Helena Aebersold, Fabienne Foster-Witassek, Sina Amberg, Miquel Serra-Burriel, Giorgio Moschovitis, Raffaele Zannoni, Stefanie Aeschbacher, Giulio Conte, Jürg H Beer, Eva Blozik, Leo H Bonati, David Conen, Stefan Felder, Moa L Haller, Philipp Krisai, Michael Kühne, Rebecca E Paladini, Tobias Reichlin, Nicolas Rodondi, Christian Sticherling, Thomas Szucs, Yuki Tomonaga, Stefan Osswald, Matthias Schwenkglenks
Aims: We aimed to explore atrial fibrillation (AF)-induced productivity losses in working-age atrial fibrillation patients and to estimate atrial fibrillation-related indirect costs.
Methods: Between 2014 and 2017, the Swiss Atrial Fibrillation prospective cohort study (Swiss-AF) enrolled 217 working-age patients with documented atrial fibrillation. Self-reported changes in professional activity and the reasons thereof were descriptively analysed over 8 years of follow-up or until patients reached the retirement age. Results were put into perspective, and indirect costs were planned to be estimated, through comparison with a general population-based, age-, sex- and year-matched comparison sample from the Swiss labour force survey (SLFS).
Results: Of 217 analysed Swiss-AF patients, 14.7% reported a professional activity change (9.2% stop, 5.5% reduction) due to atrial fibrillation before the end of observation. Of those working at enrolment (n = 157), 3.8% had a subsequent professional activity change due to atrial fibrillation, 11.6% due to other reasons. Patients were more likely to report an impact of atrial fibrillation on professional activity if they had had atrial fibrillation longer and were closer to the retirement age. Slightly fewer Swiss-AF patients were employed (75%) than in the comparison sample (77%). For those working however, the degree of employment was higher (88% vs 83%). Lack of differences between the Swiss-AF patients and the comparison sample indicated no relevant indirect costs of atrial fibrillation due to lost productivity.
Conclusion: Only a minority of atrial fibrillation patients reported a negative impact of atrial fibrillation on their professional activity. Professional activity changes due to other reasons were reported more frequently. Compared with the general population, atrial fibrillation did not cause distinct differences.
{"title":"Impact of atrial fibrillation on productivity in working-age patients: an analysis of Swiss-AF prospective cohort study data.","authors":"Helena Aebersold, Fabienne Foster-Witassek, Sina Amberg, Miquel Serra-Burriel, Giorgio Moschovitis, Raffaele Zannoni, Stefanie Aeschbacher, Giulio Conte, Jürg H Beer, Eva Blozik, Leo H Bonati, David Conen, Stefan Felder, Moa L Haller, Philipp Krisai, Michael Kühne, Rebecca E Paladini, Tobias Reichlin, Nicolas Rodondi, Christian Sticherling, Thomas Szucs, Yuki Tomonaga, Stefan Osswald, Matthias Schwenkglenks","doi":"10.57187/s.3669","DOIUrl":"https://doi.org/10.57187/s.3669","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to explore atrial fibrillation (AF)-induced productivity losses in working-age atrial fibrillation patients and to estimate atrial fibrillation-related indirect costs.</p><p><strong>Methods: </strong>Between 2014 and 2017, the Swiss Atrial Fibrillation prospective cohort study (Swiss-AF) enrolled 217 working-age patients with documented atrial fibrillation. Self-reported changes in professional activity and the reasons thereof were descriptively analysed over 8 years of follow-up or until patients reached the retirement age. Results were put into perspective, and indirect costs were planned to be estimated, through comparison with a general population-based, age-, sex- and year-matched comparison sample from the Swiss labour force survey (SLFS).</p><p><strong>Results: </strong>Of 217 analysed Swiss-AF patients, 14.7% reported a professional activity change (9.2% stop, 5.5% reduction) due to atrial fibrillation before the end of observation. Of those working at enrolment (n = 157), 3.8% had a subsequent professional activity change due to atrial fibrillation, 11.6% due to other reasons. Patients were more likely to report an impact of atrial fibrillation on professional activity if they had had atrial fibrillation longer and were closer to the retirement age. Slightly fewer Swiss-AF patients were employed (75%) than in the comparison sample (77%). For those working however, the degree of employment was higher (88% vs 83%). Lack of differences between the Swiss-AF patients and the comparison sample indicated no relevant indirect costs of atrial fibrillation due to lost productivity.</p><p><strong>Conclusion: </strong>Only a minority of atrial fibrillation patients reported a negative impact of atrial fibrillation on their professional activity. Professional activity changes due to other reasons were reported more frequently. Compared with the general population, atrial fibrillation did not cause distinct differences.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3669"},"PeriodicalIF":2.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandre Déglise, Youcef Guechi, Christophe Le Terrier, Vincent Ribordy, Anne-Laure Feral-Pierssens, Thomas Schmutz
Aims of the study: As emergency department consultations rise across Europe, patients must be guided to obtain appropriate care at the right time and place.In Switzerland, the absence of a unique health number that would enable the avoidance of emergency services through telephone medical advice, and the shortage of general practitioners, redirecting low-severity patients from the emergency department before medical consultation to other healthcare facilities could help reduce emergency department overload. This study assessed the safety of a newly implemented redirection process by examining the rate of unexpected returns to any healthcare facility.
