Development and evaluation of a lightweight large language model chatbot for medication enquiry.

Large Language Models (LLMs) show promise in augmenting digital health applications. However, development and scaling of large models face computational constraints, data security concerns and limitations of internet accessibility in some regions. We developed and tested Med-Pal, a medical domain-specific LLM-chatbot fine-tuned with a fine-grained, expert curated medication-enquiry dataset consisting of 1,100 question and answer pairs.

Understanding Patient and Physiotherapist Requirements for a Personalized Automated Smartphone Telemonitored App for Posttotal Knee Arthroplasty Rehabilitation: Qualitative Study.

Background: Total knee arthroplasty (TKA) is a cost-effective surgical intervention for painful knee osteoarthritis in older adults, but postsurgery rehabilitation access is limited. Telerehabilitation offers a solution, but existing models require significant therapist involvement and a costly setup. A personalized smartphone-based automated program could be a cost-effective alternative.

Health Coaching and Its Impact in the Remote Management of Patients With Type 2 Diabetes Mellitus: Scoping Review of the Literature.

Background: Health coaching refers to the practice of health education and promotion to drive goal-directed behavioral changes and improve an individual's well-being. Remote patient monitoring systems, which employ health coaching interventions, have been gaining interest and may aid in the management of patients with type 2 diabetes mellitus (T2DM).

Objective: This scoping review aims to summarize the impact of health coaching in the remote monitoring of patients with T2DM.

Acceptability of an AI-enabled family module in a mobile app for enhanced diabetes management: Patient and family perspectives.

Objective: To explore the acceptability of family support through an AI-enabled mobile app and identify preferences for its novel family module features among patients with type 2 diabetes (T2DM) and family members.

Methods: Semi-structured interviews were conducted with patients with T2DM and family members. A mock wireframe of the FAMILY module was created to help participants visualize the module features.

Monitoring psoriatic arthritis in research and clinical practice.

Purpose Of Review: To discuss the varies outcome measure instruments for the assessment of different domains for psoriatic arthritis (PsA) both in trial and clinical practice settings.

Recent Findings: PsA is a multifaceted chronic inflammatory disease with diverse manifestations. This pose challenges of comprehensive assessment of the outcome of PsA.

Physical activity of patients with rheumatoid arthritis in Singapore: a pilot study.

Introduction: Studies have shown that patients with rheumatoid arthritis (RA) have lower levels of physical activity (PA) than healthy controls, despite the benefits of PA in reducing pain and stiffness. We aimed to compare the levels of PA in patients with RA with that of the general population and identify factors associated with meeting the World Health Organization (WHO) recommendations for PA.

Methods: Consecutive patients with RA were recruited from an outpatient rheumatology clinic in a tertiary hospital in Singapore.

Facilitators and Barriers to Physical Activity for Patients With Rheumatoid Arthritis and Axial Spondyloarthritis.

Background: Physical activity is important in patients with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA). Current literature suggests they engage in less physical activity compared to healthy controls. Reasons for this discrepancy has not been well studied in Asian populations.

Association of Novel Clinical and Behavioural Markers with HbA1c Improvement: A Latent Class Analysis of 912 Patients with Type 2 Diabetes Mellitus.

Objective: The escalating prevalence of Type 2 Diabetes Mellitus (T2DM) overwhelms healthcare systems. Lifestyle interventions enhancing patient monitoring and adherence vary in efficacy, emphasizing the need to understand differential response across patient subgroups. This study aimed to segment patients with T2DM into distinct latent classes and identify characteristics associated with optimal 12-month glycated haemoglobin (HbA1c) reduction.

Exploring the Implementation of Shared Decision-Making Involving Health Coaches for Diabetes and Hypertension Self-Management: Qualitative Study.

Background: An emerging focus on person-centered care has prompted the need to understand how shared decision-making (SDM) and health coaching could support self-management of diabetes and hypertension.

Objective: This study aims to explore preferences for the scope of involvement of health coaches and health care professionals (HCPs) in SDM and the factors that may influence optimal implementation of SDM from the perspectives of patients and HCPs.

Methods: We conducted focus group discussions with 39 patients with diabetes and hypertension and 45 HCPs involved in their care.

Acceptability of Mobile App-Based Motivational Interviewing and Preferences for App Features to Support Self-Management in Patients With Type 2 Diabetes: Qualitative Study.

Background: Patients with type 2 diabetes mellitus (T2DM) experience multiple barriers to improving self-management. Evidence suggests that motivational interviewing (MI), a patient-centered communication method, can address patient barriers and promote healthy behavior. Despite the value of MI, existing MI studies predominantly used face-to-face or phone-based interventions.

