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Sethwala A, Hirschfeld CB, O'Sullivan P, Akbarally M, Younger J, Van Pelt N, Randazzo M, Lenturut-Katal D, Vitola JV, Cerci R, Williams MC, Shaw LJ, Karthikeyan G, Villines TC, Dorbala S, Choi AD, Cohen YA, Malkovskiy E, Pascual TNB, Pynda Y, Dondi M, Paez D, Einstein AJ, Better N. Recovery Rates of Diagnostic Cardiac Procedural Volume in Oceania 1 Year Into COVID-19: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID 2). Heart Lung Circ 2024; 33:384-391. [PMID: 38365497 DOI: 10.1016/j.hlc.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/10/2023] [Accepted: 12/10/2023] [Indexed: 02/18/2024]
Abstract
AIM The aim of this study was to assess the recovery rates of diagnostic cardiac procedure volumes in the Oceania Region, midway through the coronavirus disease 2019 (COVID-19) pandemic. METHODS A survey was performed comparing procedure volumes between March 2019 (pre-pandemic), April 2020 (during first wave of COVID-19 pandemic), and April 2021 (1 year into the COVID-19 pandemic). A total of 31 health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, as well as teaching and non-teaching hospitals. A comparison was made with 549 centres in 96 countries in the rest of the world (RoW) outside of Oceania. The total number and median percentage change in procedure volume were measured between the three timepoints, compared by test type and by facility. RESULTS A total of 11,902 cardiac diagnostic procedures were performed in Oceania in April 2021 as compared with 11,835 pre-pandemic in March 2019 and 5,986 in April 2020; whereas, in the RoW, 499,079 procedures were performed in April 2021 compared with 497,615 pre-pandemic in March 2019 and 179,014 in April 2020. There was no significant difference in the median recovery rates for total procedure volumes between Oceania (-6%) and the RoW (-3%) (p=0.81). While there was no statistically significant difference in percentage recovery been functional ischaemia testing and anatomical coronary testing in Oceania as compared with the RoW, there was, however, a suggestion of poorer recovery in anatomical coronary testing in Oceania as compared with the RoW (CT coronary angiography -16% in Oceania vs -1% in RoW, and invasive coronary angiography -20% in Oceania vs -9% in RoW). There was no statistically significant difference in recovery rates in procedure volume between metropolitan vs regional (p=0.44), public vs private (p=0.92), hospital vs outpatient (p=0.79), or teaching vs non-teaching centres (p=0.73). CONCLUSIONS Total cardiology procedure volumes in Oceania normalised 1 year post-pandemic compared to pre-pandemic levels, with no significant difference compared with the RoW and between the different types of health care facilities.
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Affiliation(s)
| | - Cole B Hirschfeld
- Department of Medicine, Columbia University Irving Medical Center, Weill Cornell Medicine, and NewYork-Presbyterian Hospital, New York, NY, USA
| | | | | | - John Younger
- Royal Brisbane Hospital, Brisbane, Qld, Australia University of Queensland, Brisbane, Qld, Australia
| | | | - Michael Randazzo
- Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | | | | | | | - Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Leslee J Shaw
- Blavatnik Family Women's Health Research Institute, Mount Sinai Medical Center, New York, NY, USA
| | - Ganesan Karthikeyan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sharmila Dorbala
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew D Choi
- The George Washington University School of Medicine, Washington, DC, USA
| | - Yosef A Cohen
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA; Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
| | - Eli Malkovskiy
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
| | - Thomas N B Pascual
- Department of Science and Technology-Philippines, Philippine Nuclear Research Institute, Manila, Philippines
| | - Yaroslav Pynda
- Department of Science and Technology-Philippines, Philippine Nuclear Research Institute, Manila, Philippines
| | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Andrew J Einstein
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA; Department of Radiology, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
| | - Nathan Better
- Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of Cardiology, Cabrini Health, Malvern, Vic, Australia; Monash University and University of Melbourne, Melbourne, Vic, Australia.
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Kost GJ, Füzéry AK, Caratao LKR, Tinsay S, Zadran A, Ybañez AP. Using geographic rescue time contours, point-of-care strategies, and spatial care paths to prepare island communities for global warming, rising oceans, and weather disasters. Int J Health Geogr 2023; 22:38. [PMID: 38124128 PMCID: PMC10731708 DOI: 10.1186/s12942-023-00359-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES To perform geographic contour analysis of sea and land ambulance rescue times in an archipelago subject to super typhoons; to design point-of-care testing strategies for medical emergencies and weather disasters made more intense by global warming and rising oceans; and to assess needs for prehospital testing on spatial care paths that accelerate decision making, increase efficiency, improve outcomes, and enhance standards of care in island nations. METHODS We performed needs assessments, inspected healthcare facilities, and collected ambulance rescue times from professionals in the Bantayan Archipelago, Philippines. We mapped sea/land ambulance rescue routes and time contours. To reveal gaps, we statistically compared the fastest and slowest patient rescue times from islands/islets and barangays to the District Hospital on Bantayan Island. We developed spatial care paths (the fastest routes to care) for acute myocardial infarction, community care, and infectious diseases. We generated a compendium of prehospital diagnostic testing and integrated outcomes evidence, diagnostic needs, and public health goals to recommend point-of-care strategies that build geographic health resilience. RESULTS We observed limited access to COVID-19 assays, absence of blood gas/pH testing for critical care support, and spatial gaps in land and airborne rescues that worsened during inclement weather and sea swells. Mean paired differences (slowest-fastest) in ambulance rescue times to the District Hospital for both islands and barangays were significant (P < 0.0001). Spatial care path analysis showed where point-of-care cardiac troponin testing should be implemented for expedited care of acute myocardial infarction. Geospatial strengths comprised distributed primary care that can be facilitated by point-of-care testing, logical interisland transfers for which decision making and triage could be accelerated with onboard diagnostics, and healthcare networks amenable to medical advances in prehospital testing that accelerate treatment. CONCLUSIONS Point-of-care testing should be positioned upstream close to homes and island populations that have prolonged rescue time contours. Geospatially optimized point-of-need diagnostics and distributed prehospital testing have high potential to improve outcomes. These improvements will potentially decrease disparities in mortality among archipelago versus urban dwellers, help improve island public health, and enhance resilience for increasingly adverse and frequent climate change weather disasters that impact vulnerable coastal areas. [350 words].
