Vivian W Y Lee

• BSc, PharmD, BCPS (Added Qualification Cardiology), FCPP (HK) SFHEA (UK)
• Professor (Associate) at Chinese University of Hong Kong

Background A technologically integrated, multidisciplinary approach to stroke rehabilitation service was delivered and embedded into conventional health care practice. This article reports an evaluation of cost‐effectiveness analysis of a new Virtual Multidisciplinary Stroke Care Clinic (VMSCC) service for community‐dwelling survivors of stroke. M...

Introduction: Virtual reality (VR) technology may provide a promising alternative to promote stroke survivors’ social participation. Three innovative social participation-focused, game-based VR training modules for community-dwelling stroke survivors were developed. Aim: This study sought to understand the survivors’ and caregivers’ perceptions of...

Background: Stroke survivors constantly feel helpless and unprepared after discharge from hospitals. More flexible and pragmatic support are needed for their optimized recovery. We examined the effects of a virtual multidisciplinary stroke care clinic on survivors' health and self-management outcomes. Methods: A randomized controlled trial was c...

Purpose: To address the problem of teaching noncore specialties, for which there is often limited teaching time and low student engagement, a flipped classroom case learning (FCCL) module was designed and implemented in a compulsory 5-day ophthalmology rotation for undergraduate medical students. The module consisted of a flipped classroom, online...

Introduction: In 2017, breast cancer was the most common cancer and third leading cause of cancer death among women in Hong Kong. Approximately 20% of patients were human epidermal growth factor receptor-2 (HER2)-positive. This study was conducted to investigate cost differences between intravenous and subcutaneous trastuzumab regimens in Hong Kon...

Background: Previous studies indicate that stroke survivors encounter difficulties in participating in self-management programs because of lack of transportation to rehabilitation centres and unsuitable scheduling. A virtual multidisciplinary stroke care clinic (VMSCC) that builds on the advantages of self-management programs to promote survivors’...

Background: Past research has supported the benefits of dance in improving balancing and walking ability in people with neurological conditions. More evidence on stroke survivors’ satisfaction and perceived benefits of dance interventions on their recovery is needed. Purpose: This study explored the experiences of participating in a virtual ballet-...

Introduction: Cerebral small vessel disease (SVD) is an important cause of dementia that lacks effective treatment. We evaluated the efficacy and safety of cilostazol, an antiplatelet agent with potential neurovascular protective effects, in slowing the progression of white matter hyperintensities (WMHs) in stroke- and dementia-free subjects harbo...

Purpose: To evaluate the short-term effectiveness of a personalized survivorship care plan (SCP) in improving cancer-related literacy among childhood cancer survivors, and to identify characteristics of survivors who demonstrated minimal gain from the intervention. Methods: We recruited survivors diagnosed with cancer at ≤18 years old and were >...

Background During the COVID-19 pandemic, educational interventions have become necessary to prevent the spread of health-related misinformation among Hong Kong older adults. The primary objective of this study was to assess the feasibility of a student-led, telephone-delivered intervention to improve COVID-19-related health knowledge among Hong Kon...

Medical education in the 21st century is shifting more toward online learning because of extensive application of information and communication technology (ICT). We surveyed medical students’ 21st century online learning experiences and modeled the interrelations among relevant dimensions of 21st century online learning. Based on the general themes...

Purpose While blended learning has been proved to be successful in learning outcomes, the landscape of blended learning has changed under coronavirus disease (COVID-19) pandemic. Hence, the present study aims to explore first-year university students' perceptions of wholly blended learning during the pandemic, through the three constructs in the co...

Studies have provided evidence that Interprofessional Education (IPE) can improve learners’ attitudes, knowledge, skills, behaviors, and competency. Traditionally, IPE is commonly seen in the healthcare professional training in tertiary education. Aging is a global issue that requires more than just a single healthcare sector. It requires interdisc...

Introduction: Studies show that stroke survivors encounter physical and psychological limitations that restrict their participation in social and community activities. Systematic reviews have yielded inconclusive evidence regarding the effectiveness of different interventions intended to support stroke survivors' social participation. Recent advan...

