3
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Wynne R, Nolte J, Matthews S, Angel J, Le A, Moore A, Campbell T, Ferguson C. Effect of an mHealth self-help intervention on readmission after adult cardiac surgery: Protocol for a pilot randomized controlled trial. J Adv Nurs 2021; 78:577-586. [PMID: 34841554 PMCID: PMC9299838 DOI: 10.1111/jan.15104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
Aim To describe a protocol for the pilot phase of a trial designed to test the effect of an mHealth intervention on representation and readmission after adult cardiac surgery. Design A multisite, parallel group, pilot randomized controlled trial (ethics approval: HREC2020.331‐RMH69278). Methods Adult patients scheduled to undergo elective cardiac surgery (coronary artery bypass grafting, valve surgery, or a combination of bypass grafting and valve surgery or aortic surgery) will be recruited from three metropolitan tertiary teaching hospitals. Patients allocated to the control group with receive usual care that is comprised of in‐patient discharge education and local paper‐based written discharge materials. Patients in the intervention group will be provided access to tailored ‘GoShare’ mHealth bundles preoperatively, in a week of hospital discharge and 30 days after surgery. The mHealth bundles are comprised of patient narrative videos, animations and links to reputable resources. Bundles can be accessed via a smartphone, tablet or computer. Bundles are evidence‐based and designed to improve patient self‐efficacy and self‐management behaviours, and to empower people to have a more active role in their healthcare. Computer‐generated permuted block randomization with an allocation ratio of 1:1 will be generated for each site. At the time of consent, and 30, 60 and 90 days after surgery quality of life and level of patient activation will be measured. In addition, rates of representation and readmission to hospital will be tracked and verified via data linkage 1 year after the date of surgery. Discussion Interventions using mHealth technologies have proven effectiveness for a range of cardiovascular conditions with limited testing in cardiac surgical populations. Impact This study provides an opportunity to improve patient outcome and experience for adults undergoing cardiac surgery by empowering patients as end‐users with strategies for self‐help. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000082808.
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Affiliation(s)
- Rochelle Wynne
- Western Sydney Nursing & Midwifery Research Centre, Blacktown Clinical & Research School, Western Sydney University & Western Sydney Local Health District, Blacktown Hospital, Blacktown, New South Wales, Australia.,School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia.,The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Joanne Nolte
- The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Stacey Matthews
- The Royal Melbourne Hospital, Parkville, Victoria, Australia.,National Heart Foundation, Docklands, Victoria, Australia
| | - Jennifer Angel
- The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Ann Le
- Liverpool Hospital, South West Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Andrew Moore
- Healthily Pty Ltd, Melbourne, Victoria, Australia
| | | | - Caleb Ferguson
- Western Sydney Nursing & Midwifery Research Centre, Blacktown Clinical & Research School, Western Sydney University & Western Sydney Local Health District, Blacktown Hospital, Blacktown, New South Wales, Australia
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4
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Liu D, Zeng X, Ding Z, Lv F, Mehta JL, Wang X. Adverse Cardiovascular Effects of Anti-COVID-19 Drugs. Front Pharmacol 2021; 12:699949. [PMID: 34512335 PMCID: PMC8424204 DOI: 10.3389/fphar.2021.699949] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 infection is the cause of the ongoing global pandemic. Mortality from COVID-19 infection is particularly high in patients with cardiovascular diseases. In addition, COVID-19 patients with preexisting cardiovascular comorbidities have a higher risk of death. Main cardiovascular complications of COVID-19 are myocardial infarction, myocarditis, acute myocardial injury, arrhythmias, heart failure, stroke, and venous thromboembolism. Therapeutic interventions in terms of drugs for COVID-19 have many cardiac adverse effects. Here, we review the relative therapeutic efficacy and adverse effects of anti-COVID-19 drugs.
