Lay Hoon Goh

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mdcglh@nus.edu.sg


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    Publication
    Approach to infantile colic in primary care
    (SINGAPORE MEDICAL ASSOC, 2019-01-01) Lam, Teck Meng Lawrence; Chan, Poh Chong; Goh, Lay Hoon; Dr Poh Chong Chan; MEDICINE; PAEDIATRICS
    Infantile colic is a common self-limiting condition that causes significant distress to parents and caregivers. There is no clear cause, gold standard remedy or preventative action. The role of the family physician is to rule out sinister causes while providing counselling and reassurance for parents. The mainstay of management is parental support and reassurance while looking out for red flags in the baby such as fever, lethargy, distended abdomen and failure to thrive. This article provides a framework to approaching infantile colic and practical pointers to share with parents.
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    General Public's knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population
    (FRONTIERS MEDIA SA, 2023-04-24) Anand, Vickram Vijay; Goh, Rachel Sze Jen; Nah, Benjamin; Koh, Sky Wei Chee; Lim, Jieyu; Neo, Nicholas WS; Chew, Jocelyn; Lee, Yuan Ying; Chin, Yip Han; Chong, Bryan; Kong, Gwyneth; Tan, Bryan; Low, Zhiwen; Khoo, Chin Meng; Goh, Lay Hoon; Loh, Poay Huan; Chai, Ping; Dalakoti, Mayank; Chan, Mark; Foo, Roger; Muthiah, Mark; Chew, Nicholas WS; Dr Ping Chai; MEDICINE
    Background: Health literacy and illness perception play crucial roles in tackling the cardiometabolic disease epidemic. We aim to compare the attitudes, knowledge, self-perceived risks and actions taken, between individuals with and without metabolic risk factors (MFs). Methods: From 5 June to 5 October 2022, participants of the general public were invited to complete a self-administered questionnaire. MF status was defined as the presence of hypertension, hyperlipidemia, diabetes mellitus and/or current/previous smoking. Participants were assessed based on four categories (knowledge-based, attitude-based, perceived risk, and action-based) of questions pertaining to four cardiometabolic diseases – diabetes mellitus, hypertension, hyperlipidemia, and non-alcoholic fatty liver disease. Results: A total of 345 participants were enrolled, of whom 34.5% had at least one MF. Compared to those without MFs, participants with MFs had lower knowledge scores, but higher perceived risk scores across all cardiometabolic diseases. The largest knowledge gap pertained to hypertension-related questions. After adjustment, linear regression demonstrated that the presence of MFs (β:2.752, 95%CI: 0.772–4.733, p = 0.007) and higher knowledge scores (β:0.418, 95%CI: 0.236–0.600, p < 0.001) were associated with higher perceived risk. Despite increased perceived risk in those with MFs, this translated to only few increased self-reported preventive actions, when compared to those without MFs, namely the reduction in red meat/processed food consumption (p = 0.045) and increase in fruits/vegetables consumption (p = 0.009). Conclusion: This study identified a vulnerable subpopulation living with MFs, with high perceived risks, and discordant levels of knowledge and preventive actions taken. Nationwide efforts should be channeled into addressing the knowledge-to-action gap.
