Theory-based behaviour modification of Asian adults with type-2 diabetes mellitus after participating in a novel telemonitoring system: a qualitative research study.

Objective: Telemonitoring (TM) remotely monitors individuals' health. Awareness of personal clinical data has resulted in improved glycaemic control in adults with type-2 diabetes mellitus (T2DM). However, its effects on their health-seeking behaviour remain unclear.

Proxy medical decision-making: national survey.

Objectives: Population ageing and increased care needs lead to adults making consequential medical decisions for others, potentially impacting treatment and end of life. We aim to describe the prevalence of medical decision-making by proxy among the national population and associated demographic and care factors.

Methods: We designed a cross-sectional online survey with a nationally representative adult cohort with an 80% participation rate.

Effectiveness of continuous glucose monitoring in patient management of Type 2 Diabetes Mellitus: an umbrella review of systematic reviews from 2011 to 2024.

Background: Continuous glucose monitoring (CGM) is increasingly popular for managing Type 2 Diabetes Mellitus (T2DM). Many systematic reviews have reported on CGM's effectiveness, but with heterogeneous methodologies and objectives. We aim to conduct an umbrella review (UR) to consolidate a most contemporaneous and comprehensive evidence base comparing CGM with self-monitoring of blood glucose or usual care (SMBG/UC).

Sustainability of health outcomes of patients with type-2 diabetes mellitus after completing 6 months of remote tele-monitoring: Two-year results from a randomised controlled trial (OPTIMUM).

Introduction: Meta-analysis shows that home tele-monitoring (HTM) improves glycaemic control in patients with type-2 diabetes mellitus (T2DM) up to 12 months, but their health outcomes after HTM cessation remains unclear. This study aimed to determine the health outcomes of these patients 18 months after completing 6 months of HTM, compared to standard care.

Methods: Patients with T2DM were enrolled in an open-labelled randomised controlled trial, aged 26 to 65 years, and suboptimal glycaemic control (HbA1c = 7.

Characterization and individual-level prediction of cognitive state in the first year after 'mild' stroke.

Background: Mild stroke affects more than half the stroke population, yet there is limited evidence characterizing cognition over time in this population, especially with predictive approaches applicable at the individual-level. We aimed to identify patterns of recovery and the best combination of demographic, clinical, and lifestyle factors predicting individual-level cognitive state at 3- and 12-months after mild stroke.

Methods: In this prospective cohort study, the Montreal Cognitive Assessment (MoCA) was administered at 3-7 days, 3- and 12-months post-stroke.

Foot care behaviours and associated factors among patients with type 2 diabetes: A cross-sectional study.

Background: As numerous studies highlighted the importance of maintaining proper foot care (FC) behaviours among individuals with diabetes to prevent complications, we sought to assess FC behaviours among patients with diabetes and to identify the factors associated with the practice of diabetic FC.

Methods: We used a cross-sectional design and collected data through self-reported questionnaires administered to a sample of 586 patients from five medical centres. We conducted descriptive and inferential analyses to explore the relationships between potential risk and protective factors and FC behaviours.

Health outcomes of telemonitoring of patients with type-2 diabetes mellitus: One-year results from a randomized controlled trial (Optimizing care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus).

Introduction: Telehealth increases care accessibility to patients with type-2 diabetes mellitus but the duration of its implementation to sustain optimal glycaemic control remains unclear. This study aimed to assess the health outcomes of these patients using the Optimizing care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus (OPTIMUM) home tele-monitoring (HTM) system 6 months post-intervention, compared to standard care.

Methods: An open-labelled randomized controlled trial involving 330 participants with type-2 diabetes mellitus, aged 26-65 years, and suboptimal glycaemic control (HbA1c = 7.

Health practices, behaviours and quality of life of low-income preschoolers: A community-based cross-sectional comparison study in Singapore.

Introduction: Children from low-income (LI) families often suffer from poor health, with sub-optimal health practices. This cross-sectional study examined the differences in health habits and health-related quality of life (HRQoL) of LI preschool children compared to non-low-income preschool peers (PPG).

Method: Using data from the social-health Circle of Care-Health Development Screening Programme (CoC-HDSP) in Singapore, 118 LI children and 304 PPG children aged 18 months to 6 years old and their families were recruited from 13 government-funded preschools.

Cost-Effectiveness of a Home Telemonitoring System for Asian Adults with Type 2 Diabetes Mellitus.

Telemonitoring programs have been found to be effective in improving diabetic control by promoting patients' self-management of diabetes through medication adherence, dietary modifications, and exercise. Nonetheless, few studies have assessed the cost-effectiveness of telemonitoring for the self-management of diabetes based on real-world data. A randomized controlled trial entitled Optimizing care of Patients via Telehealth In Monitoring and Augmenting their control of Diabetes Mellitus was conducted among adults with Type 2 Diabetes Mellitus in Singapore.

Comparative policy analysis of national rare disease funding policies in Australia, Singapore, South Korea, the United Kingdom and the United States: a scoping review.

Background: Rare diseases pose immense challenges for healthcare systems due to their low prevalence, associated disabilities, and attendant treatment costs. Advancements in gene therapy, such as treatments for Spinal Muscular Atrophy (SMA), have introduced novel therapeutic options, but the high costs, exemplified by Zolgensma® at US$2.1 million, present significant financial barriers.

Primary Technology Enhanced Care Home HbA1c Testing (PTEC HAT) programme: a feasibility pilot study in Singapore.

Background: Considering time-consuming, cost-related limitations of laboratory-based HbA1c testing and follow-up clinic visits for diabetes management, it is important to explore alternative care models which incorporate point-of-care testing for HbA1c to monitor glycaemic control and related management.

