Cardiovascular disease, Brunei’s second highest cause of death

Izah Azahari

Cardiovascular disease remains the second highest cause of death in Brunei Darussalam after cancer. It contributed to nearly 25 per cent of deaths in 2018, with the age-standardised mortality rate for cardiovascular diseases for all ages was approximately 167 per 100,000 population for both genders, which is higher in men at 205 per 100,000, than women at 135 per 100,000.

This was disclosed by Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar in his welcoming address for the 7th Annual Scientific Meeting of the Cardiac Society Brunei Darussalam (CSBD), at the Pantai Jerudong Specialist Centre (PJSC) yesterday.

He said, “The premature mortality rate (age-standardised) for cardiovascular diseases was 131 per 100,000, higher among men at 160 per 100,000 than women at 99 per 100,000; and overall, premature mortality due to cardiovascular disease increased from 20 per cent in 2013 to 26 per cent in 2018.

“Worryingly, our surveillance indicates that cardiovascular diseases are increasingly occurring in the younger population, with 14.7 per cent of those undergoing percutaneous coronary intervention being under the age of 40.”

“It is especially important to think about new ways to deliver healthcare in this ‘new normal’ amidst the pandemic; and with the current epidemic of non-communicable diseases (NCDs), there is a need to think about leveraging the lessons learned recently about digital health towards the management of NCDs, including cardio-vascular disease.”

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar

Citing the World Heart Organization’s (WHO) term on eHealth, Dato Seri Setia Dr Haji Mohd Isham said, “It is the use of information and communications technology in support of health and health-related fields, where mobile health (mHealth) is a subset of eHealth, and is defined as the use of mobile wireless technologies for health; and the term digital health is defined as a broad umbrella term encompassing eHealth (which includes eHealth), as well as emerging areas, such as the use of advanced computing sciences in big data, genomics and artificial intelligence.

“Brunei Darussalam has made great strides in the use of digital health recently, with the release of the BruHealth app which initially was a method to facilitate contact tracing during the COVID-19 pandemic. It has now been utilised and linked with our national digital patient record system, BruHIMS.

“With the introduction of the digital health technology, Brunei Darussalam’s population has and will be able to benefit further from better planning, management and delivery of healthcare.

“With the capacity of data analytics and artificial intelligence, BruHealth can help identify health system performances gaps, tackle health system challenges and prioritise areas for improvement in healthcare delivery, including planning for prevention, promotion and public health interventions.”

He said, “At the moment, with the BruHealth mobile app, the public has access to their personal health details, as well as other health information at their fingertips, as individuals can now access their personal medical history including diagnosis, hospital and clinic visits, laboratory test results and prescription records through their mobile phones.

“This will enable the empowerment of the public to manage their own health, as well as give them the authority to share health details with other health professionals.

“The BruHealth app is envisioned to provide appointment bookings with clinicians, as well as telemedicine consultations in the future, which will help cut down the waiting time, as well as save professionals and patients the trip to the clinic or health facility, especially those living in remote areas. This is being piloted in selected clinics and will be implemented nationwide in future phases.

“Furthermore, the true meaning of ‘One patient, One record’ will also be realised with the BruHealth digital platform, as it links government with private medical records at non-governmental hospitals and clinics, which will enable government health professionals to access private medical records and vice versa, important details such as medication prescription, allergies and treatment, which will be made visible to all and contribute to a more holistic patient care and enhanced patient safety in healthcare.”

The minister noted that in terms of data protection, information and communication are monitored and guarded by national authority agencies, in making sure confidential patient information data is secured and protected.

“In the context of management of NCDs, health professionals can make use of the BruHealth app as a tool to improve health literacy by educating the public on NCDs such as cardiovascular diseases, diabetes, cancer; their risk factors, guidance on prevention and lifestyle changes, information on medications and self-management.

“Data analytics and artificial intelligence will also help health professionals in monitoring and research of NCDs in the population, including implementation of nationwide surveys,” he added.

He also highlighted that mobile health technology will also have the capability to utilise wearable wireless devices in managing an individual’s health, such as the monitoring of heart rate, steps count and ECGs in the near future.

“The Ministry of Health (MoH) will continually assess the use of technologies for health and prioritise, as appropriate, the development, evaluation, implementation, scale-up and greater use of digital technologies,” he said.