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Sukosd IE, Gadde ST, Pravallika M, Pescariu SA, Prodan M, Toma AO, Fericean RM, Hrubaru I, Sarau OS, Fira-Mladinescu O. Evaluating the Health-Related Quality of Life in Patients with COPD and Chronic Heart Failure Post-Hospitalization after COVID-19 Using the EQ-5D and KCCQ Questionnaires. Diseases 2024; 12:124. [PMID: 38920556 PMCID: PMC11203136 DOI: 10.3390/diseases12060124] [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: 05/26/2024] [Revised: 05/29/2024] [Accepted: 06/01/2024] [Indexed: 06/27/2024] Open
Abstract
Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) frequently coexist, significantly impacting health-related quality of life (HRQoL). This study evaluated HRQoL in patients with CHF, COPD, or both, three months post-COVID-19 discharge using EQ-5D and KCCQ questionnaires to guide targeted healthcare interventions. We conducted a cross-sectional study at "Victor Babes" Hospital in Timisoara, enrolling 180 patients who had recovered from COVID-19 (60 in each group including CHF, COPD, and both conditions). HRQoL was assessed via EQ-5D and KCCQ. Significant disparities in HRQoL measures were noted across the groups. Patients with both CHF and COPD reported the worst outcomes, especially in terms of hospital stay lengths due to COVID-19 (11.63 days) and initial oxygen saturation levels (88.7%). HRQoL improvements from discharge to three months post-discharge were significant, with EQ-5D mobility scores improving notably across all groups (CHF and COPD: 2.87 to 2.34, p = 0.010). KCCQ results reflected substantial enhancements in physical limitation (CHF and COPD: 38.94 to 58.54, p = 0.001) and quality of life scores (CHF and COPD: 41.38 to 61.92, p = 0.0031). Regression analysis revealed that dual diagnosis (CHF and COPD) significantly impacted usual activities and quality of life (β = -0.252, p = 0.048; β = -0.448, p = 0.017), whereas the initial severity of COVID-19 was a significant predictor of worse HRQoL outcomes (β = -0.298, p = 0.037; β = -0.342, p = 0.024). The presence of both CHF and COPD in patients recovering from COVID-19 was associated with more severe HRQoL impairment compared with either condition alone. These findings emphasize the need for specialized, comprehensive post-COVID-19 recovery programs that address the complex interplay among chronic conditions to optimize patient outcomes and enhance quality of life.
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Affiliation(s)
- Ilona Emoke Sukosd
- Doctoral School, Department of General Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.E.S.); (O.S.S.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (M.P.); (O.F.-M.)
| | - Sai Teja Gadde
- Faculty of General Medicine, All India Institute of Medical Sciences (AIIMS), Mangalagiri 522503, India;
| | | | | | - Mihaela Prodan
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (M.P.); (O.F.-M.)
- Department of Plastic Surgery, “Pius Brinzeu” Timis County Emergency Clinical Hospital, 300723 Timisoara, Romania
| | - Ana-Olivia Toma
- Discipline of Dermatology, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Dermatology, Timisoara Municipal Emergency Hospital, 300254 Timisoara, Romania;
| | - Roxana Manuela Fericean
- Department of Dermatology, Timisoara Municipal Emergency Hospital, 300254 Timisoara, Romania;
| | - Ingrid Hrubaru
- Department of Obstetrics and Gynecology, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Oana Silvana Sarau
- Doctoral School, Department of General Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.E.S.); (O.S.S.)
- Department V, Internal Medicine, Discipline of Hematology, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Fira-Mladinescu
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (M.P.); (O.F.-M.)
- Department of Infectious Diseases, Discipline of Pulmonology, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Vallée A. The impact of the COVID-19 pandemic on the socioeconomic gradient of hypertension. J Public Health Policy 2024:10.1057/s41271-024-00491-4. [PMID: 38831023 DOI: 10.1057/s41271-024-00491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 06/05/2024]
Abstract
The COVID-19 pandemic has brought into sharp focus the impact of socioeconomic factors on hypertension outcomes. This review examines the implications of the pandemic on the socioeconomic gradient of hypertension and explores the physiological and pathophysiological processes underlying this relationship. Changes in socioeconomic factors have disproportionately affected individuals with lower socioeconomic status, leading to adverse hypertension outcomes. The pandemic-related stressors, coupled with social isolation and disrupted daily routines, have contributed to elevated stress levels among individuals, particularly those with lower socioeconomic status. Equitable access to healthcare, enhancing health literacy and patient empowerment, and addressing social determinants of health are essential components of hypertension management strategies. By recognizing the specific challenges faced by individuals with lower socioeconomic status and implementing targeted interventions, public health efforts can help reduce the socioeconomic gradient of hypertension.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, 92150, Suresnes, France.