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Affiliation(s)
- Gerald J Kost
- Fulbright Scholar 2020-2022, ASEAN Program, Point-of-Care Testing Center for Teaching and Research (POCT•CTR), Pathology and Laboratory Medicine, School of Medicine, University of California, Davis, CA, 95616, USA.
| | - Anna K Füzéry
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Samantha Tinsay
- Municipality of Bantayan, Bantayan-Santa Fe-Madridejos Primary Care Provider Network, Cebu, Philippines
| | - Amanullah Zadran
- POCT·CTR, Public Health Sciences, School of Medicine, University of California, Davis, USA
| | - Adrian P Ybañez
- Institute for Molecular Genetics, Parasitology, and Vector-Borne Diseases, and College of Veterinary Medicine, Cebu Technological University, Cebu, Philippines
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Ruksakulpiwat S, Zhou W, Niyomyart A, Wang T, Kudlowitz A. How does the COVID-19 pandemic impact medication adherence of patients with chronic disease?: A systematic review. Chronic Illn 2023; 19:495-513. [PMID: 35971949 PMCID: PMC9382573 DOI: 10.1177/17423953221110151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine how the COVID-19 pandemic impacts patients with chronic disease medication adherence. METHODS Four electronic databases, PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text, were searched for literature between 2019 and 2021. Abstracts and later full texts were independently screened by the authors of this review using inclusion and exclusion criteria to determine relevance to our study. Joanna Briggs Institute (JBI) critical appraisal tools were used to assess the quality of included texts. Relevant information and data from the included texts were extracted into tables for data synthesis and analysis. RESULTS Ten studies met the study criteria, the most popular study design was cross-sectional design (n = 9, 90.0%), others were case series (n = 1, 10.0%). Barriers to medication adherence and facilitators of medication adherence were the major two themes that participants reported regarding the impact of COVID-19 on medication adherence. Moreover, these two main themes have been organized in sub-themes that are dealt with in-depth. DISCUSSION Our results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for chronic disease patients, especially regarding medication adherence. Future research incorporating programs that support patients' needs is recommended.
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Affiliation(s)
- Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Wendie Zhou
- School of Nursing, Peking University, Beijing, China
| | - Atsadaporn Niyomyart
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tongyao Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Aaron Kudlowitz
- The College of Arts and Sciences, Case Western Reserve University, Cleveland, USA
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Tually PJ, Currie G, Lenzo NP, Hendrie DV, Meadows JW, Janssen JHA. Potential utility of B-Type natriuretic peptides in secondary prevention following percutaneous coronary intervention in remote communities of Western Australia. Biomarkers 2023:1-8. [PMID: 37128799 DOI: 10.1080/1354750x.2023.2209705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Introduction: A third of all acute coronary events that present in the Australian population occur in patients with established coronary heart disease. This study assessed the prognostic value of combined B-type natriuretic peptides (BNP) measurement and quantitative myocardial perfusion scan (MPS) data for cardiac events (CE).Material and methods: This retrospective cohort study involved 133 patients from rural Western Australia. The cut-off for normality was 6.0 for qualitative summed difference scores (SDS) of MPS and 400 pg/mL for BNP.Results: Patients with no CE had a mean SDS and BNP (1.52 with a 95% CI of 0.34 to 2.69), (175.9 with a 95% CI of 112.7-239.1) that was lower than patients with CE (6.54 with 95% CI 4.18-9.89) (P = 0.0003), (669.1 with 95% CI 543.9-794.3) (P < 0.0001). The sensitivity and specificity of combined testing for predicting CE respectively were 79.6% and 86.3% for SDS, 84.6% and 94.1% for BNP, and 100% and 92.7% for SDS and BNP combined.Discussion and conclusion: Elevated BNP is marginally superior to MPS in predicting CEs in patients who have previously undergone percutaneous coronary intervention (PCI); however, MPS can identify the region of myocardium most at risk. Routine BNP monitoring in this subgroup may serve as secondary prevention by identifying subclinical disease.
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Affiliation(s)
- Peter J Tually
- Department of Nuclear Medicine, Telemed Health, 20 Maritana St, Kalgoorlie, 6430, WA Australia
- Centre for Population Health Research, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Geoff Currie
- School of Dentistry and Health Sciences, Charles Sturt University, Wagga Wagga, 2678 New South Wales, Australia
| | - Nat P Lenzo
- Department of Nuclear Medicine, Telemed Health, 20 Maritana St, Kalgoorlie, 6430, WA Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Delia V Hendrie
- Centre for Population Health Research, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Jack W Meadows
- Department of Nuclear Medicine, Telemed Health, 20 Maritana St, Kalgoorlie, 6430, WA Australia
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Deng L, Wu Q, Ding F, Liu Y, Shen J, Lin Y, Shi K, Zeng B, Wu L, Tong H. The effect of telemedicine on secondary prevention of atherosclerotic cardiovascular disease: A systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:1020744. [PMID: 36440018 PMCID: PMC9683074 DOI: 10.3389/fcvm.2022.1020744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Aim The purpose of this systematic review was to evaluate the efficiency of telemedicine on the secondary level of prevention of patients with arteriosclerotic cardiovascular disease (ASCVD), provide evidence for the application of telemedicine in secondary prevention and promote the development of telemedicine in secondary prevention. Methods A computer-based search was conducted in MEDLINE, Embase, Pubmed, EBSCO, CINAHL, the Cochrane Library, and Web of Science. Randomized controlled trials regarding the effect of telemedicine on secondary prevention of ASCVD were included from inception to May, 2022. Meta-analysis was used to compare the results of the included studies by RevMan5.4 software. The Cochrane Collaboration bias risk tool was used to perform risk of bias assessment in this study. Outcomes included risk factors, physical activity and exercise, muscle function, exercise compliance, medication adherence, healthy diet, depression and anxiety, self-efficacy, knowledge score, economy, and safety endpoints. Subgroup analysis was carried out for different main intervention measures included in the literature. Results A total of 32 randomized clinical studies (n = 10 997 participants) were included in the meta-analysis. Compared with usual secondary prevention (USP) group, participants in telemedicine of secondary prevention (TOSP) group showed significant improvement in some risk factors including BMI (MD -0.87, p = 0.002), SBP (MD -4.09, p = 0.007) and DBP (MD -2.91, p = 0.0002) when they use the telephone as the intervention. In physical activity and exercise, Patients in TOSP showed an improvement in VO2 Peak (mL⋅kg-1⋅min-1) (OR 1.58, p = 0.02), 6MWT (MD 21.41, p = 0.001), GSLTPA score (MD 2.89, p = 0.005). Effects on medication adherence, exercise compliance, muscle function, healthy diet, economy and self-efficacy were synthesized narratively. Patients in TOSP did not show a reduction in knowledge score, depression, anxiety and safety endpoints. Conclusion There is a net benefit of secondary prevention supported by telemedicine (especially when using the telephone as an intervention) in patients with ASCVD in the terms of some risk factors, physical activity and exercise. There are still controversies in the improvement of medication adherence, exercise compliance, muscle function, healthy diet, knowledge score, self-efficacy and economy via telemedicine, which is worth exploring. Larger samples size and longer-term follow-ups are needed in future studies. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=330478], identifier [CRD42022330478].
