Joyce Yu-Chia Lee

Health-related quality of life and glycaemic control in patients with Type 2 diabetes mellitus in Singapore.

Diabet. Med. 29, e241–e248 (2012)

Cost-of-illness studies of diabetes mellitus: A systematic review

BACKGROUND Diabetes mellitus (DM) is recognised as a major health problem. OBJECTIVES The aims of this study are two-fold: (1) to describe the methods used in the identified cost-of-illness (COI) studies of DM and (2) to summarise their study findings regarding the economic impact of DM. METHODS This is a systematic review of MEDLINE and Scopus journal articles reporting the cost of type 1 and/or 2 DM that were published in English from 2007 to 2011. Costs reported in the included studies were converted to US dollars. RESULTS The systematic search yielded 30 articles. The studies varied considerably in their study design, perspective and included cost categories. Estimates for the total annual costs of DM ranged from US

Perceptions of insulin therapy amongst Asian patients with diabetes in Singapore

141.6 million to US

Development and validation of a general health literacy test in Singapore

174 billion; direct costs ranged from US

Direct Medical Cost of Type 2 Diabetes in Singapore

150 to US

Validity and reliability of a self-reported measure of medication adherence in patients with Type 2 diabetes mellitus in Singapore

14,060 per patient per year (pppy) whereas indirect costs ranged from US

Development and implementation of signs- and symptoms-based insulin adjustment algorithm.

39.6 to US

Hype or hope for diabetes mobile health applications

7,164 pppy. Inpatient cost was the major contributor to direct cost in half of the studies that included inpatient costs, physician services and medications. CONCLUSION There is a considerable economic burden associated with DM. Future research should focus on improving methods of estimating costs, enhancing the interpretation of study findings and facilitating comparisons between studies.

Mediators of medication adherence and glycaemic control and their implications for direct outpatient medical costs: a cross-sectional study

Diabet. Med. 28, 206–211 (2011)

HbA1c variability in type 2 diabetes is associated with the occurrence of new-onset albuminuria within three years

Due to the concern of equating correct pronunciation with comprehension and the differences in health care systems, existing health literacy (HL) instruments may not be appropriate for or applicable to English-speaking countries other than the USA. The purpose of this study was to develop and validate the Health Literacy Test for Singapore (HLTS), which is an adapted version of the Short-Test of Functional Health Literacy in Adults. Three hundred and two patients were interviewed and administered the HLTS, the Newest Vital Sign (NVS), a demographic questionnaire, and a knowledge test of chronic diseases. The convergent validity of HLTS was determined by examining the association between HLTS and NVS HL levels, whereas predictive validity was tested by examining the difference in knowledge of chronic conditions between the two HLTS HL (i.e. adequate and inadequate HL) groups. Bivariate correlation of HLTS HL levels with age and education was assessed to test a priori hypotheses that patients with inadequate HL were older and less educated. The results showed that HLTS displayed good internal reliability (Cronbachs alpha = 0.87). The correlation between HLTS and NVS was moderate (γ = 0.55; P = 0.005) and individuals with inadequate HL were older (P = 0.002) and less educated (P = 0.007). In addition, patients with adequate HL had a higher mean score on the chronic disease knowledge test (P = 0.036). In conclusion, the HLTS is a valid and reliable measure for assessing Singaporeans ability to read and comprehend health-related materials written in English.