This article shows how Primary Care Physicians can manage stable chronic schizophrenia with complex psycho-social issues in the community. This is made possible through improved access to mental healthcare services. The case study highlights the utilisation of the Mental Health-GP Partnership Programme and Community Mental Health Team to facilitate a smooth transition and maintenance of mental well-being in the community. Resources like Aged Psychiatry Community Assessment and Treatment Service, Assessment and Shared Care Teams, Community Intervention Teams are discussed as well as future directions to strengthen care in the community.

Singapore is among the fastest-aging countries in the world. By 2030, about one in every five residents would be 65 years or older and many of them may need long-term home care. Local studies have predicted a rise in disability rates as the population ages. To meet this need, our government has ramped up home care services to enable the elderly to “age in place” at home. In line with the Singapore Ministry of Health's vision of building sustainable healthcare and the initiative of "Beyond Hospital to Home", transitional care programmes in hospitals were renamed Hospital-to-Home in April 2017.

Based on the National Health Survey in 2010, almost half a million Singaporeans have diabetes, higher than the global prevalence. Diabetes is associated with a host of complications including heart disease, stroke, kidney failure, blindness and amputation. In 2016, Singapore declared a ‘war on diabetes’ to decrease the incidence of diabetes and its complications. Beyond providing healthcare resources, tackling diabetes requires the shifting of mindsets and changing of habits. The case study illustrates how biopsychosocial factors play a role in the optimal care of a diabetic patient. Self-management, acceptance, empowerment and health literacy are essential components to good diabetic care. System and support factors, as well as excellent communication with healthcare providers, are advocated as strategies to optimise outcome.

Genetic testing has the power to identify individuals with increased predisposition to disease, allowing individuals the opportunity to make informed management, treatment and reproductive decisions. As genomic medicine continues to be integrated into aspects of everyday patient care and the indications for genetic testing continue to expand, genetic services are increasingly being offered by non-genetic clinicians. The current complexities of genetic testing highlight the need to support and ensure non-genetic professionals are adequately equipped with the knowledge and skills to provide services. We describe a series of misdiagnosed/mismanaged cases, highlighting the common pitfalls in genetic testing to identify the knowledge gaps and where education and support is needed. We highlight that education focusing on differential diagnoses, test selection and result interpretation is needed. Collaboration and communication between genetic and non-genetic clinicians and integration of genetic counsellors into different medical settings are important. This will minimise the risks and maximise the benefits of genetic testing, ensuring adverse outcomes are mitigated.
Humans ; Missed Diagnosis ; Genetic Testing ; Educational Status ; Diagnosis, Differential ; Genotype