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Cognitive Function and Participation of Stroke Survivors Living With Companion Animals: A Cross-Sectional Study. 与伴侣动物共同生活的中风幸存者的认知功能和参与度:一项横断面研究
IF 3.6 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241240356
Naor Demeter, Sigal Zilcha-Mano, Sandra Zukerman, Naomi Josman

Introduction/objectives: Companion animals (CAs) may benefit human health, but few studies have examined their impact on stroke survivors. This study examines participation, quality of life (QoL), attachment, cognition, and executive function differences between stroke survivors living with and without CAs.

Methods: In this cross-sectional, community-setting study, 25 stroke survivors with a CA and a matched group of 27 without a CA completed standard tools.

Results: Stroke survivors with a CA scored significantly higher in participation and 1 cognitive performance test. No significant differences were found in other cognitive measures or QoL, and attachment to a CA was not correlated with participation or QoL within the research group. However, lower attachment avoidance correlated with better participation in survivors living with dogs.

Conclusion: Living with CAs, especially dogs, might be associated with some cognitive function and participation benefits among stroke survivors. The link between CAs and cognitive function is unclear: Survivors with higher cognitive functioning might be more capable of caring for a CA, or having and caring for a CA might promote better cognitive function. Attachment patterns also might explain stroke survivors' participation levels. Further study is warranted.

引言/目的:伴侣动物(CA)可能有益于人类健康,但很少有研究探讨其对中风幸存者的影响。本研究探讨了有伴侣动物和没有伴侣动物的中风幸存者在参与、生活质量(QoL)、依恋、认知和执行功能方面的差异:在这项以社区为背景的横断面研究中,25 名有 CA 的中风幸存者和 27 名没有 CA 的匹配组完成了标准工具:结果:有 CA 的中风幸存者在参与度和一项认知能力测试中得分明显更高。在其他认知测量或 QoL 方面未发现明显差异,在研究组中,对 CA 的依恋与参与度或 QoL 无关。然而,与狗生活在一起的幸存者中,依恋回避程度越低,参与度越高:结论:与 CA(尤其是狗)生活在一起可能会对中风幸存者的认知功能和参与度有所帮助。CA 与认知功能之间的联系尚不清楚:认知功能较高的幸存者可能更有能力照顾 CA,或者拥有和照顾 CA 会促进认知功能的提高。依恋模式也可以解释中风幸存者的参与水平。还需要进一步研究。
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引用次数: 0
The Intersections Between Sexual Orientation, Latine Ethnicity, Social Determinants of Health, and Lifetime Suicide Attempts in a Sample Being Assessed for Entry to Co-Occurring Mental Health and Substance Use Disorder Treatment. 性取向、拉丁族裔、健康的社会决定因素与终生自杀未遂之间的交叉关系,在接受精神健康和药物使用紊乱并发症治疗评估的样本中。
IF 3.6 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241240425
Akeem Modeste-James, Therese Fitzgerald, Emily Stewart, Diliana De Jesus, Melisa Canuto, Micaurys Guzman, Jessica Mateo, Melinda D'lppolito, Lena Lundgren

Purpose: Few studies have examined the relationship between the intersections of lesbian, gay, and bisexual (LGB) sexual orientation, Latine ethnicity, and lifetime suicide attempts in Latine individuals with substance use disorder. This study examines this intersection and controls for social determinants of health, mental health disorder symptoms, and substance use disorder symptoms in a sample of Latine adults entering treatment for co-occurring disorders.

Method: Bivariate statistics and multivariate logistic regression were used to analyze assessment data (n = 360) from a bilingual/bicultural integrated behavioral health system serving Latine communities in Massachusetts to examine the relationship between sexual orientation, Latine ethnicity, and history of lifetime suicide attempts. We controlled for social determinants of health, mental health disorders, and substance use disorder (SUD) factors significantly associated with lifetime suicide attempts at the bivariate level.

Results: Over 27% of the sample and 35% of Puerto Ricans (PR) reported lifetime suicide attempts. The logistic regression identified that PR clients were 78% more likely to have attempted suicide in a lifetime compared to non-PR clients. Clients identifying as LGB were 3.2 times more likely to report having attempted suicide in their lifetime compared to heterosexual clients. Unemployed clients were 2.4 times more likely to report having attempted suicide in their lifetime compared to employed clients.