Empowering patients with comorbid diabetes and hypertension through a multi-component intervention of mobile app, health coaching and shared decision-making: Protocol for an effectiveness-implementation of randomised controlled trial.

Introduction: Diabetes and hypertension are prevalent and costly to the health system. We have developed a mobile app (EMPOWER app) which enables remote monitoring and education through personalised nudges. We aim to study the effectiveness of a multi-component intervention comprising the EMPOWER mobile app with health coaching and shared decision-making for diabetes and hypertension.

Establishing language and ethnic equivalence for health-related quality of life item banks and testing their efficiency via computerised adaptive testing simulations.

Purpose: We aimed to (1) establish linguistic and ethnic equivalence (i.e. lack of bias) for the items in the English and Chinese versions of the Singapore Health and Well Being (SHAWS) Physical Functioning (PF), Positive Mindset (PM) and Social Relationship (SR) item banks (IBs); and (2) evaluate the preliminary efficiency of these IBs using Computer Adaptive Testing (CAT) simulations.

Evidence of the interactions between immunosuppressive drugs used in autoimmune rheumatic diseases and Chinese herbal medicine: A scoping review.

Objectives: Chinese herbal medicine (CHM) has been shown to be effective in autoimmune rheumatic diseases, but harmful herb-drug interactions might be inherent. We aim to review the evidence regarding herb-drug interactions between immunosuppressive drugs used in autoimmune rheumatic diseases and CHM.

Methods: We searched PubMed, EMBASE and CINAHL from inception till 30 April 2023 using keywords that encompassed 'herb-drug interactions', 'herbs' and 'immunosuppressants'.

The association between chronic sinonasal inflammation and nasopharyngeal carcinoma - A systematic review and meta-analysis.

Purpose: There has been mounting evidence that inflammation is a key risk factor towards the development of certain cancers. Past studies have shown associations between nasopharyngeal carcinoma (NPC) and sinonasal tract inflammation. We aim to conduct a review and meta-analysis on the association between NPC and chronic sinus inflammation.

Socioeconomic and behavioral determinants of non-compliance with physician referrals following community screening for diabetes, hypertension and hyperlipidemia: a mixed-methods study.

Early detection of undiagnosed diabetes, hypertension or hyperlipidemia through screening could reduce healthcare costs resulting from disease complications. To date, despite ample research on the factors linked to the uptake of community health screening programs, little attention has been directed at delayed or incomplete follow-up after positive outcomes are identified in community screening tests. This study aimed to investigate the socioeconomic and behavioral factors that influence non-compliance with recommendations for primary care physician referrals, following community-based screening for diabetes, hypertension and hyperlipidemia.

Evaluating the association of COVID-19 restrictions on discharge planning and post-discharge outcomes in the community hospital and Singapore regional health system.

Objectives: The COVID-19 is a global health issue with widespread impact around the world, and many countries initiated lockdowns as part of their preventive measures. We aim to quantify the duration of delay in discharge to community from Community Hospitals, as well as quantify adverse patient outcomes post discharge pre and during lockdown period.

Design And Methods: We conducted a before-after study comparing the length of stay in Community Hospitals, unscheduled readmissions or Emergency Department attendance, patients' quality of life using EQ5D-5l, number and severity of falls, in patients admitted and discharged before and during lockdown period.

Role of Caregivers in Remote Management of Patients With Type 2 Diabetes Mellitus: Systematic Review of Literature.

Background: With the growing use of remote monitoring technologies in the management of patients with type 2 diabetes mellitus (T2DM), caregivers are becoming important resources that can be tapped into to improve patient care.

Objective: This review aims to summarize the role of caregivers in the remote monitoring of patients with T2DM.

Methods: We performed a systematic review in MEDLINE, Embase, Scopus, PsycINFO, and Web of Science up to 2022.

Residents' Report of COVID-19 Associated Training Disruptions, Stressors, and Opportunities During the Pandemic-The Singapore Experience.

Background: The COVID-19 pandemic has disrupted residency training. Several studies have been performed to investigate the impact of the pandemic on residency training in Accreditation Council for Graduate Medical Education-International (ACGME-I)-accredited institutions. However, these were either limited to certain specialties or failed to consider possible opportunities from the pandemic.

Association of anxiety, depression and resilience with overall health and functioning in axial spondyloarthritis (axSpA): a cross-sectional study.

Objectives: To evaluate the association between anxiety, depression and resilience with overall health and functioning in axial spondyloarthritis (axSpA).

Design: Cross-sectional evaluation of baseline data from a prospective cohort study, with recruitment from January 2018 to March 2021.

Setting: Outpatient clinic in a tertiary hospital in Singapore.