Comprehensive Chronic Disease Management Center

Our Core Services

• Comprehensive Geriatric Assessment (CGA) – Multi-dimensional evaluation covering physical function, cognition, nutrition, fall risk, and medication safety.

• Multidisciplinary Team (MDT) Care – Collaborative planning involving physicians, clinical pharmacists, dietitians, and rehabilitation therapists to create personalized treatment and care plans.

• Medication Optimization – Pharmacist-led review and adjustment of complex drug regimens to reduce polypharmacy risks and adverse reactions.

• Rehabilitation & Functional Maintenance – Targeted programs for frailty, sarcopenia, and mobility impairment, integrating modern physiotherapy with functional training.

• Remote Monitoring & Long-term Follow-up – Digital health records and telehealth platforms enabling seamless coordination between hospital, community, and home settings.