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Article: Managing adult asthma during the COVID-19 pandemic: A 2022 review and current recommendations.

Ong, Kheng Yong / Tiew, Pei Yee / Koh, Mariko Siyue

Annals of the Academy of Medicine, Singapore

2022 Volume 51, Issue 10, Page(s) 637–647

Abstract: Introduction: This review aims to examine asthma management during the COVID-19 pandemic.: Method: Relevant recommendations and articles were identified by respiratory professional societies and PubMed search using the terms "asthma" and "COVID-19", ... ...

Abstract	Introduction: This review aims to examine asthma management during the COVID-19 pandemic. Method: Relevant recommendations and articles were identified by respiratory professional societies and PubMed search using the terms "asthma" and "COVID-19", and examined for relevance and inclusion in this study. Results: Recommendations for the management of asthma have remained similar but are now supported by new evidence between the years 2020 and 2022. Patients with well-controlled, mild-to-moderate asthma are unlikely to be at increased risk of acquiring COVID-19 or having worse outcomes from COVID-19. All asthma patients should receive COVID-19 vaccination. Spirometry can be performed with the usual strict infection control procedures unless there is a suspicion of COVID-19. Mask-wearing and other health measures remain important for asthma patients. Conclusion: While previous recommendations were largely based on expert opinion, the tremendous amount of literature published since the pandemic first emerged 2 years ago has helped guide respiratory professional bodies to update their recommendations. This study provides a timely review of the various recommendations and can be used to guide healthcare professionals in managing asthma patients, as the world prepares for a future with COVID-19 becoming endemic. The long-term consequences of COVID-19 infection in asthma patients and the ripple effects of COVID-19 remain uncertain and deserve ongoing study.
MeSH term(s)	Adult ; Humans ; COVID-19 ; Pandemics/prevention & control ; COVID-19 Vaccines ; Asthma/therapy ; Asthma/epidemiology ; Infection Control
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-08-08
Publishing country	Singapore
Document type	Review ; Journal Article
ZDB-ID	604527-3
ISSN	0304-4602
ISSN	0304-4602
DOI	10.47102/annals-acadmedsg.202285
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Article ; Online: Predictors of persistent poor control and validation of ASSESS score: Longitudinal 5-year follow-up of severe asthma cohort.

Tiew, Pei Yee / Tay, Tunn Ren / Chen, Wenjia / Price, David B / Ong, Kheng Yong / Chotirmall, Sanjay H / Koh, Mariko Siyue

The journal of allergy and clinical immunology. Global

2023 Volume 3, Issue 1, Page(s) 100188

Abstract: Background: Longitudinal predictors of persistent poor asthma control in severe asthma (SA) cohort remain scarce. The predictive value of the asthma severity scoring system (ASSESS) in the SA cohort outside the original study and in the Asian population ...

Abstract	Background: Longitudinal predictors of persistent poor asthma control in severe asthma (SA) cohort remain scarce. The predictive value of the asthma severity scoring system (ASSESS) in the SA cohort outside the original study and in the Asian population is unknown. Objective: We sought to determine the 5-year longitudinal outcome of patients with SA and validate the use of ASSESS score in predicting future outcomes in SA. Methods: A prospective longitudinal observational study of patients with SA attending the multidisciplinary specialist SA clinic of the Singapore General Hospital from 2011 to 2021 was conducted. The number of exacerbations and asthma control test results were recorded yearly for 5 consecutive years. The ASSESS score was computed at baseline, and the area under the receiver-operating characteristic curve for predicting persistent poor asthma control was generated. Results: Of the 489 patients recruited into the study, 306 patients with 5-year follow-up data were analyzed. Seventy-three percent had type 2 inflammation with increased overall exacerbations over 5 years (rate ratio, 2.55; 95% CI, 1.31-4.96; Conclusions: Bronchiectasis and gastroesophageal reflux disease are predictors for persistent poor asthma control and targeted traits for precision medicine in SA. The ASSESS score has a good prediction for persistent poor asthma control over 5 years.
Language	English
Publishing date	2023-11-20
Publishing country	United States
Document type	Journal Article
ISSN	2772-8293
ISSN (online)	2772-8293
DOI	10.1016/j.jacig.2023.100188
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Article ; Online: A qualitative study of challenges and enablers faced by private general practitioners providing primary care to patients with complex needs in Singapore.

Wong, Peng Yong Andrew / Chan, Foong Yee Sara / Ong, Laysee / Lee, Kheng Hock

BMC primary care

2022 Volume 23, Issue 1, Page(s) 14

Abstract: Background: Singapore faces an ageing population with increasingly complex healthcare needs, a problem which could be addressed by high quality primary care. Many patients with complex needs are not managed by private general practitioners (GPs) who ... ...