HPV vaccine uptake rates are suboptimal in Hong Kong. A multi-disciplinary school-based HPV health-promotion programme (MDL-SHPVP) aimed at raising HPV knowledge levels and increasing vaccine uptake has therefore been developed to address vaccine hesitancy. This qualitative study was conducted to collect user feedback and identify the strengths and...

The recent COVID-19 pandemic prompted the implementation of online teaching and online assessment. Online assessment can be challenging to both teachers and students due to technical, academic, and ethical issues. In this survey, we adopted both qualitative and quantitative approaches to evaluate (1) the perceived effectiveness of online assessment...

Objective: Oral melatonin is a potential alternative treatment for hypertension, but high-quality and relevant meta-analyses have not yet been conducted. This meta-analysis aimed to investigate whether oral melatonin supplementation could reduce daytime/asleep blood pressure, reduce cardiovascular risks, improve sleep quality, and if it is well-to...

Introduction: The opioid epidemic persists in the United States. The use of opioid medications is often assessed by claims data but potentially underestimated. Objectives: We evaluated the temporal trend in the use of opioid and nonopioid pain medications from a national survey. Methods: Using data from the 2001 to 2018 National Health and Nut...

Oral melatonin is a potential alternative treatment for hypertension and nocturnal hypertension. However, high‐quality and relevant meta‐analyses are lacking. This meta‐analysis aimed to investigate whether oral melatonin supplementation reduces daytime/asleep blood pressure and cardiovascular risk, improves sleep quality, and is well‐tolerated com...

Introduction: Lifestyle choices may influence health outcomes in cancer survivors. This study of childhood cancer survivors in Hong Kong investigated factors associated with health-protective and health-damaging behaviours; it also examined expectations of a survivorship programme. Methods: This cross-sectional study recruited survivors of child...

Introduction: Augmented reality (AR) technology has demonstrated potential on various areas of healthcare practice. Its role on medical education is starting to emerge. This study aimed to investigate students’ perspectives on using AR as learning tools in undergraduate pharmacy education. Methods: Four AR micro modules on post-stroke management an...

Abstract Background Community perception on antimicrobials plays a role in driving the development of antimicrobial resistance (AMR). The aim of the study was to evaluate the impact of interprofessional service-learning on the effectiveness of AMR knowledge transfer in Hong Kong elders aged 65 or above and students from university and secondary sch...

Background Educational interventions were necessary to clarify COVID-19 related misconceptions among Hong Kong older adults. Yet, face-to-face interventions were infeasible under the pandemic. The primary objective of the present study was to evaluate the efficacy of a healthcare student-led, telephone-delivered intervention in educating older adul...

Objective: This qualitative study was an integral part in the development of a multidisciplinary team-led school-based human papillomavirus vaccination health-promotion programme (MDL-SHPVP) aiming to increase HPV vaccine uptake in Hong Kong. Study findings will inform the design of the MDL-SHPVP by drawing on interview data regarding the expectat...

Purpose To understand the user expectations and the facilitators and barriers of using a virtual multidisciplinary stroke care clinic (“virtual clinic”). Methods A qualitative descriptive study involving two rounds of face-to-face semi-structured interviews per participant was conducted. We purposively recruited ten participants in Hong Kong who w...

Introduction: This study aimed to provide information about the clinical and physiochemical effects of pill splitting training in elderly cardiac patients in Hong Kong. Methods: A parallel study design was adopted. Patients taking lisinopril, amlodipine, simvastatin, metformin, or perindopril who needed to split pills were recruited from the Pri...

Background For survivors of childhood cancer, awareness of personal health risks is a critical component of long‐term health management. Objective To evaluate the awareness of the diagnosis, treatment and risk of late effects among survivors of childhood cancer in Hong Kong. Methods Between June 2019 and March 2020, this cross‐sectional study rec...

