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3 results on '"Wan Xi Goh"'

1. Patients’ perspectives on a programme to reduce emergency department use for low acuity conditions

Author

Wan Xi Goh, Rebecca Hui Shan Ong, Salome Antonette Rebello, Priscilla Sook Kheng Goh, Edris Atikah Ahmad, Choon How How, Mohan Tiruchittampalam, Hong Choon Oh, and Steven Hoon Chin Lim

Subjects
Medicine
Abstract

Background Emergency Department (ED) crowding is a global public health issue with low-acuity ED attendances (LAA) being widely identified as contributors to the issue. A primary care partnership programme, GPFirst, was developed to encourage low-acuity patients to visit their General Practitioners (GP) first, instead of the ED. We utilised a qualitative approach to gain an understanding of participants’ perceptions of GPFirst, their health-seeking behaviours, and explore recommendations for enhancing GPFirst. Methods A qualitative study design, underpinned by an interpretivist approach, was employed. Purposive sampling was used to recruit 12 GPFirst patients from a single tertiary care centre for semi-structured interviews. These interviews were analysed using Braun and Clarke’s reflexive thematic analysis. Results Participants’ age ranged from 25 to 63 years old. Four themes were identified. Firstly, “ perceptions of GPs” , described the variations in participants’ perceptions about GPs. Secondly, “patients’ expectations of GPFirst” , noted the ED fee subsidy and prioritisation of ED care as key expectations of GPFirst. Thirdly, “facilitators and barriers to utilising GPFirst” highlighted the facilitators and barriers that influenced participants’ health-seeking behaviours and finally “recommendations for programme improvement” offered strategies for improvements. Conclusion This is the first qualitative study to examine participants’ perceptions of GPFirst. Recommendations may inform future programme redesign to optimise patient experience and facilitate programme uptake, contributing to overall efforts to reduce ED crowding locally. Future research may consider exploring GPFirst providers’ perspectives to elicit facilitators and barriers in implementation.

Published
2024
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3. An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

Author

J. E. C. Boey, Manfred Mak, Xin Jie Soh, Sze Ling Chan, R. W. L. Lee, Tjun Y. Tang, Charyl Jq Yap, I. A. B. Ishak, Wan Xi Goh, and Shereen X. Y. Soon

Subjects
business.industry, medicine.medical_treatment, Ischemia, General Medicine, medicine.disease, Revascularization, Diabetic foot, Diabetic foot ulcer, Amputation, Anesthesia, Concomitant, Oxygen therapy, Ambulatory, medicine, Surgery, business
Abstract

Natrox™topical oxygen therapy (TOT) ( Inotec AMD Ltd, Cambridgeshire, UK) employs a small battery-powered “oxygen generator” to concentrate atmospheric oxygen and feeds pure, moist, oxygen through a fine, soft tube to a dressing-like “oxygen distribution system”, which is placed over the wound and is held in place by a conventional dressing. The aim was to determine the effectiveness of Natrox™for non-healing diabetic foot ulcers (DFU) over a 3-month period.Longitudinal, single-arm, open prospective registry study using 12 weeks of TOT using a 4 week run-in period. 20 patients recruited to OTONAL had chronic DFU greater than 3 months duration or minor amputation sites with less than 50% healing in 4 weeks.There were 13 (65%) males and the mean age was 65.7 (±11.6) years. The mean glycated haemoglobin (HbA1c) was 6.9 (±1.3) mmol mol−1and mean wound duration before TOT was 114 (±79.1) days. 18/20 (90.0%) patients had concomitant lower limb revascularization angioplasty for chronic limb threatening ischaemia. The mean size of the foot ulcer at baseline was 11.3 ± 14.8 cm2and mean transcutaneous oxygen measurement value was 34.1 (±19.6) mm Hg. Wound closure of >75% was observed in 14/20 (70.0%) patients. There was a 91.3% (±14.9%) wound area reduction by 3 months (P = .001) and mean time for 100% closure was 77.6 ± 32.5 days. Mean pain scores reduced from 2.4 (±1.8) at baseline to .5 (±1.0) at 3 months (P = .008). All patients were very satisfied using the ambulatory device. Use of TOT in chronic diabetic foot wounds stimulates a healing state, underpinning the concept that oxygen plays a central role in wound healing. Our results are more compelling if you consider they started with relatively large-sized DFUs and majority of patients were frail with underlying peripheral artery disease. (NCT03863054)

Published
2021
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