MyMedR

Displaying all 4 publications

Abstract:

Sort:

Fulltext Massive open online courses (MOOCs) for continuing medical education - why and how?

Setia S, Tay JC, Chia YC, Subramaniam K

Adv Med Educ Pract, 2019;10:805-812.
PMID: 31572042 DOI: 10.2147/AMEP.S219104

Continuing medical education (CME) is meant to not only improve clinicians' knowledge and skills but also lead to better patient care processes and outcomes. The delivery of CME should be able to encourage the health providers to accept new evidence-based practices, and discard or discontinue less effective care. However, continuing use of expensive yet least effective and inappropriate tools and techniques predominates for CME delivery. Hence, the evidence shows a disconnect between evidence-based recommendations and real-world practice - borne out by less than optimal patient outcomes or treatment targets not being met especially in low- to middle-income countries. There is an ethical and professional obligation on CME-providers and decision-makers to safeguard that CME interventions are appraised not only for their quality and effectiveness but also for cost-effectiveness. The process of learning needs to be engaging, convenient, user-friendly and of minimal cost, especially where it is most needed. Today's technology permits these characteristics to be integrated, along with further enhancement of the engagement process. We review the literature on the mechanics of CME learning that utilizes today's technology tools and propose a framework for more engaging, efficient and cost-effective approach that implements massive open online courses for CME, adapted for the twenty-first century.
Fulltext Nonadherence to statins: individualized intervention strategies outside the pill box

Lansberg P, Lee A, Lee ZV, Subramaniam K, Setia S

Vasc Health Risk Manag, 2018;14:91-102.
PMID: 29872306 DOI: 10.2147/VHRM.S158641

Poor adherence to statin therapy is linked to significantly increased risk of cardiovascular events and death. Unfortunately, adherence to statins is far from optimal. This is an alarming concern for patients prescribed potentially life-saving cholesterol-lowering medication, especially for those at high risk of cardiovascular events. Research on statin adherence has only recently garnered broader attention; hence, major reasons unique to adherence to statin therapy need to be identified as well as suggestions for countermeasures. An integrated approach to minimizing barriers and enhancing facilitation at the levels of the patient, provider, and health system can help address adherence issues. Health care professionals including physicians, pharmacists, and nurses have an obligation to improve patient adherence, as routine care. In order to achieve sustained results, a multifaceted approach is indispensable.
Fulltext Integrated Real-World Data Warehouses across Seven Evolving Asian Healthcare Systems: A Scoping Review

Shau WY, Santoso H, Jip V, Setia S

J Med Internet Res, 2024 May 07.
PMID: 38749399 DOI: 10.2196/56686

BACKGROUND: Asia consists of diverse nations with extremely variable healthcare systems and socio-economic intricacies. Integrated real-world data (RWD) research warehouses provide vast interconnected datasets that uphold statistical rigor. However, their intricate details remain underexplored, restricting their broader application in healthcare research, policies and partnerships.
OBJECTIVE: Building on our prior research that analyzed integrated RWD warehouses in India, Thailand and Taiwan, this study is an extension to seven distinct Asian healthcare systems: Hong Kong, Indonesia, Malaysia, Pakistan, the Philippines, Singapore, and Vietnam. We aimed to map the evolving landscape of RWD use, elucidate the current state of real-world evidence (RWE) generation from integrated databases, and understand evolving preferences for RWD methodologies and database(s) use.
METHODS: : A systematic scoping review methodology was employed, centering on contemporary English literature search on PubMed (search date: May 9, 2023). Rigorous screening followed defined eligibility criteria to pinpoint studies utilizing integrated RWD from multiple healthcare facilities in at least one of the seven target Asian nations. No statistical hypotheses were established for the description of the results. Point estimates and their associated errors were determined for the data collected from eligible studies.
RESULTS: Out of the 1483 RWE research titles identified on May 9, 2023, 369 (24.9%) fulfilled the requirements for data extraction and subsequent analysis. Singapore, Hong Kong, and Malaysia contributed to ≥100 publications, each marked by a higher proportion of SCS at 51% (80/157), 66.2% (86/130), and 50% (50/100), respectively, and were classified as Solo Scholars. Indonesia, Pakistan, Vietnam and the Philippines had fewer publications and a higher proportion of CCCS at 78.8% (26/33), 58.1% (18/31), 74.1% (20/27), and 86.4% (19/22), respectively and were classified as Global Collaborators. Collaboration with the countries outside the seven target nations appeared in 84.2%-97.7% of the CCCS of each nation. Among target nations, Singapore and Malaysia emerged as preferred research partners for other nations. From 2018 to 2023, most nations displayed an increasing trend in study numbers, with Vietnam (24.5%) and Pakistan (21.2%) leading the growth; the only exception was the Philippines, which declined by -14.5%. Clinical registry databases were predominant across all CCCS from every target nation. For SCS, Indonesia, Malaysia, and the Philippines favored clinical registries; Singapore had a balanced usage of clinical registries and EMR/EHR, while Hong Kong, Pakistan, and Vietnam leaned towards EMR/EHR. Over 90% of the studies took more than 2 years from completion to publication.
CONCLUSIONS: The observed variations in contemporary RWD publications across the 7 nations in Asia exemplify distinct research landscapes across nations that are partially explained by their diverse economic, clinical, and research settings. Nevertheless, recognizing these variations is pivotal for fostering tailored, synergistic strategies that amplify RWD's potential in guiding future healthcare research and policy decisions.
Fulltext Integrated health care systems in Asia: an urgent necessity

Tham TY, Tran TL, Prueksaritanond S, Isidro JS, Setia S, Welluppillai V

Clin Interv Aging, 2018;13:2527-2538.
PMID: 30587945 DOI: 10.2147/CIA.S185048

A rapidly aging population along with the increasing burden of patients with chronic conditions in Asia requires efficient health systems with integrated care. Although some efforts to integrate primary care and hospital care in Asia are underway, overall care delivery remains fragmented and diverse, eg, in terms of medical electronic record sharing and availability, patient registries, and empowerment of primary health care providers to handle chronic illnesses. The primary care sector requires more robust and effective initiatives targeted at specific diseases, particularly chronic conditions such as diabetes, hypertension, depression, and dementia. This can be achieved through integrated care - a health care model of collaborative care provision. For successful implementation of integrated care policy, key stakeholders need a thorough understanding of the high-risk patient population and relevant resources to tackle the imminent population demographic shift due to the extremely rapid rate of increase in the aging population in Asia.