Methods: This monocentric cohort study included patients aged 18 or older who presented to the emergency department of a regional hospital in Switzerland between 1 January and 31 May 2023 and who accepted redirection before medical consultation. Patients were identified from our electronic medical registry and retrospectively enrolled after telephone interviews. The primary outcome was the rate of unexpected returns to any healthcare facility within 2 days of redirection. The secondary outcomes were the rate of returns within 7 days, hospital admissions, and patient satisfaction.
Results: Among 16,362 patients who came to the emergency department during the study period, 688 (4%) were redirected. A total of 321 patients were included in the final analysis after telephone interviews. The rate of unexpected returns to any healthcare facility after redirection was 4% within 2 days and 16% within 7 days. The rate of returns to any hospital was 1.2% within 2 days and 4.7% within 7 days after redirection. Six patients (2%) required hospitalisation, and no fatalities were reported. The mean satisfaction score was 3.9/5 (standard deviation [SD] = 1.1) for triage experience, 4.4/5 (SD = 1) for care received in partner clinics, and 3.7/5 (SD = 1) for the redirection process.
Conclusion: The rate of unexpected returns to any healthcare facility after redirection was 4% within 2 days and 16% within 7 days. The implementation of this protocol appeared to provide safe redirection to nearby clinics for redirected low-acuity patients. Satisfaction with care received in partner clinics was high, although it was lower for the redirection process and triage experience.
{"title":"SAFEty assessment of a REdirection process after TRIage (SAFE RETRI) by a triage nurse in an emergency department: a monocentric cohort study.","authors":"Alexandre Déglise, Youcef Guechi, Christophe Le Terrier, Vincent Ribordy, Anne-Laure Feral-Pierssens, Thomas Schmutz","doi":"10.57187/s.4030","DOIUrl":"https://doi.org/10.57187/s.4030","url":null,"abstract":"<p><strong>Aims of the study: </strong>As emergency department consultations rise across Europe, patients must be guided to obtain appropriate care at the right time and place.In Switzerland, the absence of a unique health number that would enable the avoidance of emergency services through telephone medical advice, and the shortage of general practitioners, redirecting low-severity patients from the emergency department before medical consultation to other healthcare facilities could help reduce emergency department overload. This study assessed the safety of a newly implemented redirection process by examining the rate of unexpected returns to any healthcare facility.</p><p><strong>Methods: </strong>This monocentric cohort study included patients aged 18 or older who presented to the emergency department of a regional hospital in Switzerland between 1 January and 31 May 2023 and who accepted redirection before medical consultation. Patients were identified from our electronic medical registry and retrospectively enrolled after telephone interviews. The primary outcome was the rate of unexpected returns to any healthcare facility within 2 days of redirection. The secondary outcomes were the rate of returns within 7 days, hospital admissions, and patient satisfaction.</p><p><strong>Results: </strong>Among 16,362 patients who came to the emergency department during the study period, 688 (4%) were redirected. A total of 321 patients were included in the final analysis after telephone interviews. The rate of unexpected returns to any healthcare facility after redirection was 4% within 2 days and 16% within 7 days. The rate of returns to any hospital was 1.2% within 2 days and 4.7% within 7 days after redirection. Six patients (2%) required hospitalisation, and no fatalities were reported. The mean satisfaction score was 3.9/5 (standard deviation [SD] = 1.1) for triage experience, 4.4/5 (SD = 1) for care received in partner clinics, and 3.7/5 (SD = 1) for the redirection process.</p><p><strong>Conclusion: </strong>The rate of unexpected returns to any healthcare facility after redirection was 4% within 2 days and 16% within 7 days. The implementation of this protocol appeared to provide safe redirection to nearby clinics for redirected low-acuity patients. Satisfaction with care received in partner clinics was high, although it was lower for the redirection process and triage experience.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"4030"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ulf C Schneider, Stephan Bohlhalter, Florian Wüthrich, Dirk Lehnick, Alexander Von Hessling
The choice of modality of treatment for unruptured intracranial aneurysms is based on various clinical aspects and the patient's preference. Financial considerations should not be among these. To evaluate any financial variations between endovascular and microsurgical treatment of unruptured intracranial aneurysms in the Swiss healthcare system, we retrospectively reviewed 100 consecutive aneurysm cases treated as inpatients in our institution. Case-based financial data were collected (revenues, costs, net earnings) and compared between the treatments. Among 100 consecutive aneurysm cases treated at our institution (2021-2023), 58 were unruptured intracranial aneurysm. Treatment was endovascular in 33, microsurgery in 23 and conservative/antibiotic in 2 cases. Length of stay (but not duration in the intensive care unit) was longer after microsurgical treatment. Total median revenues (public insurance, private insurance, material reimbursement) were Swiss Francs (CHF) 30,012.25 with a maximum of CHF 125,337.20 and a minimum of CHF 9543.25. No marked difference was found between the treatment groups (endovascular and microsurgery). Despite the fact that median net earnings per patient were positive (CHF 3655.03), more than one third of all cases led to a net loss for the hospital with a tendency for more stable net earnings in microsurgery cases. The only factor associated with a higher risk of net loss per case was higher implant costs in endovascular cases. Reimbursement within the Swiss healthcare system does not promote financial bias for decision-making in treatment modality for unruptured intracranial aneurysm. The fact that one third of all cases does not result in positive net earnings (even in the highly paid unruptured intracranial aneurysm sector), although overall net earnings were positive, should be monitored - especially in times of rising costs.