Background Partial repair of bone erosions in rheumatoid arthritis (RA) is known from high-resolution peripheral quantitative computer tomography (HR-pQCT) studies in patients with moderate to high disease activity using biologics [1]. Whether RANKL inhibition by denosumab is efficacious in healing existing erosions in RA patients with low disease...

Background Clinical evidence of prasugrel/ticagrelor in dual antiplatelet therapy (DAPT) in Asian acute coronary syndrome (ACS) population remains inconclusive. We aimed to compare the clinical efficacy and safety of prasugrel/ticagrelor compared to clopidogrel as part of DAPT in Hong Kong ACS population for 10 years. Hypothesis Prasugrel/ticagrel...

Introduction: Smoking is a modifiable risk factor for many diseases. The public should recognize the impact of smoking on their health and their wealth. The current study aimed to evaluate the cost burden of smoking to target Asia-Pacific countries. Methods: The current study estimated the annual spending and lifetime spending of smokers in the...

Virtual reality (VR) refers to an artificial environment which is experienced through sensory stimuli (such as sights and sounds) provided by a computer and in which one's actions partially determine what happens in the environment (Merriam-Webster.com Dictionary, Merriam-Webster, 2020). In recent years, VR is increasingly used in different fields,...

Objective To evaluate the effects of denosumab on erosion healing at 2–4 metacarpophalangeal (MCP) head as determined by high-resolution peripheral quantitative CT (HR-pQCT) in patients with rheumatoid arthritis (RA) with stable disease. Methods This was a randomised, placebo-controlled, double-blind study. Patients with RA with disease activity s...

Background Extravasation injury remains a significant preventable cause of morbidity and mortality in neonates. Equipping nursing students with the requisite knowledge and skills is essential for appropriate prevention, early detection, and management of extravasation injury. Objectives To develop a technology-enhanced, enquiry-based learning prog...

Introduction: Hypertension is a modifiable risk factor for multiple cardiovascular diseases. Early identification and intervention of new cases are crucial to improve patients' outcomes. May Measurement Month (MMM) is an annual global synchronised blood pressure (BP) screening campaign. Participants can have their BP measured at the screening site...

Objectives The objective of this study is to examine the temporal trend of antiplatelet prescribing pattern during index hospitalisation discharge in Hong Kong (HK) acute coronary syndrome (ACS) population. Design The study is a retrospective observational cohort study. Setting The study retrieved data from electronic health record from Hospital...

Background Interprofessional collaborative practice (IPCP) is increasingly recognised as being crucial for the provision of holistic care and optimising health outcomes among older adults, many with multiple complex health problems. However, little is known about the challenges of facilitating this in practice. Therefore, this study explores these...

Background Green tea has been extensively studied for its potential health benefits against diseases, such as cancers, cognitive degenerative diseases, and cardiovascular diseases. Methods The authors undertook a structured search of peer-reviewed research articles from three databases including PubMed, Embase, and Ovid MEDLINE. Recent and up-to-d...

Introduction: Chronic spontaneous urticaria (CSU) refers to urticaria (wheals) or angioedema, which occur for a period of six weeks or longer without an apparent cause. The condition may impair the patient's quality of life. Areas covered: Treatment for CSU is mainly symptomatic. Both AAAAI/ACAAI practice parameters and EAACI/GA2LEN/EDF/WAO guid...

Introduction: Evidence has consistently shown the high efficacy of human papillomavirus (HPV) vaccines in preventing cervical cancers. However, the HPV vaccine uptake rate in Hong Kong is very low. We will develop and evaluate an innovative, theory-based multidisciplinary team-led school-based HPV vaccination health-promotion program (MDL-SHPVP),...

Introduction: Time in therapeutic range (TTR) assesses the safety and effectiveness of warfarin therapy using the international normalised ratio. This study investigated the TTR in Hong Kong patients using both European and Japanese therapeutic ranges and patients' economic and clinical outcomes. Predictors of poor warfarin control and patient kno...

SARS-CoV2 is dramatically impacting the global population. Worldwide, pharmacists are changing their roles and being increasingly recognized for their role as essential service providers. This commentary provides some examples collected from Asia, Europe, the Americas and Africa, ranging from essential services to meet human rights basic needs, ext...

