2016 Consensus statement on prevention of atherosclerotic cardiovascular disease in the Hong Kong population

published_or_final_versio

Communicative health literacy in diabetic care: different perspectives from diabetic patients and health professionals

Conference Theme: Asia-Pacific perspectives and evidence on health promotion and education: sharing experiences, efforts and evidenc

Depression care management for Chinese older adults with depressive symptoms

Theme: Healthy Community: We Can Make A Differenc

Depression Care Management Programme in Primary Care Setting: a pilot study

Introduction : Older adults with chronic illness were reported with depressive symptoms but many of them did not receive essential treatment and care. Depression care management programme was piloted in a primary care clinic from March 2010 to October 2010 in Hong Kong.This study reported the effects of this DCM programme on patients’ health-related quality of life, mental health and social network. Method : A quasi-experimental design, using SF-12 Health Survey, Depression, Anxiety, Stress Scale (DASS) and Lubben Social Network Scale (C-LSNS). T-test was used to measure the difference between pre-intervention and post-intervention tests. Results : A total of 34 subjects completed the pre-intervention and post-intervention questionnaires. Majority (79.4%) of the subjects was female and mean age (SD) was 63.26 (10.73). 24% had diabetes and 59% had hypertension. Mental health component of SF-12 changed significantly after the intervention (mean difference (m.d.) = 13.42, p<0.001). Depression was reduced significantly after the intervention (m.d. = - 9.59, p<0.001). Similar pattern occurred in anxiety and stress. Social network was also improved after the intervention (m.d. = 4.06, p< 0.05). Conclusion : DCM programme seemed to improve participants’ mental health and social network. Study with larger sample is warrant to show the actual effects of this programme. Keywords : depression, care management, mental health, primary car

Screening for diabetic retinopathy with or without a copayment in a randomized controlled trial: Influence of the inverse care law

Objective: To examine whether the inverse care law operates in a screening program for diabetic retinopathy (DR) based on fee for service in Hong Kong. Design: Randomized controlled trial. Participants: All those with type 1 or 2 diabetes from 2 clinics were recruited. Intervention: Diabetic retinopathy screening with a small copayment versus free access in a publicly funded family medicine service. Main Outcome Measures: Uptake of screening and severity of DR detected. Association between these outcome variables and independent variables were determined using multivariate logistic regression models and reported as odds ratios (ORs). Results: After randomization, 1387 subjects in the free group and 1379 subjects in the pay group were eligible for screening, and 94.9% (1316/1387) and 92.6% (1277/1379), respectively, agreed to participate in the study. The offer of screening was accepted by 94.8% (1247/1316) in the free group and 91.2% (1164/1277) in the pay group, and the final uptake ratios were 88.5% (1165/1316) and 82.4% (1052/1277), respectively (Pearson chi = 19.74, P<0.001). Being in the pay group was associated with a lower uptake of screening than being in the free group (OR, 0.59; confidence interval [CI], 0.47-0.74) and a lower detection rate of DR (OR, 0.73; CI, 0.60-0.90) after adjustment for potential confounding factors. Subjects with higher socioeconomic status were more likely to attend screening and had a lower prevalence of DR detected. Conclusions: The inverse care law seems to operate in a preventive intervention when a relatively small copayment is applied. There is a case for making effective preventive services free of charge. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2013 American Academy of Ophthalmology.link_to_subscribed_fulltex

Screening for diabetic retinopathy in Hong Kong: a cost-effectiveness analysis

Poster PresentationConference Theme: Global Public Health Challenge

Systematic screening for diabetic retinopathy in Hong Kong

Oral Presentations: Session 3 - Reproduction & Development and Public Health: 3.1

Prevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: A prospective cohort study

Background. Despite World Health Organization recommendations, the rate of 23-valent pneumococcal (PPV) and influenza (TIV) vaccination among elderly persons in Hong Kong, China, is exceptionally low because of doubts about effectiveness of vaccination. The efficacy of dual vaccination remains unknown. Methods. From 3 December 2007 to 30 June 2008, we conducted a prospective cohort study by recruiting outpatients aged ≥65 years with chronic illness to participate in a PPV and TIV vaccination program. All were observed until 31 March 2009. The outcome of subjects, including the rates of death, hospitalization, pneumonia, ischemic stroke, acute myocardial infarction, and coronary and intensive care admissions, were determined. Results. Of the 36,636 subjects recruited, 7292 received both PPV and TIV, 2076 received TIV vaccine alone, 1875 received PPV alone, and 25,393 were unvaccinated, with a duration of follow-up of 45,834 person-years. Baseline characteristics were well matched between the groups, except that there were fewer male patients in the PPV and TIV group and fewer cases of comorbid chronic obstructive pulmonary disease among unvaccinated persons. At week 64 from commencement of the study, dual-vaccinees experienced fewer deaths (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.55-0.77]; P < .001) and fewer cases of pneumonia (HR, 0.57; 95% CI, 0.51-0.64; P < .001), ischemic stroke (HR, 0.67; 95% CI, 0.54-0.83; P < .001), and acute myocardial infarction (HR, 0.52; 95% CI, 0.38-0.71; P < .001), compared with unvaccinated subjects. Dual vaccination resulted in fewer coronary (HR, 0.59; 95% CI, 0.44-0.79; P < .001) and intensive care admissions (HR, 0.45; 95% CI, 0.22-0.94; P = .03), compared with among unvaccinated subjects. Conclusions. Dual vaccination with PPV and TIV is effective in protecting elderly persons with chronic illness from developing complications from respiratory, cardiovascular, and cerebrovascular diseases, thereby reducing hospitalization, coronary or intensive care admissions, and death. © 2010 by the Infectious Diseases Society of America. All rights reserved.link_to_subscribed_fulltex

Evaulating a low-intensity health education intervention on pneumococcal vaccination uptake among elders with chronic illinesses

Conference Theme: Cultivating Healthy Communitie