Integrating Mental Health Into Eczema Care
About a third of dermatology patients experience some degree of mental health struggles, which include
depression or anxiety. This can in turn worsen patients’ skin conditions or affect their compliance with
treatment. Recognising the heavy mental health burden of eczema, a multidisciplinary team at NSC introduced
an initiative in August 2022 to better identify eczema patients who may benefit from psychosocial
interventions. This was part of a Clinical Practice Improvement Programme (CPIP) led by a doctor, supported
by a multidisciplinary team comprising members from Pharmacy, Clinic Operations, and Care & Counselling.
Following the CPIP initiative, there are plans to make depression screening a part of clinic workflows, so
that patients who need help can be identified early and referred to NSC’s Psychodermatology Clinic.
Cancer Care Line
The Cancer Care Line, operationalised at TTSH in October 2022, is a phone service that allows cancer
patients to receive timely advice from oncology-trained nurses on their symptom-related enquiries during
clinic operation hours. Nurses can make referrals to other healthcare professionals, such as dietitians and
medical social workers, to support patients’ cancer treatment, where required.
This service is focused on educating and empowering patients with self-care skills, and improving
turnaround time for timely symptomatic management without the need to escalate queries to doctors. With this
channel, unnecessary visits to the ED could be reduced while facilitating necessary urgent emergency care.
Since its launch, Pharmacist Clinics have demonstrated improvements in healthcare manpower resource
allocation. Clinical pharmacists assess patients, engage them in shared decision-making on treatments,
prescribe medications, and monitor for efficacy and adverse effects. As a result, each Pharmacist Clinic
consultation opens up one dermatology specialist appointment for complex cases. This interprofessional
co-management care model has reduced patients’ out-of-pocket payments by about 45 per cent.
By the end of FY2022, the clinical pharmacists co-managed a total of 82 patients, with Patient Reported
Outcome Measures (PROM) at Pharmacist Clinics similar to those at dermatologist clinics. Patient Reported
Experience Measures (PREM) — that includes patient satisfaction with the care experience — were also
positive.
Minimally Invasive Surgical Therapy (MIST) For Benign Prostatic
Hyperplasia
The Urology department at KTPH introduced Minimally Invasive Surgical Therapy (MIST) — REZUM therapy — for
Benign Prostatic Hyperplasia (BPH) in 2021, and since 2022, a full suite of MIST with the addition of
Prostatic Urethral Lift (UroLIFT) has been made available. These low-morbidity procedures allow patients to
be discharged on the same day and negate the need for frequent follow-ups, without medication side effects
such as postural hypotension and sexual dysfunction.
Furthermore, these procedures can be performed under local anaesthesia, and thus, are suitable for patients
who are unfit for general anaesthesia. By the end of 2022, 18 patients with BPH had experienced MIST without
major complications. Importantly, all patients showed improvement in their lower urinary tract symptoms and
urinary flow rate. These outcomes were comparable to standards reported in landmark publications.
