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Morris AA, Masoudi FA, Abdullah AR, Banerjee A, Brewer LC, Commodore-Mensah Y, Cram P, DeSilvey SC, Hines AL, Ibrahim NE, Jackson EA, Joynt Maddox KE, Makaryus AN, Piña IL, Rodriguez-Monserrate CP, Roger VL, Thorpe FF, Williams KA. 2024 ACC/AHA Key Data Elements and Definitions for Social Determinants of Health in Cardiology: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Data Standards. J Am Coll Cardiol 2024; 84:e109-e226. [PMID: 39207317 DOI: 10.1016/j.jacc.2024.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
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Ukah UV, Platt RW, Nordeng HME. Impact of COVID-19 Pandemic on Dispensing of Cardiovascular Drugs in Norway: An Interrupted Time Series Study. Am J Prev Med 2024; 66:672-680. [PMID: 37972795 DOI: 10.1016/j.amepre.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION The COVID-19 pandemic resulted in changes in prescription patterns and fillings for certain medications, but little is known about its impact on the dispensing of cardiovascular drugs. METHODS Trends in dispensing of cardiovascular drugs before and during the pandemic were examined using a population-based cohort in Norway. Using interrupted time series analyses and considering March 1, 2020 as the interruption point, the impact of the pandemic on defined daily dose dispensing of prescribed cardiovascular drugs was estimated in a population of adults with and without pre-existing cardiovascular disease from January 2018 to December 2021. All data were analyzed in 2023. RESULTS In a total of 4,053,957 adults, 690,910 (17.0%) had pre-existing cardiovascular disease. Prior to the pandemic, there was a significant monthly increase in any cardiovascular drug dispensing among those with pre-existing cardiovascular disease (0.30 defined daily dose per month per adult), including prescription of diuretics, calcium channel blockers, and lipid-modifying agents. After controlling for preinterruption trends, there was a slight decrease in level change immediately after the start of the pandemic (2.5 defined daily dose per month per adult) but an increase in the postinterruption trend (0.06 defined daily dose per month per adult) for dispensing of cardiovascular prescriptions, although these changes were not significant. CONCLUSIONS Although the COVID-19 pandemic did not appear to result in significant changes in patterns of cardiovascular drug dispensing in Norway, continued access to cardiovascular drugs remains important to prevent further related morbidity.
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Affiliation(s)
- Ugochinyere Vivian Ukah
- Pregnancy and Child Health Research Center, HealthPartners Institute, Minneapolis, Minnesota; Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada.
| | - Robert William Platt
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Hedvig Marie Egeland Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, PharmaTox Strategic Research Initiative, Department of Pharmacy, The Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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Hegeman P, Vader D, Kamke K, El-Toukhy S. Patterns of digital health access and use among US adults: A latent class analysis. RESEARCH SQUARE 2024:rs.3.rs-3895228. [PMID: 38352382 PMCID: PMC10862941 DOI: 10.21203/rs.3.rs-3895228/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Background Digital technologies allow users to engage in health-related behaviors associated with positive outcomes. We aimed to identify classes of US adults with distinct digital technologies access and health use patterns and characterize class composition. Data came from Health Information National Trends Survey Wave 5 Cycles 1-4, a nationally representative cross-sectional survey of US adults ( N = 13,993). We used latent class analysis to identify digital technologies access and health use patterns based on 32 behaviors and access to requisite technologies and platforms that include the internet, internet-enabled devices, health monitors, and electronic health records (EHRs). We ran a multinomial logistic regression to identify sociodemographic and health correlates of class membership ( n = 10,734). Results Ten classes captured patterns of digital technology access and health use among US adults. This included a digitally isolated, a mobile-dependent, and a super user class, which made up 8.9%, 7.8%, and 13.6% of US adults, respectively, and captured access patterns from only basic cellphones and health monitors to near complete access to web-, mobile-, and EHR-based platforms. Half of US adults belonged to classes that lacked access to EHRs and relied on alternative web-based tools typical of patient portals. The proportion of class members who used digital technologies for health purposes varied from small to large. Older and less educated adults had lower odds of belonging to classes characterized by access or engagement in health behaviors. Hispanic and Asian adults had higher odds of belonging to the mobile-dependent class. Individuals without a regular healthcare provider and those who had not visited a provider in the past year were more likely to belong to classes with limited digital technologies access or health use. Discussion Only one third of US adults belonged to classes that had near complete access to digital technologies and whose members engaged in almost all health behaviors examined. Sex, age, and education were associated with membership in classes that lacked access to 1 + digital technologies or exhibited none to limited health uses of such technologies. Results can guide efforts to improve access and health use of digital technologies to maximize associated health benefits and minimize disparities.
