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Article ; Online: How Should the Rehabilitation Community Prepare for 2019-nCoV?

Choon-Huat Koh, Gerald / Hoenig, Helen

Archives of physical medicine and rehabilitation

2020 Volume 101, Issue 6, Page(s) 1068–1071

Abstract: With the novel coronavirus 2019 (2019-nCoV) pandemic spreading quickly in the United States and the world, it is urgent that the rehabilitation community quickly understands the epidemiology of the virus and what we can and must do to face this microbial ...

Abstract	With the novel coronavirus 2019 (2019-nCoV) pandemic spreading quickly in the United States and the world, it is urgent that the rehabilitation community quickly understands the epidemiology of the virus and what we can and must do to face this microbial adversary at the early stages of this likely long global pandemic. The 2019-nCoV is a novel virus so most of the world's population does not have prior immunity to it. It is more infectious and fatal than seasonal influenza, and definitive treatment and a vaccine are months away. Our arsenal against it is currently mainly social distancing and infection control measures.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Communication ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Humans ; Infection Control ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Rehabilitation/methods ; Rehabilitation/organization & administration ; Risk Factors ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-03-16
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2020.03.003
Database	MEDical Literature Analysis and Retrieval System OnLINE

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

Tyagi, Shilpa / Koh, Victoria / Koh, Gerald Choon-Huat / Low, Lian Leng / Lee, Eng Sing

PloS one

2022 Volume 17, Issue 12, Page(s) e0278559

Abstract: 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 ... ...

Abstract	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. Our Delphi study comprised three rounds of online voting from purposively sampled family physicians in public and private settings. Delphi round 1 included open-ended questions for idea generation. The subsequent two rounds used questions with pre-selected options. Consensus was achieved based on a pre-defined criteria following an iterative process. The response rates for the three rounds were 61.7% (37/60), 86.5% (32/37) and 93.8% (30/32), respectively. Among 40 panellists who responded, 46.0% were 31-40 years old, 64.9% were male and 73.0% were from the public primary healthcare setting. Based on the findings of rounds 1, 2 and 3, consensus on the definition of a chronic condition, multimorbidity and finalised list of chronic conditions were achieved. For a condition to be chronic, it should last for six months or more, be recurrent or persistent, impact patients across multiple domains and require long-term management. The consensus-derived definition of multimorbidity is the presence of three or more chronic conditions from a finalised list of 23 chronic conditions. We anticipate that our findings will inform multimorbidity conceptualisation at the national level, standardise multimorbidity measurement in primary care and facilitate resource allocation for patients with multimorbidity.
MeSH term(s)	Humans ; Male ; Adult ; Female ; Multimorbidity ; Delphi Technique ; Singapore ; Concept Formation ; Primary Health Care
Language	English
Publishing date	2022-12-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0278559
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The associations between caregivers' psychosocial characteristics and caregivers' depressive symptoms in stroke settings: a cohort study.

Koh, Yen Sin / Subramaniam, Mythily / Matchar, David Bruce / Hong, Song-Iee / Koh, Gerald Choon-Huat

BMC psychology

2022 Volume 10, Issue 1, Page(s) 121

Abstract: Background: Studies have found that caregivers can influence stroke survivors' outcomes, such as mortality. It is thus pertinent to identify significant factors associated with caregivers' outcomes. The study objective was to examine the associations ... ...

Abstract	Background: Studies have found that caregivers can influence stroke survivors' outcomes, such as mortality. It is thus pertinent to identify significant factors associated with caregivers' outcomes. The study objective was to examine the associations between caregivers' psychosocial characteristics and caregivers' depressive symptoms. Methods: The analysis obtained three-month and one-year post-stroke data from the Singapore Stroke Study, which was collected from hospital settings. Caregivers' depressive symptoms were assessed via the Center for Epidemiologic Studies Depression instrument. Psychosocial characteristics of caregivers included subjective burden (Zarit Burden Interview), quality of care-relationship (a modified 3-item scale from the University of Southern California Longitudinal Study of Three-Generation Families) and expressive social support (an 8-item scale from Pearlin et al.). Mixed effect Tobit regressions were used to examine the associations between these study variables. Results: A total of 214 caregivers of stroke patients hospitalized were included in the final analysis. Most caregivers were Chinese women with secondary school education, unemployed and married to the patients. Caregivers' subjective burden was positively associated with their depressive symptoms (Partial regression coefficient: 0.18, 95% CI 0.11-0.24). Quality of care-relationship (Partial regression coefficient: - 0.35, 95% CI - 0.63 to - 0.06) and expressive social support (partial regression coefficient: - 0.28, 95% CI - 0.37 to - 0.19) were negatively associated with caregivers' depressive symptoms. Caregivers' depressive symptoms were higher at three-month post-stroke than one-year post-stroke (Partial regression coefficient: - 1.00, 95% CI - 1.80 to - 0.20). Conclusion: The study identified subjective burden, quality of care-relationship and expressive social support as significantly associated with caregivers' depressive symptoms. Caregivers' communication skills may also play a role in reducing caregivers' depressive symptoms.
MeSH term(s)	Caregivers/psychology ; Cohort Studies ; Depression/psychology ; Female ; Humans ; Longitudinal Studies ; Stroke/psychology
Language	English
Publishing date	2022-05-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2705921-2
ISSN	2050-7283 ; 2050-7283
ISSN (online)	2050-7283
ISSN	2050-7283
DOI	10.1186/s40359-022-00828-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Defining and measuring multimorbidity in primary care in Singapore

