Understanding reasons and determinants of medication non-adherence in community-dwelling adults: a cross-sectional study comparing young and older age groups.

Background: Medication non-adherence has become a striking problem among patients with chronic diseases worldwide. However, literature on prevalence, reasons and factors associated with medication non-adherence in Singapore general population is still lacking. This study aimed to (1) estimate the prevalence of intentional and unintentional medication non-adherence in young (aged 21-64 years) and older adults (aged ≥ 65 years), respectively; (2) identify and compare the main reasons for non-adherence; and (3) examine the association between potential factors and non-adherence in each group.

Risk factors for incident falls in Singaporean community-dwelling adult men and women: a prospective cohort study.

Objectives: Our study aimed to identify the risk factors of incident falls between men and women.

Design: Prospective cohort study.

Setting: The study recruited participants from the Central region of Singapore.

Chronic low back pain and its impact on physical function, mental health, and health-related quality of life: a cross-sectional study in Singapore.

Chronic low back pain, defined as low back pain lasting more than 3 months, is a globally prevalent health problem with significantly high medical and economic burden on individuals and the society. This study aimed to estimate the prevalence of chronic low back pain and examine its association with health outcomes including physical function, mental health, and quality of life among adult population in Singapore. Cross-sectional secondary data analysis was performed using baseline data of the 1941 adults (mean age: 52.

Psychometric Properties of the Patient Activation Measure in Community-Dwelling Adults in Singapore.

Introduction: Measuring health activation in general population using valid instruments is needed to facilitate the evaluation of health education and behavioral programs in community. The 13-item Patient Activation Measure was well validated in patients with different chronic diseases but rarely validated in general population. The objective of this study was to assess the psychometric properties of the Patient Activation Measure among community-dwelling adults in Singapore.

Associations of social isolation, social participation, and loneliness with frailty in older adults in Singapore: a panel data analysis.

Background: There is a shortage of research evidence about how social isolation, social participation, and loneliness were longitudinally associated with frailty. This study was to 1) examine the associations of social isolation, social participation, and loneliness with level of frailty among community-dwelling older adults using panel data, and 2) explore the moderating effect of gender on the association of social isolation, social participation and loneliness with frailty.

Methods: The study included 606 participants aged 60 years and above from the longitudinal Population Health Index Survey conducted in Singapore.

Psychometric evaluation of the 8-item Altarum Consumer Engagement (ACE) Measure™ in community-dwelling adults in Singapore.

Background: A valid and reliable measure is essential to assess patient engagement and its impact on health outcomes. This study aimed to examine the psychometric properties of the 8-item Altarum Consumer Engagement Measure™ (ACE Measure) among English-speaking community-dwelling adults in Singapore.

Methods: This cross-sectional study involved 400 randomly selected community-dwelling adults (mean age: 49.

Medical cost of advanced illnesses in the last-year of life-retrospective database study.

Objective: This study aims to quantify medical care utilisation, and to describe the cost trajectories of individuals with advanced illnesses in the last-year of life, differentiated by advanced cancer, end-stage organ failure and progressive neurological disorders.

Methods: This retrospective database study included decedents who had previous inpatient or outpatient encounters at a public hospital in Singapore. Patients with advanced diseases were identified based on diagnostic codes and clinical criteria.

Association between patient-reported functional measures and incident falls.

Lower extremity muscle strength, and functional limitations are important modifiable predictors of falls, but are often examined using performance based measures. We examined the association between self-reported physical function limitations, determined using Late-Life Function and Disability Instrument(LLFDI) and incident falls in community-dwelling elderly individuals. 283 older adults participants were included in this analysis.

Temporal changes of haematological and radiological findings of the COVID-19 infection-a review of literature.

Background: COVID-19 is a systemic viral infection which mainly targets the human respiratory system with many secondary clinical manifestations especially affecting the hematopoietic system and haemostasis. Few studies have highlighted the prognostic value of blood findings such as lymphopenia, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, LDH, CRP, cardiac troponin, low-density lipoproteins and chest radiographic abnormality. A study of progressions of blood and radiological results may help to identify patients at high risk of severe outcomes.

Feasibility analysis of a prevention programme for patients with early chronic disease using A mathematical model.

The increasing prevalence of the chronic disease is of considerable concern to health-care organisations. Prevention programmes to patients with early chronic disease have the potential to improve individual health and quality of life through disease avoidance or delay and to save the medical cost of the health care system. Due to the limited budget in healthcare this study seeks to analyse the feasibility of a programme prior to implementation.

Psychosocial impact of skin diseases: A population-based study.

Background: While it is well established that skin disease places significant psychosocial burden on a patient's wellbeing, its effects have rarely been examined in Asian populations.

Objective: Evaluate the psychosocial burden of skin disease among community-dwelling adults in Singapore.

Methods: This cross-sectional study included 1510 participants interviewed on their history of thirteen skin diseases.

Development of a scalable and extendable multi-dimensional health index to measure the health of individuals.

Background: For population health management, it is important to have health indices that can monitor prevailing health trends in the population. Traditional health indices are generally measurable at different geographical levels with varied number of health dimensions. The aim of this work was to develop and validate a scalable and extendable multi-dimensional health index based on individual data.

Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore.

Background: Frailty is frequently found to be associated with increased healthcare utilisation in western countries, but little is known in Asian population. This study was conducted to investigate the association between frailty and healthcare utilisation in different care settings among community-dwelling older adults in Singapore.