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Affiliation(s)
- Liangying Deng
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Qing Wu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Feng Ding
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Yanfeng Liu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jianping Shen
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Lin
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Kaihu Shi
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bailin Zeng
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lixing Wu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Huangjin Tong
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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Champion S, Clark RA, Tirimacco R, Tideman P, Gebremichael L, Beleigoli A. The Impact of the SARS-CoV-2 Virus (COVID-19) Pandemic and the Rapid Adoption of Telehealth for Cardiac Rehabilitation and Secondary Prevention Programs in Rural and Remote Australia: A Multi-Method Study. Heart Lung Circ 2022; 31:1504-1512. [PMID: 35987722 PMCID: PMC9384540 DOI: 10.1016/j.hlc.2022.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Centre-based cardiac rehabilitation (CR) programs were disrupted and urged to adopt telehealth modes of delivery during the COVID-19 public health emergency. Previously established telehealth services may have faced increased demand. This study aimed to investigate a) the impact of the COVID-19 pandemic on CR attendance/completion, b) clinical outcomes of patients with cardiovascular (CV) diseases referred to CR and, c) how regional and rural centre-based services converted to a telehealth delivery during this time. METHODS A cohort of patients living in regional and rural Australia, referred to an established telehealth-based or centre-based CR services during COVID-19 first wave, were prospectively followed-up, for ≥90 days (February to June 2020). Cardiac rehabilitation attendance/completion and a composite of CV re-admissions and deaths were compared to a historical control group referred in the same period in 2019. The impact of mode of delivery (established telehealth service versus centre-based CR) was analysed through a competitive risk model. The adaption of centre-based CR services to telehealth was assessed via a cross-sectional survey. RESULTS 1,954 patients (1,032 referred during COVID-19 and 922 pre-COVID-19) were followed-up for 161 (interquartile range 123-202) days. Mean age was 68 (standard deviation 13) years and 68% were male. Referrals to the established telehealth program did not differ during (24%) and pre-COVID-19 (23%). Although all 10 centre-based services surveyed adopted telehealth, attendance (46.6% vs 59.9%; p<0.001) and completion (42.4% vs 75.4%; p<0.001) was significantly lower during COVID-19. Referral during vs pre-COVID-19 (sub hazard ratio [SHR] 0.77; 95% CI 0.68-0.87), and to a centre-based program compared to the established telehealth service (SHR 0.66; 95% CI 0.58-0.76) decreased the likelihood of CR uptake. DISCUSSION An established telehealth service and rapid adoption of telehealth by centre-based programs enabled access to CR in regional and rural Australia during COVID-19. However, further development of the newly implemented telehealth models is needed to promote CR attendance and completion.
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Affiliation(s)
- Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Robyn A Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Rosy Tirimacco
- Integrated Cardiovascular Clinical Network SA, Rural and Remote Support Services, SA Department of Health, Adelaide, SA, Australia
| | - Philip Tideman
- Integrated Cardiovascular Clinical Network SA, Rural and Remote Support Services, SA Department of Health, Adelaide, SA, Australia
| | - Lemlem Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
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Vanzella LM, Ghisi GLDM, Colella TJF, Larkin J, Vanderlei LCM, Marzolini S, Thomas S, Oh P. Physical Activity Level and Perspectives of Participants Transitioning from Onsite to Virtual Cardiac Rehabilitation during the Early COVID-19 Pandemic: A Mixed-Method Study. J Clin Med 2022; 11:4838. [PMID: 36013076 PMCID: PMC9409687 DOI: 10.3390/jcm11164838] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
This mixed-method study aimed to compare physical activity (PA) patterns of a cross-over cardiac rehabilitation (CR) cohort with a center-based CR cohort and to explore barriers and facilitators of participants transitioning and engaging in virtual CR. It included the retrospective self-reported PA of a cross-over CR cohort (n = 75) and a matched center-based CR cohort (n = 75). Some of the participants included in the cross-over cohort (n = 12) attended semi-structured focus group sessions and results were interpreted in the context of the PRECEDE-PROCEED model. Differences between groups were not observed (p > 0.05). The center-based CR cohort increased exercise frequency (p = 0.002), duration (p = 0.007), and MET/minutes (p = 0.007) over time. The cross-over cohort increased exercise duration (p = 0.04) with no significant change in any other parameters. Analysis from focus groups revealed six overarching themes classified under predisposing factors (knowledge), enabling factors (external support, COVID-19 restrictions, mental health, personal reasons/preferences), and reinforcing factors (recommendations). These findings suggest an improvement of the PA levels of center-based CR cohort participants pre-pandemic and mitigated improvement in those who transitioned to a virtual CR early in the pandemic. Improving patients’ exercise-related knowledge, provider endorsements, and the implementation of group videoconferencing sessions could help overcome barriers to participation in virtual CR.
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Affiliation(s)
- Lais Manata Vanzella
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
| | | | - Tracey Jacqueline Fitchett Colella
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Jillian Larkin
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada
| | | | - Susan Marzolini
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada
| | - Scott Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada
| | - Paul Oh
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
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Rentta NN, Bennett J, Leung W, Webb R, Jack S, Harwood M, Baker MG, Lund M, Wilson N. Medical Treatment for Rheumatic Heart Disease: A Narrative Review. Heart Lung Circ 2022; 31:1463-1470. [PMID: 35987720 DOI: 10.1016/j.hlc.2022.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are rare in high-income countries; however, in Aotearoa New Zealand ARF and RHD disproportionately affect Indigenous Māori and Pacific Peoples. This narrative review explores the evidence regarding non-surgical management of patients with clinically significant valve disease or heart failure due to RHD. METHODS Medline, EMBASE and Scopus databases were searched, and additional publications were identified through cross-referencing. Included were 28 publications from 1980 onwards. RESULTS Of the available interventions, improved anticoagulation management and a national RHD register could improve RHD outcomes in New Zealand. Where community pharmacy anticoagulant management services (CPAMS) are available good anticoagulation control can be achieved with a time in the therapeutic range (TTR) of more than 70%, which is above the internationally recommended level of 60%. The use of pharmacists in anticoagulation control is cost-effective, acceptable to patients, pharmacists, and primary care practitioners. There is a lack of local data available to fully assess other interventions; including optimal therapy for heart failure, equitable access to specialist RHD care, prevention, and management of endocarditis. CONCLUSION As RHD continues to disproportionately affect Indigenous and minority groups, pro-equity tertiary prevention interventions should be fully evaluated to ensure they are reducing disease burden and improving outcomes in patients with RHD.