Conclusion: Findings identify high rates of lifetime suicide attempts among LGBs and PRs entering SUD treatment. Targeted outreach and treatment efforts designed to address intersectionality for this underserved population are needed.

研究目的很少有研究对拉美裔药物使用障碍患者的女同性恋、男同性恋和双性恋(LGB)性取向、拉美裔种族和终生自杀企图之间的交叉关系进行研究。本研究对这一交叉点进行了研究,并对因并发症而接受治疗的拉丁裔成年人样本中的健康社会决定因素、精神健康障碍症状和药物使用障碍症状进行了控制:我们使用双变量统计和多变量逻辑回归分析了来自马萨诸塞州一个为拉丁裔社区提供服务的双语/双文化综合行为健康系统的评估数据(n = 360),以研究性取向、拉丁裔种族和终生自杀未遂史之间的关系。我们在双变量水平上控制了与终生自杀未遂显著相关的健康社会决定因素、心理健康障碍和药物使用障碍(SUD)因素:超过 27% 的样本和 35% 的波多黎各人(PR)报告了终生自杀未遂。逻辑回归结果表明,与非波多黎各人相比,波多黎各人在一生中自杀未遂的可能性要高出 78%。与异性恋客户相比,被认定为女同性恋、男同性恋、双性恋和变性者的客户在其一生中自杀未遂的可能性要高出 3.2 倍。与在职客户相比,失业客户在其一生中自杀未遂的可能性是在职客户的 2.4 倍:研究结果表明,在接受 SUD 治疗的男女同性恋、双性恋和变性人中,终生企图自杀的比例很高。有必要开展有针对性的外联和治疗工作,以解决这一服务不足人群的交叉性问题。
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引用次数: 0
Effect of a Telehealth Navigator Program on Video Visit Scheduling and Completion in Primary Care. 远程医疗导航计划对基层医疗机构视频就诊安排和完成情况的影响》(Effect of a Telehealth Navigator Program on Video Visit Scheduling and Completion in Primary Care)。
IF 3 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319231225997
Kevin Chen, Kenan Katranji, Khera Bailey, Michele Rains, Helena Mirzoyan, Christine Zhang, Shivali Choxi, Hannah B Jackson

Introduction: Patients and clinicians face challenges in participating in video telehealth visits. Patient navigation has been effective in other settings in enhancing patients' engagement with clinical programs. Our objective was to assess whether implementing a telehealth navigator program to support patients and clinicians affected video visit scheduling, video usage, and non-attendance.

Methods: This was a quasi-experimental quality improvement project using difference-in-differences. We included data from 17 adult primary care sites at a large, urban public healthcare system from October 1, 2021 to October 31, 2022. Six sites received telehealth navigators and 11 sites were used as comparators. Navigators contacted patients (by phone) with upcoming video visits to assess and address potential barriers to successful video visit completion. They also provided on-site support to patients and clinicians regarding telehealth visits and usage of an electronic patient portal. The primary outcomes were difference-in-differences for the proportion of telehealth visits scheduled and, separately, completed as video visits and non-attendance for visits scheduled as video visits.

Results: There were 65 488 and 71 504 scheduled telehealth appointments at intervention and non-intervention sites, respectively. The adjusted difference-in-differences for the proportion of telehealth visits scheduled as video was -9.1% [95% confidence interval -26.1%, 8.0%], the proportion of telehealth visits completed as video visits 1.3% [-4.9%, 7.4%], and non-attendance for visits scheduled as video visits -3.7% [-6.0%, -1.4%].

Conclusions: Sites with telehealth navigators had comparatively lower video visit non-attendance but did not have comparatively different video visit scheduling or completion rates. Despite this, navigators' on-the-ground presence can help identify opportunities for improvements in care design.

