Publications
540 results found
Xu X, Van Galen LS, Bajpai R, et al., 2020, Factors Influencing Family Burden of Paediatric Patients with Atopic Dermatitis: A Cross-sectional Study, ACTA DERMATO-VENEREOLOGICA, Vol: 100, ISSN: 0001-5555
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- Citations: 2
Mahirah D, Sauter C, Thuan-Quoc T, et al., 2020, Factors associated with health-related quality of life in a working population in Singapore, EPIDEMIOLOGY AND HEALTH, Vol: 42, ISSN: 2092-7193
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- Citations: 4
Posadzki P, Bala MM, Kyaw BM, et al., 2020, Offline Digital Education for Postregistration Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (vol 21, e12968, 2019), JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 22, ISSN: 1438-8871
Foo CD, Surendran S, Tam CH, et al., 2020, Perceived facilitators and barriers to chronic disease management in primary care networks: a qualitative study
<jats:title>Abstract</jats:title> <jats:p>BackgroundThe increasing chronic disease burden in developed countries has placed tremendous strain on tertiary healthcare infrastructure and resources. Therefore, there is an urgent need to shift chronic disease management from tertiary to primary care providers to mitigate the increase in demand for chronic care at hospitals. The organization of private general practitioners (GPs) into Primary Care Networks (PCNs) is a pragmatic move by Singapore, a developed and multi-ethnic urban city, to provide private GPs with team-based care capabilities and a platform to track care indicators for better management of chronic patients. As the PCN initiative is still in its embryonic stages, there is a void in research regarding its ability to empower private GPs to manage chronic patients effectively. This qualitative study aims to explore the facilitators and barriers for the management of chronic patients by private GPs in the PCN.Method:We conducted 30 semi-structured in-depth interviews with GPs enrolled in a PCN. Qualitative analysis of audio transcripts was performed to extract themes which highlighted the facilitators and barriers faced by PCN in the early stages of its development.ResultsOur results suggest that PCNs facilitated private GPs to more effectively manage chronic patients through 1) provision of ancillary services such as diabetic foot screening, diabetic retinal photography and nurse counselling to permit a “one-stop-shop”, 2) systematic monitoring of process and clinical outcome indicators through a chronic disease registry (CDR) to promote accountability for patients’ health outcomes and 3) funding streams for PCNs to hire additional manpower to oversee operations and to reimburse GPs for extended consultations. Barriers include high administrative load in maintaining the CDR due to the lack of a smart electronic clinic management system and financial gradient faced by
Lo ZJ, Lim X, Eng D, et al., 2020, Clinical and economic burden of wound care in the tropics: a 5-year institutional population health review, International Wound Journal, Vol: 17, Pages: 790-803, ISSN: 1742-4801
The aim of this study is to evaluate the clinical and economic burden of wound care in the Tropics via a 5-year institutional population health review. Within our data analysis, wounds are broadly classified into neuro-ischaemic ulcers (NIUs), venous leg ulcers (VLUs), pressure injuries (PIs), and surgical site infections (SSIs). Between 2013 and 2017, there were a total of 56 583 wound-related inpatient admissions for 41 461 patients, with a 95.1% increase in wound episodes per 1000 inpatient admissions over this period (142 and 277 wound episodes per 1000 inpatient admissions in 2013 and 2017, respectively). In 2017, the average length of stay for each wound episode was 17.7 days, which was 2.4 times that of an average acute admission at our institution. The average gross charge per wound episode was USD $12 967. Among the 12 218 patients with 16 674 wound episodes in 2017, 71.5% were more than 65 years of age with an average Charlson Comorbidity Index (CCI) of 7.2. Half (51.9%) were moderately or severely frail, while 41.3% had two or more wound-related admission episodes. In 2017, within our healthcare cluster, the gross healthcare costs for all inpatient wound episodes stand at USD $216 million within hospital care and USD $596 000 within primary care. Most NIU patients (97.2%) had diabetes and they had the most comorbidities (average CCI 8.4) and were the frailest group of patients (44.9% severely frail). The majority of the VLU disease burden was at the specialist outpatient setting, with the average 1-year VLU recurrence rate at 52.5% and median time between healing and recurrence at 9.5 months. PI patients were the oldest (86.5% more than 65 years-old), constituted the largest cohort of patients with 3874 patients at an incidence of 64.6 per 1000 admissions in 2017, and have a 1-year all-cause mortality rate of 14.3%. For SSI patients, there was a 125% increase of 14.2 SSI wound episodes per 100
Soriano JB, Kendrick PJ, Paulson KR, et al., 2020, Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017, The Lancet Respiratory Medicine, Vol: 8, Pages: 585-596, ISSN: 2213-2600