Shilpa Tyagi / Victoria Koh / Gerald Choon-Huat Koh / Lian Leng Low / Eng Sing Lee

PLoS ONE, Vol 17, Iss

Results of an online Delphi study

2022 Volume 12

Abstract	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. Our Delphi study comprised three rounds of online voting from purposively sampled family physicians in public and private settings. Delphi round 1 included open-ended questions for idea generation. The subsequent two rounds used questions with pre-selected options. Consensus was achieved based on a pre-defined criteria following an iterative process. The response rates for the three rounds were 61.7% (37/60), 86.5% (32/37) and 93.8% (30/32), respectively. Among 40 panellists who responded, 46.0% were 31–40 years old, 64.9% were male and 73.0% were from the public primary healthcare setting. Based on the findings of rounds 1, 2 and 3, consensus on the definition of a chronic condition, multimorbidity and finalised list of chronic conditions were achieved. For a condition to be chronic, it should last for six months or more, be recurrent or persistent, impact patients across multiple domains and require long-term management. The consensus-derived definition of multimorbidity is the presence of three or more chronic conditions from a finalised list of 23 chronic conditions. We anticipate that our findings will inform multimorbidity conceptualisation at the national level, standardise multimorbidity measurement in primary care and facilitate resource allocation for patients with multimorbidity.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Healthier SG: Singapore's multi-year strategy to transform primary healthcare.

Foo, Chuan De / Chia, Hui Xiang / Teo, Ken Wah / Farwin, Aysha / Hashim, Jumana / Choon-Huat Koh, Gerald / Matchar, David Bruce / Legido-Quigley, Helena / Yap, Jason C H

The Lancet regional health. Western Pacific

2023 Volume 37, Page(s) 100861

Language	English
Publishing date	2023-07-27
Publishing country	England
Document type	Journal Article
ISSN	2666-6065
ISSN (online)	2666-6065
DOI	10.1016/j.lanwpc.2023.100861
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Examining the Influence of Social Interactions and Community Resources on Caregivers' Burden in Stroke Settings: A Prospective Cohort Study.

Koh, Yen Sin / Koh, Gerald Choon-Huat / Matchar, David Bruce / Hong, Song-Iee / Tai, Bee Choo

International journal of environmental research and public health

2021 Volume 18, Issue 23

Abstract: Since the introduction of the integrated care model, understanding how social interactions and community resources can alleviate caregivers' burden is vital to minimizing negative patients' outcomes. This study ( ...

Abstract	Since the introduction of the integrated care model, understanding how social interactions and community resources can alleviate caregivers' burden is vital to minimizing negative patients' outcomes. This study (
MeSH term(s)	Caregivers ; Community Resources ; Humans ; Prospective Studies ; Quality of Life ; Social Interaction ; Stroke/therapy
Language	English
Publishing date	2021-11-23
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph182312310
Database	MEDical Literature Analysis and Retrieval System OnLINE

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

Koh, Jin Hean / Chong, Lydia Ching Yee / Koh, Gerald Choon Huat / Tyagi, Shilpa

Journal of medical Internet research

2023 Volume 25, Page(s) e33185

Abstract: 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 ... ...

Abstract	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. Several systematic reviews and meta-analyses have been conducted to assess the effectiveness of these interventions. However, these reviews often have conflicting conclusions. Objective: We aim to conduct an umbrella review to critically appraise and summarize the available evidence on telemedicine interventions for the management of COPD. Methods: In this umbrella review, the MEDLINE, Embase, PsycINFO, and Cochrane databases were searched from inception to May 2022 for systematic reviews and meta-analyses relating to telemedicine interventions for the management of COPD. We compared odds ratios, measures of quality, and heterogeneity across different outcomes. Results: We identified 7 systematic reviews that met the inclusion criteria. Telemedicine interventions used in these reviews were teletreatment, telemonitoring, and telesupport. Telesupport interventions significantly reduced the number of inpatient days and quality of life. Telemonitoring interventions were associated with significant reductions in respiratory exacerbations and hospitalization rates. Teletreatment showed significant effectiveness in reducing respiratory exacerbations, hospitalization rate, compliance (acceptance and dropout rate), and physical activity. Among studies that used integrated telemedicine interventions, there was a significant improvement in physical activity. Conclusions: Telemedicine interventions showed noninferiority or superiority over the standard of care for the management of COPD. Telemedicine interventions should be considered as a supplement to usual methods of care for the outpatient management of COPD, with the aim of reducing the burden on health care systems.
MeSH term(s)	Humans ; Quality of Life ; Systematic Reviews as Topic ; Pulmonary Disease, Chronic Obstructive/therapy ; Telemedicine/methods ; Delivery of Health Care
Language	English
Publishing date	2023-02-16
Publishing country	Canada
Document type	Journal Article ; Review
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1438-8871
ISSN (online)	1438-8871
ISSN	1438-8871
DOI	10.2196/33185
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: How Should the Rehabilitation Community Prepare for 2019-nCoV?

