BACKGROUND: Chronic urticaria is a common skin condition that causes significant impact on patient's quality of life. OBJECTIVE: The purpose of the study was to assess adherence to therapy and quality of life of patients with chronic urticaria. We also aimed to study the relationship of medication adherence and quality of life of patients with chronic urticaria. METHODS: A cross sectional study was conducted with 103 patients from the dermatology clinic of National University Hospital, Singapore. Patients with chronic urticaria were asked to fill out a questionnaire for assessment of adherence to therapy and quality of life. We used the Morisky 8-Item Medication Adherence Scale to categorize adherence as high, medium, low. For assessment of quality of life, we used the validated chronic urticaria quality of life questionnaire (CU-Q2oL) by Bairadani et al. RESULTS: The highest median scores for the items measuring quality of life were interference with sleep and pruritus. We also observed that the majority of patients (71.9%) had low adherence to medical therapy. No difference in adherence was noted in patients on once daily medication or more frequent dosing. There was no significant difference in the quality of life among patients with low and medium adherence to therapy. CONCLUSION: Quality of life of patients with chronic urticaria does not depend on the patients' adherence to medications. Dosing frequency does not affect adherence in our study population. It is also important to recognize the symptoms and issues most affecting quality of life of patients with chronic urticaria, so as to improve overall management.
Adult ; Dermatology ; Humans ; Medication Adherence ; Pruritus ; Quality of Life ; Singapore ; Skin ; Urticaria

Aim: To examine the trend of youth depression diagnosed in a healthcare group in Singapore over a 6-year period. Methods: This is a retrospective analysis of the medical records of patients who had been diagnosed with depression from Jan 2013 to Dec 2018 in a healthcare group in Singapore. The yearly trend of depression diagnosis among the youths (10-24 years of age) was compared with adults (25-64 years of age) and the elderly (≥ 65 years of age). The mean age at diagnosis, distribution of gender, ethnicity and clinical care settings among the subgroup of youth patients were compared across the years using analysis of variance or Pearson’s chi-square test. Results: A total of 4701 youths, 15243 adults and 6908 elderly patients were included in the analysis. Between 2013 and 2018, the rise in depression diagnosis in the youth was greater than in the adult and elderly populations, and the mean age at diagnosis decreased from 49.7 ± 0.3 (mean ± SE) years in 2013 to 39.6 ± 0.3 years in 2018. Among the youths, more females had been diagnosed with depression than males and females displayed a larger increase in diagnosis of depression. There was also a larger increase in the diagnosis of depression in primary care compared to emergency departments, outpatient specialist clinics and in-hospital wards. Conclusion Youth depression is a major health problem in Singapore. There is a need for the expansion of resources in a variety of avenues for depressed youths to seek help.

Objective: At the beginning of the coronavirus disease (COVID-19) pandemic in Singapore, the strategy initially involved aggressive ring-fencing of infections, before pivoting towards managing recurrent local interspersed outbreaks of COVID-19. A key feature of Singapore’s efforts to preserve health-care capacity was the implementation of the nationwide Home Recovery Programme (HRP), whereby patients were allowed to recover at home as long as they met certain criteria. The programme was centrally coordinated by Singapore’s Ministry of Health and was supported by telemedicine providers, primary care physicians and government agencies. This report aims to highlight Singapore’s experience in coordinating and implementing the HRP, the challenges faced and the outcomes. Methods: Published and internal data from the Ministry of Health in Singapore, along with policy documents, were reviewed together with a brief literature review of similar programmes conducted globally. Results: Implementation of the HRP led to the majority of patients (98%) recovering from COVID-19 in the outpatient setting, with similar mortality rates to inpatient settings. Hospitalization rates for COVID-19 cases were reduced as compared to previously, alleviating strain on the health-care system. Discussion: The HRP was largely successful at preventing health-care capacities from being overwhelmed, while keeping fatalities to a minimum. Nonetheless, the risks of emergent variants of concern remain present, and heightened vigilance and potential modification of existing protocols based on fluctuations in virulence and infectivity are still needed.