INTRODUCTIONWeight management programmes (WMPs) can help overweight individuals lose weight, and thus prevent complications associated with obesity. Herein, we describe the demographic profile, clinical characteristics, motivations and expectations, and outcomes of patients enrolled in a nonsurgical WMP. METHODSThis was a retrospective study of consecutive patients with a body mass index (BMI) of > 23 kg/m 2 enrolled in the four-month WMP at the Health For Life Clinic, Alexandra Hospital, Singapore, between 1 and 31 August 2009. Demographic data, medical history and source of referral were recorded. Details on personal motivations and weight loss goals were obtained from the completed self-administered questionnaires of the WMP participants. Weight, waist circumference, fat percentage and BMI were measured at the start and end of the WMP. A weight loss of ≥ 5% was deemed as a successful outcome. RESUlTSA total of 58 patients (mean age 37.2 years) were included in our study. Of these 58 patients, 58.6% were of Chinese ethnicity and 55.2% were male. Many patients (32.8%) attributed their weight gain to work-or study-related stress, and a minority to poor eating habits (12.1%) or a lack of exercise (10.3%). Patients' motivations included a desire for better health (53.4%) and better fitness (15.5%). However, only 53.4% patients scored their motivation as high (i.e. a score of > 7). The mean expected weight loss was 9.9 kg at 4 months, and 14.1 kg at 12 months. Among the 40 patients (69.0%) who completed the programme, the mean percentage weight loss was 1.8 ± 4.3%. A weight loss of ≥ 5% was achieved by 8 (13.8%) patients. CONClUSIONAlthough the patients in our study cohort were young and educated, only a portion of them appeared to be highly motivated to lose weight, despite joining the WMP. There is a need for patients to be guided on how to set realistic weight loss goals. Keywords: demographics, obesity, results, Singapore, weight management Singapore Med J 2014; 55(3): 150-154

Background The 2019 novel COVID-19 has severely burdened the health care system through its rapid transmission. Mobile health (mHealth) is a viable solution to facilitate remote monitoring and continuity of care for patients with COVID-19 in a home environment. However, the conceptualization and development of mHealth apps are often time and labor-intensive and are laden with concerns relating to data security and privacy. Implementing mHealth apps is also a challenging feat as language-related barriers limit adoption, whereas its perceived lack of benefits affects sustained use. The rapid development of an mHealth app that is cost-effective, secure, and user-friendly will be a timely enabler. Objective This project aimed to develop an mHealth app, DrCovid+, to facilitate remote monitoring and continuity of care for patients with COVID-19 by using the rapid development approach. It also aimed to address the challenges of mHealth app adoption and sustained use. Methods The Rapid Application Development approach was adopted. Stakeholders including decision makers, physicians, nurses, health care administrators, and research engineers were engaged. The process began with requirements gathering to define and finalize the project scope, followed by an iterative process of developing a working prototype, conducting User Acceptance Tests, and improving the prototype before implementation. Co-designing principles were applied to ensure equal collaborative efforts and collective agreement among stakeholders. Results DrCovid+ was developed on Telegram Messenger and hosted on a cloud server. It features a secure patient enrollment and data interface, a multilingual communication channel, and both automatic and personalized push messaging. A back-end dashboard was also developed to collect patients’ vital signs for remote monitoring and continuity of care. To date, 400 patients have been enrolled into the system, amounting to 2822 hospital bed–days saved. Conclusions The rapid development and implementation of DrCovid+ allowed for timely clinical care management for patients with COVID-19. It facilitated early patient hospital discharge and continuity of care while addressing issues relating to data security and labor-, time-, and cost-effectiveness. The use case for DrCovid+ may be extended to other medical conditions to advance patient care and empowerment within the community, thereby meeting existing and rising population health challenges.

Inclusion and exclusion criteria Inclusion criteriaRecipient of minimally 2 doses of a COVID-19 vaccine Normal mental state Stable vital signs (defined as systolic blood pressure 100-160 mmHg, heart rate 60-100 beats/min, pulse oximetry saturations >94% on room air) Able to self-care in isolation (does not require assistance with activities of daily living) Competent to participate in telemedicine Exclusion criteria Kidney transplantation <6 mo Recent treatment/augmentation of immunosuppression for rejection <3 mo Significant pulmonary disease, eg, chronic obstructive pulmonary disease Other medical concerns of increased adverse outcome if home-based recovery Significant abnormalities on preenrollment screening tests a Ongoing chest/abdominal pain Dyspnea Severe vomiting or diarrhea where absorption of drugs may be impaired Oliguria or anuria Vulnerable uninfected household people (eg, ≥ 80 y, pregnant) and/or inability for self-isolation in the home Patient declines enrollment into HaH program a Patients underwent preenrollment screening tests of complete blood count, kidney function test, and C-reactive protein levels. A confirmatory polymerase chain reaction testing for SARS-CoV-2 and RBD levels was performed at time of preenrollment screening tests.

BACKGROUND The 2019 novel Coronavirus (COVID-19) has severely burdened the healthcare system through its rapid transmission. To facilitate remote monitoring and continuity of care for COVID-19 patients, mobile health (mHealth) is seen as a viable solution. However, the conceptualization and development of mHealth applications are often labor and time-intensive, laden with concerns relating to data security and privacy, and faced poor adoption due to communication-related barriers, and struggle with continued engagement due to perceived lack of benefits. The rapid development of a mHealth application that is cost-effective and secure will be a timely enabler. OBJECTIVE This project aims to develop a mHealth application – The DrCovid+ to facilitate the remote monitoring and continuity of care for COVID-19 patients. METHODS Rapid Application Development (RAD) approach was adopted in the development of the application prototype. Stakeholders including decision-makers, physicians, nurses, healthcare administrators, and research engineers were engaged. The process began with requirements gathering to define and finalize the project scope followed by an iterative process of developing a working prototype, User Acceptance Test (UAT), and improvement work before the actual implementation. Co-designing principles were applied to ensure equal collaborative efforts and common agreement amongst stakeholders. RESULTS The DrCovid+ was developed on Telegram services and hosted on a cloud server. It features a secure enrolment and patient data interface, a multi-lingual communication channel, and automatic and personalized push messaging. A backend dashboard was also developed to collect patients’ vital signs for remote monitoring and continuity of care. To date, 20 patients have been enrolled into the system, amounting to 203 bed days saved. CONCLUSIONS Rapid development and implementation of the DrCovid+ allow for timely clinical and social care management for COVID-19 patients. This facilitates early patient hospital discharge and continuity of care while ensuring the safety and wellbeing of healthcare providers by minimizing physical interactions. The use case for the DrCovid+ can also be extended beyond the hospital walls and adopted for other medical conditions to advance patient care and empowerment within the community to meet the existing and rising population health challenges. CLINICALTRIAL N.A.