{"title":"Economic evaluation in the treatment of unruptured intracranial aneurysms in the Swiss healthcare system: a retrospective cost evaluation.","authors":"Ulf C Schneider, Stephan Bohlhalter, Florian Wüthrich, Dirk Lehnick, Alexander Von Hessling","doi":"10.57187/s.3727","DOIUrl":"https://doi.org/10.57187/s.3727","url":null,"abstract":"<p><p>The choice of modality of treatment for unruptured intracranial aneurysms is based on various clinical aspects and the patient's preference. Financial considerations should not be among these. To evaluate any financial variations between endovascular and microsurgical treatment of unruptured intracranial aneurysms in the Swiss healthcare system, we retrospectively reviewed 100 consecutive aneurysm cases treated as inpatients in our institution. Case-based financial data were collected (revenues, costs, net earnings) and compared between the treatments. Among 100 consecutive aneurysm cases treated at our institution (2021-2023), 58 were unruptured intracranial aneurysm. Treatment was endovascular in 33, microsurgery in 23 and conservative/antibiotic in 2 cases. Length of stay (but not duration in the intensive care unit) was longer after microsurgical treatment. Total median revenues (public insurance, private insurance, material reimbursement) were Swiss Francs (CHF) 30,012.25 with a maximum of CHF 125,337.20 and a minimum of CHF 9543.25. No marked difference was found between the treatment groups (endovascular and microsurgery). Despite the fact that median net earnings per patient were positive (CHF 3655.03), more than one third of all cases led to a net loss for the hospital with a tendency for more stable net earnings in microsurgery cases. The only factor associated with a higher risk of net loss per case was higher implant costs in endovascular cases. Reimbursement within the Swiss healthcare system does not promote financial bias for decision-making in treatment modality for unruptured intracranial aneurysm. The fact that one third of all cases does not result in positive net earnings (even in the highly paid unruptured intracranial aneurysm sector), although overall net earnings were positive, should be monitored - especially in times of rising costs.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3727"},"PeriodicalIF":2.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving sex and gender equity in research protocols: the new SAGER-swissethics recommendations.","authors":"Angèle Gayet-Ageron, Carole Clair, Joëlle Schwarz, Shirin Heidari, Emilie Bovet, Raphaël Bize, Petra Stute, David Nadal, Annette Magnin, Nicole Kalberer, Pierre-André Michaud","doi":"10.57187/s.4051","DOIUrl":"https://doi.org/10.57187/s.4051","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"4051"},"PeriodicalIF":2.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deborah Eberle, Annina Bauer, Cordula Landgraf, Joëlle Roos, Regina Grossmann
Background: While patient and public involvement (PPI) in clinical research contributes substantially to research ethics, feasibility and quality, the uptake and implementation of PPI-based approaches in Switzerland remain unknown. This study aimed to evaluate the current state and acceptance of PPI in academic clinical research in Switzerland, with the goal of developing recommendations for its future implementation and development.
Methods: A sequential explanatory mixed-methods study was conducted to assess the current landscape and acceptance of PPI in academic clinical research across different stakeholder groups in Switzerland. The groups were "Patients and Public", "Researchers", "Staff Members of Academic Research Infrastructure (ARI)" and representatives from "Regulatory and Funding Bodies". Data was collected through a combination of surveys and semi-structured interviews. The survey results were analysed descriptively, while interview data was analysed qualitatively. The results were further synthesised into a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis.
Results: A total of 123 survey responses were collected.Surveys revealed great support and acceptance for PPI in academic clinical research in Switzerland across all stakeholder groups. Despite this support, several challenges were identified, including gaps in training, limited funding opportunities and insufficient infrastructure to facilitate PPI.
Conclusion: The current framework for PPI in Switzerland is in an early stage of development. A joint effort by all stakeholders is needed to catch up with international progress to reach high-level ethical and quality standards. A basic framework for PPI in academic clinical research in Switzerland should be implemented, including guidelines for qualification and collaboration, best practices as well as widespread information for patients, the public and researchers. Further needed are training opportunities in "PPI in clinical research" for all stakeholders as well as sustainable sources of funding.
