Singapore medical journal
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Singapore medical journal · Nov 2024
Early physiotherapy referral for low back pain reduces healthcare utilisation for advanced imaging and specialist spine surgery consultations.
Low back pain (LBP) is one of the most common presenting complaints among patients and the costliest orthopaedic condition. This study aimed to compare the healthcare utilisation rates of advanced imaging and specialist consultations for LBP between patients presenting with early physiotherapy (EPT) before specialist review and routine physiotherapy (RPT) after specialist review. ⋯ Early physiotherapy reduces the (a) overall treatment duration from the first referral by the primary physician, (b) number of advanced imaging ordered (and thus, associated imaging costs), and (c) total number of clinic and therapy sessions, and it is safe and allows patients to achieve comparable functional outcomes to their counterparts undergoing RPT. These findings support the implementation of EPT for patients with LBP to reduce healthcare utilisation and associated costs for patients, providers and healthcare systems.
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Singapore medical journal · Nov 2024
Long-term clinical outcomes of remote monitoring for implantable cardioverter-defibrillators in Singapore.
Remote monitoring (RM) for cardiac implantable electronic devices is on the rise and has been shown to reduce the burden of in-clinic follow-up visits. We aimed to investigate the long-term clinical outcomes of RM versus no RM. ⋯ Remote monitoring was associated with significantly lower mortality in both ICDs and CRT-Ds and in primary and secondary indications, as well as fewer heart failure hospitalisations. This supports current guidelines recommending the use of RM in all patients with ICD or CRT-D.
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Singapore medical journal · Nov 2024
Factors associated with readmission after long-term administration of tolvaptan in patients with congestive heart failure.
We investigated the factors associated with readmission in patients with congestive heart failure (HF) receiving long-term administration of tolvaptan (TLV) to support treatment decisions for HF. ⋯ We revealed that eGFR was strongly associated with readmission in patients with HF who received long-term administration of TLV. Furthermore, we showed that eGFR is an important indicator in guiding treatment of HF in patients receiving TLV.