Impact of a Multidisciplinary Supportive Care Model Using Distress Screening at an Asian Ambulatory Cancer Center: A Cluster Randomized Controlled Trial.

Purpose: The Accessible Cancer Care to Enable Support for Cancer Survivors (ACCESS) program adopts a multidisciplinary supportive care model with routine distress screening to triage newly diagnosed cancer survivors for additional support on the basis of distress levels. This study aimed to evaluate the clinical impact of ACCESS over 1 year.

Methods: We performed cluster random assignment at the oncologist level in a 1:1 ratio to receive ACCESS or usual care.

Ethical and regulatory challenges of large language models in medicine.

With the rapid growth of interest in and use of large language models (LLMs) across various industries, we are facing some crucial and profound ethical concerns, especially in the medical field. The unique technical architecture and purported emergent abilities of LLMs differentiate them substantially from other artificial intelligence (AI) models and natural language processing techniques used, necessitating a nuanced understanding of LLM ethics. In this Viewpoint, we highlight ethical concerns stemming from the perspectives of users, developers, and regulators, notably focusing on data privacy and rights of use, data provenance, intellectual property contamination, and broad applications and plasticity of LLMs.

Brain-derived neurotrophic factor as a biomarker in cancer-related cognitive impairment among adolescent and young adult cancer patients.

Brain-derived neurotrophic factor (BDNF) improves cognitive function by stimulating neurogenesis and neuroplasticity. We hypothesize that higher plasma BDNF levels are protective against cognitive toxicity among adolescent and young adult cancer patients (15-39 years old). In a prospective, longitudinal study, we recruited 74 newly diagnosed cancer and 118 age-matched non-cancer controls who completed the Cambridge Neuropsychological Test Automated Battery (CANTAB), Functional Assessment of Cancer Therapy-Cognitive Function questionnaire (FACT-Cog) and blood draws.

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.

Determining acceptance and perceptions of chemotherapy dose banding in an ambulatory cancer centre.

Introduction: Despite the advantages of dose banding (DB) and numerous plans to adopt this practice, uptake of DB is still poor. As opinions of healthcare professionals were deemed essential in DB's acceptance, this study surveyed key stakeholders to determine the acceptance, facilitators, and barriers of DB in chemotherapy to improve its implementation.

Methods: A cross-sectional study at the National Cancer Centre Singapore, involving physicians, nurses, and pharmacy staff, was conducted in February 2022.

Quantifying chemotherapy wastage in an ambulatory cancer centre in Singapore.

Introduction: To ensure the efficient use of chemotherapy drugs, chemotherapy wastage is an area that can be investigated. This study aims to quantify current parenteral chemotherapy wastage and estimate parenteral chemotherapy wastage when dose banding is executed, using a chemotherapy wastage calculator in an ambulatory cancer centre. The study also examines the variables that significantly predict the total cost of chemotherapy wastage, investigates the reasons for wastage, and explores opportunities to reduce wastage.

Implementing an Inclusive, Multidisciplinary Supportive Care Model to Provide Integrated Care to Breast and Gynaecological Cancer Survivors: A Case Study at an Asian Ambulatory Cancer Centre.

Introduction: Supportive care models considering inclusivity and community services to improve integrated care for cancer survivors are limited. In this case study, we described the implementation of a multidisciplinary care model employing routine distress screening and embedded integrated care pathways to integrate care across disciplines and care sectors, while remaining inclusive of the multi-ethnic and multilingual population in Singapore. We reported implementation outcomes after 18 months of implementation.

Curriculum reform and trainees' perception of the pharmacy educational environment: a modified DREEM study.

Objectives: An undergraduate pharmacy curriculum reform was undertaken to meet the future healthcare demands of the people in Singapore. Understanding how educational reforms affect the learners' perceptions of the learning environment is important for quality assurance. The primary aim of this study was to investigate how pharmacy trainees perceive their educational environment before and after curriculum reform.

Cognitive impairment in adolescent and young adult cancer patients: Pre-treatment findings of a longitudinal study.

Background: There is little information about cancer-related cognitive impairment (CRCI) in adolescent and young adults (AYA, 15-39 years old) due to its rare incidence. Here, we present the pre-treatment (before chemotherapy or radiotherapy) evaluation of cognitive function and ability of AYA with cancer (AYAC) in a multicentered cohort study.

Methods: Newly diagnosed AYAC and age-matched healthy controls (HC) were recruited between 2018 and 2021.

Work Outcomes and Medical Costs Among Singaporean Adolescent and Young Adult Cancer Survivors.

To quantify and evaluate trends of work outcomes and medical costs among Singaporean adolescent and young adult (AYA) cancer survivors. This cross-sectional study was conducted at the National Cancer Centre Singapore between July 2016 and October 2018. Cancer patients who were diagnosed between the age of 15 and 39 years and had completed treatment were eligible.

The Impact of Statin Use and Breast Cancer Recurrence - A Retrospective Study in Singapore.

Introduction: Statins, HMG-CoA reductase inhibitors, are commonly used cholesterol-lowering medications which are also increasingly recognized to have anti-cancer properties for various cancers, including breast cancer. Most clinical evidence supports a protective effect of statin on reducing breast cancer recurrence, particularly in hormone-receptor positive breast cancers.This study seeks to study the impact of statin use on breast cancer recurrence in an Asian population.

Burnout and resilience among pharmacy technicians: A Singapore study.

Background: Burnout describes emotional exhaustion (EE), depersonalization (DP), and low personal achievement caused by work and is known to bring about negative consequences to practitioners, patients, and health systems. Various organizational and personal factors, such as organizational strategies and resilience, have been associated with this phenomenon. However, there is a paucity of data describing the prevalence of burnout among pharmacy staff within Singapore and Asia, especially in the pharmacy technician (PT) population.