{"title":"Patient and public involvement in academic clinical research in Switzerland - a mixed methods study.","authors":"Deborah Eberle, Annina Bauer, Cordula Landgraf, Joëlle Roos, Regina Grossmann","doi":"10.57187/s.3563","DOIUrl":"https://doi.org/10.57187/s.3563","url":null,"abstract":"<p><strong>Background: </strong>While patient and public involvement (PPI) in clinical research contributes substantially to research ethics, feasibility and quality, the uptake and implementation of PPI-based approaches in Switzerland remain unknown. This study aimed to evaluate the current state and acceptance of PPI in academic clinical research in Switzerland, with the goal of developing recommendations for its future implementation and development.</p><p><strong>Methods: </strong>A sequential explanatory mixed-methods study was conducted to assess the current landscape and acceptance of PPI in academic clinical research across different stakeholder groups in Switzerland. The groups were \"Patients and Public\", \"Researchers\", \"Staff Members of Academic Research Infrastructure (ARI)\" and representatives from \"Regulatory and Funding Bodies\". Data was collected through a combination of surveys and semi-structured interviews. The survey results were analysed descriptively, while interview data was analysed qualitatively. The results were further synthesised into a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis.</p><p><strong>Results: </strong> A total of 123 survey responses were collected.Surveys revealed great support and acceptance for PPI in academic clinical research in Switzerland across all stakeholder groups. Despite this support, several challenges were identified, including gaps in training, limited funding opportunities and insufficient infrastructure to facilitate PPI.</p><p><strong>Conclusion: </strong>The current framework for PPI in Switzerland is in an early stage of development. A joint effort by all stakeholders is needed to catch up with international progress to reach high-level ethical and quality standards. A basic framework for PPI in academic clinical research in Switzerland should be implemented, including guidelines for qualification and collaboration, best practices as well as widespread information for patients, the public and researchers. Further needed are training opportunities in \"PPI in clinical research\" for all stakeholders as well as sustainable sources of funding.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3563"},"PeriodicalIF":2.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christophe Kosinski, Emilie Zuercher, Tania Carron, Julie Chevallereau, Marie-Annick Le Pogam, Chiara Storari, Anne Wojtusciszyn, Isabelle Peytremann-Bridevaux
Aim: To assess the perceptions of adults with diabetes regarding their care and health during the COVID-19 pandemic in the canton of Vaud, Switzerland.
Methods: Cross-sectional data was analysed from the 2021 follow-up questionnaire of the CoDiab-VD survey, a cohort of adults living with diabetes in the canton of Vaud. Various aspects of diabetes care and issues relating to the COVID-19 pandemic were assessed. Descriptive analyses were conducted to detail access to care, self-management, and psychosocial burden during the pandemic. Regression analyses were then performed to explore the relationship between these domains and factors associated with COVID-19 outcomes.
Results: Respondents (n = 566; 79%) had a mean age of 70 years (range: 22-94), and most had type 2 diabetes (73%). The COVID-19 pandemic did not appear to have strongly affected their care. Indeed, access to diabetes care remained similar to before the pandemic: only 10% of respondents reported having diabetes-related care postponed or cancelled. While 16% experienced increased difficulty in managing physical activity, the majority were able to continue diabetes self-management, with minimal changes in glucose control. In terms of psychosocial burden, only 33% expressed high levels of worry about the pandemic.
Conclusion: Diabetes self-management, glucose control, and access to diabetes care were not severely affected for the CoDiab-VD cohort during the COVID-19 pandemic. Despite some reported postponements in care and increased difficulty in physical activity management, the majority maintained their diabetes management practices with minimal impact on glucose control. Overall, psychosocial worry about the pandemic was relatively low, highlighting the resilience of individuals in managing their diabetes despite challenging circumstances.
