Wed. May 15, 2019 1:30 PM - 3:00 PM Room 5 (1F Room D)

Organizer:Hideto Ariumi(Kitasato University, Japan)

The purpose of every pharmacist should be improving medication use and advancing patient care. Pharmacists will be the health care professionals responsible for providing patient care that ensures optimal medication therapy outcomes. The profession is moving toward a model that attempts to integrate patient-centered care with drug distribution services. Primary care is one of very important roles. In this symposium, we will discuss “Pharmaceutical knowledge required by Primary Care Pharmacists in Japan”. This symposium is composed of five presentations, “Approach to Primary Care in Community Pharmacy”, “Career choice attitudes and career design of pharmacy students”, “Cross-cultural Interdisciplinary Case Study”, “Effectiveness of pharmacist intervention in community pharmacy for asthma control improvement providing adequate instruction” and “Roles in inter-professional cooperation and healthcare services at home among other healthcare professionals in the community”. The six-year pharmacy programme, focusing on practical pharmaceutical care, includes practical training on-site and was started in 2006 in Japan. The attitudes of the six-year pharmacy students toward career choice are unclear because the programme is relatively new. The interdisciplinary case study lets the students exchange their most recent and evidence based medical skill and knowledge, as well as providing social value and an ethical standpoint across countries. The objective of this symposium is that understand the necessity of a basic knowledge in the provision of primary care.

Wed. May 15, 2019 3:30 PM - 5:00 PM Room 5 (1F Room D)

Organizer: Mei-Ju Chen(Taipei City Hospital,
Chair: Chin-Yu Ho(Taipei City Hospital Yangming Branch, Taiwan)
Facilitator: Mei-Ju Chen(Department of Community Medicine, Taipei City Hospital, Taiwan)

This session will introduce the integraed care model promoted in Taipei City Hospital (TCH) from 2016. Eight doctors from various branches of TCH will discuss related issues in this session. Because Taiwan has entered the aging society since 1993 and officially enter the aged society from 2018, the issues related with elderly caring have gradually gain their importance. The government in Taiwan initiated the ”Combined Home Healthcare Project (CHHP)” from 2016, to meet the needs for the disabled elderly in Taiwanese society. On the one hand, the multidisciplinary medical teams forming in TCH, named as ”The Home Health Care Project of Blue Magpie (Blue Magpie Project)＂, to execute and accomplish CHHP’s missions, which cover three stages of care, from ”home healthcare”, ”severe home healthcare＂to ”home hospice care”. On the one other hand, the Blue Magpie Project which were composed of physicians, nurses, pharmacists, therapists and other specialists also gradually transform to provide high value home healthcare at patients' home in the community started through walking out of the hospital. It is ultimately expected that palliative care and home-based long term care in Taiwan can achieve the goal of high healthcare System.

Thu. May 16, 2019 8:30 AM - 10:00 AM Room 3 (2F Room B-1)

Organizer/Chair: Regina Wing Shan Sit(The Chinese University of Hong Kong, Hong Kong)

The World Health Organization 2015 reported that musculoskeletal health conditions represent a global threat to healthy aging, with detrimental effects on physical and mental wellbeing. The disability burden of musculoskeletal disorders ranked second among all chronic diseases globally. Musculoskeletal pain is a common encountered in primary care. It constitutes up to 18% of a general practitioner’s workload and takes up significant consultation time. Although healthcare system vary between countries, primary care is generally regarded as the point of first contact for musculoskeletal pain, and is the setting in which majority of cases are assessed and managed. However, training of primary care physicians in diagnosing and treating chronic pain is mostly inadequate. This leads to multiple barriers in the treatment of various musculoskeletal complaints.


