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The COVID-19 pandemic presented the greatest challenge to modern intensive care medicine since its founding as a specialty in 1952, with its effects felt across health care services in all regions, including low-resourced settings. A paucity of data remains regarding the provision of intensive care medicine across the globe, particularly after the COVID-19 pandemic. To determine the broad state of critical care medicine after the pandemic in the Asia-Pacific region, the inaugural Asia-Pacific Critical Care Societies Summit was held in Singapore as a satellite meeting of the Asia-Pacific Intensive Care Symposium on August 18, 2023. This article summarizes this summit and provides key health and economic data for representative countries before detailing the resolutions and planned actions arising from this initiative. Fourteen critical care societies participated in the inaugural summit and consented to publication of societal reports. Common challenges and priorities for participating societies included issues around education and training, specialty and workforce advocacy, and collaboration and research. As a result of this summit, societies resolved to establish an Asia-Pacific education forum, to encourage the development of Asia-Pacific critical care trials, and to support engagement in multinational studies. A second Asia-Pacific Critical Care Societies Summit will be convened in 2024, with a focus on safety and quality challenges within ICUs represented by the societies present and discussion of the listed priority areas.

Introduction The SMART Quit Clinic Program (FAHSAI Clinic) has been implemented in Thailand since 2010; however, it remains unclear whether the benefits gained from this program justify its costs. We assessed its cost-effectiveness compared to usual care in a population of Thai smokers with cardiovascular disease (CVD) from a societal perspective. Methods We conducted a cost-utility analysis using a Markov model to simulate lifetime costs and quality-adjusted life years (QALYs) of Thai smokers aged ≥35 years receiving smoking cessation services offered from FAHSAI Clinic or usual care over a horizon of 50 years. The model used a 6-month continuous abstinence rate from a multicenter prospective study of 24 FAHSAI Clinics. A series of sensitivity analyses including probabilistic sensitivity analysis were conducted to assess robustness of study findings. Cost data are presented in US$ for 2020. Results The FAHSAI Clinic was dominant as it was less costly ($9537.92 vs $10964.19) and more effective (6.06 vs 5.96 QALYs) compared with usual care over the 50-year time horizon. Changes in risks of stroke and coronary heart disease among males had the largest impact on the cost-effectiveness findings. The probability that FAHSAI Clinic was cost-effective was 99.8% at a willingness-to- pay threshold of $5120. Conclusions The FAHSAI Clinic smoking cessation program was clinically superior and cost-saving compared to usual care for Thai patients with CVD in all scenarios. A budget impact analysis is needed to estimate the financial impact of adopting this program within the Thai healthcare system.

IntroductionTobacco use is the leading preventable cause of morbidity and mortality worldwide. Since 2010, Thailand has implemented a multidisciplinary smoking cessation clinic, which provides smoking cessation services, but the effectiveness of the clinics was not formally evaluated. This study was conducted to assess the real-world effectiveness of this multidisciplinary smoking cessation program.MethodsWe conducted a prospective, multicentre, observational study on Thai participants aged 13 years and older in 24 smoking cessation clinics across Thailand's 13 health regions. Each clinic offered smoking cessation interventions according to the well-established 5As model for smoking cessation (Ask, Advise, Assess, Assist, and Arrange). Outcomes of interest were continuous abstinence rates (CAR) at 3 and 6 months. Biochemical confirmation and self-reporting were used to assess the outcomes. Descriptive statistics (mean, SD, median, IQR, and percentage) were used to analyze the smoking cessation outcomes in both intention-to-treat and per-protocol analysis approaches.ResultsSmokers receiving services from the Thai multidisciplinary smoking cessation clinics had CAR of 17.49 and 8.33% at 3 and 6 months, respectively. For those with cardiovascular disease (CVD) or cerebrovascular disease, CAR was found to be 26.36% at 3 months and 13.81% at 6 months. While participants with chronic obstructive pulmonary disease (COPD) had CAR ranging from 32.69% at 3 months to 17.31% at 6 months.ConclusionThe multidisciplinary team smoking cessation clinic was effective in assisting smokers in quitting smoking. The effectiveness of the clinic was more pronounced for smokers with CVD, cerebrovascular disease, or COPD. Findings from this study support a decision to include multidisciplinary smoking cessation clinics in the universal health care benefits package.