导言:患者和临床医生在参与视频远程保健就诊时面临挑战。在其他情况下,患者导航能有效提高患者参与临床项目的积极性。我们的目标是评估实施远程医疗导航计划以支持患者和临床医生是否会影响视频就诊安排、视频使用和不就诊情况:这是一个采用差分法的准实验性质量改进项目。我们纳入了一个大型城市公共医疗系统的 17 个成人初级医疗点从 2021 年 10 月 1 日到 2022 年 10 月 31 日的数据。其中 6 个医疗点接受了远程医疗导航,11 个医疗点作为比较对象。导航员(通过电话)联系即将进行视频就诊的患者,以评估和解决成功完成视频就诊的潜在障碍。他们还为患者和临床医生提供远程医疗就诊和电子患者门户网站使用方面的现场支持。研究的主要结果是远程医疗计划就诊比例的差异,以及分别完成视频就诊和未参加计划视频就诊的比例:干预地点和非干预地点分别有 65 488 次和 71 504 次预定的远程保健就诊。经调整后,以视频方式预约的远程保健就诊比例的差异为-9.1%[95%置信区间为-26.1%,8.0%],以视频方式完成的远程保健就诊比例为1.3%[-4.9%,7.4%],未参加以视频方式预约的就诊比例为-3.7%[-6.0%,-1.4%]:有远程医疗导航员的医疗点的视频就诊缺勤率相对较低,但视频就诊的安排或完成率并无明显差异。尽管如此,导航员的实地考察有助于发现改进护理设计的机会。
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引用次数: 0
Integrated Care Model by the Village Health Volunteers to Prevent and Slow down Progression of Chronic Kidney Disease in a Rural Community, Thailand. 乡村保健志愿者在泰国农村社区预防和减缓慢性肾病进展的综合护理模式。
IF 3.6 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241240355
Ampornpan Theeranut, Nonglak Methakanjanasak, Sunee Lertsinudom, Pattama Surit, Nichanun Panyaek, Saisamon Leeladapattarakul, Peangtikumporn Nilpetch, Pattapong Kessomboon, Chalongchai Chalermwat, Watcharapong Rintara, Wudipong Khongtong, Pawich Paktipat, Pannee Banchonhattakit, Darunee Chunlertrith, Amod Sharma, Ubon Cha'on, Sirirat Anutrakulchai

Introduction: Chronic kidney disease (CKD) is a major health problem in Thailand and health behaviors are central to its risk and progression. Because of the shortage of healthcare personnel, village health volunteers (VHVs) have been collaborating in the primary health care system. However, the contribution of VHVs to CKD reduction has not been evaluated yet. This study aimed to evaluate the efficacy of the VHV-integrated model in preventing and slowing down CKD and its risk factors.

Methods: The population-based cohort study was conducted in a rural community of Thailand between 2017 and 2019. Baseline clinical and behavioral characteristics including CKD, diabetes, hypertension, and other high-risk factors of the participants were collected. The integrated care model was initiated by the multidisciplinary care team that facilitated, empowered, and trained VHVs targeting risk factors of CKD, health literacy, and health promotion. Then the participants were educated and trained for lifestyle modification and were monitored continuously for 18 months by VHVs. Changes in the CKD risk factors, and kidney functions before and after the application of integrated care model were compared.

Results: A total of 831 subjects participated in the study with an average age of 57.5 years, and 69.5% were female. Among them, 222 participants (26.7%) were diagnosed as having CKD, the vast majority (95%) of which were in the early stages (G1-G3 and A1-A2). CKD risk factors such as high salt intake, smoking, alcohol consumption, self-NSAID (non-steroidal anti-inflammatory drugs) use were significantly decreased after application of the care model. Also, hemoglobin A1c was significantly reduced in diabetic patients, and blood pressure was controlled better than before in the hypertensive patients. Most importantly, a decline of estimated glomerular filtration rate of the CKD group was improved and lower than the non-CKD group.

Conclusion: The integrated care model through VHV significantly attenuated the risk factors associated with CKD in the general and high-risk population and effectively slowed down the progression of CKD.