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    The unwelcome visitor
    (SINGAPORE MEDICAL ASSOC, 2012-08-01) Teng, Gim Gee; Tong, Chung Yan; How, Choon How; Goh, Lay Hoon; Dr Lay Hoon Goh; MEDICINE
    Gout is a chronic, progressive inflammatory disease with intermittent arthritic flares, which should not be regarded as a minor inconvenience or nuisance. It can be effectively controlled when the patient's serum urate level is reduced to less than 360 μmol/l (6 mg/dL) by consistent use of urate-lowering pharmacotherapy. Colchicine prophylaxis for gouty flares during titration of urate-lowering therapy has been underused. Holistic long-term management of gout must encompass patient education, evidence-based dietary advice, screening and aggressive treatment of comorbidities such as hypertension, diabetes mellitus, dyslipidaemia and renal impairment. Acute therapies for recurrent attacks with non-steroidal anti-inflammatory drugs, colchicine and/or corticosteroids should be used judiciously, especially in the elderly, due to the risk of toxicities. With appreciation of the underlying pathogenesis and artful use of the limited drug options, control of gout can be effectively achieved, bringing tremendous satisfaction to the patient and doctor. ©Singapore Medical Association
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    The Asia-Pacific Academic Primary Care Group (AAPCG): A Platform for regional Primary Care research collaboration
    (2019-05-18) Goh, Lay Hoon; Loh, Victor; Low, Lian Leng; Yu, Esther Yee Tak; Sit, Regina; Dr Victor Weng Keong Loh; MEDICINE; DEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
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    Changes in primary care visits arising from the COVID-19 pandemic: an international comparative study by the International Consortium of Primary Care Big Data Researchers (INTRePID)
    (BMJ PUBLISHING GROUP, 2022-05-01) Tu, Karen; Sarkadi Kristiansson, Robert; Gronsbell, Jessica; de Lusignan, Simon; Flottorp, Signe; Goh, Lay Hoon; Hallinan, Christine Mary; Hoang, Uy; Kang, Seo Young; Kim, Young Sik; Li, Zhou; Ling, Zheng Jye; Manski-Nankervis, Jo-Anne; Ng, Amy Pui Pui; Pace, Wilson D; Wensaas, Knut-Arne; Wong, William CW; Stephenson, Ellen; Dr Lay Hoon Goh; MEDICINE
    INTRODUCTION: Through the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), we compared the pandemic impact on the volume of primary care visits and uptake of virtual care in Australia, Canada, China, Norway, Singapore, South Korea, Sweden, the UK and the USA. METHODS: Visit definitions were agreed on centrally, implemented locally across the various settings in INTRePID countries, and weekly visit counts were shared centrally for analysis. We evaluated the weekly rate of primary care physician visits during 2019 and 2020. Rate ratios (RRs) of total weekly visit volume and the proportion of weekly visits that were virtual in the pandemic period in 2020 compared with the same prepandemic period in 2019 were calculated. RESULTS: In 2019 and 2020, there were 80 889 386 primary care physician visits across INTRePID. During the pandemic, average weekly visit volume dropped in China, Singapore, South Korea, and the USA but was stable overall in Australia (RR 0.98 (95% CI 0.92 to 1.05, p=0.59)), Canada (RR 0.96 (95% CI 0.89 to 1.03, p=0.24)), Norway (RR 1.01 (95% CI 0.88 to 1.17, p=0.85)), Sweden (RR 0.91 (95% CI 0.79 to 1.06, p=0.22)) and the UK (RR 0.86 (95% CI 0.72 to 1.03, p=0.11)). In countries that had negligible virtual care prepandemic, the proportion of visits that were virtual were highest in Canada (77.0%) and Australia (41.8%). In Norway (RR 8.23 (95% CI 5.30 to 12.78, p<0.001), the UK (RR 2.36 (95% CI 2.24 to 2.50, p<0.001)) and Sweden (RR 1.33 (95% CI 1.17 to 1.50, p<0.001)) where virtual visits existed prepandemic, it increased significantly during the pandemic. CONCLUSIONS: The drop in primary care in-person visits during the pandemic was a global phenomenon across INTRePID countries. In several countries, primary care shifted to virtual visits mitigating the drop in in-person visits.
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    Crossing Cultural Bridges in a Globalised World
    (2018-10-19) Loh, Victor Weng Keong; Goh, Lay Hoon; Furler, John; Wong, Carmen Ka Mun; Dr Victor Weng Keong Loh; MEDICINE
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    Failure to thrive in babies and toddlers
    (SINGAPORE MEDICAL ASSOC, 2016-06-01) GOH LAY HOON; HOW CHOON HOW (HOU JUNHAO); Ng, Kar-Hui; Dr Lay Hoon Goh; MEDICINE; PAEDIATRICS
    Mrs Thomas, a homemaker, took her only child, 18-month-old Marcy, to the family clinic for fever and running nose. You diagnosed the common fl u and was about to prescribe paracetamol when Mrs Thomas mentioned her concern that Marcy was not gaining weight and looked skinny compared to other children in the neighbourhood. She asked you if there was anything seriously wrong with Marcy and requested vitamin supplements to boost her appetite.
