Communities of Care Approach: Developing a Place-based Model of Care and Building Partnerships in the Communities in Central Singapore.

The population in Singapore is ageing, adding pressure to community care as the health and social needs of its residents increase. This has accelerated the pace at which Regional Health Systems adopt and deliver its population health strategies from early prevention, chronic disease management, crisis care to end-of-life care. To this end, the Central Health Integrated Care Network (ICN) began its journey to develop Communities of Care (CoCs) with other health and social care partners to meet the needs of residents in the Central Zone of Singapore.

Using the Johns Hopkins ACG Case-Mix System for population segmentation in a hospital-based adult patient population in Singapore.

Objective: Population health management involves risk characterisation and patient segmentation. Almost all population segmentation tools require comprehensive health information spanning the full care continuum. We assessed the utility of applying the ACG System as a population risk segmentation tool using only hospital data.

Epidemiological, Clinical, and Phylogenetic Characteristics of the First SARS-CoV-2 Transmission in a Nursing Home of Singapore: A Prospective Observational Investigation.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has resulted in a significant burden among nursing home facilities globally. This prospective observational cohort study aims to define the potential sources of introduction and characteristics of SARS-CoV-2 transmission of the first nursing home facility in Singapore. An epidemiological serial point-prevalence survey of SARS-CoV-2 was conducted among 108 residents and 56 healthcare staff (HCS).

Integrated palliative homecare in advanced dementia: reduced healthcare utilisation and costs.

Objectives: To determine the economic benefit of an integrated home-based palliative care programme for advanced dementia (Programme Dignity), evaluation is required. This study aimed to estimate Programme Dignity's average monthly cost from a provider's perspective; and compare healthcare utilisation and costs of programme patients with controls, accounting for enrolment duration.

Methods: This was a retrospective cohort study.

Association of Deprescribing With Reduction in Mortality and Hospitalization: A Pragmatic Stepped-Wedge Cluster-Randomized Controlled Trial.

Objectives: Deprescribing has gained awareness recently, but the clinical benefits observed from randomized trials are limited. The aim of this study was to examine the effectiveness of a pharmacist-led 5-step team-care deprescribing intervention in nursing homes to reduce falls (fall risks and fall rates). Secondary aims include reducing mortality, number of hospitalized residents, pill burden, medication cost, and assessing the deprescribing acceptance rate.

Advanced dementia: an integrated homecare programme.

Objectives: We established an integrated palliative homecare programme for advanced dementia. This study explores patients' symptoms and quality-of-life and their association with enteral feeding, evaluates the impact of the programme on these parameters and examines familial caregiver burden.

Methods: This is a prospective cohort study.

Nursing home team-care deprescribing study: a stepped-wedge randomised controlled trial protocol.

Introduction: An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often challenging, and prospective outcome data on deprescribing practice in the elderly is lacking.

Economic impact analysis of an end-of-life programme for nursing home residents.

Background: Due to limited end-of-life discussions and the absence of palliative care, hospitalisations are frequent at the end of life among nursing home residents in Singapore, resulting in high health-care costs.

Aim: Our objective was to evaluate the economic impact of Project Care at the End-of-Life for Residents in homes for the Elderly (CARE) programme on nursing home residents compared to usual end-of-life care. DESIGN AND SETTINGS/PARTICIPANTS: Project CARE was introduced in seven nursing homes to provide advance care planning and palliative care for residents identified to be at risk of dying within 1 year.

Validation of the care transition measure in multi-ethnic South-East Asia in Singapore.

Background: The 15-item Care Transition Measure (CTM-15) is a measure for assessing the quality of care during transition from the patients' perspective. The purpose of this study was to test the psychometric properties of the CTM-15 and CTM-3 (a 3-item version of the CTM-15) in Singapore, a multi-ethnic urban state in South-east Asia.

Methods: A consecutive sample of patients was recruited from two tertiary hospitals.

Prevalence of pain in nursing home residents with different cognitive and communicative abilities.

Objectives: To determine the prevalence of pain and its impact among nursing homes residents with different cognitive and communication abilities.

Design: Cross-sectional study.

Setting: Three nursing homes in Singapore.

The use of a self-reported pain measure, a nurse-reported pain measure and the PAINAD in nursing home residents with moderate and severe dementia: a validation study.

Objectives: To assess the construct validity of three measures of pain and to determine a categorical version of the Pain Assessment in Advanced Dementia (PAINAD) scale.

Design: Validation study determining the concurrent validity of a self-reported pain score (SRPS), a nurse-reported pain score (NRPS) and the PAINAD; the divergent validity of the three pain measures with the Abbreviated Mental Test (AMT) and the Cornell Scale for Depression in Dementia (CSDD).

Setting And Subjects: eighty-eight nursing home residents with moderate and severe dementia.

The challenge of providing holistic care in a viral epidemic: opportunities for palliative care.

Objective: To determine, using the perspective of a hospital-based palliative care service (PCS), the spiritual and psychosocial impact of a novel and potentially fatal viral epidemic on patients, their families and health care workers.

Design: Qualitative study using semi-structured interviews. The data were analysed using the constant comparative method and were validated using respondent validation.