简介慢性肾脏病(CKD)是泰国的一个主要健康问题,而健康行为是其风险和发展的核心。由于医疗保健人员短缺,村卫生志愿者(VHVs)一直与初级医疗保健系统合作。然而,尚未评估村卫生志愿者对减少慢性肾脏病的贡献。本研究旨在评估村卫生志愿者综合模式在预防和减缓慢性肾脏病及其风险因素方面的功效:这项基于人群的队列研究于 2017 年至 2019 年在泰国的一个农村社区进行。收集了参与者的基线临床和行为特征,包括 CKD、糖尿病、高血压和其他高危因素。综合护理模式由多学科护理团队发起,该团队针对慢性肾脏病的风险因素、健康知识普及和健康促进,促进、授权并培训了VHV。随后,对参与者进行了改变生活方式的教育和培训,并由自愿健康志愿者对其进行为期 18 个月的持续监测。结果显示,共有 831 名受试者参加了综合护理模式:共有 831 名受试者参与了研究,平均年龄为 57.5 岁,69.5% 为女性。其中,222 人(26.7%)被诊断为患有慢性肾脏病,绝大多数(95%)处于早期阶段(G1-G3 和 A1-A2)。采用护理模式后,高盐摄入、吸烟、饮酒、自行服用非甾体抗炎药(NSAID)等慢性肾脏病风险因素明显减少。此外,糖尿病患者的血红蛋白 A1c 明显降低,高血压患者的血压控制也比以前更好。最重要的是,慢性肾脏病组的估计肾小球滤过率的下降得到了改善,且低于非慢性肾脏病组:结论:通过 VHV 综合护理模式,普通人群和高危人群中与慢性肾脏病相关的危险因素明显减少,并有效延缓了慢性肾脏病的进展。
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引用次数: 0
Association Between SARS-CoV-2 Vaccination and Development of Antinuclear Antibodies Among Students. 学生接种SARS-CoV-2疫苗与抗核抗体发展之间的关系
IF 3 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241273213
Karol Laskowski, Justyna Paszkiewicz, Dorota Plewik, Adam Szepeluk, Kamil K Hozyasz

Introduction: Antinuclear antibodies (ANA) are the hallmark of many connective tissue disorders (including lupus), which comprise roughly 5% to 10% of chronic debilitating diseases causing morbidity and mortality. In society, fear of these diseases increases illness-related uncertainty because the prognosis of progression is often difficult to determine and at least some symptoms fluctuate unpredictably. In the anti-vaccination movement, the question of the possible connection between vaccination and connective tissue disorders and other autoimmune diseases has grown to rank as an important argument for rejecting vaccination. In 2021, every fifth Polish first-degree nursing student decided to not be vaccinated against COVID-19.

Objective: This study aimed to explore the prevalence of antinuclear antibodies in students vaccinated and unvaccinated against COVID-19.

Participants and methods: A single university cross-sectional study was performed in a small academic centre in Poland, where 210 students were recruited in 2022. All the participants were screened for SARS-CoV-2 IgG and antinuclear antibodies.

Results: The mean age of the students who rejected vaccination was higher than that of those who were vaccinated. Among nursing students, 30.0% of vaccinated and 58.3% of unvaccinated individuals had COVID-19. The frequency of antinuclear antibodies was 3 times lower in vaccinated students than in unvaccinated students (2/159 vs 2/51; P > .05).

Conclusion: The results of our study did not confirm the rationality of rejecting vaccinations against COVID-19 for fear of developing autoimmune diseases among healthy students.

简介:抗核抗体(ANA)是许多结缔组织疾病(包括狼疮)的标志:抗核抗体(ANA)是许多结缔组织疾病(包括红斑狼疮)的标志,约占导致发病和死亡的慢性衰弱疾病的 5%至 10%。在社会中,对这些疾病的恐惧增加了与疾病有关的不确定性,因为病情发展的预后往往难以确定,而且至少有些症状的波动是不可预测的。在反疫苗接种运动中,疫苗接种与结缔组织疾病和其他自身免疫性疾病之间可能存在的联系问题已逐渐成为反对疫苗接种的重要论据。2021 年,波兰每五名一级护理专业学生中就有一人决定不接种 COVID-19 疫苗:本研究旨在探讨接种和未接种 COVID-19 疫苗的学生体内抗核抗体的流行情况:在波兰的一个小型学术中心开展了一项单一大学横断面研究,该中心在 2022 年招募了 210 名学生。所有参与者均接受了 SARS-CoV-2 IgG 和抗核抗体筛查:拒绝接种疫苗的学生的平均年龄高于接种疫苗的学生。在护理专业学生中,30.0%的接种者和 58.3%的未接种者有 COVID-19。接种过疫苗的学生的抗核抗体频率比未接种过疫苗的学生低 3 倍(2/159 vs 2/51;P > .05):结论:我们的研究结果并未证实因担心健康学生患自身免疫性疾病而拒绝接种 COVID-19 疫苗的合理性。
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引用次数: 0
The Impact of Diabetes Education by Clinical Pharmacist on Quality of Life and Treatment Satisfaction of Sudanese Individuals With Type II Diabetes Mellitus: Randomized, Double-Blind, Controlled Trial. 临床药剂师糖尿病教育对苏丹 II 型糖尿病患者生活质量和治疗满意度的影响:随机、双盲、对照试验。
IF 3 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241279681
Safaa Badi, Sara Zainelabdein Suliman, Rayan Almahdi, Mohammed A Aldomah, Mohamed H Ahmed, Habab Khalid Elkheir, Mohamed Izham Mohamed Ibrahim

Background: Patients' satisfaction with their treatment directly impacts the control of their diabetes. Quality of life is crucial for patients with diabetes mellitus to maintain long-term health and minimize complications. The current study aimed to evaluate the impact of diabetes education on quality of life (QoL) and treatment satisfaction of patients with type 2 diabetes mellitus.