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Affiliation(s)
| | - Julie Bennett
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | - William Leung
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Rachel Webb
- Auckland District Health Board, Auckland, New Zealand; University of Auckland, Department of Paediatrics: Child and Youth Health, Auckland, New Zealand
| | - Susan Jack
- Public Health South, Southern District Health Board, Dunedin, New Zealand
| | - Matire Harwood
- General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Mayanna Lund
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Nigel Wilson
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand; Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
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Kappel C, Rushton-Marovac M, Leong D, Dent S. Pursuing Connectivity in Cardio-Oncology Care-The Future of Telemedicine and Artificial Intelligence in Providing Equity and Access to Rural Communities. Front Cardiovasc Med 2022; 9:927769. [PMID: 35770225 PMCID: PMC9234696 DOI: 10.3389/fcvm.2022.927769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/24/2022] [Indexed: 01/22/2023] Open
Abstract
The aim of this review is to discuss the current health disparities in rural communities and to explore the potential role of telehealth and artificial intelligence in providing cardio-oncology care to underserviced communities. With advancements in early detection and cancer treatment, survivorship has increased. The interplay between cancer and cardiovascular disease, which are the leading causes of morbidity and mortality in this population, has been increasingly recognized. Worldwide, cardio-oncology clinics (COCs) have emerged to deliver a multidisciplinary approach to the care of patients with cancer to mitigate cardiovascular risks while minimizing interruptions in cancer treatment. Despite the value of COCs, the accessibility gap between urban and rural communities in both oncology and cardio-oncology contributes to health care disparities and may be an underrecognized determinant of health globally. Telehealth and artificial intelligence offer opportunities to provide timely care irrespective of rurality. We therefore explore current developments within this sphere and propose a novel model of care to address the disparity in urban vs. rural cardio-oncology using the experience in Canada, a geographically large country with many rural communities.
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Affiliation(s)
- Coralea Kappel
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Moira Rushton-Marovac
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada
| | - Darryl Leong
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Susan Dent
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, United States
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Solà-Muñoz S, Azeli Y, Trenado J, Jiménez X, Bisbal R, López À, Morales J, García X, Sánchez B, Fernández J, Soto MÁ, Ferreres Y, Cantero C, Jacob J. Effect of a Prioritization Score on the Inter-Hospital Transfer Time Management of Severe COVID-19 Patients. A Quasi-Experimental Intervention Study. Int J Qual Health Care 2022; 34:6548674. [PMID: 35289365 PMCID: PMC8992311 DOI: 10.1093/intqhc/mzac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/21/2022] [Accepted: 03/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background The overburdening of the healthcare system during the coronavirus disease 19 (COVID-19) pandemic is driving the need to create new tools to improve the management of inter-hospital transport for patients with a severe COVID-19 infection. Objective The aim of this study was to analyse the usefulness of the application of a prioritization score (IHTCOVID-19) for inter-hospital transfer of patients with COVID-19 infection. Methods The study has a quasi-experimental design and was conducted on the Medical Emergency System, the pre-hospital emergency department of the public company belonging to the Autonomous Government of Catalonia that manages urgent healthcare in the region. Patients with a severe COVID-19 infection requiring inter-hospital transport were consecutively included. The pre-intervention period was from 1 to 31 March 2020, and the intervention period with the IHTCOVID-19 score was from 1 to 30 April 2020 (from 8 am to 8 pm). The prioritization score comprises four priority categories, with Priority 0 being the highest and Priority 3 being the lowest. Inter-hospital transfer (IHT) management times (alert-assignment time, resource management time and total central management time) and their variability were evaluated according to whether or not the IHTCOVID-19 score was applied. Results A total of 344 IHTs were included: 189 (54.9%) in the pre-intervention period and 155 (45.1%) in the post-intervention period. The majority of patients were male and the most frequent age range was between 50 and 70 years. According to the IHTCOVID-19 score, 12 (3.5%) transfers were classified as Priority 0, 66 (19.4%) as Priority 1, 247 (71.8%) as Priority 2 and 19 (5.6%) as Priority 3. Overall, with the application of the IHTCOVID-19 score, there was a significant reduction in total central management time [from 112.4 (inter-quartile range (IQR) 281.3) to 89.8 min (IQR 154.9); P = 0.012]. This significant reduction was observed in Priority 0 patients [286.2 (IQR 218.5) to 42.0 min (IQR 58); P = 0.018] and Priority 1 patients [130.3 (IQR 297.3) to 75.4 min (IQR 91.1); P = 0.034]. After applying the IHTCOVID-19 score, the average time of the process decreased by 22.6 min, and variability was reduced from 618.1 to 324.0 min. Conclusion The application of the IHTCOVID-19 score in patients with a severe COVID-19 infection reduces IHT management times and variability.