We propose a 90-minutes symposium jointly organized by the Chinese University of Hong Kong and the Hong Kong Institute of Musculoskeletal Medicine. (http://www.hkimm.hk/)

Thu. May 16, 2019 8:30 AM - 10:00 AM Room 4 (2F Room B-2)

Organizer: Tze Lee Tan(COLLEGE OF FAMILY PHYSICIANS, SINGAPORE, Singapore)
Chair: AMANDA BERNARD(IPCRG, Australia)

1. COPD, Updates for 2019
Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory problem caused by exposure to smoke from cigarette smoking, indoor air pollution from passive smoking or indoor air pollution from residential biomass fuel use. Its prevalence and impact are increasing. It causes significant morbidity and mortality in all countries of the world. The symposium will cover the importance of a correct diagnosis, action following diagnosis, disease classification and treatment, vaccinations, and management of exacerbations.

2. Introduction to Spirometry. This workshop will introduce the basics of spirometry. It will highlight the important spirometry parameters of a spirometric reading, how to
identify a “good quality” spirometry, how to identify the different spirometry patterns, and how to accurately “read” the results of the test.
Spirometers will be available for a hands-on session.

Thu. May 16, 2019 8:30 AM - 10:00 AM Room 5 (1F Room D)

Organizer: Takuya Aoki(Kyoto University, Japan)
Chair: Machiko Inoue(Hamamatsu University School of Medicine, Japan)

Health systems based on primary care have been shown to achieve better health outcomes, equity, and costs. Therefore, many countries have been making efforts through primary care reforms to strengthen the care delivery. Especially in Europe and North America, efforts of exchange of experiences and health service researches through international collaboration have been active for the improvement of primary care quality. In East Asia, because such efforts have been poor, we have established the East Asian Primary Care Research Network (EAPCRN) at WONCA World 2018 Seoul. In this symposium, we will aim to share the information on trends in each country at key characteristics of the primary care system such as primary care governance, economic conditions of primary care, primary care workforce development, and primary care process. Furthermore, we will discuss research themes that are currently being addressed or important in the future based on the situations of each country. We expect this symposium can be a stepping stone to the success of the EAPCRN.

Thu. May 16, 2019 10:30 AM - 12:00 PM Room 4 (2F Room B-2)

Organizer/Chair: Harold Jacobs(James Cook University, Australia)

This symposium will explore the enablers and disruptors from the perspective of the start-up of a new generalist training delivery organisation. James Cook University established a post-graduate GP Training program [JCU/Generalist Medical Training] in 2015. James Cook University is the first Australian university contracted to deliver Australian general practice training [AGPT]. The training area covers 90% of the state of Queensland with around 500 registrars. Also discussed will be the first decade of the Queensland Rural Generalist training program and the more recently established Rural Generalist Program Japan

Thu. May 16, 2019 10:30 AM - 12:00 PM Room 5 (1F Room D)

Organizer: Junichiro Miyachi(Azai-Higashi Clinic, Hokkaido Centre for Family Medicine, Japan)
Chair: Yuka Miyachi(Department of Palliative Medicine, Kyoto University Hospital, Japan)

Cultural and medical anthropology, a field of social sciences, is a discipline which can offer collaborative opportunities for family physicians. In this symposium, we will share our experiences of two illustrative collaborative activities between cultural or medical anthropologists and family physicians. The first example will be our case conference to help family physicians to understand how sociocultural contexts, health problems, and clinical interactions are entangled with each other. The second example will be a collaboration regarding qualitative research in which anthropologists can help the process of forming research question, gathering data, and reflexively articulating emerging findings.
Physicians, as well as anthropologists, will present how they perceive the collaborative process to elicit lessons in facilitating the process and overcoming potential barriers. Ultimately, we aim to provide tips for collaboration which will surely motivate participants to take part in existing collaborative activities as well as to initiate their own new collaborative projects with social scientists.

