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Moving Towards Optimized Noncommunicable Disease Management in the ASEAN Region: Recommendations from a Review and Multidisciplinary Expert Panel

Castillo-Carandang NT 1 , Buenaventura RD 2 , Chia YC 3 , Do Van D 4 , Lee C 5 , Duong NL 6 Show all authors , Ng CH 7 , Robles YR 8 , Santoso A 9 , Sigua HS 10 , Sukonthasarn A 11 , Tan R 12 , Viora E 13 , Zakaria H 14 , Brizuela GE 15 , Ratnasingham P 16 , Thomas M 17 , Majumdar A 16

Affiliations 

  • 1 Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines; and Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
  • 2 Department of Psychiatry, Manila Theological College - College of Medicine, Manila, Philippines
  • 3 Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
  • 4 The University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
  • 5 National Addictions Management Service, Institute of Mental Health, Singapore
  • 6 Department of Research, Education and Technology, Vietnam National Heart Institute, Hanoi, Vietnam
  • 7 Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
  • 8 College of Pharmacy, University of the Philippines Manila, Manila, Philippines
  • 9 Department of Cardiology, Vascular Medicine, National Cardiovascular Centre - Harapan Kita Hospital, Universitas Indonesia, Jakarta, Indonesia
  • 10 University of the Philippines Open University, Laguna, Philippines
  • 11 Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • 12 Roger Kidney Clinic, Gleneagles Hospital, Singapore
  • 13 Indonesia Psychiatrist Association, Jakarta, Indonesia
  • 14 Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 15 Research, Development and Medical, Pfizer Upjohn, Manila, Philippines
  • 16 Research, Development and Medical, Pfizer Upjohn, Singapore
  • 17 Corporate Affairs, Pfizer Upjohn, Singapore
Risk Manag Healthc Policy, 2020;13:803-819.
PMID: 32765135 DOI: 10.2147/RMHP.S256165

Abstract

Introduction: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in the Association of Southeast Asian Nations (ASEAN) member states. Progress has been slow despite the World Health Organization action plan for the prevention and control of NCDs in the region. This paper presents recommendations focused on practical strategies for optimizing NCD management in the ASEAN region.

Methods: A multidisciplinary group of experts from six ASEAN member states convened for two face-to-face meetings to discuss barriers and possible recommendations for optimizing NCD management, focused on cardiovascular diseases and mental disorders, in the region. Multiple approaches, ie, analysis of insights from the meetings and a review of existing literature on NCD programs in the ASEAN region were followed. The proposed recommendations were also based on selected successful interventions in ASEAN member states, thus providing actionable strategies.

Results: The gaps identified in NCD management for cardiovascular diseases and mental disorders in the ASEAN region were classified into gaps relating to policies and to clinical and public health practice. The proposed solutions addressing policy gaps include fostering multisectoral public-private partnerships, employing "whole-of-government" and "whole-of-society" approaches and promoting "health-in-all policies approach" to manage issues with financing, accessibility, efficiency and quality of health services. Whereas proposed solutions to bridge clinical and public health practice gaps entail strengthening primary care services, building the capacity of trained healthcare workers and employing collaborative care for holistic management of patients.

Conclusion: The scale of premature and preventable deaths from NCDs in the ASEAN region remains a serious public health concern and requires a "whole-of-system approach". The interventions proposed in this paper build on regional collaborations and knowledge sharing to help develop a concerted and targeted response to NCDs.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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