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Affiliation(s)
- Silvia Solà-Muñoz
- Address reprint requests to: Silvia Solà-Muñoz, Area of Research and Development, Sistema d’Emergències Mèdiques, Pablo Iglesias 101-115, L’Hospitalet de Llobregat, Barcelona 08908, Spain. Tel: +34 93 264 44 00; E-mail:
| | - Youcef Azeli
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
- Sociedad Española de Medicina de Urgencias y Emergencias, Red de Investigación de Emergencias Prehospitalarias RINVEMER, nuñez de balboa 116 3° office 9, Madrid 28020, Spain
- Hospital Universitari Sant Joan de Reus, Institut d’Investigació Sanitària Pere Virgili (IISPV), Avda, Josep Laporte, 2 Planta 0 – E2 color taronja, Reus, Tarragona 43204, Spain
| | - Josep Trenado
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
- Intensive Care Unit, Hospital Universitari Mutua de Terrassa, Plaça del Doctor Robert, 5, Terrassa, Barcelona 08221, Spain
| | - Xavier Jiménez
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
- Sociedad Española de Medicina de Urgencias y Emergencias, Red de Investigación de Emergencias Prehospitalarias RINVEMER, nuñez de balboa 116 3° office 9, Madrid 28020, Spain
| | - Roger Bisbal
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Àngels López
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Jorge Morales
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Xaime García
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Bernat Sánchez
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - José Fernández
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Av. Colom 16-20, Tortosa, Tarragona 43500, Spain
- Unidat de Recerca, Gerència Territorial Terres de l´Ebre, Institut Català de la Salut, Ctra. de la Simpàtica, 44, Tortosa, Tarragona 43500, Spain
| | - Maria Ángeles Soto
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Yolanda Ferreres
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Cristina Cantero
- Area of Research and Development, Clinical Department, Sistema d’Emergències Mèdiques de Catalunya, C. Pablo Iglesias 101-155, L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Javier Jacob
- Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Universitat de Barcelona, Carrer de la Feixa Llarga, s/n, Barcelona 08907, Spain
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Beleigoli A, Nicholls SJ, Brown A, Chew DP, Beltrame J, Maeder A, Maher C, Versace VL, Hendriks JM, Tideman P, Kaambwa B, Zeitz C, Prichard IJ, Tavella R, Tirimacco R, Keech W, Astley C, Govin K, Nesbitt K, Du H, Champion S, Pinero de Plaza MA, Lynch I, Poulsen V, Ludlow M, Wanguhu K, Meyer H, Krollig A, Gebremichael L, Green C, Clark RA. Implementation and prospective evaluation of the Country Heart Attack Prevention model of care to improve attendance and completion of cardiac rehabilitation for patients with cardiovascular diseases living in rural Australia: a study protocol. BMJ Open 2022; 12:e054558. [PMID: 35173003 PMCID: PMC8852732 DOI: 10.1136/bmjopen-2021-054558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Despite extensive evidence of its benefits and recommendation by guidelines, cardiac rehabilitation (CR) remains highly underused with only 20%-50% of eligible patients participating. We aim to implement and evaluate the Country Heart Attack Prevention (CHAP) model of care to improve CR attendance and completion for rural and remote participants. METHODS AND ANALYSIS CHAP will apply the model for large-scale knowledge translation to develop and implement a model of care to CR in rural Australia. Partnering with patients, clinicians and health service managers, we will codevelop new approaches and refine/expand existing ones to address known barriers to CR attendance. CHAP will codesign a web-based CR programme with patients expanding their choices to CR attendance. To increase referral rates, CHAP will promote endorsement of CR among clinicians and develop an electronic system that automatises referrals of in-hospital eligible patients to CR. A business model that includes reimbursement of CR delivered in primary care by Medicare will enable sustainable access to CR. To promote CR quality improvement, professional development interventions and an accreditation programme of CR services and programmes will be developed. To evaluate 12-month CR attendance/completion (primary outcome), clinical and cost-effectiveness (secondary outcomes) between patients exposed (n=1223) and not exposed (n=3669) to CHAP, we will apply a multidesign approach that encompasses a prospective cohort study, a pre-post study and a comprehensive economic evaluation. ETHICS AND DISSEMINATION This study was approved by the Southern Adelaide Clinical Human Research Ethics Committee (HREC/20/SAC/78) and by the Department for Health and Wellbeing Human Research Ethics Committee (2021/HRE00270), which approved a waiver of informed consent. Findings and dissemination to patients and clinicians will be through a public website, online educational sessions and scientific publications. Deidentified data will be available from the corresponding author on reasonable request. TRIAL REGISTRATION NUMBER ACTRN12621000222842.
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Affiliation(s)
- Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Stephen J Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia
| | - Alex Brown
- Indigenous Health, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Derek P Chew
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - John Beltrame
- The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anthony Maeder
- Flinders Digital Health Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Deakin University, Melbourne, Victoria, Australia
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Philip Tideman
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Integrated Cardiovascular Clinical Network, Rural Support Service, Adelaide, South Australia, Australia
| | - Billingsley Kaambwa
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Christopher Zeitz
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ivanka J Prichard
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Rosanna Tavella
- The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rosy Tirimacco
- Integrated Cardiovascular Clinical Network, Rural Support Service, Adelaide, South Australia, Australia
| | - Wendy Keech
- Health Translation SA, Adelaide, South Australia, Australia
| | - Carolyn Astley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Kay Govin
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Katie Nesbitt
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Huiyun Du
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Imelda Lynch
- National Heart Foundation of Australia, Mawson, Australia Central Territory, Australia
| | - Vanessa Poulsen
- National Heart Foundation of Australia, Mawson, Australia Central Territory, Australia
| | - Marie Ludlow
- National Heart Foundation of Australia, Mawson, Australia Central Territory, Australia
| | - Ken Wanguhu
- Royal Australian College of General Practitioners, Waikerie, Victoria, Australia
| | - Hendrika Meyer
- Rural Support Service, SA Health, Adelaide, South Australia, Australia
| | - Ali Krollig
- Rural Support Service, SA Health, Adelaide, South Australia, Australia
| | - Lemlem Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Chloe Green
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Robyn A Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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12
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Buyting R, Melville S, Chatur H, White CW, Légaré JF, Lutchmedial S, Brunt KR. Virtual Care With Digital Technologies for Rural Canadians Living With Cardiovascular Disease. CJC Open 2022; 4:133-147. [PMID: 35198931 PMCID: PMC8843960 DOI: 10.1016/j.cjco.2021.09.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/26/2021] [Indexed: 01/14/2023] Open
Abstract
Canada is a wealthy nation with a geographically diverse population, seeking health innovations to better serve patients in accordance with the Canada Health Act. In this country, population and geography converge with social determinants, policy, procurement regulations, and technological advances with the goal to achieve equity in the management and distribution of health care. Rural and remote patients are a vulnerable population; when managing chronic conditions like cardiovascular disease, there is currently inequity to accessing specialist physicians at the recommended frequency-increasing the likelihood of poor health outcomes. Ensuring equitable care for this population is an unrealized priority of several provincial and federal government mandates. Virtual care technology might provide practical, economical, and innovative solutions to remedy this discrepancy. We conducted a scoping review of the literature pertaining to the use of virtual care technologies to monitor patients living in rural areas of Canada with cardiovascular disease. A search strategy was developed to identify the literature specific to this context across 3 bibliographic databases. Two hundred thirty-two unique citations were ultimately assessed for eligibility, of which 37 met the inclusion criteria. In our assessment of these articles, we provide a summary of the interventions studied, their reported effectiveness in reducing adverse events and mortality, the challenges to implementation, and the receptivity of these technologies among patients, providers, and policy-makers. Furthermore, we glean insight into the barriers and opportunities to ensure equitable care for rural patients and conclude that there is an ongoing need for clinical trials on virtual care technologies in this context.
