 6 mixed-method studies were included. Factors influencing health screening uptake in men can be categorized into five domains: individual, social, health system, healthcare professional and screening procedure. The most commonly reported barriers are fear of getting the disease and low risk perception; for facilitators, they are perceived risk and benefits of screening. Male-dominant barriers include heterosexual -self-presentation, avoidance of femininity and lack of time. The partner's role is the most common male-dominant facilitator to screening. This systematic review provides a comprehensive overview of barriers and facilitators to health screening in men including the male-dominant factors. The findings are particularly useful for clinicians, researchers and policy makers who are developing interventions and policies to increase screening uptake in men.

Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus. The prevalence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment. This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012), contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles. We selected randomised controlled trials (RCTs) and quasi‐RCTs comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis. Two review authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author. Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as 'supportive therapy' versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic. There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high‐quality, double‐blinded RCTs to determine whether antibiotics should be used in this common postpartum condition. Antibióticos para mastite em lactantes A mastite pode ser causada por erros de posicionamento do bebê no seio materno ou amamentação restrita. A mastite infecciosa é geralmente causada pelo Staphylococcus aureus. Até 33 % das lactantes podem ter mastite. O tratamento habitual da mastite se baseia no esvaziamento do leite, analgésicos e antibióticos. O objetivo desta revisão foi avaliar a efetividade da antibioticoterapia no alívio dos sintomas de lactantes com mastite, com ou sem confirmação laboratorial do diagnóstico. Fizemos buscas na base de dados eletrônica no Cochrane Pregnancy and Childbirth Group Trials Register (em 30 de Setembro de 2012). Entramos em contato com pesquisadores e outros especialistas da área, buscando identificar estudos não publicados. A busca foi complementada pela análise das listas de referências bibliográficas dos artigos encontrados. Foram incluídos nesta revisão apenas ensaios clínicos controlados e randomizados (ECR) ou quasi ‐randomizados que compararam a efetividade de diversos esquemas de antibioticoterapia para o tratamento da mastite ou que compararam antibioticoterapia versus outros tipos de tratamento. Dois revisores avaliaram de forma independente a qualidade dos estudos e extraíram os dados. Um terceiro revisor foi consultado em caso de discordância entre os dois revisores. Dois estudos preencheram os critérios de inclusão. Um estudo com pequena casuística (n = 25) comparou Amoxacilina com Cefradina e não encontrou diferença significante entre esses dois antibióticos para o alívio dos sintomas ou na formação de abscessos. Outro estudo mais antigo, comparou o uso exclusivo do esvaziamento mamário versus antibioticoterapia mais esvaziamento, versus nenhum tratamento. Segundo esse estudo, a duração dos sintomas foi menor nas mulheres que receberam antibióticos; porém esse estudo teve falhas no seu desenho. As evidências são insuficientes para avaliar a efetividade da antibioticoterapia no tratamento da mastite puerperal. São necessários mais ensaios clínicos randomizados duplo‐cego e de boa qualidade antes que possam ser feitas recomendações quanto à prescrição, ou não, de antibióticos para o tratamento da mastite puerperal.