{"title":"Self-reported perceptions of adults with diabetes regarding their care and health in the time of COVID-19 pandemic in a Swiss region: a cross-sectional study.","authors":"Christophe Kosinski, Emilie Zuercher, Tania Carron, Julie Chevallereau, Marie-Annick Le Pogam, Chiara Storari, Anne Wojtusciszyn, Isabelle Peytremann-Bridevaux","doi":"10.57187/s.3578","DOIUrl":"https://doi.org/10.57187/s.3578","url":null,"abstract":"<p><strong>Aim: </strong>To assess the perceptions of adults with diabetes regarding their care and health during the COVID-19 pandemic in the canton of Vaud, Switzerland.</p><p><strong>Methods: </strong>Cross-sectional data was analysed from the 2021 follow-up questionnaire of the CoDiab-VD survey, a cohort of adults living with diabetes in the canton of Vaud. Various aspects of diabetes care and issues relating to the COVID-19 pandemic were assessed. Descriptive analyses were conducted to detail access to care, self-management, and psychosocial burden during the pandemic. Regression analyses were then performed to explore the relationship between these domains and factors associated with COVID-19 outcomes.</p><p><strong>Results: </strong>Respondents (n = 566; 79%) had a mean age of 70 years (range: 22-94), and most had type 2 diabetes (73%). The COVID-19 pandemic did not appear to have strongly affected their care. Indeed, access to diabetes care remained similar to before the pandemic: only 10% of respondents reported having diabetes-related care postponed or cancelled. While 16% experienced increased difficulty in managing physical activity, the majority were able to continue diabetes self-management, with minimal changes in glucose control. In terms of psychosocial burden, only 33% expressed high levels of worry about the pandemic.</p><p><strong>Conclusion: </strong>Diabetes self-management, glucose control, and access to diabetes care were not severely affected for the CoDiab-VD cohort during the COVID-19 pandemic. Despite some reported postponements in care and increased difficulty in physical activity management, the majority maintained their diabetes management practices with minimal impact on glucose control. Overall, psychosocial worry about the pandemic was relatively low, highlighting the resilience of individuals in managing their diabetes despite challenging circumstances.</p><p><strong>Clinicaltrials: </strong>gov number: NCT01902043.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3578"},"PeriodicalIF":2.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ioannis I Lazaridis, Sofya Lukovnikova, Georgios Peros, Andreas Andreou, Diana Mattiello, Thomas Köstler, Dimitrios Schizas, Urs Zingg, Claudia Cavelti-Weder, Tarik Delko
Aims: A wide range of reproductive health issues, including fertility, pregnancy outcomes and contraceptive practices can be affected by morbid obesity and weight loss subsequent to bariatric surgery. This study aimed to explore the attitudes and practices of bariatric healthcare professionals in Switzerland regarding reproductive health counselling in the context of bariatric surgery.
Methods: We conducted a national, cross-sectional, 36-question online survey among bariatric professionals in Switzerland. Survey topics included demographic factors, baseline characteristics of bariatric patients, perioperative reproductive health practices, attitudes and knowledge about contraception and recommendations regarding pregnancy. The survey was open from 1 October 2022 to 30 April 2023.
Results: A total of 75 healthcare professionals participated in the survey. The majority of participants responded that female patients of reproductive age constitute more than half of the referred bariatric patients. Forty participants (57%) recommended contraception for a duration of 18-24 months following a bariatric operation. Only twenty-three respondents (31%) stated that they always refer their female bariatric patients of reproductive age to a gynaecologist prior to bariatric surgery. Fifty-six participants (75%) replied that they always discuss family planning prior to surgery. There was high variation regarding the recommended methods of contraception after surgery.Only thirty-nine participants (52%) reported that they always inform their patients about the occurrence of possible surgery-related complications during future pregnancies. More than half of the participants reported inadequate knowledge regarding absorption and safety of contraceptive pills after bariatric surgery. Although most professionals routinely follow up and provide counselling on maternal and foetal risks in pregnant women with previous bariatric surgery, forty-nine participants (65%) have no standardised protocol for such patients who present with acute abdominal pain in their practice.
Conclusion: Despite acknowledging the importance of reproductive health counselling, bariatric professionals address perioperative and contraception issues inconsistently and mostly reported a lack of adequate knowledge in the latter. Therefore, a stronger collaboration between bariatric professionals and women's healthcare providers is needed to improve care of female bariatric patients of reproductive age.