Abstract	Background: Singapore faces an ageing population with increasingly complex healthcare needs, a problem which could be addressed by high quality primary care. Many patients with complex needs are not managed by private general practitioners (GPs) who form the majority of the primary care workforce. Currently, there is paucity of literature describing the needs of these private GPs in providing such care. Aim: Understand the challenges, enablers and possible solutions from the perspective of private GPs in providing primary care of patients with complex needs. Method: We conducted a qualitative study using an inductive approach. Private GPs were interviewed using a semi-structured question guide with convenience sampling until thematic saturation was reached. These 12 interviewees were part of a network of clinics that provide primary care for complex patients who were recently discharged from a community hospital providing post-acute care. Data was transcribed prior to a process of familiarisation, coded and analysed using thematic analysis by three independent investigators. Results: Three themes emerged in the analysis. From a micro-organizational standpoint, private GPs and patients with complex needs must be willing to accept each other to have a therapeutic encounter (e.g., patients' multidimensional needs, GP clinic set-up is simple yet busy). Next, from a meso-organizational view, trust and good communication channels between the referring doctors and private GPs must exist for effective collaboration in managing complex care. Lastly, macro-organizationally, external stakeholders (e.g., policy-makers) should fund care models, which are financially viable to both patients, and private GPs (e.g., via adequate subsidies and renumeration respectively) as such complex care require many resources. Conclusion: Multiple factors exist which influence the ability of private GPs in Singapore to care for patients with complex needs. Addressing these factors may reduce the over dependence on high-cost hospitals for care delivery in similar healthcare systems.
MeSH term(s)	General Practitioners ; Humans ; Patient Discharge ; Qualitative Research ; Quality of Health Care ; Singapore
Language	English
Publishing date	2022-01-19
Publishing country	England
Document type	Journal Article
ISSN	2731-4553
ISSN (online)	2731-4553
DOI	10.1186/s12875-022-01625-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: What is the hepatitis B vaccination regimen in chronic kidney disease?

Ong, Kheng Yong / Wong, Hong Yun / Khee, Giat Yeng

Cleveland Clinic journal of medicine

2018 Volume 85, Issue 1, Page(s) 32–34

MeSH term(s)	Adolescent ; Adult ; Female ; Hepatitis B/prevention & control ; Hepatitis B Vaccines/standards ; Humans ; Male ; Middle Aged ; Practice Guidelines as Topic ; Renal Insufficiency, Chronic/virology ; Vaccination/standards ; Young Adult
Chemical Substances	Hepatitis B Vaccines
Language	English
Publishing date	2018-01-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	639116-3
ISSN	1939-2869 ; 0891-1150
ISSN (online)	1939-2869
ISSN	0891-1150
DOI	10.3949/ccjm.85a.17017
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Article ; Online: Managing asthma in the COVID-19 pandemic and current recommendations from professional bodies: a review.

Ong, Kheng Yong / Tan, Tze Lee / Chan, Adrian Kwok Wai / Tan, Karen Li Leng / Koh, Mariko Siyue

The Journal of asthma : official journal of the Association for the Care of Asthma

2020 Volume 58, Issue 11, Page(s) 1536–1543

Abstract: Objective: To provide a summary of the management of asthma in the current COVID-19 pandemic by examining and comparing the recommendations from various professional bodies.: Data sources and study selection: Websites of known respiratory ... ...

Abstract	Objective: To provide a summary of the management of asthma in the current COVID-19 pandemic by examining and comparing the recommendations from various professional bodies. Data sources and study selection: Websites of known respiratory professional bodies were searched for COVID-19 guidance related to asthma. Subject matter experts were also consulted for useful resources. Resources that were targeted at healthcare professionals were included, while those targeting patients and the general public were excluded. Results: There is currently little data to suggest that asthma protects from or increases the risk of COVID-19, nor is there any data to support strong recommendations for or against specific asthma treatments. Physicians should continue to manage asthma according to existing accepted asthma guidelines and recommendations. All prescribed medications, especially inhaled corticosteroids, should be continued, and, where indicated, oral corticosteroids and biologic therapies should still be used. Nebulizers and spirometry should be avoided where possible to reduce the risk of viral transmission. A detailed history should be taken to differentiate asthma exacerbations from COVID-19. Conclusion: Understanding similarities and differences among the recommendations of the various professional bodies will aid in medical decision-making in managing asthma in the COVID-19 pandemic. Health professionals should also consider the individual needs, preferences and values of their patients and the unique characteristics of their local healthcare systems.
MeSH term(s)	Adrenal Cortex Hormones/administration & dosage ; Asthma/drug therapy ; COVID-19/epidemiology ; COVID-19 Vaccines/immunology ; Humans ; Nebulizers and Vaporizers ; Rhinitis, Allergic/drug therapy ; SARS-CoV-2 ; Vaccination
Chemical Substances	Adrenal Cortex Hormones ; COVID-19 Vaccines
Keywords	covid19
Language	English
Publishing date	2020-08-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	603816-5
ISSN	1532-4303 ; 0277-0903
ISSN (online)	1532-4303
ISSN	0277-0903
DOI	10.1080/02770903.2020.1804578
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Article ; Online: Managing asthma in the COVID-19 pandemic and current recommendations from professional bodies

