These guidelines provide an update on the management of chronic obstructive pulmonary disease (COPD) in Singapore and take into account the new evidence which has emerged since the publication of the previous guidelines in 2006. Target groupThe guidelines are intended for all healthcare professionals who care for patients with COPD. These include physicians, nurses, pharmacists, and rehabilitation and respiratory therapists. Guideline developmentThese guidelines have been produced by a committee comprising senior respiratory physicians, general practitioners, polyclinic physicians, pharmacists, physiotherapists and a patient representative, appointed by the Ministry of Health (MOH). They were developed using the best available current evidence and expert opinion. What is new in the revised guidelinesThe following is a list of major revisions or additions to the guidelines: (1) a template for the combined assessment of COPD; (2) a simplified COPD quality of life test: the COPD Assessment Test (CAT) score; (3) recommendations on pharmacological treatment based on results from recent clinical trials; and (4) a chapter on community care and comorbidities.

High DRD was more common among younger patients and patients with poorer glycemic control. High DRD was associated with poorer quality of life and early screening and management of DRD is recommended.

The pharmacist-managed RFMP exhibited improved clinical outcomes and reduced health care costs compared with usual care within a tertiary institute.

Objectives The primary objectives of this study were to evaluate the change in glycated haemoglobin (HbA1c) and its association to clinical activities. The secondary objective was to elucidate moderators of the relationship between pharmacist-involved collaborative care (PCC) and change in HbA1c. Methods This study was a retrospective cohort study conducted in a tertiary hospital over 12 months. Individuals with Type 2 diabetes, aged ≥21 years with established cardiovascular diseases were included while individuals with incomplete care documentation or missing data related to cardiovascular diseases were excluded. Individuals under the care of PCC were matched 1:1 based on baseline HbA1c with an eligible person who received care from the cardiologists (CC). Changes in mean HbA1c were analysed using linear mixed model. Linear regression was used to determine clinical activities that associated with improvement in HbA1c. Moderation analyses were conducted using the MacArthur framework. Key findings A total of 420 participants (PCC:210, CC:210) were analysed. The mean age of the participants was 65.6 ± 11.1 years, with the majority being male and Chinese. The mean HbA1c among participants in the PCC group decreased significantly after 6 months (PCC: −0.4% versus CC: −0.1%, P = 0.016), with maintenance of improvement at 12 months (PCC: −0.4% versus CC: −0.2%, P < 0.001). Frequencies of lifestyle counselling, reinforcement of visits to healthcare providers, health education, resolution of drug-related problems, emphasis on medication adherence, dose adjustments and advice on self-care techniques were significantly higher in the intervention group (P < 0.001). Conclusion Improvements in HbA1c were associated with the provision of health education and medication adjustments.

Dear Editor,Hospitalisation, especially for a tobacco-related illness, may render patients to be more receptive to smoking cessation efforts by increasing their perceived vulnerability. The hospital setting also increases the contact time that patients have with the healthcare professionals. In addition, hospitals are generally smoke-free to protect patients and staff from passive smoking. Patients who smoke have no choice but to abstain from smoking during the period of hospitalisation. Such an environment may therefore promote permanent tobacco abstinence. 1 We would like to share our experience with smoking cessation in a hospital setting-comparing the quit rates of the inpatient smoking cessation programme and the outpatient smoking cessation clinic service available in Tan Tock Seng Hospital (TTSH) and the signifi cant predictors affecting smoking cessation outcomes.