BackgroundPrevious attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017.MethodsUsing data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs.FindingsIn 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–
Bajpai R, Chaturvedi HK, Car J, 2020, How varying CD4 criteria for treatment initiation was associated with mortality of HIV-patients? A retrospective analysis of electronic health records from Andhra Pradesh, India, JOURNAL OF GLOBAL HEALTH, Vol: 10, ISSN: 2047-2978
Dunleavy G, Bajpai R, Tonon AC, et al., 2020, Prevalence of psychological distress and its association with perceived indoor environmental quality and workplace factors in under and aboveground workplaces, BUILDING AND ENVIRONMENT, Vol: 175, ISSN: 0360-1323
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- Citations: 12
Posadzki P, Bala MM, Kyaw BM, et al., 2020, Correction: Offline Digital Education for Postregistration Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)
Jimenez G, Matchar D, Koh CHG, et al., 2020, The Role of Health Technologies in Multicomponent Primary Care Interventions: Systematic Review (Preprint)
<sec> <title>BACKGROUND</title> <p>Several countries around the world have implemented multicomponent interventions to enhance primary care, as a way of strengthening their health systems to cope with an aging chronically ill population and rising costs. Some of these efforts have included technology-based enhancements as one of the features to support the overall intervention, but their details and impacts have not been explored.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study aimed to identify the role of digital/health technologies within wider multifeature interventions that are aimed at enhancing primary care, and to describe their aims and stakeholders, types of technologies used, and potential impacts.</p> </sec> <sec> <title>METHODS</title> <p>A systematic review was performed following Cochrane guidelines. An electronic search, conducted on May 30, 2019, was supplemented with manual and grey literature searches in December 2019, to identify multicomponent interventions that included at least one technology-based enhancement. After title/abstract and full text screening, selected articles were assessed for quality based on their study design. A descriptive narrative synthesis was used for analysis and presentation of the results.</p> </sec> <sec> <title>RESULTS</title> <p>Of 37 articles, 14 (38%) described the inclusion of a technology-based innovation as part of their multicomponent interventions to enhance primary care. The most commonly identified technologies were the use of electronic health records, data monitoring
Olsson M, Bajpai R, Wee LWY, et al., 2020, The cost of childhood atopic dermatitis in a multi-ethnic Asian population: a cost-of-illness study, BRITISH JOURNAL OF DERMATOLOGY, Vol: 182, Pages: 1245-1252, ISSN: 0007-0963
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- Citations: 5
LBD Double Burden of Malnutrition Collaborators, 2020, Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017, Nature Medicine, Vol: 26, Pages: 750-759, ISSN: 1078-8956
A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
Huang Z, Tan E, Lum E, et al., 2020, Correction: A Smartphone App to Improve Medication Adherence in Patients With Type 2 Diabetes in Asia: Feasibility Randomized Controlled Trial., JMIR Mhealth Uhealth, Vol: 8
[This corrects the article DOI: 10.2196/14914.].
Huang Z, Tan E, Lum E, et al., 2020, A Smartphone App to Improve Medication Adherence in Patients With Type 2 Diabetes in Asia: Feasibility Randomized Controlled Trial (vol 8, e18411, 2018), JMIR MHEALTH AND UHEALTH, Vol: 8, ISSN: 2291-5222
Spinazze P, Kasteleyn MJ, Aardoom JJ, et al., 2020, Cross-sectional analysis of university student’s health using a digitised health survey, International Journal of Environmental Research and Public Health, Vol: 17, ISSN: 1660-4601
University student years are a particularly influential period, during which time students may adopt negative behaviours that set the precedent for health outcomes in later years. This study utilised a newly digitised health survey implemented during health screening at a university in Singapore to capture student health data. The aim of this study was to analyze the health status of this Asian university student population. A total of 535 students were included in the cohort, and a cross-sectional analysis of student health was completed. Areas of concern were highlighted in student’s body weight, visual acuity, and binge drinking. A large proportion of students were underweight (body mass index (BMI) < 18.5)—18.9% of females and 10.6% of males—and 7% of males were obese (BMI > 30). Although the overall prevalence of alcohol use was low in this study population, 9% of females and 8% of males who consumed alcohol had hazardous drinking habits. Around 16% of these students (male and female combined) typically drank 3–4 alcoholic drinks each occasion. The prevalence of mental health conditions reported was very low (<1%). This study evaluated the results from a digitised health survey implemented into student health screening to capture a comprehensive health history. The results reveal potential student health concerns and offer the opportunity to provide more targeted student health campaigns to address these.