Thu. May 16, 2019 3:30 PM - 5:00 PM Room 2 (2F Room A)

Organizer: Juichi Sato(Nagoya University Graduate School of Medicine, Japan)
Chair: Kiyoshi Minamizawa(Department of oriental medicine, Kameda medical center, Japan), Juichi Sato(Nagoya University Graduate School of Medicine, Japan)

The Japanese medical service has been maintaining a good level with the mainstream use of modern western medicine, but traditional medicine (Japanese oriental medicine) is also playing an important role. Kampo (traditional herbal medicine) is integrated into the Japanese national health care system. Every Japanese doctor can prescribe Kampo formulas in their daily clinical practice and most primary care physicians usually use it to solve many problems. In addition, acupuncture can help alleviate various types of pain without the use of drugs. Much research in this area has been conducted and it is becoming clear that acupuncture can play a significant part in today’s medical service. By using Kampo and acupuncture, we can have another point of view from which to understand patients’ sickness and offer another way of treatment which values patients’ constitutions, quality of life and circumstances. In this symposium, we will give presentations about the use of Kampo therapies in primary care and general hospitals, acupuncture to treat pain, and how oriental medical care has supported people after a large scale disaster. We hope to demonstrate the efficacy of Japanese oriental medicine, which is widely used in various settings of medical services in our country.

Thu. May 16, 2019 3:30 PM - 5:00 PM Room 3 (2F Room B-1)

Organizer: Yoshihisa Honda(Kaita Hospital, Japan)
Chair: Kentaro Kinjo(Morinosaot Hospital, Japan)
Facilitator: Kaita Hospital, Japan)

Community Hospitals(CHs) are present in many countries and their roles in the healthcare system varies from setting to setting. What is common is that they are often staffed by Family Physicians(FPs) who provide integrated and coordinated care, as well as continuity of care. In this session we introudce three CHs in Asia and discuss on their similarities and differencies. It’ll be useful for understanding integrated care model in each contry and the roles of family physicians in CH.
Kaita hospital is a 96 bedded teaching hospital in Japan run by FPs and provides outpatient care, sub- and post-acute inpatient care and home care including end of life care.
St Lukes Hospital is a 200 bedded CH in Singapore. It is a “step-down” inpatient facility which receives referrals from tertiary hospitals for inpatient rehabilitation, wound care, intravenous antibiotics, dementia care and palliative care. The FP leads the multidisciplinary team in coordinating goals of care. After discharge, the patients are followed up in a continuity one stop FP clinic that provides a wide range of services.
CHs in Thailand are located in the district level and are usually providing general care, primary care treatment, integrate care and health promotion.

Thu. May 16, 2019 3:30 PM - 5:00 PM Room 5 (1F Room D)

Organizer: Po-Lin Chan(World Health Organization Western Pacific Regional Office, Philippines)
Chair: Po-Lin Chan(World Health Organization Western Pacific Regional Office, Philippines), William CW Wong(The University of Hong Kong, China)

A recent systematic review on hepatitis interventions showed that only one of 56 studies included was from an Asian country but the experience from Western countries show that engaging primary care providers through issuing hepatitis testing policies, making system adjustments, training of primary care physicians and education of patients increased uptake and yield of Hepatitis C virus (HCV) and improved linkage to care. Hepatitis testing combined with liver cancer screening for 2489 individuals in primary care clinics in rural Mongolia found 25% positive for HCV.
Up to 10 million people in China are infected with HCV and many unknown to their status. The China CDC found 70% of community health centres (CHCs) have capacity to conduct HCV antibody testing but only half of them would offer it. Patients having to pay and lack of awareness were major barriers. Strong evidence exists that targeted active case finding in primary care in older age groups with a history of injecting drug use, plasma donation and received unscreened blood or blood products in the past was cost-effective for HCV screening.
Our national representative survey found that many CHCs do not have any written policies for hepatitis screening despite testing guidelines for HCV is available in China since 2008. This workshop aims to review the evidence of HCV testing in primary care and WHO guideline on HCV testing and management. The delegates will share their home experience on HCV management and there will be exercise to help them familarise HCV management.

Fri. May 17, 2019 8:30 AM - 10:00 AM Room 3 (2F Room B-1)

Organizer: Yuiko Nagamine(Chiba University, Japan)
Chair: Satoko Hotta(Keio University, Japan)

It is increasingly recognised that socioecoomic and enviromental factos have a large impact on the status of our health. The need for a holistic review of people and to intervene as necessary in the social deteriminants of their ill health in order to support their independent living in the community is being stressed.
We would like to hold a sympoisum to introduce to a concept called social prescribing as a response to this situation and give its general overview – why, what it is, its benefits as well as its challenges, and how social prescribing service can ge delivered with example cases from Japan and the UK, followed by panel discussion and answering questions from the audience.