Methods: Therefore, we adopted an implementation perspective to conduct one group pre- and post-intervention feasibility pilot assessing feasibility, acceptability and satisfaction with conducting home HbA1c test by patients with type 2 diabetes coupled with telemonitoring and teleconsultations (i.e.

Cost-of-illness studies of inherited retinal diseases: a systematic review.

Background: While health care and societal costs are routinely modelled for most diseases, there is a paucity of comprehensive data and cost-of-illness (COI) studies for inherited retinal diseases (IRDs). This lack of data can lead to underfunding or misallocation of resources. A comprehensive understanding of the COI of IRDs would assist governmental and healthcare leaders in determining optimal resource allocation, prioritizing funding for research, treatment, and support services for these patients.

Using EQ-5D for Proxy Assessment of Health-Related Quality of Life in Residential Care Facilities: A Systematic Review of Feasibility and Psychometric Properties.

Objectives: The accurate assessment of Health-Related Quality of Life (HRQoL) in residents of residential care facilities (RCF) necessitates the use of proxy-reported instruments that possess robust psychometric properties. Generally, these instruments are modified versions of self-reported tools, with adjustments made to pronouns and instructions to better suit the respondent. Among such tools, the EQ-5D has emerged as a prominent instrument for evaluating HRQoL within RCF settings.

Preferences and willingness-to-pay for a blood pressure telemonitoring program using a discrete choice experiment.

This study aimed to elicit the preferences and willingness-to-pay for blood pressure (BP) telemonitoring programs. This study also investigated the different factors or participant characteristics that could influence preferences and choice behaviors. Participants with hypertension were identified from an online survey panel demographically representative of Singapore's general population.

Older adult patient preferences for the content and format of prescription medication labels - A best-worst scaling and discrete choice experiment study.

Background: Patient preferences for the content and format of prescription medication labels (PMLs, i.e., sticker labels placed on medication bottles/packets at dispensing) have been extensively studied.

Implementation and use of technology-enabled blood pressure monitoring and teleconsultation in Singapore's primary care: a qualitative evaluation using the socio-technical systems approach.

Background: Telemedicine is becoming integral in primary care hypertension management, and is associated with improved blood pressure control, self-management and cost-effectiveness. This study explored the experiences of patients and healthcare professionals and their perceived barriers and facilitators in implementing and using a technology-enabled blood pressure monitoring intervention with teleconsultation in the Singapore primary care setting.

Methods: This was a qualitative study embedded within the Primary Technology-Enhanced Care Hypertension pilot trial.

Qualitative study exploring heterogeneity in caregiving experiences post-stroke in Singapore.

Objective: Stroke, a common illness in older adults, accounts for up to 4% of direct medical costs in developed nations. Informal caregiving contributing a significant proportion of economic burden post-stroke warrants a deeper understanding of the caregiving context to sustain caregiving arrangement. While literature exists describing differences in motivation and preferences of caregivers, limited literature explores differences in caregiving experiences of different types of caregivers (ie, spouse, adult-child, sibling or others).

Telemedical Interventions for Chronic Obstructive Pulmonary Disease Management: Umbrella Review.

Background: Chronic obstructive pulmonary disease (COPD) is a growing epidemic, with a heavy associated economic burden. Education, physical activity, and pulmonary rehabilitation programs are important aspects of the management of COPD. These interventions are commonly delivered remotely as part of telemedicine interventions.

Challenges encountered by pharmacy staff in using prescription medication labels during medication counselling with older adults and solutions employed: A mixed-methods study.

Background: Prescription medication labels (PMLs) predominantly dispensed in English, are an important adjunct to medication counselling. PMLs are routinely used by pharmacy staff to counsel older adults about their medications. This study sought to identify challenges that pharmacy staff observe older adults face in using their PMLs, and to identify and quantify solutions employed by pharmacy staff during medication counselling to address such challenges.

Evaluating the Effects of Capacity Building Initiatives and Primary Care Networks in Singapore: Outcome Harvesting of System Changes to Chronic Disease Care Delivery.

The high tertiary healthcare utilisation in Singapore due to an ageing population and increasing chronic disease load has resulted in the establishment of primary care networks (PCNs) for private general practitioners (GPs) to provide team-based, community care for chronic diseases. A total of 22 PCN leaders and programme managers from 10 PCNs participated in online group discussions and a survey. Outcome harvesting was used to retrospectively link the intended and unintended outcomes to the programme initiatives and intermediate results (IRs).

Trust and Uncertainty in the Implementation of a Pilot Remote Blood Pressure Monitoring Program in Primary Care: Qualitative Study of Patient and Health Care Professional Views.

Background: Trust is of fundamental importance to the adoption of technologies in health care. The increasing use of telemedicine worldwide makes it important to consider user views and experiences. In particular, we ask how the mediation of a technological platform alters the trust relationship between patient and health care provider.

Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study.

Multimorbidity, common in the primary care setting, has diverse implications for both the patient and the healthcare system. However, there is no consensus on the definition of multimorbidity globally. Thus, we aimed to conduct a Delphi study to gain consensus on the definition of multimorbidity, the list and number of chronic conditions used for defining multimorbidity in the Singapore primary care setting.

Developing integration among stakeholders in the primary care networks of Singapore: a qualitative study.

Background: Integrating healthcare services across and between the different health system levels can be achieved in a few ways; however, examining the social side of integration is essential and challenging. This paper explores the concept of integration perceived by general practitioners (GPs) and primary care network (PCN) representatives from the regional health systems (RHS) in a GP-RHS PCN and their perceived partnership success.

Methods: In this study, we explored three GP-RHS PCNs in Singapore.