Atrial fibrillation (AF) accounts for up to one third of strokes, one of the lead mortality causes worldwide. The European Society of Cardiology guidelines recommend opportunistic screening as a means to increase the odds of early detection and institution of appropriate treatment according to risk factors identified. However, in most countries the...

Background: Atopic dermatitis (AD) is a chronic inflammatory disease associated with pruritus and sleep loss. Pine-tar has long been used for various chronic skin conditions in which its polycyclic aromatic hydrocarbon (PAH) component is anti-inflammatory and its resin acids antiseptic. The null hypothesis of this trial is that there is no differen...

Introduction: Atopic dermatitis (AD) is a type of allergic/inflammatory dermatitis characterized by itch and an impairment in quality of life. Areas covered: Herein, the authors review drug discovery efforts for AD, highlighting the clinical efficacy of novel drugs, with a particular focus on the relief of pruritus. Topical agents include emollient...

Introduction: Studies of Caucasian populations have shown that beta-blockers may exacerbate weight gain, a risk factor for many chronic diseases. Still, beta-blockers are the most prescribed antihypertensives in the Chinese population in Hong Kong. We aimed to explore the association between beta-blocker use, hypertension, and weight status of thi...

University educators anticipate better engagement with students through the adoption of the three-dimensional visualization made possible by immersive virtual reality (IVR). Materials can be captured in 360° video for viewing through smartphones bracketed in head-mounted displays (HMDs) with motion sensors. Alternatively, materials can be viewed on...

Background & aims: Mild cognitive impairment (MCI) patients are at risk of cognitive decline, while elevated serum homocysteine is also associated with cognitive impairment. Thus, older people with MCI and hyperhomocysteinemia may be under greater risk of cognitive decline. We therefore performed a randomized trial of homocysteine-lowering by B vi...

Teachers in higher education have a growing interest in embedding virtual reality in learning and teaching. This means that students can have a virtual exploration or a simulated experience in a range of situations. They can have an immersive virtual reality (IVR) experience using their smartphones mounted with cardboard boxes. Alternatively, table...

Objectives: Time-in-therapeutic range (TTR) assesses safety and effectiveness of warfarin therapy using international normalized ratio (INR). This study aimed to investigate the status of TTR in Hong Kong and patients’ economic and clinical outcomes. Predictors of poor warfarin control and patient’s knowledge in warfarin therapy were assessed. Meth...

Background The precise age distribution and calculated stroke risk of screen-detected atrial fibrillation (AF) is not known. Therefore, it is not possible to determine the number needed to screen (NNS) to identify one treatable new AF case (NNS-Rx) (i.e., Class-1 oral anticoagulation [OAC] treatment recommendation) in each age stratum. If the NNS-R...

Background: This study aimed at investigating the CV health and CV disease knowledge in terms of LS7 score among 3 age groups in Hong Kong. Methods: A cross-sectional multicenter observational study was conducted to observe the CV health and disease risk knowledge in Hong Kong. Elderly subjects were recruited from 15 elderly centers, whereas you...

Pharmacy practice goes beyond drug dispensing and prescription checks. More importantly, it is about connecting patients and continuously performing medication reviews because patients' health conditions change over time [1]. This case study reports how a pharmacy educator redesigned the curriculum so that students could gain both cognitive knowled...

Pharmacy practice goes beyond drug dispensing and prescription checks. More importantly, it is about connecting patients and continuously performing medication reviews because patients’ health conditions change over time [1]. This case study reports how a pharmacy educator redesigned the curriculum so that students could gain both cognitive knowled...

Technologies such as notebook computers, virtual reality devices and mobile applications can be useful tools to prepare pharmacy students in the 21st century [1]. Pharmacy educators start getting their students to use mobile applications and technology to enrich the learning experience, and students can find useful and reliable medical references a...