Methods: The current study was a randomized controlled trial. Patients with type 2 diabetes who were attending the diabetes clinic for 1 year were recruited. The overall sample in this study was 364 participants; 182 controls 182 cases. The interventional and control group participants were assigned randomly by simple random sampling technique. Controls were managed per usual care while cases were managed per usual care plus education done by the researcher. Pre-structured standardized questionnaires were used to collect the data. Data were processed and analyzed by using SPSS; version 28.

Results: More than three-fourth of the participants; 76.4% were females. The average (±SD) age of the cases was 54.5 (±10) years, while was 56 (±9.8) years for controls. The overall median (IQR) years of DM diagnosis for all participants was 8 (4-14) years. The results showed a statistically significant difference between the mean satisfaction score from baseline to 12 months in the cases compared the controls (P < .001). Furthermore, there are statistically insignificant differences between the changes of mean overall QoL score from baseline to 12 months among the 2 groups.

Conclusion: The education provided improved self-reported treatment-satisfaction among individuals with diabetes .A statistically insignificant differences in QoL between the 2 groups compared to baseline have been shown at the study end.The trial registration number is PACTR202311766174946 which was registered by pan African clinical trials registry, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26928.

背景:患者对治疗的满意度直接影响到对糖尿病的控制。生活质量对糖尿病患者保持长期健康和减少并发症至关重要。本研究旨在评估糖尿病教育对 2 型糖尿病患者生活质量(QoL)和治疗满意度的影响:本研究是一项随机对照试验。研究招募了在糖尿病诊所就诊一年的 2 型糖尿病患者。本研究的总体样本为 364 人,其中对照组 182 人,病例组 182 人。干预组和对照组的参与者是通过简单随机抽样技术随机分配的。对照组按照常规护理进行管理,而病例组则按照常规护理加上研究人员的教育进行管理。研究人员使用预先设计的标准化问卷收集数据。数据使用 SPSS 28 版本进行处理和分析:超过四分之三的参与者(76.4%)为女性。病例的平均年龄(±SD)为 54.5(±10)岁,对照组为 56(±9.8)岁。所有参与者被诊断为糖尿病的总体中位数(IQR)为 8(4-14)年。结果显示,从基线到 12 个月期间,病例的平均满意度得分与对照组相比有显著的统计学差异(P 结论:教育改善了病例对治疗的自我评价:教育提高了糖尿病患者对治疗的自我满意度。研究结束时,两组患者的 QoL 与基线相比差异无统计学意义。该试验的注册号为 PACTR202311766174946,已在泛非临床试验注册中心(https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26928)注册。
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引用次数: 0
Physician Communication Behaviors on Patient Satisfaction in Primary Care Medical Settings in Bangladesh. 孟加拉国初级医疗机构中医生沟通行为对患者满意度的影响。
IF 3 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241277396
Muhammad Zakaria, Subarna Mazumder, Hasan Mahmud Faisal, Rubaiya Zannat, Md Rejaul Haque, Tanjina Afrin, Feng Cheng, Junfang Xu

Objectives: This study aims at exploring the effects of physicians' communication behaviors on patients' satisfaction in primary care medical consultations in Chattogram, Bangladesh. The study used a quantitative research approach designed with a cross-sectional survey.

Methods: Data were collected using post-consultation and facilitator administered questionnaire from the patients who visited the physician for medical consultation in different hospitals and clinics in Chattogram city. Seven hundred patients were included as the study participants. A hierarchical linear regression analysis was performed to examine the factors contributing to the outcome variables.