{"title":"Family planning, reproductive health and pregnancy after bariatric surgery: a survey of bariatric healthcare professionals in Switzerland.","authors":"Ioannis I Lazaridis, Sofya Lukovnikova, Georgios Peros, Andreas Andreou, Diana Mattiello, Thomas Köstler, Dimitrios Schizas, Urs Zingg, Claudia Cavelti-Weder, Tarik Delko","doi":"10.57187/s.3841","DOIUrl":"https://doi.org/10.57187/s.3841","url":null,"abstract":"<p><strong>Aims: </strong>A wide range of reproductive health issues, including fertility, pregnancy outcomes and contraceptive practices can be affected by morbid obesity and weight loss subsequent to bariatric surgery. This study aimed to explore the attitudes and practices of bariatric healthcare professionals in Switzerland regarding reproductive health counselling in the context of bariatric surgery.</p><p><strong>Methods: </strong>We conducted a national, cross-sectional, 36-question online survey among bariatric professionals in Switzerland. Survey topics included demographic factors, baseline characteristics of bariatric patients, perioperative reproductive health practices, attitudes and knowledge about contraception and recommendations regarding pregnancy. The survey was open from 1 October 2022 to 30 April 2023.</p><p><strong>Results: </strong>A total of 75 healthcare professionals participated in the survey. The majority of participants responded that female patients of reproductive age constitute more than half of the referred bariatric patients. Forty participants (57%) recommended contraception for a duration of 18-24 months following a bariatric operation. Only twenty-three respondents (31%) stated that they always refer their female bariatric patients of reproductive age to a gynaecologist prior to bariatric surgery. Fifty-six participants (75%) replied that they always discuss family planning prior to surgery. There was high variation regarding the recommended methods of contraception after surgery.Only thirty-nine participants (52%) reported that they always inform their patients about the occurrence of possible surgery-related complications during future pregnancies. More than half of the participants reported inadequate knowledge regarding absorption and safety of contraceptive pills after bariatric surgery. Although most professionals routinely follow up and provide counselling on maternal and foetal risks in pregnant women with previous bariatric surgery, forty-nine participants (65%) have no standardised protocol for such patients who present with acute abdominal pain in their practice.</p><p><strong>Conclusion: </strong>Despite acknowledging the importance of reproductive health counselling, bariatric professionals address perioperative and contraception issues inconsistently and mostly reported a lack of adequate knowledge in the latter. Therefore, a stronger collaboration between bariatric professionals and women's healthcare providers is needed to improve care of female bariatric patients of reproductive age.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3841"},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Jungblut, Stefania Maria Rizzo, Lukas Ebner, Adrian Kobe, Thi Dan Linh Nguyen-Kim, Katharina Martini, Justus Roos, Carla Puligheddu, Ali Afshar-Oromieh, Andreas Christe, Patrick Dorn, Manuela Funke-Chambour, Andreas Hötker, Thomas Frauenfelder
In 2015, around 4400 individuals received a diagnosis of lung cancer, and Switzerland recorded approximately 3200 deaths related to lung cancer. Advances in detection, such as lung cancer screening and improved treatments, have led to increased identification of early-stage lung cancer and higher chances of long-term survival. This progress has introduced new considerations in imaging, emphasising non-invasive diagnosis and characterisation techniques like radiomics. Treatment aspects, such as preoperative assessment and the implementation of immune response evaluation criteria in solid tumours (iRECIST), have also seen advancements. For those undergoing curative treatment for lung cancer, guidelines propose follow-up with computed tomography (CT) scans within a specific timeframe. However, discrepancies exist in published guidelines, and there is a lack of universally accepted recommendations for follow-up procedures. This white paper aims to provide a certain standard regarding the use of imaging on the diagnosis, staging, treatment and follow-up of patients with lung cancer.
{"title":"Advancements in lung cancer: a comprehensive perspective on diagnosis, staging, therapy and follow-up from the SAKK Working Group on Imaging in Diagnosis and Therapy Monitoring.","authors":"Lisa Jungblut, Stefania Maria Rizzo, Lukas Ebner, Adrian Kobe, Thi Dan Linh Nguyen-Kim, Katharina Martini, Justus Roos, Carla Puligheddu, Ali Afshar-Oromieh, Andreas Christe, Patrick Dorn, Manuela Funke-Chambour, Andreas Hötker, Thomas Frauenfelder","doi":"10.57187/s.3843","DOIUrl":"https://doi.org/10.57187/s.3843","url":null,"abstract":"<p><p>In 2015, around 4400 individuals received a diagnosis of lung cancer, and Switzerland recorded approximately 3200 deaths related to lung cancer. Advances in detection, such as lung cancer screening and improved treatments, have led to increased identification of early-stage lung cancer and higher chances of long-term survival. This progress has introduced new considerations in imaging, emphasising non-invasive diagnosis and characterisation techniques like radiomics. Treatment aspects, such as preoperative assessment and the implementation of immune response evaluation criteria in solid tumours (iRECIST), have also seen advancements. For those undergoing curative treatment for lung cancer, guidelines propose follow-up with computed tomography (CT) scans within a specific timeframe. However, discrepancies exist in published guidelines, and there is a lack of universally accepted recommendations for follow-up procedures. This white paper aims to provide a certain standard regarding the use of imaging on the diagnosis, staging, treatment and follow-up of patients with lung cancer.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3843"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Veronika W Skrivankova, Leonie D Schreck, Claudia Berlin, Radoslaw Panczak, Kaspar Staub, Marcel Zwahlen, Sven M Schulzke, Matthias Egger, Claudia E Kuehni