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Affiliation(s)
- Ryan Buyting
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
- Division of Cardiac Surgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
- Division of Cardiology, Saint John Regional Hospital, Saint John, New Brunswick, Canada
- Horizon Health Network, CardioVascular Research New Brunswick (CVR-NB), Saint John, New Brunswick, Canada
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
| | - Sarah Melville
- Division of Cardiology, Saint John Regional Hospital, Saint John, New Brunswick, Canada
- Horizon Health Network, CardioVascular Research New Brunswick (CVR-NB), Saint John, New Brunswick, Canada
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
| | - Hanif Chatur
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
| | - Christopher W. White
- Division of Cardiac Surgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
- Horizon Health Network, CardioVascular Research New Brunswick (CVR-NB), Saint John, New Brunswick, Canada
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
| | - Jean-François Légaré
- Division of Cardiac Surgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
- Horizon Health Network, CardioVascular Research New Brunswick (CVR-NB), Saint John, New Brunswick, Canada
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
| | - Sohrab Lutchmedial
- Division of Cardiology, Saint John Regional Hospital, Saint John, New Brunswick, Canada
- Horizon Health Network, CardioVascular Research New Brunswick (CVR-NB), Saint John, New Brunswick, Canada
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
| | - Keith R. Brunt
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
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13
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Gregory AT, Denniss AR. Heart, Lung and Circulation in the COVID-19 Era: About COVID-19, Not Just About COVID-19. Heart Lung Circ 2021; 30:1792-1799. [PMID: 34742544 PMCID: PMC8563592 DOI: 10.1016/j.hlc.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - A Robert Denniss
- Heart, Lung and Circulation, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, and University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Blacktown Hospital, and Western Sydney University, Sydney, NSW, Australia.
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14
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Al Amiry A, Maguire BJ. Emergency Medical Services (EMS) Calls During COVID-19: Early Lessons Learned for Systems Planning (A Narrative Review). Open Access Emerg Med 2021; 13:407-414. [PMID: 34522146 PMCID: PMC8434918 DOI: 10.2147/oaem.s324568] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/05/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Over the course of the COVID-19 progress, reports from many locations around the world indicated major increases in EMS call volume, which imposed great pressure on EMS dispatch centers (EMSDC) globally. No studies yet have been done to examine this phenomenon. OBJECTIVE This paper examines the interrelated effects of the unprecedented global increase of EMS call, the effect of the COVID-19 crisis on responding to non-COVID-19 emergencies, and the concurrent effects of having overwhelmed dispatch centers. It tries to explain the current evidence of the bottleneck of EMS calls during the early phase of the worldwide pandemic. ELIGIBILITY CRITERIA We examine the numbers of EMS calls internationally between March and June 2020, derived from published literature and news media. Only articles in English were selected, with certain keywords related to EMS calls, ambulance delay, stroke and cardiac arrest. SOURCE OF EVIDENCE Google Scholar was the main searching source. RESULTS After applying the selection criteria, a total of 29 citations were chosen, and a pattern of knowledge resulted in the emergence of five themes: EMS calls during COVID-19, Reduced EMS operator response time, Ambulance response delays, Collateral mortality and morbidity among non-COVID-19 cases, and Total ambulance call time. CONCLUSION Over the course of COVID-19 progress, there was a global phenomenon of exponential increases in EMS calls, which is expected to impose a great pressure on EMS dispatch centers. Several factors contributing to the bottleneck of EMS calls are identified and explained.
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Affiliation(s)
- Alaa Al Amiry
- Department of Clinical Studies, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Brian J Maguire
- Leidos (Research Laboratory), Groton, CT, USA
- Central Queensland University in Australia, Rockhampton, Queensland, Australia
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15
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Khandkar C, Patel S, Arnott C. Procedural Volumes in the Era of COVID: The Risk Versus Benefit Trade-Off. Heart Lung Circ 2021; 30:1430-1432. [PMID: 34364799 PMCID: PMC8339604 DOI: 10.1016/j.hlc.2021.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Chinmay Khandkar
- Department of Cardiology, Orange Health Service, Orange, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - Sanjay Patel
- The University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Heart Research Institute, Sydney, NSW, Australia
| | - Clare Arnott
- The University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
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16
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Social Determinants of Health Influencing the New Zealand COVID-19 Response and Recovery: A Scoping Review and Causal Loop Diagram. SYSTEMS 2021. [DOI: 10.3390/systems9030052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Coronavirus pandemic of 2019–20 (COVID-19) affected multiple social determinants of health (SDH) across the globe, including in New Zealand, exacerbating health inequities. Understanding these system dynamics can support decision making for the pandemic response and recovery measures. This study combined a scoping review with a causal loop diagram to further understanding of the connections between SDH, pandemic measures, and both short- and long-term outcomes in New Zealand. The causal loop diagram showed the reinforcing nature of structural SDH, such as colonization and socio-economic influences, on health inequities. While balancing actions taken by government eliminated COVID-19, the diagram showed that existing structural SDH inequities could increase health inequities in the longer term, unless the opportunity is taken for socio-economic policies to be reset. Such policy resets would be difficult to implement, as they are at odds with the current socio-economic system. The causal loop diagram highlighted that SDH significantly influenced the dynamics of the COVID-19 impact and response, pointing to a need for purposeful systemic action to disrupt the reinforcing loops which increase health inequities over time. This will require strong systems leadership, and coordination between policy makers and implementation at local level.