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Brual J, Chu C, Fang J, Fleury C, Stamenova V, Bhattacharyya O, Tadrous M. Virtual care use among older immigrant adults in Ontario, Canada during the COVID-19 pandemic: A repeated cross-sectional analysis. PLOS DIGITAL HEALTH 2023; 2:e0000092. [PMID: 37531346 PMCID: PMC10395820 DOI: 10.1371/journal.pdig.0000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 02/22/2023] [Indexed: 08/04/2023]
Abstract
The critical role of virtual care during the COVID-19 pandemic has raised concerns about the widening disparities to access by vulnerable populations including older immigrants. This paper aims to describe virtual care use in older immigrant populations residing in Ontario, Canada. In this population-based, repeated cross-sectional study, we used linked administrative data to describe virtual care and healthcare utilization among immigrants aged 65 years and older before and during the COVID-19 pandemic. Visits were identified weekly from January 2018 to March 2021 among various older adult immigrant populations. Among older immigrants, over 75% were high users of virtual care (had two or more virtual visits) during the pandemic. Rates of virtual care use was low (weekly average <2 visits per 1000) prior to the pandemic, but increased for both older adult immigrant and non-immigrant populations. At the start of the pandemic, virtual care use was lower among immigrants compared to non-immigrants (weekly average of 77 vs 86 visits per 1000). As the pandemic progressed, the rates between these groups became similar (80 vs 79 visits per 1000). Virtual care use was consistently lower among immigrants in the family class (75 visits per 1000) compared to the economic (82 visits per 1000) or refugee (89 visits per 1000) classes, and was lower among those who only spoke French (69 visits per 1000) or neither French nor English (73 visits per 1000) compared to those who were fluent in English (81 visits per 1000). This study found that use of virtual care was comparable between older immigrants and non-immigrants overall, though there may have been barriers to access for older immigrants early on in the pandemic. However, within older immigrant populations, immigration category and language ability were consistent differentiators in the rates of virtual care use throughout the pandemic.
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Affiliation(s)
- Janette Brual
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Cherry Chu
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | | | - Cathleen Fleury
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Vess Stamenova
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Onil Bhattacharyya
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mina Tadrous
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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Abdullayev K, Chico TJ, Manktelow M, Buckley O, Condell J, Van Arkel RJ, Diaz V, Matcham F. Stakeholder-led understanding of the implementation of digital technologies within heart disease diagnosis: a qualitative study protocol. BMJ Open 2023; 13:e072952. [PMID: 37369399 PMCID: PMC10410804 DOI: 10.1136/bmjopen-2023-072952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Cardiovascular diseases are highly prevalent among the UK population, and the quality of care is being reduced due to accessibility and resource issues. Increased implementation of digital technologies into the cardiovascular care pathway has enormous potential to lighten the load on the National Health Service (NHS), however, it is not possible to adopt this shift without embedding the perspectives of service users and clinicians. METHODS AND ANALYSIS A series of qualitative studies will be carried out with the aim of developing a stakeholder-led perspective on the implementation of digital technologies to improve holistic diagnosis of heart disease. This will be a decentralised study with all data collection being carried out online with a nationwide cohort. Four focus groups, each with 5-6 participants, will be carried out with people with lived experience of heart disease, and 10 one-to-one interviews will be carried out with clinicians with experience of diagnosing heart diseases. The data will be analysed using an inductive thematic analysis approach. ETHICS AND DISSEMINATION This study received ethical approval from the Sciences and Technology Cross Research Council at the University of Sussex (reference ER/FM409/1). Participants will be required to provide informed consent via a Qualtrics survey before being accepted into the online interview or focus group. The findings will be disseminated through conference presentations, peer-reviewed publications and to the study participants.