<p><strong>Background and aims: </strong>Despite a well-funded healthcare system with universal insurance coverage, Switzerland has one of the highest neonatal and infant mortality rates among high-income countries. Identifying avoidable risk factors targeted by evidence-based policies is a public health priority. We describe neonatal and infant mortality in Switzerland from 2011 to 2018 and explore associations with neonatal- and pregnancy-related variables, parental sociodemographic information, regional factors and socioeconomic position (SEP) using data from a long-term nationwide cohort study.</p><p><strong>Methods: </strong>We included 680,077 live births, representing 99.3% of all infants born in Switzerland between January 2011 and December 2018. We deterministically linked the national live birth register with the mortality register and with census and survey data to create a longitudinal dataset of neonatal- and pregnancy-related variables; parental sociodemographic information, such as civil status, age, religion, education, nationality; regional factors, such as urbanity, language region; and the Swiss neighbourhood index of socioeconomic position (Swiss-SEP index). Information on maternal education was available for a random subset of 242,949 infants. We investigated associations with neonatal and infant mortality by fitting multivariable Poisson regression models with robust standard errors. Several sensitivity analyses assessed the robustness of our findings.</p><p><strong>Results: </strong>Overall, neonatal mortality rates between 2011 and 2018 were 3.0 per 1000 live births, with regional variations: 3.2 in German-speaking, 2.4 in French-speaking and 2.1 in Italian-speaking Switzerland. For infant mortality, the rates were 3.7 per 1000 live births overall, and 3.9 in the German-speaking, 3.3 in the French-speaking and 2.9 in the Italian-speaking region. After adjusting for sex, maternal age, multiple birth and birth rank, neonatal mortality remained significantly associated with language region (adjusted rate ratio [aRR] 0.72, 95% confidence interval [CI]: 0.64-0.80 for the French-speaking region and aRR 0.66, 95% CI: 0.51-0.87 for the Italian-speaking region vs German-speaking region), with marital status (aRR 1.55, 95% CI: 1.40-1.71 for unmarried vs married), nationality (aRR 1.40, 95% CI: 1.21-1.62 for non-European Economic Area vs Swiss) and the Swiss-SEP index (aRR 1.17, 95% CI: 1.00-1.36 for lowest vs highest SEP quintile). In the subset, we showed a possible association of neonatal mortality with maternal education (aRR 1.24, 95% CI: 0.95-1.61 for compulsory vs tertiary education).</p><p><strong>Conclusion: </strong>We provide detailed evidence about the social patterning of neonatal and infant mortality in Switzerland and reveal important regional differences with about 30% lower risks in French- and Italian-speaking compared with German-speaking regions. Underlying causes for such regional differences, such as cultural, l
{"title":"Sociodemographic and regional differences in neonatal and infant mortality in Switzerland in 2011-2018: the Swiss National Cohort.","authors":"Veronika W Skrivankova, Leonie D Schreck, Claudia Berlin, Radoslaw Panczak, Kaspar Staub, Marcel Zwahlen, Sven M Schulzke, Matthias Egger, Claudia E Kuehni","doi":"10.57187/s.3682","DOIUrl":"https://doi.org/10.57187/s.3682","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite a well-funded healthcare system with universal insurance coverage, Switzerland has one of the highest neonatal and infant mortality rates among high-income countries. Identifying avoidable risk factors targeted by evidence-based policies is a public health priority. We describe neonatal and infant mortality in Switzerland from 2011 to 2018 and explore associations with neonatal- and pregnancy-related variables, parental sociodemographic information, regional factors and socioeconomic position (SEP) using data from a long-term nationwide cohort study.</p><p><strong>Methods: </strong>We included 680,077 live births, representing 99.3% of all infants born in Switzerland between January 2011 and December 2018. We deterministically linked the national live birth register with the mortality register and with census and survey data to create a longitudinal dataset of neonatal- and pregnancy-related variables; parental sociodemographic information, such as civil status, age, religion, education, nationality; regional factors, such as urbanity, language region; and the Swiss neighbourhood index of socioeconomic position (Swiss-SEP index). Information on maternal education was available for a random subset of 242,949 infants. We investigated associations with neonatal and infant mortality by fitting multivariable Poisson regression models with robust standard errors. Several sensitivity analyses assessed the robustness of our findings.</p><p><strong>Results: </strong>Overall, neonatal mortality rates between 2011 and 2018 were 3.0 per 1000 live births, with regional variations: 3.2 in German-speaking, 2.4 in French-speaking and 2.1 in Italian-speaking Switzerland. For infant mortality, the rates were 3.7 per 1000 live births overall, and 3.9 in the German-speaking, 3.3 in the French-speaking and 2.9 in the Italian-speaking region. After adjusting for sex, maternal age, multiple birth and birth rank, neonatal mortality remained significantly associated with language region (adjusted rate ratio [aRR] 0.72, 95% confidence interval [CI]: 0.64-0.80 for the French-speaking region and aRR 0.66, 95% CI: 0.51-0.87 for the Italian-speaking region vs German-speaking region), with marital status (aRR 1.55, 95% CI: 1.40-1.71 for unmarried vs married), nationality (aRR 1.40, 95% CI: 1.21-1.62 for non-European Economic Area vs Swiss) and the Swiss-SEP index (aRR 1.17, 95% CI: 1.00-1.36 for lowest vs highest SEP quintile). In the subset, we showed a possible association of neonatal mortality with maternal education (aRR 1.24, 95% CI: 0.95-1.61 for compulsory vs tertiary education).</p><p><strong>Conclusion: </strong>We provide detailed evidence about the social patterning of neonatal and infant mortality in Switzerland and reveal important regional differences with about 30% lower risks in French- and Italian-speaking compared with German-speaking regions. Underlying causes for such regional differences, such as cultural, l","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3682"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annora Mack, Sarah Rajkumar, Jacob Kofler, Kaspar Wyss