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Wong J, Longhitano A, Yao J, Jayadeva P, Arendshorst K, Grigg L, Wynn G, Stevenson I. Remote Device Interrogation Kiosks (ReDInK) - Pharmacy Kiosk Remote Testing of Pacemakers and Implantable Cardioverter-Defibrillators for Rural Victorians. A Novel Strategy to Tackle COVID-19. Heart Lung Circ 2021; 30:1044-1049. [PMID: 33612427 PMCID: PMC7843087 DOI: 10.1016/j.hlc.2020.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 12/31/2020] [Indexed: 12/18/2022]
Abstract
Background In the era of COVID-19, travel restrictions and social distancing measures have changed the landscape for device interrogations of pacemakers and defibrillators for rural Victorians. Previously, device checks were performed infrequently in large volume, face-to-face rural clinics by visiting cardiologists and technicians. Access to remote areas and social distancing restrictions have made these clinics unfeasible to operate. The Cardiac Society of Australia and New Zealand (CSANZ) and Heart Rhythm Society (HRS) COVID-19 consensus statements have suggested the utilisation of remote monitoring to minimise the potential spread of COVID-19 infections between clinicians and high-risk patients. A novel solution to this challenge was the implementation of a remote device interrogation (RI) service located in two kiosks at two rural pharmacies. This service was termed Remote Device Interrogation Kiosks (ReDInK). Aim This cross-sectional observational study aimed to describe the set-up process, safety and efficacy of RI and customer satisfaction of the ReDInK program. Methods Two-hundred-and-ninety-two (292) rurally located patients with implantable cardiac devices were identified via the cardiology department database. Of these, 101 (44%) were enrolled into the ReDInK program across two rurally located pharmacies between April and July 2020. RI was performed and download outcomes were reviewed. A customer satisfaction survey assessed attitudes towards the program and explored options of ongoing service application. Results Of 101 patients enrolled into ReDInK, 96 (95%) resulted in satisfactory device checks. Four (4) individuals failed-to-attend and one individual experienced technical download issues. Of the 96 satisfactory device checks, three required in-person follow-up for reasons including battery replacement, lead repositioning and in-person programming. No adverse events were reported. A satisfaction telephone survey was conducted with 81 (83%) participants enrolled in ReDInK. Seventy-one (71) individuals (88%) of those surveyed expressed satisfaction and 73 (90%) labelled the process as efficiently conducted. Sixty-nine (69) (85%) participants felt reassured that this service was established during the pandemic. However 47 (58%) participants reported they would still feel comfortable to undergo in-person reviews despite social distancing recommendations. Conclusions With the COVID-19 pandemic posing restrictions to social distancing and reducing unnecessary in-person interaction, the ReDInK program emerges as an efficacious and safe solution for patients in rural Victoria. The program’s widely positive reception and successful conduction in rural Victoria invites further opportunity for a wider application of similar programs, expanding its role to metropolitan areas.
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Affiliation(s)
- Joshua Wong
- Royal Melbourne Hospital, Melbourne, Vic, Australia.
| | | | - Jessica Yao
- Royal Melbourne Hospital, Melbourne, Vic, Australia
| | | | | | | | - Gareth Wynn
- Royal Melbourne Hospital, Melbourne, Vic, Australia
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Nan J, Zhang T, Tian Y, Song K, Li Q, Fu Q, Ma Y, Jin Z. Impact of the 2019 Novel Coronavirus Disease Pandemic on the Performance of a Cardiovascular Department in a Non-epidemic Center in Beijing, China. Front Cardiovasc Med 2021; 8:630816. [PMID: 33681305 PMCID: PMC7929980 DOI: 10.3389/fcvm.2021.630816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Knowledge of the impact of the 2019 novel coronavirus disease (COVID-19) pandemic on the performance of a cardiovascular department in a medical referral hub center from a non-epidemic area of China is limited. Method: The data on the total number of non-emergency medical cares (including the number of out-patient clinic attendances, the number of patients who were hospitalized in non-intensive care wards, and patients who underwent elective cardiac intervention procedures) and emergency medical cares [including the number of emergency department (ED attendances) and chest pain center (CPC attendances), as well as the number of patients who were hospitalized in coronary care unit (CCU) and the number of patients who underwent emergency cardiac intervention procedures] before and during the pandemic (time before the pandemic: 20th January 2019 to 31st March 2019 and time during the pandemic: 20th January 2020 to 31st March 2020) in the Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University were collected and compared. Results: Both the non-emergency medical and emergency medical cares were affected by the pandemic. The total number of out-patient clinic attendance decreased by 44.8% and the total number of patients who were hospitalized in non-intensive care wards decreased by 56.4%. Pearson correlation analysis showed that the number of out-patient clinic attendance per day was not associated with the number of new confirmed COVID-19 cases and the cumulative number of confirmed COVID-19 patients in Beijing (r = −0.080, p = 0.506 and r = −0.071, p = 0.552, respectively). The total number of patients who underwent non-emergency cardiac intervention procedures decreased during the pandemic, although there were no statistically significant differences except for patent foramen ovale (PFO) occlusion (1.7 ± 2.9 vs. 8.3 ± 2.3, p = 0.035). As for the emergency medical cares, the ED attendances decreased by 22.4%, the total number of CPC attendances increased by 10.3%, and the number of patients who were hospitalized in CCU increased by 8.9%: these differences were not statistically significant. During the pandemic, the proportion of hospitalized patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) significantly increased (19.0 vs. 8.7%, p < 0.001; 28.8 vs. 18.0%, p < 0.001, respectively); also, the number of primary percutaneous coronary intervention (PCI) increased by 10.3%. There was no significant difference between patients before and during the pandemic regarding the age, gender, baseline and discharge medication therapy, as well as length of stay and in-hospital mortality. Conclusions: Our preliminary results demonstrate that both the non-emergency and emergency medical cares were affected by the COVID-19 pandemic even in a referral medical center with low cross-infection risk. The number of the out-patient clinic attendances not associated with the number of confirmed COVID-19 cases could be due to different factors, such as the local government contamination measures. The proportion of hospitalized patients with acute myocardial infarction increased in our center during the pandemic since other hospitals stopped performing primary angioplasty. A hub-and-spoke model could be effective in limiting the collateral damage for patients affected by cardiovascular diseases when the medical system is stressed by disasters, such as COVID-19 pandemic.
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Affiliation(s)
- Jing Nan
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yali Tian
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ke Song
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qun Li
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qiang Fu
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yan Ma
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zening Jin
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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19
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Song J, McDonald C. Experiences of New Zealand registered nurses of Chinese ethnicity during the COVID-19 pandemic. J Clin Nurs 2021; 30:757-764. [PMID: 33348470 DOI: 10.1111/jocn.15607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/22/2020] [Accepted: 12/13/2020] [Indexed: 11/27/2022]
Abstract
AIMS This study aimed to investigate the experiences and challenges of New Zealand registered nurses of Chinese ethnicity who have been working during the COVID-19 pandemic. BACKGROUND New Zealand's nursing workforce is becoming increasingly multicultural as foreign nurses make up an essential part of the New Zealand health workforce. The ongoing COVID-19 pandemic has highlighted the contributions that nurses have made in providing front-line services to the public. However, little has been documented about challenges and experiences of this minority ethnic group-Chinese nurses-who have been working as registered nurses in New Zealand during the COVID-19 pandemic. METHODS This study used an anonymous online questionnaire and a thematic approach to establishing understandings of the experiences of New Zealand registered nurses of Chinese ethnicity in working through the COVID-19 pandemic. A total of 51 Chinese nurses completed this survey. A self-explanatory checklist for reporting results of Internet e-surveys (CHERRIES) was used for the purpose of the quality of this online survey. RESULTS The result showed that 47.06% participants (n = 24) reported negative experiences including racial discrimination, workplace bullying and judgement, while 52.94% (n = 27) participants reported positive working experiences including supports received in the workplace and positive recognition by the pubic in New Zealand. CONCLUSION Ethnic minority nurses are key assets to the New Zealand health system. It is important to understand their experiences and challenges, particularly during the COVID-19 pandemic to make sure they are supported and protected from any physical and emotional injury. RELEVANCE TO CLINICAL PRACTICE COVID-19 has brought additional challenges and concerns to nurses who are working on the front line of health services. Having knowledge of nurses' working experiences will help with their job satisfaction and has potential implications for the sustainability of the New Zealand nursing workforce and retention strategies to address nursing workforce shortages which is foreseeable in New Zealand.