Results: A statistically significant difference (P < .001) appeared regarding patients' perception of adequate consultation, physicians' nonverbal behavior, inhibiting behavior and patients' participating behavior in private and public settings. However, R2 value shows that physicians' patient-centered behaviors appeared as the stronger predictors of patient satisfaction toward medical interviews, followed by socioeconomic variables of patients and physicians and patients' participation during the consultation. Presence of a third person with patients during consultation (β = -.05, P = .040), physicians' private setting of consultation (β = .16, P < .001), physicians' seniority (β = .05, P = .042), patients' participating behavior during consultation (β = .20, P < .001), physicians' nonverbal behavior (β = .10, P < .001), physicians' inhibiting behavior (β = -.39, P < .001), and physicians' facilitating behavior with patients (β = .32, P < .001) were reported as the influencing factors of patients' satisfaction with medical consultation.

Conclusion: This study suggests the profound impact of physicians' patient-centered communication behaviors on patient satisfaction in primary care settings, overshadowing even socioeconomic factors and patient participation.

研究目的本研究旨在探讨孟加拉国恰特格勒市初级医疗咨询中医生的沟通行为对患者满意度的影响。研究采用横断面调查的定量研究方法:方法:在恰特洛格市的不同医院和诊所,通过咨询后和协助者发放的调查问卷,收集就诊患者的数据。研究对象包括 700 名患者。研究人员对结果变量的影响因素进行了分层线性回归分析:统计学上的显着差异(P R2 值)表明,医生以患者为中心的行为似乎是预测患者对问诊满意度的更有力因素,其次是患者和医生的社会经济变量以及患者在问诊过程中的参与度。问诊过程中患者身边有第三者(β = -.05,P = .040)、医生的私人问诊环境(β = .16,P P = .042)、患者在问诊过程中的参与行为(β = .20,P P P P 结论:本研究表明,在初级医疗机构中,医生以患者为中心的沟通行为对患者满意度的影响深远,甚至超过了社会经济因素和患者参与度。
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引用次数: 0
Cost Analysis of a Patient Portal Used to Remotely Monitor COVID-19 Patients in Quebec. 用于远程监控魁北克 COVID-19 患者的患者门户网站成本分析。
IF 3 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241271190
Randa Attieh, Marie-Pascale Pomey, Bertrand Lebouché, Yuanchao Ma, Tarek Hijal, Thomas G Poder

Background: Telemonitoring for COVID-19 has gained much attention due to its potential in reducing morbidity, healthcare utilization, and costs. However, its benefit with regard to economic outcomes has yet to be clearly demonstrated.

Objective: To analyze the costs associated with the use of the Opal portal to monitor COVID-19 patients during their 14-day confinement in Quebec and compare them to those of non-users of any home telemonitoring technology.

Methods: A cost analysis was conducted through a cross-sectional study between COVID-19 patients who used (PU) the Opal platform during their 14-day confinement at home and those who did not use (PNU) any home remote monitoring technology. Data was collected between June 2021 to April 2022. An individual interview with each participant using an adapted questionnaire was conducted by telephone or online using a teleconferencing platform. A micro-costing approach was undertaken using a dual patient and Quebec's health-care system perspective.

Results: 27 telemonitoring participants, 29 non-users, 8 clinicians, and 4 managers were included. Telemonitoring reduced the average total costs incurred by PU by 82% ($537.3CAD) between PU ($117.2CAD) and PNU ($654.5CAD). Telemonitoring enrollees used healthcare less intensely with fewer emergency room visits (1 PU compared to 6 PNU), which translated to an average savings of $253.3CAD per patient.

Conclusion: This is the first study to demonstrate that telemonitoring through the Opal platform is a viable strategy to reduce healthcare costs and utilization for patients and the healthcare system. The evidence provides strong support for introducing telemonitoring as a component of case management.

