Association of dipeptidyl peptidase-4 inhibitor initiation at glycated haemoglobin <7.5% with reduced major clinical events mediated by low glycated haemoglobin variability.

Aim: Therapeutic inertia, hypoglycaemia and poor treatment persistence can lead to glycaemic fluctuation and poor outcomes in type 2 diabetes (T2D). We compared glycated haemoglobin (HbA1c) variability, insulin initiation, severe hypoglycaemia and clinical events in patients with T2D initiated dipeptidyl peptidase-4 inhibitors (DPP4is) at low versus high HbA1c thresholds.

Methods: Using territory-wide electronic medical records in Hong Kong, we curated a propensity score-matched cohort of patients initiated DPP4i at HbA1c <7.

MAFLD fibrosis score: Using routine measures to identify advanced fibrosis in metabolic-associated fatty liver disease.

Background: Early screening may prevent fibrosis progression in metabolic-associated fatty liver disease (MAFLD).

Aims: We developed and validated MAFLD fibrosis score (MFS) for identifying advanced fibrosis (≥F3) among MAFLD patients.

Methods: This cross-sectional, multicentre study consecutively recruited MAFLD patients receiving tertiary care (Malaysia as training cohort [n = 276] and Hong Kong and Wenzhou as validation cohort [n = 431]).

Trends in risk factor control and treatment among patients with non-alcoholic fatty liver disease and type 2 diabetes between 2000 and 2020: A territory-wide study.

Background & Aims: We aimed to determine the trends in risk factor control and treatment among patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D) in 2000-2020.

Methods: We conducted a territory-wide cohort study of adult patients with NAFLD and T2D diagnosed between 1 January 2000 and 31 July 2021 in Hong Kong. T2D was defined by use of any anti-diabetic agents, laboratory tests and/or diagnosis codes.

Can teaching serious illness communication skills foster multidimensional empathy? A mixed-methods study.

Background: To investigate the impact of a serious illness communication skills training course on medical students' attitudes regarding clinical empathy, self-efficacy in empathic communication, and learning on different dimensions of empathy.

Methods: A mixed-methods design was used. A blended learning Serious Illness Communication Skills Training (SI-CST) course was delivered to sixth-year medical students.

Initiation of sodium-glucose cotransporter-2 inhibitors at lower HbA1c threshold attenuates eGFR decline in type 2 diabetes patients with and without cardiorenal disease: A propensity-matched cohort study.

Aim: To examine the association of initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) at lower glycemic threshold with decline in estimated-glomerular filtration rate (eGFR).

Methods: We analyzed a prospective cohort of Chinese patients with type 2 diabetes from Hong Kong. Patients initiating SGLT2i at HbA1c < 7.

Real-world usage of sulphonylureas in Asian patients with type 2 diabetes using the Joint Asia Diabetes Evaluation (JADE) register.

Aims: To explore the patterns of use of oral glucose-lowering drugs (OGLDs) in Asian patients with type 2 diabetes (T2D), focusing on sulphonylureas (SUs), and to describe patient profiles according to treatment regimen.

Methods: We conducted a cross-sectional analysis of data from adults with T2D from 11 Asian countries/regions with structured assessment enrolled in the prospective Joint Asia Diabetes Evaluation (JADE) register between November 2007 and December 2019. Patients receiving insulin and/or injectable glucagon-like peptide-1 receptor agonists were excluded.

Combined associations of family history and self-management with age at diagnosis and cardiometabolic risk in 86,931 patients with type 2 diabetes: Joint Asia Diabetes Evaluation (JADE) Register from 11 countries.

Background: Family history (FamH) of type 2 diabetes might indicate shared genotypes, environments, and/or behaviors. We hypothesize that FamH interacts with unhealthy behaviors to increase the risk of early onset of diabetes and poor cardiometabolic control.

Methods: In a cross-sectional analysis of the prospective Joint Asia Diabetes Evaluation Register including patients from 427 clinics in 11 Asian countries/regions in 2007-2021, we defined positive FamH as affected parents/siblings and self-management as (1) healthy lifestyles (balanced diet, non-use of alcohol and tobacco, regular physical activity) and (2) regular self-monitoring of blood glucose (SMBG).

Risk of liver-related events by age and diabetes duration in patients with diabetes and nonalcoholic fatty liver disease.

Background And Aims: Several guidelines recommend screening for NAFLD in patients with type 2 diabetes (T2D). We aimed to determine if there is a threshold of age and duration of T2D for liver-related event development to guide screening strategies.

Approach And Results: We conducted a territory-wide retrospective cohort study of adult patients with NAFLD and T2D diagnosed between 2000 and 2014 in Hong Kong to allow for at least 5 years of follow-up.

Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong.

Background: The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care.

Methods: This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong.

Is polypharmacy beneficial or detrimental for older adults with cardiometabolic multimorbidity? Pooled analysis of studies from Hong Kong and Europe.

Background: Physicians often prescribe high numbers of medications for managing multiple cardiometabolic diseases. It is questionable whether polypharmacy (concurrent use of five or more medications) is beneficial or detrimental for older adults with cardiometabolic multimorbidity (co-occurrence of two or more diseases).

Objective: To examine combined effects of multimorbidity and polypharmacy on hospitalization and frailty and to determine whether effect sizes of polypharmacy vary with numbers of cardiometabolic diseases.

Barriers to advance care planning: a qualitative study of seriously ill Chinese patients and their families.

Background: Advance care planning (ACP) facilitates identification and documentation of patients' treatment preferences. Its goal aligns with that of palliative care - optimizing quality of life of seriously ill patients. However, concepts of ACP and palliative care remain poorly recognized in Chinese population.

Geriatric syndromes, multimorbidity, and disability overlap and increase healthcare use among older Chinese.

Background: Geriatric syndromes, multimorbidity, and disability are prevalent among ageing population. However, no study empirically examined their additive or synergistic effect on healthcare use. The present study aims to estimate overlapping prevalence of geriatric syndromes, multimorbidity, and disability; and to examine associations of these three conditions with healthcare use.

Self-competence in death work among health and social care workers: a region-wide survey in Hong Kong.

Background: According to the Quality of Death Index, Hong Kong is lagging behind many other Western and Asian countries in the category of palliative and healthcare. To ensure the provision of high-quality palliative care, it is important to explore the self-competence of health and social care workers in coping with death work including palliative care. This region-wide study aims to assess the level of self-competence with a validated Self-Competence in Death Work Scale (SC-DWS) and examine its correlates.