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    Vaginal discharge: evaluation and management in primary care
    (Singapore Medical Journal, 2020-06-01) Sim, M; Logan, S; Goh, LH; Dr Lay Hoon Goh; MEDICINE; MICROBIOLOGY AND IMMUNOLOGY; OBSTETRICS & GYNAECOLOGY
    Miss Lim, a 26-year-old business executive, came to your clinic for vaginal discharge of over one week’s duration. A month ago, she had been treated with one dose of oral fluconazole for a vaginal yeast infection and had seen symptomatic improvement. On this occasion, she reported the same symptoms of itch and vaginal discharge. This was her third episode in six months. She was sexually active with one stable male partner. She thought the yeast infection had recurred and requested the same treatment.© Singapore Medical Association
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    Patients' and healthcare professionals' perspectives towards technology-assisted diabetes self-management education. A qualitative systematic review
    (Public Library of Science, 2020) Jain, S.R.; Sui, Y.; Ng, C.H.; Chen, Z.X.; Goh, L.H.; Shorey, S.; MEDICINE; PHYSIOLOGY; ALICE LEE CENTRE FOR NURSING STUDIES
    Introduction Diabetes self-management education is a key aspect in the long-term management of type 2 diabetes. The patient and healthcare professional (HCP) perspective on the use of technology-assisted DSME has yet to be studied. Hence, the objective of this study was to better understand the factors that facilitate or hinder the adoptions of such education by adults with type 2 diabetes and their HCPs. Methods We systematically searched five databases (Medline, Embase, CINAHL, Web of Science Core Collection, and PsycINFO) until August 2019. The search included qualitative and mixed-method studies that reported the views of patients and HCPs regarding features, uses, and implementations of technology-assisted DSME. Data were synthesized through an inductive thematic analysis. Results A total of 13 articles were included, involving 242 patients, ranging from 18 to 81 years and included web-based, mobile application, digital versatile disc (DVD), virtual reality or telehealth interventions. Patients and HCPs had mixed views towards features of the technology-assisted interventions, with patients' personal qualities and HCPs' concerns affecting uses of the interventions. Patients generally preferred technologies that were easy to access, use, and apply and that had reliable information. Patients' ambitions motivated them, and personal attributes such as poor competence with technology, poor literacy, and language barriers acted as barriers. Patients especially liked the peer support that they received but did not like it when there was no regulation of advice on these platforms. HCPs believed that while the interventions were useful to patients, they faced difficulties with integration into their clinical workflows. Conclusion This review explored the features of technology-assisted diabetes self-management education interventions that enhanced positive patient engagements and the negative aspects of both the platforms and the target groups. Technical support and training will be effective in managing these concerns and ensuring meaningful use of these platforms. Copyright: © 2020 Jain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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    Nephrologist referrals of elderly CKD patients in Singapore: A cross-sectional study.
    (Royal College of General Practitioners, 2022-03-22) Tan, Wei Beng; Szücs, Anna; Burkill, Sarah M; Ong, Shih Hui; Young, Doris; Goh, Lay Hoon; Dr Lay Hoon Goh; MEDICINE
    BACKGROUND: Chronic kidney disease (CKD) is common in the elderly population. By 2035, approximately one-quarter of Singapore residents are expected to have CKD. Many of these patients are not referred to nephrologists. AIM: We aimed to compare the characteristics of elderly (≥ 65 years old) patients with stage 3B CKD and above in the referral and non-referral groups. DESIGN AND SETTINGS: A cross-sectional study in the primary care organisation National University Polyclinics (NUP), Singapore. METHOD: Retrospective data were extracted from the electronic health records of CKD patients (≥ 65 years old) with stage 3B CKD and above. RESULTS: From 1 January to 31 December 2018, a total of 1,536 patients aged 65 years or older were diagnosed with stage 3B CKD or above (non-referral group =1,179 vs. referral group =357). The mean patient age in the non-referral group (78.3 years) was older than that in the referral group (75.9 years) (P<0.001). Indian elderly patients were referred more compared to their Chinese counterparts (P=0.008). The non-referral group was prescribed significantly less fibrate, statins, insulin, sulfonylureas, dipeptidyl peptidase-4 inhibitors, and antiplatelet than the referral group (P<0.05), but only the difference in fibrates remained significant on subsequent multivariate analysis. CONCLUSIONS: This study demonstrates that there is a considerable number of elderly CKD patients exclusively managed in the primary care setting (n = 1,179) and that referrals primarily depend on demographic factors, namely age and ethnicity, rather than medical determinants of CKD severity or case complexity.