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Affiliation(s)
- Dongling Liu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Xiang Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, China
| | - Zufeng Ding
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| | - Fenghua Lv
- Department of Cardiology, Xinxiang Medical University First Affiliated Hospital, Weihui, China
| | - Jawahar L. Mehta
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| | - Xianwei Wang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
- Department of Cardiology, Xinxiang Medical University First Affiliated Hospital, Weihui, China
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5
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Cadilhac DA, Kim J, Tod EK, Morrison JL, Breen SJ, Jaques K, Grimley R, Jones B, Cloud GC, Kleinig T, Hillier S, Castley H, Lindley RI, Lannin NA, Middleton S, Yan B, Hill K, Clissold BB, Mitchell PJ, Anderson CS, Faux SG, Campbell BCV. COVID-19 Pandemic Impact on Care for Stroke in Australia: Emerging Evidence From the Australian Stroke Clinical Registry. Front Neurol 2021; 12:621495. [PMID: 33716925 PMCID: PMC7952624 DOI: 10.3389/fneur.2021.621495] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/04/2021] [Indexed: 01/01/2023] Open
Abstract
We present information on acute stroke care for the first wave of the COVID-19 pandemic in Australia using data from the Australian Stroke Clinical Registry (AuSCR). The first case of COVID-19 in Australia was recorded in late January 2020 and national restrictions to control the virus commenced in March. To account for seasonal effects of stroke admissions, patient-level data from the registry from January to June 2020 were compared to the same period in 2019 (historical-control) from 61 public hospitals. We compared periods using descriptive statistics and performed interrupted time series analyses. Perceptions of stroke clinicians were obtained from 53/72 (74%) hospitals participating in the AuSCR (80% nurses) via a voluntary, electronic feedback survey. Survey data were summarized to provide contextual information for the registry-based analysis. Data from the registry covered locations that had 91% of Australian COVID-19 cases to the end of June 2020. For the historical-control period, 9,308 episodes of care were compared with the pandemic period (8,992 episodes). Patient characteristics were similar for each cohort (median age: 75 years; 56% male; ischemic stroke 69%). Treatment in stroke units decreased progressively during the pandemic period (control: 76% pandemic: 70%, p < 0.001). Clinical staff reported fewer resources available for stroke including 10% reporting reduced stroke unit beds. Several time-based metrics were unchanged whereas door-to-needle times were longer during the peak pandemic period (March-April, 2020; 82 min, control: 74 min, p = 0.012). Our data emphasize the need to maintain appropriate acute stroke care during times of national emergency such as pandemic management.
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Affiliation(s)
- Dominique A Cadilhac
- Stroke and Ageing Research School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Joosup Kim
- Stroke and Ageing Research School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Emma K Tod
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Julie L Morrison
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Sibilah J Breen
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Katherine Jaques
- Statewide Stroke Clinical Network, Healthcare Improvement Unit, Clinical Excellence, Queensland Health, Brisbane, QLD, Australia
| | - Rohan Grimley
- Stroke and Ageing Research School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,Statewide Stroke Clinical Network, Healthcare Improvement Unit, Clinical Excellence, Queensland Health, Brisbane, QLD, Australia
| | | | - Geoffrey C Cloud
- Department of Neuroscience, Central Clinical School, Monash University, Clayton, VIC, Australia.,Alfred Health, Prahran, VIC, Australia
| | | | - Susan Hillier
- Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | | | - Richard I Lindley
- Westmead Clinical School, University of Sydney, Darlington, NSW, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Clayton, VIC, Australia.,Alfred Health, Prahran, VIC, Australia
| | - Sandy Middleton
- Nursing Research Institute, Australian Catholic University, Sydney, NSW, Australia.,St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
| | - Bernard Yan
- Department of Radiology, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Kelvin Hill
- Stroke Foundation, Melbourne, VIC, Australia
| | - Benjamin B Clissold
- Stroke and Ageing Research School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,Monash Health, Clayton, VIC, Australia
| | - Peter J Mitchell
- Department of Radiology, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Craig S Anderson
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,The George Institute for Global Health, Camperdown, NSW, Australia
| | - Steven G Faux
- St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.,University of New South Wales, Kensington, NSW, Australia
| | - Bruce C V Campbell
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.,Department of Radiology, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
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7
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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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8
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Coote S, Cadilhac DA, O'Brien E, Middleton S. Letter to the Editor regarding: Critical Considerations for Stroke Management During COVID-19 Pandemic in response to Inglis et al., Heart Lung Circ. 2020;29(9): 1263-1267. Heart Lung Circ 2020; 29:1895-1896. [PMID: 33129695 PMCID: PMC7546268 DOI: 10.1016/j.hlc.2020.09.925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/18/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Skye Coote
- Melbourne Brain Centre and Department of Neurology, Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of Medicine and Radiology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic, Australia; The Acute Stroke Nurses Education Network (ASNEN), Melbourne, Vic, Australia. https://twitter.com/skyecoote
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic, Australia; Stroke Theme, The Florey Institute of Neuroscience and Mental Health, Melbourne, Vic, Australia
| | - Elizabeth O'Brien
- The Acute Stroke Nurses Education Network (ASNEN), Melbourne, Vic, Australia; Department of Neurology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, NSW, Australia
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