Ong, Kheng Yong / Tan, Tze Lee / Chan, Adrian Kwok Wai / Tan, Karen Li Leng / Koh, Mariko Siyue

Journal of Asthma

a review

2020 , Page(s) 1–8

Keywords	Immunology and Allergy ; Pediatrics, Perinatology, and Child Health ; Pulmonary and Respiratory Medicine ; covid19
Language	English
Publisher	Informa UK Limited
Publishing country	uk
Document type	Article ; Online
ZDB-ID	603816-5
ISSN	0277-0903
ISSN	0277-0903
DOI	10.1080/02770903.2020.1804578
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Improving drug allergy label accuracy by supervised safety- and protocol-driven evaluation.

Chong, Chiara Jiamin / Choo, Karen Jui Lin / Ong, Kheng Yong / Tan, Vivian / Khoo, Janet Beng Neo / Murthee, Kavitha Garuna / Hanif, Ibrahim Muhammad / Naing, Chaw Su / Lee, Haur Yueh

Annals of the Academy of Medicine, Singapore

2022 Volume 51, Issue 11, Page(s) 677–685

Abstract: Introduction: Drug allergies are often self-reported but of unknown accuracy. We carried out a prospective study to examine the utility and safety of formal allergology evaluation, and to identify factors associated with accurate drug allergy labels.: ...

Abstract	Introduction: Drug allergies are often self-reported but of unknown accuracy. We carried out a prospective study to examine the utility and safety of formal allergology evaluation, and to identify factors associated with accurate drug allergy labels. Method: All patients who underwent drug allergy evaluation in our clinic during the study period were recruited. Baseline demographics, characteristics of index hypersensitivity reaction and outcomes of evaluation were recorded. Results: A total of 331 patients from March 2019 to June 2021 completed drug allergy evaluation to index drugs of concern. There were 123 (37%) male patients, and the mean age was 49 years (standard deviation 17). There were 170 beta-lactam antibiotics, 53 peri-operative drugs, 43 others, 38 non steroidal anti-inflammatory drugs, and 27 non-beta-lactam antibiotic evaluations. Index reaction occurred within 5 years in 165 (50%) patients, with latency of less than 4 hours in 125 (38%) patients. The most common index reactions were rash, angioedema and urticaria. There were 57 (17%) evaluations stratified as low risk, 222 (67%) moderate risk, and 52 (16%) high risk based on multidisciplinary consensus. Allergy label was found to be false (negative drug evaluation) in 248 (75%) patients, while 16/237 (7%) skin tests, 44/331 (13%) in-clinic graded challenge, and 23/134 (17%) home prolonged challenges were positive (true drug allergy). The most common evaluation reactions were rash and urticaria. No cases of anaphylaxis were elicited. Conclusion: Seventy-five percent of drug allergy labels are inaccurate. Risk-stratified, protocolised allergy evaluation is safe. Prolonged drug challenge increases the sensitivity of drug allergy evaluation and should therefore be performed when indicated.
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Prospective Studies ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/epidemiology ; Exanthema ; Urticaria ; Monobactams
Chemical Substances	Monobactams
Language	English
Publishing date	2022-12-01
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	604527-3
ISSN	0304-4602
ISSN	0304-4602
DOI	10.47102/annals-acadmedsg.2022118
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Article ; Online: Project Octo-Pills - A practice model engaging community pharmacists in the care of patients from a tertiary hospital.

Ong, Kheng Yong / Chung, Wing Lam / Mamun, Kaysar / Chen, Li Li

Research in social & administrative pharmacy : RSAP

2017 Volume 14, Issue 8, Page(s) 792–794

Abstract: Even while pharmacy practice evolves to a more patient-centric mode of practice, local hospitals, due to high patient load as well as space and resource constraints, find it challenging to conduct thorough medication review and physical medication ... ...