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Affiliation(s)
- Jenny Song
- Waikato Institute of Technology, Hamilton, New Zealand
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20
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Gregory AT, Pepe S, Denniss AR. COVID-19 and Heart, Lung and Circulation: Riding the 2020 Waves of Change in Australia & New Zealand ✰. Heart Lung Circ 2020; 29:1737-1740. [PMID: 33218388 PMCID: PMC7834382 DOI: 10.1016/j.hlc.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Ann T Gregory
- Heart, Lung and Circulation, Sydney, NSW, Australia.
| | - Salvatore Pepe
- Heart, Lung and Circulation, Sydney, NSW, Australia; Murdoch Children's Research Institute; Department of Cardiology, Royal Children's Hospital; Department of Paediatrics, University of Melbourne, Vic, Australia
| | - A Robert Denniss
- Heart, Lung and Circulation, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, and University of Sydney, NSW, Australia; Department of Cardiology, Blacktown Hospital, and Western Sydney University, NSW, Australia
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21
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Ferguson C, Inglis SC, Gallagher R, Davidson PM. Reflecting on the Impact of Cardiovascular Nurses in Australia and New Zealand in the International Year of the Nurse and Midwife. Heart Lung Circ 2020; 29:1744-1748. [PMID: 33067125 PMCID: PMC7553902 DOI: 10.1016/j.hlc.2020.09.921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Caleb Ferguson
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney Local Health District & Western Sydney University, Blacktown Hospital, Sydney, NSW, Australia.
| | - Sally C Inglis
- IMPACCT and School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Robyn Gallagher
- Charles Perkins Centre & Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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22
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Inglis SC, Naismith C, White K, Hendriks JM, Bray J, Hickman LD, Aldridge C, Bardsley K, Cameron J, Candelaria D, Cartledge S, Du H, Ferguson C, Martin L, Selkow T, Xu X, Wynne R, Driscoll A, Gallagher R, Clark R, Davidson PM. CSANZ COVID-19 Cardiovascular Nursing Care Consensus Statement: Executive Summary. Heart Lung Circ 2020; 29:1263-1267. [PMID: 32859539 PMCID: PMC7413197 DOI: 10.1016/j.hlc.2020.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Sally C Inglis
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Carolyn Naismith
- Department of Cardiology, Austin Health, Melbourne, Vic, Australia
| | | | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University; Centre for Heart Rhythm Disorders, University of Adelaide; Department of Cardiology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Janet Bray
- Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Louise D Hickman
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Chris Aldridge
- Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | | | - Jan Cameron
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Dion Candelaria
- Susan Wakil School of Nursing and Midwifery, & Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Susie Cartledge
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Huiyun Du
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Caleb Ferguson
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney University & Western Sydney Local Health District, Blacktown Hospital, Sydney, NSW, Australia
| | - Lorelle Martin
- Department of Cardiology, Austin Health, Melbourne, Vic, Australia
| | | | - Xiaoyue Xu
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Rochelle Wynne
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney University & Western Sydney Local Health District, Blacktown Hospital, Sydney, NSW, Australia; Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Geelong, Vic, Australia
| | - Andrea Driscoll
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Geelong, Vic, Australia; Department of Cardiology, Austin Health, Melbourne, Vic, Australia; Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Robyn Gallagher
- Susan Wakil School of Nursing and Midwifery, & Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Robyn Clark
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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23
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Sarathy K, Pitney M, Konecny P, Jepson N. Letter to the Editor: CSANZ Consensus Guidelines for Interventional Cardiology Services Delivery During COVID-19 Pandemic in Australia and New Zealand. Heart Lung Circ 2020; 29:1260-1261. [PMID: 32646639 PMCID: PMC7338017 DOI: 10.1016/j.hlc.2020.05.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 10/27/2022]
Affiliation(s)
- Kiran Sarathy
- Prince of Wales Hospital, University of New South Wales, Sydney, NSW, Australia
| | - Mark Pitney
- Prince of Wales Hospital, University of New South Wales, Sutherland Hospital, Eastern Heart Clinic, Sutherland Heart Clinic, Sydney, NSW, Australia
| | - Pamela Konecny
- University of New South Wales, St. George Hospital, Sydney, NSW, Australia
| | - Nigel Jepson
- Prince of Wales Hospital, University of New South Wales, Eastern Heart Clinic, Sydney, NSW, Australia.
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24
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Dhakal BP, Sweitzer NK, Indik JH, Acharya D, William P. SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart. Heart Lung Circ 2020; 29:973-987. [PMID: 32601020 PMCID: PMC7274628 DOI: 10.1016/j.hlc.2020.05.101] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/02/2020] [Accepted: 05/07/2020] [Indexed: 02/06/2023]
Abstract
Coronavirus disease (COVID-19) is a serious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The symptoms of the disease range from asymptomatic to mild respiratory symptoms and even potentially life-threatening cardiovascular and pulmonary complications. Cardiac complications include acute myocardial injury, arrhythmias, cardiogenic shock and even sudden death. Furthermore, drug interactions with COVID-19 therapies may place the patient at risk for arrhythmias, cardiomyopathy and sudden death. In this review, we summarise the cardiac manifestations of COVID-19 infection and propose a simplified algorithm for patient management during the COVID-19 pandemic.
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Affiliation(s)
| | | | - Julia H Indik
- Sarver Heart Center, University of Arizona, Tucson, AZ, USA
| | - Deepak Acharya
- Sarver Heart Center, University of Arizona, Tucson, AZ, USA
| | - Preethi William
- Sarver Heart Center, University of Arizona, Tucson, AZ, USA.
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