背景:COVID-19 的远程监控因其在降低发病率、医疗使用率和成本方面的潜力而备受关注。然而,其在经济效益方面的益处尚未得到明确证实:分析在魁北克省使用 Opal 门户监控 COVID-19 患者 14 天住院期间的相关成本,并将其与未使用任何家庭远程监控技术的患者进行比较:方法:通过一项横断面研究,对在 14 天居家护理期间使用(PU)Opal 平台的 COVID-19 患者和未使用(PNU)任何居家远程监控技术的患者进行了成本分析。数据收集时间为 2021 年 6 月至 2022 年 4 月。通过电话或在线远程会议平台,使用改编问卷对每位参与者进行了单独访谈。从患者和魁北克医疗保健系统的双重角度进行了微观成本计算。结果:27 名远程监控参与者、29 名非使用者、8 名临床医生和 4 名管理者参与其中。在 PU(117.2 加元)和 PNU(654.5 加元)之间,远程监控将 PU 的平均总成本降低了 82% (537.3 加元)。远程监控患者使用医疗服务的强度降低,急诊就诊次数减少(PU 1 次,PNU 6 次),平均每位患者节省 253.3 加元:这是第一项证明通过 Opal 平台进行远程监控是降低医疗成本、减少患者和医疗系统使用的可行策略的研究。这些证据为将远程监控作为病例管理的一部分提供了有力支持。
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引用次数: 0
Patient Perceived Barriers and Enablers to Medication Adherence in the Treatment of Depression: A Qualitative Study. 在抑郁症治疗过程中,患者对坚持用药的障碍和促进因素的认识:定性研究。
IF 3 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241286313
Yuki Meng, Christopher Chiu, Mamta Kapoor, Shelly-Anne Li, Navaldeep Kaur, Patricia Marr, Debbie Kwan, Kori Leblanc, Catherine Ji, Christine Papoushek

Background: Depression affects approximately 280 million individuals globally and it is a leading cause of disability. Despite effective medication options, 50% of patients prematurely discontinue antidepressants within 6 months. We sought to understand patients' perspectives regarding their needs and expectations related to antidepressants.

Objectives: To identify and describe enablers and barriers that influence adult patients' medication adherence in depression treatment and to explore patients' educational needs on initiating or continuing antidepressant therapy.

Methods: Qualitative descriptive study was conducted using individual, semi-structured interviews of adult patients with depression who were prescribed an antidepressant within 3 months of study recruitment at an urban primary care clinic in Toronto, Canada. Thirteen participants were interviewed. Interviews were recorded and transcribed verbatim for inductive thematic analysis.

Results: Six themes emerged: safety and effectiveness of antidepressant, understanding of depression and its management, medication administration, healthcare experiences in the treatment of depression, and social influences and relationships. Barriers to adherence included adverse effects of antidepressants, preference for non-pharmacological therapies, uncertainty about therapeutic effects, and social stigma. In contrast, enablers were positive responses from antidepressants, fear of relapse, reminder aids, established routine, and a trusting patient-provider relationship. Participants desired access to reliable, evidence-based, and personalized educational information delivered through verbal, written, and digital formats to support antidepressant adherence.

Conclusion: To overcome the identified barriers, educational strategies should involve both patients and their prescribers to identify patient-specific needs and treatment goals, engage in shared decision-making, and maintain consistent follow-up to support antidepressant adherence.

背景:抑郁症影响着全球约 2.8 亿人,是导致残疾的主要原因之一。尽管可以选择有效的药物治疗,但仍有 50%的患者在 6 个月内过早停用抗抑郁药物。我们试图从患者的角度了解他们对抗抑郁药物的需求和期望:确定并描述影响成年患者坚持抗抑郁药物治疗的因素和障碍,并探讨患者在开始或继续抗抑郁药物治疗方面的教育需求:在加拿大多伦多的一家城市初级保健诊所,对在研究招募后 3 个月内开具抗抑郁药处方的成年抑郁症患者进行了个人半结构式访谈,从而开展了定性描述研究。共对 13 名参与者进行了访谈。对访谈进行了记录并逐字转录,以便进行归纳式主题分析:结果:出现了六个主题:抗抑郁药的安全性和有效性、对抑郁症及其管理的理解、用药、治疗抑郁症的医疗经验以及社会影响和人际关系。妨碍患者坚持用药的因素包括抗抑郁药的不良反应、对非药物疗法的偏好、治疗效果的不确定性以及社会耻辱感。与此相反,抗抑郁药物的积极反应、对复发的恐惧、提醒辅助工具、固定的作息时间以及病人与医护人员之间的信任关系则是坚持治疗的有利因素。参与者希望获得可靠、循证和个性化的教育信息,这些信息可通过口头、书面和数字形式提供,以支持坚持服用抗抑郁药:为了克服已发现的障碍,教育策略应让患者及其处方医生共同参与,以确定患者的特定需求和治疗目标,共同参与决策,并保持持续的跟踪,以支持患者坚持服用抗抑郁药。
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引用次数: 0
Factors Associated with Hospital Length of Stay among VTE Cases: Insights from the i-RegVed Registry. 与 VTE 病例住院时间相关的因素:来自 i-RegVed 登记处的启示。
IF 3 Q1 PRIMARY HEALTH CARE Pub Date : 2024-01-01 DOI: 10.1177/21501319241266815
Sumit Aggarwal, Peteneinuo Rulu, Heena Tabassum

Introduction: Venous thromboembolism (VTE) is a multifactorial condition and one of the leading causes of mortality and disability. The present study explores the factors associated with hospitalization duration among different types of venous thromboembolism diagnoses, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and other forms of thrombosis.

