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South East Asia Task Force

Task force leaders

James Yip, Singapore

Ju Le Tan, Singapore

Type of task force

Disease & Speciality

The South East Asia Taskforce has been established as a section of the PVRI with the aim of exploring collaboration with doctors in Malaysia and Singapore who have an interest in pulmonary vascular disease.

2021 Annual Report

During the second year of the COVID-19 pandemic, there were few opportunities for chapter members to meet together, with national travel restrictions and prioritising the vaccination programmes for our patients.

In a previous survey (PVRI report 2020), 70.8% of our partners revealed their patients were afraid of coming to the hospital and 36% of members explained their patients had reduced access to care due to the travel restrictions.

The advent of webinar platforms such as Zoom, allowed clinicians to conduct meetings virtually across the region in addition to the excellent sessions conducted on PVRI Live globally.

Two innovations we would like to highlight from our chapter members are:

In Taiwan, the Pulmonary Hypertension Frontier Programme sent its regional pulmonary hypertension experts to smaller district hospitals. They conducted pulmonary hypertension awareness symposiums and training for local hospital staff, produced educational books, apps and videos at a national level for their patients.

In Indonesia, led by Anggoro Budi Hartopo and Kris Dinarti, the Universitas Gadjah Mada organised a summer course in pulmonary hypertension which featured our regional experts from Singapore, Malaysia, Japan, Australia as well as global partners from the United Kingdom, India and Switzerland. The 7-day sessions (twice a week) brought experts closer to the local district hospital clinicians and contextualised care in the hospital setting. A highlight, was the virtual field trip to the Dr Sardjito General Hospital and the academic hospital of Universitas Gadjah Mada.

Indonesia Pulmonary Hypertension Working Group (INAPH)

held numerous webinars throughout the year. Pulmonary hypertension, in the specialist area of pregnancy, was discussed and patient experience sessions were held. INAPH launched a national guideline in October covering all pulmonary hypertension groups based on updated international sources.

Despite the restrictions placed on our members during the pandemic, they continued to run various international clinical trials in pulmonary hypertension. The national pulmonary hypertension Building Resiliency in Bad Times Report by James Yip, Tan Ju Le & Lucia Kris Dinarti registries were updated. As we work toward building resilience in the care of patients with pulmonary hypertension, we seek to form international ties with other members.

2020 Annual Report

During the Covid-19 pandemic, the Task Force surveyed pulmonary hypertension centres across South East Asia from 1-31 October 2020 to evaluate how physicians and patients with pulmonary arterial hypertension (PAH) were coping with the crisis.

24 pulmonary hypertension specialists were surveyed from five countries. These included Thailand (4, 16.7%), Singapore (9, 37.5%), Malaysia (4, 16.7%), Indonesia (2, 8.3%), and Taiwan (5, 20.8%). 76% of these physicians were caring for more than 25 patients with PAH. Of note, only three PAH patients developed Covid-19. There were no deaths amongst these three attributable to Covid-19. 91.7% of surveyed doctors related no excess deaths in their patients when compared to the same time the previous year, however 8.3% related an increase in deaths.

The Task Force was interested to examine difficulties in delivering care during this period. 70.8% of respondents cited patients’ fear of coming to hospitals, 25.0% cited that diagnostic tests such as echocardiography and catheterisation labs were diverted to patients with other chronic diseases, 20.8% cited supply chain issues for PAH medications and routine vaccines, 16.7% cited prioritisation of care for Covid-19 patients over PAH patients. Only 4.2% of respondents said that lack of Covid-19 testing ability was an issue. None had issues with lack of personal protective equipment.

Regarding how PAH patients were coping, 72.0% of respondents said patients had issues with fear and anxiety, 60.0% reported issues with social isolation, 36.0% reported issues with travel restrictions for healthcare, 32.0% reported issues with depression, 28.0% reported difficulty procuring PAH medication, and 8.0% reported issues with procurement of masks for personal protection.

On a more reassuring note, when asked to rank how optimistic patients were for PAH treatment in the region (A score of 1 being least optimistic and 10 most optimistic) after the Covid-19 pandemic was over, they gave an average grade of 7.

 It is the opinion of the authors of this report that patients and centres caring for patients with PAH in South East Asia seem to have done well during the Covid-19 pandemic. The majority of the countries surveyed in this poll have had a low death rate from Covid-19 (Taiwan 0.3 cases/million population, Thailand 0.8/million population, Singapore 5/million population, Malaysia 8/million population, Indonesia 52/million population), and hence the better outcomes. In general, the incidence of PH patients developing Covid-19 remained unchanged in most studies (2.1 cases per 1000 in the United States of America). Some of centres in our survey have turned to telemedicine to improve access of care but supply chain issues and prioritisation of resources in favour of Covid-19 and other chronic diseases remain an issue. The long-term impact to our patients during this pandemic in terms of mental well-being cannot be understated but the optimism of our PH caregivers is encouraging.

 

2019 Annual Report

Improving the lives of PH patients in Asia Pacific – the right decisions at the right time. The APAC PH Forum was held in the Marriott Marquis Queen’s Park Hotel, Bangkok, Thailand, on 2–4 August 2019. The forum was attended by a total of 181 delegates from many countries around the world and was sponsored by Actelion.

Scientific Committee members consisted of:

• Kritvikrom Durongpisitkul (Thailand)
• Eli Gabbay (Australia)
• Gu Hong (Canada)
• Hsao-Hsun Hsu (Taiwan)
• Decho Jakrapanichakul (Thailand)
• Eli Gabbay (Australia)
• Geetha Kandavello (Malaysia)
• Andrea Low (Singapore)
• Annette Pidoux (Australia)
• Tan Ju-Le (Singapore)

The delegates and speakers attended from the following countries:

• Australia
• Hong Kong
• Japan
• Malaysia
• New Zealand
• Singapore
• Taiwan
• Thailand
• The Philippines
• Vietnam
• United Kingdom

The delegates had a variety of specialties, such as:

• Cardiology
• Cardiothoracic
• Imaging
• Nursing
• Pharmacy
• Respiratory medicine
• Rheumatology


The forum aimed to share information and best practice. It also encouraged collaboration and friendship amongst professionals in Asia to further improve the lives of our PH patients.
Forum objectives were to:

• Identify barriers to a timely diagnosis, reasons for missed diagnoses and misdiagnoses to enable early detection and management
• Share updates from international guidelines and WSPH 2018, and discuss pragmatic application in the APAC region setting, particularly around: – routine risk stratification and follow-up risk assessments
– early access to optimal treatment strategies
• Share current best practice and new innovative research in the region so that less well-developed services have a usable model to implement in their own setting
• Increase regional collaborations and foster research relationships, with a focus on establishing PH registries using contemporary tools.

 

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