Patient satisfaction and behavioural intention in using the home medication delivery service in an ambulatory oncology centre.

Background: The COVID-19 pandemic has increased usage of medication delivery service (MDS) significantly. MDS improves adherence to medication and clinical outcomes.

Objectives: To study behavioral change factors that affect adoption of MDS, determine existing patient satisfaction level, and make recommendations to improve MDS adoption.

Investigating how cancer-related symptoms influence work outcomes among cancer survivors: a systematic review.

Purpose: The purpose of this study is to investigate how different cancer-related symptoms influence work outcomes among cancer survivors.

Methods: A literature search was performed in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus to identify studies published between 1st January 1999 and 30th October 2020 that investigated the impact of specific cancer-related symptoms on work outcomes among cancer survivors who have completed primary antineoplastic treatment. Study findings were extracted and grouped by symptoms and work outcomes, allowing comparison of associations between these outcomes.

Early Outcomes of a National Cancer Center's Strategy Against COVID-19 Executed Through a Disease Outbreak Response Taskforce.

Purpose: We present the strategy of a comprehensive cancer center organized to make operations pandemic proof and achieve continuity of cancer care during the COVID-19 pandemic.

Methods: Disease Outbreak Response (DORS) measures implemented at our center and its satellite clinics included strict infection prevention, manpower preservation, prudent resource allocation, and adaptation of standard-of-care treatments. Critical day-to-day clinical operations, number of persons screened before entry, staff temperature monitoring, and personal protection equipment stockpile were reviewed as a dashboard at daily DORS taskforce huddles.

A study protocol for HEalth-Related quality of life-intervention in survivors of Breast and other cancers experiencing cancer-related fatigue using TraditionAL Chinese Medicine: the HERBAL trial.

Background: Cancer-related fatigue (CRF) is a debilitating condition which commonly affects cancer survivors. The management of CRF remains a challenge due to the lack of effective pharmacological interventions. Traditional Chinese medicine (TCM) could be a potential therapeutic option for CRF.

A Study of Medication Use of Cancer and Non-Cancer Patients in Home Hospice Care in Singapore: A Retrospective Study from 2011 to 2015.

In recent years, there has been a rising demand for home hospice care in Singapore and globally. Studies have shown that polypharmacy and the use of potentially inappropriate medications (PIMs) remain prevalent in palliative care patients. This is commonly associated with increased adverse drug reactions and hospitalization.

Design Considerations in the Development of App-Based Oral Anticancer Medication Management Systems: a Qualitative Evaluation of Pharmacists' and Patients' Perspectives.

Smartphone apps can potentially help in enhancing oral anticancer medication (OAM) adherence. Patient adoption and efficacy of such apps depends on inclusion of user-centred and evidence-based features. The objective of this study was to identify important design considerations from the perspectives of patients taking OAMs, caregivers and oncology pharmacists.

Lecture 1-Justification of the Value of Clinical Pharmacy Services and Clinical Indicators Measurements-Introductory Remarks from a Traveler on a 40-Year Wayfaring Journey with Clinical Pharmacy and Pharmaceutical Care.

Without question, health care delivery, and clinical pharmacy’s purpose in it, is changing rapidly all over the world. Pharmacy’s place in the new health care environment is ensured only to the extent that the purpose of pharmaceutical care is understood and transmitted to the global structures of these developing organizational patterns and paradigm shifts. While the current trend toward commodification of illness and treatment seems to be driving efforts to consolidate the economic factors of pharmaceutical distribution, a new type of practice—patient-driven health care—has continued to shape the interactions of pharmacists and patients all over the world.

Briefing Note: Proceedings of the Singapore National Clinical Pharmacy Colloquium-Health Manpower Development Planning.

The nation of Singapore highly values its health service as well as the component of healthcare delivery that includes clinical pharmacy and administration. The Ministry of Health (MOH) engaged the services of Dr. Richard Parrish to better understand the relationship between the Singaporean citizenry and its clinical pharmacists.

User acceptance of an app-based adherence intervention: Perspectives from patients taking oral anticancer medications.

Background: Widespread adoption by patients is imperative for the success of app-based interventions for enhancing adherence to oral anticancer medications. Patients' attitudes and beliefs should be evaluated to understand determinants of their acceptance and adoption of such interventions.

Objective: To identify factors that influence cancer patients' intention to adopt an app-based system for enhancing oral anticancer medication adherence.

Prevalence and Risk of Polypharmacy Among Elderly Cancer Patients Receiving Chemotherapy in Ambulatory Oncology Setting.

Purpose Of Review: This was a single center, retrospective cross-sectional study looking into the incidence and types of drug-related problems (DRPs) detected among elderly cancer patients receiving at least three long-term medications concurrent with IV chemotherapy, and the types of intervention taken to address these DRPs. This paper serves to elucidate the prevalence and risk of polypharmacy in our geriatric oncology population in an ambulatory care setting, to raise awareness on this growing issue and to encourage more resource allocation to address this healthcare phenomenon.

Recent Findings: DRP was detected in 77.

MedAd-AppQ: A quality assessment tool for medication adherence apps on iOS and android platforms.

Background: With the recent proliferation of smartphone medication adherence applications (apps), it is increasingly more difficult for patients and clinicians to identify the most useful app.

Objective: To develop a quality assessment tool for medication adherence apps, and evaluate the quality of such apps from the major app stores.

Methods: In this study, a Medication Adherence App Quality assessment tool (MedAd-AppQ) was developed and two evaluators independently assessed apps that fulfilled the following criteria: availability in English, had at least a medication reminder feature, non-specific to certain disease conditions (generic apps), free of technical malfunctions and availability on both the iPhone Operating System (iOS) and Android platforms.