The Team Who Empowers Patients To Breathe and Live Better

By Valissa Yap

The Pulmonary Arterial Hypertension multidisciplinary care team from L-R: Hon Jin Shing, Senior Principal Clinical Pharmacist, Dr Ruan Wen, Clin Assoc Prof Tan Ju Le, Nurse Clinician (NC) Aidila Bte Ismail and Senior Staff Nurse (SSN) Doris Lim. Not pictured: Clin Assoc Prof Lim Soo Teik and Clin Assoc Prof Yap Jiunn Liang Jonathan.

As a young adult, Ms Nuurashikin Bte Ahmad had always considered herself active and healthy. But in her early 20s, she began experiencing breathlessness while exercising and was later diagnosed with a congenital heart condition caused by a hole in her heart.

Although surgery helped correct the condition, new challenges emerged years later when she was diagnosed with Pulmonary Arterial Hypertension (PAH), a serious condition causing high pressure in her lungs, leading to chronic fatigue and breathlessness even during normal activities. After careful considerations by her PAH care team, she was started on Veletri – a continuous intravenous (IV) medication to treat advanced PAH. Unlike conventional medication, Veletri requires a high degree of commitment and independence from the patient as it is administered continuously through a portable infusion pump carried at all times. The treatment requires strict medication handling, close monitoring and intensive patient education.

Through Nuurashikin’s resilience, commitment and strong support from her family, her condition has stabilised over the years. More remarkably, she is now a registered nurse, caring for others with the compassion and strength she once received. Her inspirational journey was recognised in the recent Singapore Health Inspirational Patient & Caregiver Awards 2026.

CardioConnect speaks to her care team to understand more about managing PAH in Singapore.

Pioneering a New Treatment Journey

The NHCS PAH team first introduced Veletri in 2016 with 25 patients on the treatment over the last ten years. Today, six patients are actively on the treatment, each carefully assessed and closely monitored by the multidisciplinary team.

While the treatment offered hope to patients with advanced PAH, it also required immense responsibility from both patients and healthcare professionals. “This is a life-saving medication for intermediate to high-risk patients with PAH, but it is not a cure. The goal is to keep their lungs as stable as possible,” explained Clin Assoc Prof Tan Ju Le Tan Ju Le, who was also a Director for the Adult Congenital Heart Diseases (ACHD) Programme at NHCS from 2009 to 2025. “It requires commitment from everyone involved and is not a treatment patients can stop abruptly or take lightly.”

Before starting Veletri, patients undergo careful assessment to determine if they are ready to manage the demands of the treatment at home. This includes learning to administer the medication, proving competence in managing the pump independently and ensuring they have a reliable support system should complications arise.

NC Aidila conducts an educational session with a patient to equip her with the skills and knowledge to administer Veletri with the pump independently at home.

While doctors lead the clinical management of patients, pharmacists also play a critical role in ensuring treatment safety and continuity of care. “It is critical to ensure medication and consumables are always available, as any disruption to treatment carries serious risk,” explained Senior Principal Clinical Pharmacist Hon Jin Shing.

When the programme first began, there was no local precedent for managing Veletri. The pharmacy team worked closely with doctors and nurses, drawing on medical literature, published studies and overseas expertise to develop medication storage guidelines and infusion titration protocols suited to local practice.

Supporting Patients Beyond the Hospital

As part of the first team to administer Veletri locally, NC Aidila recalled the responsibility that came with introducing such a complex, high-risk therapy. “It was challenging because the treatment required precision, close monitoring and strong patient education,” she shared. “We spent a lot of time teaching patients and caregivers individually, with the aim of helping them gradually gain confidence and independence at their own pace.”

Even after patients return home, support from the multidisciplinary team continues. "We maintain close contact with patients through regular check-ins and video calls to ensure they are coping well,” shared SSN Doris Lim. “This allows patients to take on an active role in managing the treatment, while knowing help is still available whenever they need it. We want them to feel confident and prepared."

Beyond medical care, the team also established a PAH support group that provides patients and family members with a platform to share their experiences and support one another emotionally. The group meets regularly for activities ranging from educational talks and flower arrangement sessions to yoga and outdoor walks. “Peer support from people living with the same condition is something the medical team cannot fully replicate,” reflected Dr Ruan Wen.

Turning Challenge into Purpose

What left the strongest impression on the team was the resilience shown by patients adapting to a life-changing treatment. “Starting Veletri is a life-changing experience,” NC Aidila recounted. “Despite having to carry a pump continuously and live with the constant awareness that the therapy cannot be interrupted, patients remained incredibly determined and hopeful.”

Today, Nuurashikin has since transitioned from Veletri to oral medication and is determined to live life to the fullest. Inspired by the care and support she received throughout her journey, she currently works as a registered nurse while pursuing a Diploma in Nursing. Moreover, she remains an active member of the Pulmonary Hypertension Singapore patient support group, giving back the same encouragement she once received.

For the care team, seeing patients regain confidence and continue living meaningfully remains one of the most rewarding parts of caring for patients with PAH. Behind every patient managing a complex therapy is a dedicated team of healthcare professionals navigating the journey with them not just to deliver treatment, but to also help patients and their loved ones move forward with hope and confidence.