Greenhalgh T, Koh GCH, Car J, 2020, [Not Available]., Recenti Prog Med, Vol: 111, Pages: 231-237
Greenhalgh T, Koh GCH, Car J, 2020, 10-MINUTE CONSULTATION Covid-19: a remote assessment in primary care, BMJ-BRITISH MEDICAL JOURNAL, Vol: 368, ISSN: 0959-535X
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- Citations: 302
Martinengo L, Spinazze P, Car J, 2020, Mobile messaging with patients, BMJ-BRITISH MEDICAL JOURNAL, Vol: 368, ISSN: 0959-535X
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- Citations: 13
Thuan-Quoc T, Mahirah D, Dunleavy G, et al., 2020, Association between shift work and poor sleep quality in an Asian multi-ethnic working population: A cross-sectional study, PLOS ONE, Vol: 15, ISSN: 1932-6203
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- Citations: 11
Doherty K, Barry M, Belisario JM, et al., 2020, Personal information and public health: Design tensions in sharing and monitoring wellbeing in pregnancy, INTERNATIONAL JOURNAL OF HUMAN-COMPUTER STUDIES, Vol: 135, ISSN: 1071-5819
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- Citations: 16
Tan NC, Leng AKY, Yun IPK, et al., 2020, Cultural adaptation of a patient decision-aid for insulin therapy, BMJ OPEN, Vol: 10, ISSN: 2044-6055
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- Citations: 4
Olsson M, Bajpai R, Yew YW, et al., 2020, Associations between health-related quality of life and health care costs among children with atopic dermatitis and their caregivers: A cross-sectional study, PEDIATRIC DERMATOLOGY, Vol: 37, Pages: 284-293, ISSN: 0736-8046
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- Citations: 6
Huang Z, Lum E, Car J, 2020, Medication Management Apps for Diabetes: Systematic Assessment of the Transparency and Reliability of Health Information Dissemination, JMIR MHEALTH AND UHEALTH, Vol: 8, ISSN: 2291-5222
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- Citations: 5
Tan B, DING BTK, PEREIRA MJ, et al., 2020, Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals Trial (CONNACT) – A Feasibility Study in patients with knee osteoarthritis using a mixed method approach
<jats:title>Abstract</jats:title> <jats:p>Background Osteoarthritis is a leading cause of global disability resulting in significant morbidity and cost to the healthcare system. Current guidelines recommend lifestyle changes such exercises and weight loss as first line treatment prior to surgical consideration. Our current model of care is inefficient with suboptimal allied health intervention for effective behaviour changes. A 12-week community based, individualized, multidisciplinary new model of care for knee osteoarthritis was developed in light of current deficiencies. Methods The primary aim of this study was to determine the feasibility of a full randomized controlled trial evaluating this new model of care using pre-defined progression criteria. The secondary aim was to optimize the intervention and study design through a process evaluation. A pilot randomized trial design using a mixed method approach was utilized. Progression criteria for a full trial including key domains of patient recruitment and retention, outcome measure acceptability and improvement, adverse events were developed. The primary outcome measure was the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline and 12-weeks. Secondary outcomes included quality of life, functional and psychological assessments. Semi-structured interviews were conducted with the patients at 12-weeks. Results 20 patients (3 males, 17 females) were randomized (10 intervention, 10 control). Intervention arm patients reported better improvements in their knee function, quality of life, psychological outcome, dietary improvement and weight loss compared to the control arm at 12-weeks. Semi-structured interviews revealed several themes pertaining to feasibility and intervention optimization. 5 out of the 6 progression criteria’s domains were met. Conclusion This pilot has demonstrated the feasibility of a full randomized control trial investigating the potential effectiveness
Jimenez G, Tyagi S, Osman T, et al., 2020, Improving the Primary Care Consultation for Diabetes and Depression Through Digital Medical Interview Assistant Systems: Narrative Review (Preprint)