Abstract	Even while pharmacy practice evolves to a more patient-centric mode of practice, local hospitals, due to high patient load as well as space and resource constraints, find it challenging to conduct thorough medication review and physical medication reconciliation for all patients. In light of this, optimizing the local current healthcare system to involve community pharmacists in the care of patients from public hospitals could potentially better cater to the healthcare needs of the older population. Due to easy accessibility, community pharmacies are often the first point of contact in the healthcare system. Project Octo-Pills aims to engage community pharmacists in the collaborative care of patients from a tertiary hospital, providing patients with quality medication reconciliation and review services from a more convenient location within their neighborhood. This paper describes the model for this pilot initiative.
MeSH term(s)	Community Pharmacy Services/organization & administration ; Drug Interactions ; Drug-Related Side Effects and Adverse Reactions ; Health Services Accessibility ; Humans ; Inappropriate Prescribing ; Intersectoral Collaboration ; Medication Reconciliation ; Pharmacists/organization & administration ; Pilot Projects ; Singapore ; Tertiary Care Centers/organization & administration
Language	English
Publishing date	2017-10-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2192059-X
ISSN	1934-8150 ; 1551-7411
ISSN (online)	1934-8150
ISSN	1551-7411
DOI	10.1016/j.sapharm.2017.10.005
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Article: Heart Wellness Programme: a pilot community-based cardiac rehabilitation programme in a multiethnic society.

Kwan, Yu Heng / Ong, Kheng Yong / Tay, Hung Yong / Chang, Joanne Yeh

Singapore medical journal

2016 Volume 57, Issue 4, Page(s) 188–190

Abstract: Introduction: Community-based exercise programmes have been shown to be effective in the Western world. However, there is a dearth of literature on their effectiveness in Asia. This pilot study aims to assess the effectiveness of the Asian community- ... ...

Abstract	Introduction: Community-based exercise programmes have been shown to be effective in the Western world. However, there is a dearth of literature on their effectiveness in Asia. This pilot study aims to assess the effectiveness of the Asian community-based Health Wellness Programme (HWP) in Singapore. The HWP provides community cardiac rehabilitation services. Methods: A retrospective database analysis was conducted on cardiac rehabilitation patients who had completed the one-year wellness programme from 2010 to 2011. Patients were included in the programme if they had an underlying cardiac disease such as ischaemic heart disease and were deemed as stable by their cardiologist. Patients with New York Heart Association Class III or IV heart failure were excluded from this programme. Sociodemographic, anthropometric, clinical and laboratory data was recorded. Changes between the baseline and final measurements were analysed. Results: Complete data from a total of 136 patients was analysed. Improvements were noted in body fat percentage (change [Δ] -1.3%, p < 0.01), distance walked (Δ 9.7 m, p = 0.01), total cholesterol (Δ -7.8 mg/dL, p = 0.03), low-density lipoprotein (Δ -7.8 mg/dL, p = 0.03) and triglyceride (Δ -17.8 mg/dL, p < 0.01). Conclusion: The low-to-moderate intensity HWP seems to be effective in a multiethnic community setting. To confirm the quality and effectiveness of such a programme in secondary cardiovascular prevention, more evidence from prospective controlled trials with suitable controls is needed.
MeSH term(s)	Aged ; Cardiac Rehabilitation/methods ; Ethnic Groups ; Female ; Follow-Up Studies ; Health Promotion/organization & administration ; Heart Failure/ethnology ; Heart Failure/rehabilitation ; Humans ; Male ; Morbidity/trends ; Pilot Projects ; Retrospective Studies ; Singapore/epidemiology
Language	English
Publishing date	2016-04
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	604319-7
ISSN	0037-5675
ISSN	0037-5675
DOI	10.11622/smedj.2016073
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Article: Managing asthma in the COVID-19 pandemic and current recommendations from professional bodies: a review

Ong, Kheng Yong / Tan, Tze Lee / Chan, Adrian Kwok Wai / Tan, Karen Li Leng / Koh, Mariko Siyue

J Asthma

Abstract: OBJECTIVE: To provide a summary of the management of asthma in the current COVID-19 pandemic by examining and comparing the recommendations from various professional bodies. DATA SOURCES AND STUDY SELECTION: Websites of known respiratory professional ... ...

Abstract	OBJECTIVE: To provide a summary of the management of asthma in the current COVID-19 pandemic by examining and comparing the recommendations from various professional bodies. DATA SOURCES AND STUDY SELECTION: Websites of known respiratory professional bodies were searched for COVID-19 guidance related to asthma. Subject matter experts were also consulted for useful resources. Resources that were targeted at healthcare professionals were included, while those targeting patients and the general public were excluded. RESULTS: There is currently little data to suggest that asthma protects from or increases the risk of COVID-19, nor is there any data to support strong recommendations for or against specific asthma treatments. Physicians should continue to manage asthma according to existing accepted asthma guidelines and recommendations. All prescribed medications, especially inhaled corticosteroids, should be continued, and, where indicated, oral corticosteroids and biologic therapies should still be used. Nebulizers and spirometry should be avoided where possible to reduce the risk of viral transmission. A detailed history should be taken to differentiate asthma exacerbations from COVID-19. CONCLUSION: Understanding similarities and differences among the recommendations of the various professional bodies will aid in medical decision-making in managing asthma in the COVID-19 pandemic. Health professionals should also consider the individual needs, preferences and values of their patients and the unique characteristics of their local healthcare systems.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #706539
Database	COVID19

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