Methods: Data from a population health survey among community-dwelling adults were linked with an administrative database to retrieve data of healthcare utilisation (including government primary care clinic visits, specialised outpatient clinic visits, emergency department visits, day surgery and hospitalisations) occurred during a six-month look-back period and six-month post-baseline respectively.

Analysis via Markov decision process to evaluate glycemic control strategies of a large retrospective cohort with type 2 diabetes: the ameliorate study.

Aims: Our aim was to explore optimal treatment decisions for HbA control for type 2 diabetes mellitus patients and assess the impact on potential improvements in quality of life compared with current guidelines.

Methods: We analyzed a large dataset of HbA levels, diabetes-related key risk factors and medication dispensed to 70,069 patients with type 2 diabetes from polyclinics and a large public hospital in Singapore during January 1, 2008, to December 31, 2015. A Markov decision process (MDP) model was developed to determine the optimal treatment policy concerning medication management for glycemic control over a long-term treatment period.

Association of Nutritional Status with Physical Function and Disability in Community-Dwelling Older Adults: A Longitudinal Data Analysis.

To investigate how change in nutritional status is associated with physical function and disability among community-dwelling older adults. Baseline and 1-year follow-up data of 593 community-dwelling older adults were obtained from the Population Health Index survey in Singapore. The Mini Nutritional Assessment was used to assess nutritional status; the Late-Life Function and Disability Instrument was used to measure physical function and disability.

Is there scope for expanding the optometrist's scope of practice in Singapore? - A survey of optometrists, opticians in Singapore.

Purpose: In Singapore, optometrists' roles are limited compared to their counterparts elsewhere. The purpose of the survey is to investigate optometrists' current roles, views on extended roles, self-reported primary eye care knowledge, needs for continuing professional education (CPE) and views on suitable modes for CPE.

Methods: Members of the Optometrist and Optician Board (OOB) were invited via email to take part in an anonymous online survey.

Effects of chronic diseases on health-related quality of life and self-rated health among three adult age groups.

Little is known about whether there is any difference in associations of chronic diseases with health-related quality of life and self-rated health across age groups. The purpose of the present study was to examine the associations of one specific and multiple chronic diseases with health-related quality of life and self-rated health (measured using the 5-level EQ-5D version) in three age groups: young (21-44 years), middle-aged (45-64 years), and older adults (≥65 years). Secondary data analysis of 1932 participants in the Population Health Index Survey was performed.

Lifetime trajectory simulation of chronic disease progression and comorbidity development.

Introduction: Comorbidity is common in elderly patients and it imposes heavy burden on both individual and the whole healthcare system. This study aims to gain insights of comorbidity development by simulating the lifetime trajectory of disease progression from single chronic disease to comorbidity.

Methods: Eight health states spanning from no chronic condition to comorbidity are considered in this study.

Health Technology Disinvestment in Singapore.

Healthcare decision-makers are constantly challenged by growing healthcare needs in tandem with rising healthcare costs. Disinvesting in technologies and practices that are "low in value" is one strategy to re-allocate limited resources to the most effective, safe and cost-effective technologies. We put forward a health technology reassessment framework and examined the opportunities and challenges on technology disinvestment in Singapore and deliberated on possible solutions.

Sex differences in associations between multimorbidity and physical function domains among community-dwelling adults in Singapore.

Objectives: The aims of the study were to identify the associations between multimorbidity and specific physical function domains among community-dwelling adults in Singapore, and to examine sex differences in the associations.

Methods: This study was conducted using baseline data of 1,940 participants in the Population Health Index Survey conducted in the Central Region of Singapore from November 2015 to November 2016. Physical function was assessed using the Function Component of the Late-life Function and Disability Instrument and compared between men and women.

Prevalence of frailty and its association with depressive symptoms among older adults in Singapore.

Objectives: The aims of the study were to (1) estimate the prevalence of frailty among community-dwelling older adults , and (2) investigate the independent association between level of frailty and depressive symptoms.

Methods: A total of 721 older adults (aged 60 and above ) were included in this study. Severity of frailty was determined using the Clinical Frailty Scale and further classified into four levels (CFS1-3: F1, CFS4: F2, CFS5: F3, and CFS6-7: F4).

Evaluation of an integrated primary care-led dementia shared care program in Singapore: An effectiveness and cost-effectiveness study.

Aim: With an aging Singapore population, there is an increasing demand for dementia care. The present study aimed to evaluate the effectiveness and cost-effectiveness of the Primary Care Dementia Clinic (PCDC) in comparison with the Memory Clinic (MC; hospital-based) and other polyclinics.

Methods: A quasi-experimental design was implemented.

Medication adherence and glycemic control among newly diagnosed diabetes patients.

Background: Poor medication adherence can have negative consequences for the patients, the provider, the physician, and the sustainability of the healthcare system. To our knowledge, the association between medication adherence and glycemic control among newly diagnosed diabetes patients has not been studied. This study aims to bridge the gap.

Social isolation, loneliness and their relationships with depressive symptoms: A population-based study.

Objectives: To assess the relationship between various social isolation indicators and loneliness, and to examine the differential associations that social isolation indicators, loneliness have with depressive symptoms.

Methods: Baseline data for 1,919 adults (aged 21 years and above) from a representative health survey in the Central region of Singapore was used for this study. The association between social isolation indicators (marital status, living arrangement, social connectedness with relatives and friends) and loneliness (the three-item UCLA Loneliness) were assessed, and their differential associations with depressive symptoms (the Patient Health Questionnaire-9) were examined using multiple linear regression, controling for relevant covariates.