<sec> <title>BACKGROUND</title> <p>Digital medical interview assistant (DMIA) systems, also known as computer-assisted history taking (CAHT) systems, have the potential to improve the quality of care and the medical consultation by exploring more patient-related aspects without time constraints and, therefore, acquiring more and better-quality information prior to the face-to-face consultation. The consultation in primary care is the broadest in terms of the amount of topics to be covered and, at the same time, the shortest in terms of time spent with the patient.</p> </sec> <sec> <title>OBJECTIVE</title> <p>Our aim is to explore how DMIA systems may be used specifically in the context of primary care, to improve the consultations for diabetes and depression, as exemplars of chronic conditions.</p> </sec> <sec> <title>METHODS</title> <p>A narrative review was conducted focusing on (1) the characteristics of the primary care consultation in general, and for diabetes and depression specifically, and (2) the impact of DMIA and CAHT systems on the medical consultation. Through thematic analysis, we identified the characteristics of the primary care consultation that a DMIA system would be able to improve. Based on the identified primary care consultation tasks and the potential benefits of DMIA systems, we developed a sample questionnaire for diabetes and depression to illustrate how such a system may work.</p> </sec> <sec> <title>RESULTS</title> <p>A DMIA system, prior to the first consultation, could aid in the essential primary care tas
Jimenez G, Lum E, Huang Z, et al., 2020, REMINDERS FOR MEDICATION ADHERENCE IN TYPE 2 DIABETES MANAGEMENT APPS, Publisher: MARY ANN LIEBERT, INC, Pages: A156-A156, ISSN: 1520-9156
Jimenez G, Tyagi S, Car J, 2020, COMPUTER-ASSISTED HISTORY TAKING FOR THE IMPROVEMENT OF THE DIABETES PRIMARY CARE CONSULTATION, Publisher: MARY ANN LIEBERT, INC, Pages: A156-A157, ISSN: 1520-9156
Jimenez G, Lum E, Huang Z, et al., 2020, Reminders for medication adherence in Type 2 diabetes management apps, Journal of Pharmacy Practice and Research, Vol: 50, Pages: 78-81, ISSN: 1445-937X
Medication adherence is important for glycaemic control. However, less than half of those with Type 2 diabetes take medications as prescribed. One of the known barriers to medication adherence is forgetfulness. Given the current ubiquity of smartphones, diabetes self-management apps represent a valuable avenue for providing medication reminders to help users adhere to their medication treatments and improve health outcomes. We assessed 181 diabetes management apps for the presence of medication reminder features and compared their characteristics with the evidence provided in studies showing the effectiveness of SMS reminders. We found that only 55.8% of the apps had a basic medication reminder function, although those that had them conformed to the characteristics of SMS reminders shown to be effective. This is an important missed opportunity for diabetes management apps to contribute not only to improving medication adherence, but also in having a positive effect on the health outcomes of this population.
van Galen LS, Xu X, Koh MJA, et al., 2020, Eczema apps conformance with clinical guidelines: a systematic assessment of functions, tools and content, British Journal of Dermatology, Vol: 182, Pages: 444-453, ISSN: 1365-2133
BackgroundEczema is a prevalent complex skin condition requiring active disease monitoring and personalized education. No studies have assessed the quality of apps that aim to support eczema self‐management.ObjectivesTo evaluate the quality and comprehensiveness of English, Chinese and Spanish self‐management eczema smartphone apps for patients and/or their caregivers.MethodsA systematic assessment of eczema apps from July 2018 to November 2018. The assessment criteria were based on conformance with international eczema guidelines. The following domains were assessed: consistency and comprehensiveness of eczema‐specific educational information; quality and comprehensiveness of eczema‐specific tracking functions; compliance with health information best practice principles.ResultsIn total, 98 apps were assessed: 82 (84%) provided educational information; 38 (39%) tracking functions; and 13 (13%) both. We found that 34% (28/82) of apps provided misleading information, particularly regarding aspects of treatment and disease progression of eczema. Only 15% (12/82) provided international guideline supported information on pharmacological therapies and 16% (13/82) on nonpharmacological therapies. Among 38 apps with a tracking function, 82% (31/38) measured specific symptoms, disease severity or current skin condition and 89% (34/38) helped users to record medication usage including application of topicals. Environmental or dietary allergens were recorded by 34% (13/38). None of the included apps complied with all criteria for educational information, tracking functions or health information principles.ConclusionsEczema apps have not yet reached their potential. The large variance in quality of eczema apps highlights the need for quality assurance mechanisms for health apps and guidance for clinicians that would enable them to make personalized recommendations for patients and caregivers.
Jimenez G, Lum E, Bajpai S, et al., 2020, HEALTH APPS FOR DIABETES AND OTHER CHRONIC CONDITIONS: DEVELOPING INCLUSIVE USER EXPERIENCE (UX) CRITERIA, Publisher: MARY ANN LIEBERT, INC, Pages: A157-A157, ISSN: 1520-9156
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