INTRODUCTION The SMART Quit Clinic Program (FAHSAI Clinic) has been implemented in Thailand since 2010; however, it remains unclear whether the benefits gained from this program justify its costs. We assessed its cost-effectiveness compared to usual care in a population of Thai smokers with cardiovascular disease (CVD) from a societal perspective. METHODS We conducted a cost-utility analysis using a Markov model to simulate lifetime costs and quality-adjusted life years (QALYs) of Thai smokers aged ≥35 years receiving smoking cessation services offered from FAHSAI Clinic or usual care over a horizon of 50 years. The model used a 6-month continuous abstinence rate from a multicenter prospective study of 24 FAHSAI Clinics. A series of sensitivity analyses including probabilistic sensitivity analysis were conducted to assess robustness of study findings. Cost data are presented in US$ for 2020. RESULTS The FAHSAI Clinic was dominant as it was less costly ($9537.92 vs $10964.19) and more effective (6.06 vs 5.96 QALYs) compared with usual care over the 50-year time horizon. Changes in risks of stroke and coronary heart disease among males had the largest impact on the cost-effectiveness findings. The probability that FAHSAI Clinic was cost-effective was 99.8% at a willingness-to- pay threshold of $5120. CONCLUSIONS The FAHSAI Clinic smoking cessation program was clinically superior and cost-saving compared to usual care for Thai patients with CVD in all scenarios. A budget impact analysis is needed to estimate the financial impact of adopting this program within the Thai healthcare system. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a disease that affecting body systems especially the respiratory system, circulatory system and also hematopoietic system. Objectives: The primary objective of the present study was to determine the prevalence of anemia and polycythemia in COPD patients. The secondary objectives was to determine factors associated with anemia and polycythemia. Materials and Methods: The present study was a retrospective study. All medical records of COPD patients visiting the lung diseases clinic of HRH Princess Maha Chakri Sirindhorn Medical Center between January 1, 2016, and December 31, 2019, were reviewed. Complete blood count, biochemistry laboratory results, lung function test, 6-minute walking distance, frequency of exacerbations and admission were recorded. Results: One hundred twenty-five patients were enrolled. Patients in GOLD stage 1, 2, 3 and 4 were 41.2%, 47%, 9.8% and 2% respectively. Most of the patients were in group A (50.4%). In our study, the prevalence of anemia in COPD patients was 39.2% and none of the patients had polycythemia. There was no association between GOLD classification or group of COPD and anemia. When analyzed by multiple logistic regression, we found that the higher BMI showed a significantly lower risk of anemia than lower BMI (OR 0.877; 95% CI: 0.795 to 0.967) and the frequency of acute exacerbation correlated with anemic condition statistically significant (OR 1.402, 95% CI: 1.142 to 1.721). Anemia and frequency of exacerbation had very low level of positive correlation (r=0.282) at the significance level. Conclusion: Anemia was common comorbidity in COPD patients. Lower body mass index and frequency of exacerbation were significantly related to anemia. [ABSTRACT FROM AUTHOR]

Few studies have addressed health-related quality of life and smoking cessation although known improvements can encourage smokers to quit. This cross-sectional study examined smoking quit rates and health-related quality of life among smokers receiving cessation services in ten Quit Clinic Hospitals throughout Thailand. A random sample of 715 smokers participated in the study. Data were collected from medical records and via telephone interviews from March to July 2015. Research instruments included demographic questions, a smoking screening form, the Quit Smoking Questionnaire; and the EuroQol-5 Dimensions 5 Levels Questionnaire (Thai version). Data were analyzed using descriptive statistics, Chi-square, and independent sample t-test. Most participants (97.1%) were male and between 25 and 64 years of age. Most had heaviness of smoking index scores less than four, indicating low nicotine dependence. The self-reported continuous abstinence rate at 6-months was 40.5%. The participants who stopped smoking by 6 months had higher average scores on the health-related quality of life than those who continued to smoke. As nurses are recognized as influential persons in the health care team, they can implement tobacco cessation interventions through a variety of strategies, such as providing brief advice, and referring for advanced treatment. Likewise, nurses need to consider assessing health-related quality of life of smokers and use such information to advocate smokers to quit. [ABSTRACT FROM AUTHOR]

Objective: To explore the changes in the prevalence of smoking behavior, attitudes, and cessation training among medical students after the establishment of the Thai Health Professional Alliance against Tobacco (ThaiPAT) and its major campaigns by using the nationwide Global Health Professions Student Surveys (GHPSS). Material and Method: Multiple cross-sectional studies were conducted after three major campaigns were launched between 2007 and 2011, the Deans’ Summit on Tobacco Control, implemented tobacco control into the medical curriculum, and 100% smoke-free hospitals and medical schools. The results of two rounds of GHPSS among third year medical students across the nation in 2006 and 2011 were compared. Results: Overall prevalence of active cigarette smoking remained unchanged at 2.6%. Passive cigarette smoke exposure in public areas appeared to decrease slightly over time. In the most recent national survey, the prevalence of passive smoke exposure was 53.7%. Moreover, the number of student that agreed with the smoking ban in pubs, bars, and nightclubs increased significantly from 80.8 to 90.5%. There was significant improvement in the cessation training among medical students (p<0.001). A significant increase in the number of student that agreed that healthcare personnel needed specific training in cessation techniques (p = 0.004) and should always advise their patients to quit smoking (p<0.001). Conclusion: Nationwide tobacco control campaigns in Thai medical schools significantly improved the attitudes toward smoking cessation and cessation training among their students, although overall prevalence of active and passive cigarette smoking was unchanged. [ABSTRACT FROM AUTHOR]