Methods: The data included participants with VTE admitted to 13 hospitals within pan-India from June 2022 to December 2023 to the i-RegVed registry, where socio-demographic data, clinical history, and various factors associated with hospital length of stay (LOS) were included for analyses. Multilinear regression was performed to explore the factors associated with hospital LOS among VTE conditions such as DVT, PE, forms of thrombosis other than PE and DVT, and all VTE diagnoses.

Results: A total of 633 participants were included in the study, with 55% being males, and 28.9% being homemakers. Longer hospital LOS was significantly associated with age (β = -.09, P < .05), sex (β = 3.21, P < .05), and non-communicable diseases (β = 3.51, P < .05) among participants with DVT and among participants with at least one of the VTE diagnoses, age (β = -.12, P < .001) and anticoagulant use (β = -2.49, P < .05) was significantly associated.

Conclusion: The findings provide insights into the factors influencing hospital outcomes among participants with different types of VTE, highlighting the importance of age and comorbidities in predicting the hospital LOS.

导言:静脉血栓栓塞症(VTE)是一种多因素疾病,也是导致死亡和残疾的主要原因之一。本研究探讨了与不同类型静脉血栓栓塞症(如深静脉血栓形成(DVT)、肺栓塞(PE)和其他形式的血栓形成)的住院时间相关的因素:数据包括 2022 年 6 月至 2023 年 12 月期间在泛印度 13 家医院住院的 VTE 患者的 i-RegVed 登记数据,其中包括社会人口学数据、临床病史以及与住院时间(LOS)相关的各种因素。结果显示,共纳入了 633 名参与者的社会人口学数据、临床病史以及与住院时间(LOS)相关的各种因素:研究共纳入 633 名参与者,其中 55% 为男性,28.9% 为家庭主妇。较长的住院时间与年龄明显相关(β = -.09,P P P P 结论:研究结果有助于深入了解影响不同类型 VTE 患者住院结果的因素,突出了年龄和合并症在预测住院时间方面的重要性。
{"title":"Factors Associated with Hospital Length of Stay among VTE Cases: Insights from the i-RegVed Registry.","authors":"Sumit Aggarwal, Peteneinuo Rulu, Heena Tabassum","doi":"10.1177/21501319241266815","DOIUrl":"10.1177/21501319241266815","url":null,"abstract":"<p><strong>Introduction: </strong>Venous thromboembolism (VTE) is a multifactorial condition and one of the leading causes of mortality and disability. The present study explores the factors associated with hospitalization duration among different types of venous thromboembolism diagnoses, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and other forms of thrombosis.</p><p><strong>Methods: </strong>The data included participants with VTE admitted to 13 hospitals within pan-India from June 2022 to December 2023 to the i-RegVed registry, where socio-demographic data, clinical history, and various factors associated with hospital length of stay (LOS) were included for analyses. Multilinear regression was performed to explore the factors associated with hospital LOS among VTE conditions such as DVT, PE, forms of thrombosis other than PE and DVT, and all VTE diagnoses.</p><p><strong>Results: </strong>A total of 633 participants were included in the study, with 55% being males, and 28.9% being homemakers. Longer hospital LOS was significantly associated with age (β = -.09, <i>P</i> < .05), sex (β = 3.21, <i>P</i> < .05), and non-communicable diseases (β = 3.51, <i>P</i> < .05) among participants with DVT and among participants with at least one of the VTE diagnoses, age (β = -.12, <i>P</i> < .001) and anticoagulant use (β = -2.49, <i>P</i> < .05) was significantly associated.</p><p><strong>Conclusion: </strong>The findings provide insights into the factors influencing hospital outcomes among participants with different types of VTE, highlighting the importance of age and comorbidities in predicting the hospital LOS.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241266815"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11311186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Primary Care and Community Health
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