<p><strong>Context and goal: </strong>This research addresses the issue of suicide and attempted suicide, which have a significant impact on global premature mortality and disability. Particularly noteworthy is the prevalence among adolescents, in whom suicide ranks among the top four causes of death according to the World Health Organization (WHO). In Switzerland, suicide has remained the leading cause of death in individuals under 50 since 1990. At the same time, the burden of attempted suicides remains poorly understood. Although the legality of assisted suicide in Switzerland influences the overall suicide data, this analysis focuses solely on non-assisted suicides, as they are relevant for accurately assessing the burden of disease of suicide and attempted suicide. Amid challenges posed by limited reporting infrastructure, this analysis aims to contribute to the existing literature by investigating the cumulative impact of non-assisted suicide and attempted suicide on the population living in Switzerland.</p><p><strong>Methodology: </strong>Pre-existing data from 2009 to 2021 were collected and analysed, drawing from a variety of sources including official health records from the federal offices of statistics and public health, surveys and retrospective studies. From this data, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life-years (DALYs) were calculated in order to estimate the burden of disease. Sensitivity analyses were conducted to determine the robustness of the data and the effect of variables (suicide attempt incidence, sex distribution, disability weight, average duration) on the DALYs.</p><p><strong>Results: </strong>The analysis of the data spanning from 2009 to 2021 revealed a decrease in suicide. The present study determined that, in 2021, 32,771 DALYs were attributable to non-assisted suicide and attempted suicide and 6.4% of all years of life lost (n = 30,516) were attributable to suicide, not including assisted suicide. Using a reference incidence of 33,000 attempted suicides per year in Switzerland, the morbidity associated with attempted suicides was 2255 YLDs (range: 552-6557 YLDs). Further analysis of the data highlighted a stark sex gap in the prevalence of non-assisted suicide: male suicides account for around 2% of all male deaths, whereas female suicides account for approximately 0.8% of all female deaths. Sensitivity analyses found that incidence and sex distribution of attempted suicide were the most impactful factors, while disability weights and average duration of disability had little impact on the variation in YLD estimates.</p><p><strong>Conclusion: </strong>In conclusion, this study provides a detailed analysis of the burden of non-assisted suicide and attempted suicide in Switzerland. With non-assisted suicide accounting for 6.4% of all years of life lost and 30% of deaths in people aged 20-24 in Switzerland in 2021, it emerges that suicide contributes significantly
{"title":"Estimating the burden of disease attributable to non-assisted suicide in Switzerland from 2009 to 2021: a secondary data analysis.","authors":"Annora Mack, Sarah Rajkumar, Jacob Kofler, Kaspar Wyss","doi":"10.57187/s.3522","DOIUrl":"https://doi.org/10.57187/s.3522","url":null,"abstract":"<p><strong>Context and goal: </strong>This research addresses the issue of suicide and attempted suicide, which have a significant impact on global premature mortality and disability. Particularly noteworthy is the prevalence among adolescents, in whom suicide ranks among the top four causes of death according to the World Health Organization (WHO). In Switzerland, suicide has remained the leading cause of death in individuals under 50 since 1990. At the same time, the burden of attempted suicides remains poorly understood. Although the legality of assisted suicide in Switzerland influences the overall suicide data, this analysis focuses solely on non-assisted suicides, as they are relevant for accurately assessing the burden of disease of suicide and attempted suicide. Amid challenges posed by limited reporting infrastructure, this analysis aims to contribute to the existing literature by investigating the cumulative impact of non-assisted suicide and attempted suicide on the population living in Switzerland.</p><p><strong>Methodology: </strong>Pre-existing data from 2009 to 2021 were collected and analysed, drawing from a variety of sources including official health records from the federal offices of statistics and public health, surveys and retrospective studies. From this data, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life-years (DALYs) were calculated in order to estimate the burden of disease. Sensitivity analyses were conducted to determine the robustness of the data and the effect of variables (suicide attempt incidence, sex distribution, disability weight, average duration) on the DALYs.</p><p><strong>Results: </strong>The analysis of the data spanning from 2009 to 2021 revealed a decrease in suicide. The present study determined that, in 2021, 32,771 DALYs were attributable to non-assisted suicide and attempted suicide and 6.4% of all years of life lost (n = 30,516) were attributable to suicide, not including assisted suicide. Using a reference incidence of 33,000 attempted suicides per year in Switzerland, the morbidity associated with attempted suicides was 2255 YLDs (range: 552-6557 YLDs). Further analysis of the data highlighted a stark sex gap in the prevalence of non-assisted suicide: male suicides account for around 2% of all male deaths, whereas female suicides account for approximately 0.8% of all female deaths. Sensitivity analyses found that incidence and sex distribution of attempted suicide were the most impactful factors, while disability weights and average duration of disability had little impact on the variation in YLD estimates.</p><p><strong>Conclusion: </strong>In conclusion, this study provides a detailed analysis of the burden of non-assisted suicide and attempted suicide in Switzerland. With non-assisted suicide accounting for 6.4% of all years of life lost and 30% of deaths in people aged 20-24 in Switzerland in 2021, it emerges that suicide contributes significantly ","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3522"},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}