The provisional structure of our proposed symposium is as follows:-
1) Opening remark – (Professor Satoko Hotta)
2) Concept and why social prescribing? – (Professor Satoko Hotta)
3) Origins of social prescribing and case studies in the UK – (Dr Patrick Hutt)
4) Case studies in Japan –(Dr Daisuke Nishioka)
5) The role of medical generalism in social prescribing and differences/similarities between the UK and Japan – (Dr Noriaki Sawa)
6) Discussion – global challenges, actions and lessons
7) Questions

Fri. May 17, 2019 8:30 AM - 10:00 AM Room 4 (2F Room B-2)

Organizer/Chair: Lay Hoon Goh(National University of Singapore, Yong Loo Lin School of Medicine, Singapore)

The Asia-Pacific Academic Primary Care Group (AAPCG) is a new initiative and a voluntary collaborative partnership among family medicine and primary care academics of nine universities in the Asia-Pacific region. The institutional members include University of Melbourne, Fudan University, the University of Hong Kong, the Chinese University of Hong Kong, University of Malaysia, University of Putra Malaysia, National University of Singapore, Nanyang Technological University of Singapore and Duke-Medical School of Singapore. The objective of the AAPCG is to establish synergy, collaboration and partnership in academic primary care in the Asia-Pacific region through building academic family medicine and primary care capacity, creating a rich research and educational environment, and answering important research questions to improve health care.
In this symposium, we will be presenting on:
1. Formation of AAPCG and its activities since the inauguration in 2017.
2. Practical tips on how to begin research in primary care.
3. How to upscale your research.
4. A multi-morbidity research among AAPCG scholars using different research methodologies.

Fri. May 17, 2019 1:30 PM - 3:00 PM Room 3 (2F Room B-1)

Organizer/Chair: Regina Wing Shan Sit(The Chinese University of Hong Kong, Hong Kong)

Multimorbidity, commonly defined as the presence of two or more chronic medical conditions in an individual, is associated with decreased quality of life, functional decline, and increased healthcare utilization. Patients with multimorbidity are commonly managed by primary care physicians, knowledge about multimorbidity over time is thefrefore required to improve patient care.

In this 90-minutes symposium, we will:

1) Give an overview on the evolving definitions and epidemiology of multimorbidity. We believe a better understanding of the epidemiology of multimorbidity is necessary to develop interventions to prevent it, reduce its burden, and align health-care services more closely with patients' needs
2) Rreveal the unexplored health consequences associated with multimorbidity, such as patients’ help-seeking behaviors, drug compliance and self-management strategies, which are essential factors in chronic disease management.
3) Discuss the potential complex interventions for the management of multimorbidity. Managing several chronic conditions with the current single disease focus of clinical guidelines and research is a challenge to general practitioners. Therefore. the concepts of complex interventions will be introduced and its role to improve function in multimorbidity will be emphasized.

Fri. May 17, 2019 3:30 PM - 5:00 PM Room 4 (2F Room B-2)

Organizer: Michiko Moriyama(Hiroshima University, Japan)
Chair: Michiko Moriyama(Hiroshima University, Japan), Akira Matsushita(Nagi Family Clinic, Japan)

Positioning and role of nurses in primary care in Asian Pacific countries are not known compared to ones in Western countries. At the Japan Primary Care Association, we started a certification system for primary care nurses and has prepared a textbook and started training sessions and e-learning. In Japan, primary care from nursing perspective mainly consists of municipal public health nurses, home-visiting nurses, and nursing professionals engaged in the long-term care insurance system. However, nurses who works at primary care medical facilities are now expanding their roles in taking care of community population throughout their lives/developmental stages. In addition, nurses who practice as a nurse practitioner in depopulated areas are also increasing.
In this symposium, we would like to share the report of primary care nurses from Asian Pacific countries and Spain, of their responsibilities, scopes of practice, undergraduate and postgraduate education system, and certification. The purpose of this symposium is to develop academic and practical network in the world.