Objectives The objective was to explore the differences in medication use pattern of lipid-lowering drug (LLD) and antiplatelet agents among post-percutaneous coronary intervention patients with acute coronary syndrome aged <65 in Hong Kong (HK) and the USA. Design Retrospective study. Setting This study used deidentified claims data from Clinfor...

To prepare competent student pharmacists, university educators can adopt a mixture of augmented reality and immersive virtual reality in the curriculum so that students have more exposure to professional pharmacy practice before starting their internships. Students are exposed to using augmented reality from drug information to patient case evaluat...

Introduction The virtual multidisciplinary stroke care clinic (VMSCC) is the first nurse-led clinic developed to offer support to community-dwelling stroke survivors and caregivers, and to promote poststroke recovery. This two-arm randomised controlled trial will evaluate its effectiveness on survivors’ self-efficacy (SE), survivors’ and caregivers...

Aims: This study aimed to examine long term clinical and economic and of adults with congenital heart disease (ACHD) in Hong Kong. Methods: We retrospectively analyzed 336 consecutive ACHD patients who attended the Adult Congenital Heart Clinic between 1st Jan 2009 and 31st December 2014. Direct medical costs and clinical outcomes over 5 preceding...

The international guideline recommendations for low-density lipoprotein cholesterol (LDL-C) lowering were made based on the results of randomized controlled trials (RCTs), meta-analyses, and observational studies mostly in the White population. It was not clear whether these LDL-C targets could be applicable to other ethnic groups, for example, Asi...

Background: Very few data are available to demonstrate the economic benefit of early paliperidone palmitate once-monthly long-acting injectable (PP1M) treatment in patients with schizophrenia or schizoaffective disorder. Methods and materials: We have retrospectively compared the health care utilization and associated costs of pre and post PPIM tre...

To provide patient-centred care, healthcare professions work collaboratively to arrive at the best outcomes. However, collaborative patient-centred practice may not happen unless students studying medical sciences and healthcare programs have an inter-professional education experience. This is one of the main objectives for CU-CHAMPION, to have stu...

Introduction: The aim of the present study was to evaluate the understanding of generic substitution among health care professionals and members of the general public ("general public") in Hong Kong. Methods: This cross-sectional descriptive study was performed by using a self-completed anonymous questionnaire from March 2015 to May 2017. The qu...

Although anti‐tumor necrosis factor (TNF) agents have greatly improved the management of rheumatic diseases, their cost limits access to many patients throughout the world. As a result, patients and clinicians have turned to biosimilars to provide similar efficacy at a lower cost. Many of the regulatory guidelines in the Asia Pacific region are lar...

Background & Aims Guidelines recommend withholding clopidogrel 7 days before polypectomy to decrease bleeding risk, but these were written based on limited evidence. We investigated whether uninterrupted clopidogrel therapy increases the risk of delayed postpolypectomy bleeding in patients undergoing colonoscopy. Methods We identified patients rec...

Introduction: Many novel medications and herbal medicines have claimed efficacy on atopic dermatitis (AD). Areas covered: This review covers evidence on efficacy of topical and oral forms of novel and investigational drugs. Topical agents include emollients, phosphodiesterase E4 (PDE4) inhibitors, and topical herbs. There is little evidence that ce...

Research showed the benefits of having an immersive experience for rehabilitation more than a decade ago, and the use of head-mounted virtual-reality displays has since been attracting interest and gaining momentum in higher education in Hong Kong. Despite most university students here being considered digital natives, adopting technologies for edu...

Aim: The recommended low-density lipoprotein cholesterol (LDL-C) levels of the guideline may be appropriate for Caucasian patients but not for other ethnic groups. Methods: A cohort study was conducted in Hong Kong, and acute coronary syndrome (ACS) patients who received percutaneous coronary intervention (PCI) between 2005 and 2015 were enrolle...

Background & aims: There is no effective treatment for aspirin-induced small bowel ulcer bleeding. We performed a double-blind, randomized, placebo-controlled trial to determine whether misoprostol can heal small bowel ulcers in patients with small bowel bleeding who require continuous aspirin therapy. Methods: We performed a prospective study o...