Choon-Huat Koh, Gerald / Hoenig, Helen

Arch Phys Med Rehabil

Abstract	With the novel coronavirus 2019 (2019-nCoV) pandemic spreading quickly in the United States and the world, it is urgent that the rehabilitation community quickly understands the epidemiology of the virus and what we can and must do to face this microbial adversary at the early stages of this likely long global pandemic. The 2019-nCoV is a novel virus so most of the world's population does not have prior immunity to it. It is more infectious and fatal than seasonal influenza, and definitive treatment and a vaccine are months away. Our arsenal against it is currently mainly social distancing and infection control measures.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #8747
Database	COVID19

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Article ; Online: The Willingness to Pay for Telemedicine Among Patients With Chronic Diseases: Systematic Review.

Chua, Valerie / Koh, Jin Hean / Koh, Choon Huat Gerald / Tyagi, Shilpa

Journal of medical Internet research

2022 Volume 24, Issue 4, Page(s) e33372

Abstract: Background: Telemedicine is increasingly being leveraged, as the need for remote access to health care has been driven by the rising chronic disease incidence and the COVID-19 pandemic. It is also important to understand patients' willingness to pay ( ... ...

Abstract	Background: Telemedicine is increasingly being leveraged, as the need for remote access to health care has been driven by the rising chronic disease incidence and the COVID-19 pandemic. It is also important to understand patients' willingness to pay (WTP) for telemedicine and the factors contributing toward it, as this knowledge may inform health policy planning processes, such as resource allocation or the development of a pricing strategy for telemedicine services. Currently, most of the published literature is focused on cost-effectiveness analysis findings, which guide health care financing from the health system's perspective. However, there is limited exploration of the WTP from a patient's perspective, despite it being pertinent to the sustainability of telemedicine interventions. Objective: To address this gap in research, this study aims to conduct a systematic review to describe the WTP for telemedicine interventions and to identify the factors influencing WTP among patients with chronic diseases in high-income settings. Methods: We systematically searched 4 databases (PubMed, PsycINFO, Embase, and EconLit). A total of 2 authors were involved in the appraisal. Studies were included if they reported the WTP amounts or identified the factors associated with patients' WTP, involved patients aged ≥18 years who were diagnosed with chronic diseases, and were from high-income settings. Results: A total of 11 studies from 7 countries met this study's inclusion criteria. The proportion of people willing to pay for telemedicine ranged from 19% to 70% across the studies, whereas the values for WTP amounts ranged from US $0.89 to US $821.25. We found a statistically significant correlation of age and distance to a preferred health facility with the WTP for telemedicine. Higher age was associated with a lower WTP, whereas longer travel distance was associated with a higher WTP. Conclusions: On the basis of our findings, the following are recommendations that may enhance the WTP: exposure to the telemedicine intervention before assessing the WTP, the lowering of telemedicine costs, and the provision of patient education to raise awareness on telemedicine's benefits and address patients' concerns. In addition, we recommend that future research be directed at standardizing the reporting of WTP studies with the adoption of a common metric for WTP amounts, which may facilitate the generalization of findings and effect estimates.
MeSH term(s)	Adolescent ; Adult ; COVID-19 ; Chronic Disease ; Cost-Benefit Analysis ; Humans ; Pandemics ; Telemedicine
Language	English
Publishing date	2022-04-13
Publishing country	Canada
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1439-4456
ISSN (online)	1438-8871
ISSN	1439-4456
DOI	10.2196/33372
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evaluating the Effects of Capacity Building Initiatives and Primary Care Networks in Singapore

Andrew Teik Hong Chen / Gerald Choon-Huat Koh / Ngan Phoon Fong / Jeremy Fung Yen Lim / Zoe Jane-Lara Hildon

International Journal of Environmental Research and Public Health, Vol 20, Iss 2192, p

Outcome Harvesting of System Changes to Chronic Disease Care Delivery

2023 Volume 2192

Abstract: 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, ... ...

Abstract	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). The outcomes were generated, refined and verified before shortlisting for analysis. About 134 positive and 22 negative PCN outcomes were observed since inception in 2018. By establishing PCN headquarters and entrusting PCN leaders with the autonomy to run these, as well as focusing policy direction on GP onboarding, GP engagements and clinical governance, the programme successfully harnessed the collective capabilities of GPs. Developments in the organisation (IR1) and monitoring and evaluation (IR4) were the top two contributors for positive and negative outcomes. Sustainable practice and policy changes represented 46% and 20% of the positive outcomes respectively. Sustainable positive outcomes were predominantly contributed by funding, clear programme policy direction and oversight. Conversely, most negative outcomes were due to the limited programme oversight especially in areas not covered by the programme policy.
Keywords	outcome harvesting ; PCN ; chronic disease management ; chronic disease registry ; ancillary services ; team-based care ; Medicine ; R
Subject code	690
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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