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Affiliation(s)
| | - Timothy Ja Chico
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield, UK
| | - Matthew Manktelow
- School of Computing, Engineering and Intelligent Systems, University of Ulster at Magee, Londonderry, UK
| | - Oliver Buckley
- School of Computing Sciences, University of East Anglia, Norwich, UK
| | - Joan Condell
- School of Computing, Engineering and Intelligent Systems, University of Ulster at Magee, Londonderry, UK
| | | | - Vanessa Diaz
- Department of Mechanical Engineering, University College London, London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
| | - Faith Matcham
- School of Psychology, University of Sussex, Brighton, UK
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Stauss M, Htay H, Kooman JP, Lindsay T, Woywodt A. Wearables in Nephrology: Fanciful Gadgetry or Prêt-à-Porter? SENSORS (BASEL, SWITZERLAND) 2023; 23:1361. [PMID: 36772401 PMCID: PMC9919296 DOI: 10.3390/s23031361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Telemedicine and digitalised healthcare have recently seen exponential growth, led, in part, by increasing efforts to improve patient flexibility and autonomy, as well as drivers from financial austerity and concerns over climate change. Nephrology is no exception, and daily innovations are underway to provide digitalised alternatives to current models of healthcare provision. Wearable technology already exists commercially, and advances in nanotechnology and miniaturisation mean interest is also garnering clinically. Here, we outline the current existing wearable technology pertaining to the diagnosis and monitoring of patients with a spectrum of kidney disease, give an overview of wearable dialysis technology, and explore wearables that do not yet exist but would be of great interest. Finally, we discuss challenges and potential pitfalls with utilising wearable technology and the factors associated with successful implementation.
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Affiliation(s)
- Madelena Stauss
- Department of Nephrology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK
| | - Htay Htay
- Department of Renal Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Jeroen P. Kooman
- Department of Internal Medicine, Division of Nephrology, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Thomas Lindsay
- Department of Nephrology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK
| | - Alexander Woywodt
- Department of Nephrology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK
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Cummings P, Petitclerc A, Moskowitz J, Tandon D, Zhang Y, MacNeill LA, Alshurafa N, Krogh-Jespersen S, Hamil JL, Nili A, Berken J, Grobman W, Rangarajan A, Wakschlag L. Feasibility of Passive ECG Bio-sensing and EMA Emotion Reporting Technologies and Acceptability of Just-in-Time Content in a Well-being Intervention, Considerations for Scalability and Improved Uptake. AFFECTIVE SCIENCE 2022; 3:849-861. [PMID: 36277315 PMCID: PMC9579642 DOI: 10.1007/s42761-022-00147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/13/2022] [Indexed: 11/24/2022]
Abstract
Researchers increasingly use passive sensing data and frequent self-report to implement personalized mobile health (mHealth) interventions. Yet, we know that certain populations may find these technical protocols burdensome and intervention uptake as well as treatment efficacy may be affected as a result. In the present study, we predicted feasibility (participant adherence to protocol) and acceptability (participant engagement with intervention content) as a function of baseline sociodemographic, mental health, and well-being characteristics of 99 women randomized in the personalized preventive intervention Wellness-for-Two (W-4-2), a randomized trial evaluating stress-related alterations during pregnancy and their effect on infant neurodevelopmental trajectories. The W-4-2 study used ecological momentary assessment (EMA) and wearable electrocardiograph (ECG) sensors to detect physiological stress and personalize the intervention. Participant adherence to protocols was 67% for EMAs and 52% for ECG bio-sensors. Higher baseline negative affect significantly predicted lower adherence to both protocols. Women assigned to the intervention group engaged on average with 42% of content they received. Women with higher annual household income were more likely to engage with more of the intervention content. Researchers should carefully consider tailoring of the intensity of technical intervention protocols to reduce fatigue, especially among participants with higher baseline negative affect, which may improve intervention uptake and efficacy findings at scale.
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Affiliation(s)
- P. Cummings
- Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL USA
| | - A. Petitclerc
- Laval University School of Psychology, 2325 Rue des Bibliothèques, QC, Québec G1V 0A6 Canada
| | - J. Moskowitz
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL USA
| | - D. Tandon
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL USA
| | - Y. Zhang
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Institute for Innovations in Developmental Sciences, Chicago, IL USA
| | - L. A. MacNeill
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Institute for Innovations in Developmental Sciences, Chicago, IL USA
| | - N. Alshurafa
- Department of Preventive Medicine, Northwestern Feinberg School of Medicine, Chicago, IL USA
| | - S. Krogh-Jespersen
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Institute for Innovations in Developmental Sciences, Chicago, IL USA
| | - J. L. Hamil
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL USA
| | - A. Nili
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Institute for Innovations in Developmental Sciences, Chicago, IL USA
| | - J. Berken
- Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - W. Grobman
- Department of Obstetrics & Gynecology, Northwestern Feinberg School of Medicine, Chicago, IL USA
| | - A. Rangarajan
- Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - L. Wakschlag
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Institute for Innovations in Developmental Sciences, Chicago, IL USA
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