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Vizdiklar C, Aydin V, Tazegul G, Kaskal M, Akici A. Use of lipid-lowering drugs in restricted health access settings: Results from the trends in drug utilization during COVID-19 pandemic in Turkey (PANDUTI-TR) study. Vascul Pharmacol 2024:107382. [PMID: 38815702 DOI: 10.1016/j.vph.2024.107382] [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: 04/15/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND COVID-19 restrictions prompted changes in chronic disease management and lifestyle modifications, potentially altering cardiometabolic indicators and lipid-lowering pharmacotherapy patterns. We aimed to assess lipid-lowering drug (LLD) utilization trends during COVID-19 restrictions. METHODS We obtained nationwide outpatient drug sales and prescribing data for 01.03.2018-31.12.2022 from IQVIA™ Turkey. We evaluated average monthly LLD consumption, their costs, and quarterly prescribing levels in three periods: "before restrictions" (BfR, 01.03.2018-31.03.2020), "during restrictions" (DuR, 01.04.2020-31.03.2022), and "after restrictions" (AfR, 01.04.2022-31.12.2022). Drug utilization was measured via "defined daily dose/1000 inhabitants/day" (DID) metric. RESULTS LLD utilization increased from 25.4 ± 3.1 DID in BfR to 36.2 ± 6.8 DID in DuR (p < 0.001), and to 42.6 ± 5.3 DID in AfR (p < 0.001 vs. BfR). Statin consumption significantly rose from 22.0 ± 3.0 DID in BfR to 31.6 ± 6.3 DID in DuR (p < 0.001), and further to 37.6 ± 4.7 DID in AfR (p < 0.01 vs. DuR). High-intensity statin consumption elevated by 115.9% in AfR compared to baseline (p < 0.001). Prescribing of LLDs decreased from 12.5 ± 0.6 DID in BfR to 7.2 ± 1.2 DID in DuR (p < 0.001), later reached 13.6 ± 3.8 DID in AfR (p < 0.001 vs. DuR), with prescribing for ongoing users following similar trend. Expenditure on LLDs increased from €8.4 m ± 0.9 m in BfR to €11.4 m ± 2.0 m in DuR (p < 0.001) and to €12.8 m ± 1.9 m in AfR (p < 0.001 vs. BfR). CONCLUSIONS This study revealed a surge in consumption of LLDs in Turkey following the onset of the COVID-19 pandemic. This rise might be related to practices facilitating drug access, in addition to potentially greater adherence, or the necessity for more intense pharmacotherapy due to elevated cardiovascular risk.
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Affiliation(s)
- Caner Vizdiklar
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Volkan Aydin
- Department of Medical Pharmacology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey; Hypertension and Atherosclerosis Research Centre, Marmara University, Istanbul, Turkey
| | - Gokhan Tazegul
- Division of General Internal Medicine, Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey
| | - Mert Kaskal
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ahmet Akici
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey; Hypertension and Atherosclerosis Research Centre, Marmara University, Istanbul, Turkey.
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Naga YS, El Keraie A, Abd ElHafeez SS, Zyada RS. Impact of COVID-19 pandemic on care of maintenance hemodialysis patients: a multicenter study. Clin Exp Nephrol 2024:10.1007/s10157-024-02495-6. [PMID: 38702493 DOI: 10.1007/s10157-024-02495-6] [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: 09/15/2023] [Accepted: 03/22/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The COVID-19 pandemic posed a challenge to hemodialysis (HD) patients. While most outpatient and elective medical services stopped during lockdown, HD patients continued to visit their dialysis centers. We aimed to assess how the initial phase of the pandemic affected patient care by comparing dialysis adequacy and other parameters of patient care before and during the first 10 months of the COVID-19 pandemic. METHODS In a retrospective multi-center observational study, all adult dialysis patients in five dialysis centers in Alexandria, Egypt were included. Dialysis adequacy, missed sessions, laboratory parameters and hospitalization were recorded. Data of the 10 months before and the 10 months after the pandemic were compared and predictors of adequacy were determined. RESULTS In the 388 HD patients included in the study, the number of missed sessions was higher during the pandemic with peaks during the first and second wave of the pandemic. The ratio of patients to nurses, phosphorus and parathormone levels were significantly higher during the pandemic, while urea reduction ratio, Kt/V, hemoglobin, calcium and albumin levels were significantly lower. In patients who reported difficult accessibility, missed HD sessions were higher during lockdown. Hospital admissions doubled during the pandemic, with COVID-19 infection being the main cause (45.5%). Number of patients per nurse and interdialytic weight gain were predictors of inadequate dialysis. CONCLUSION The COVID-19 pandemic and its related lockdown negatively affected multiple aspects of dialysis patient care. Continued access of optimum care in dialysis patients should be a priority in any future mass events.
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Affiliation(s)
- Yasmine Salah Naga
- Nephrology Unit, Internal Medicine department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed El Keraie
- Nephrology Unit, Internal Medicine department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samar Samy Abd ElHafeez
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Rowan Saad Zyada
- Kidney and Urology Centre, 347 Gamal Abd El Naser Street, Montaza, Alexandria, Egypt.
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Rzymski P, Zarębska-Michaluk D, Parczewski M, Genowska A, Poniedziałek B, Strukcinskiene B, Moniuszko-Malinowska A, Flisiak R. The burden of infectious diseases throughout and after the COVID-19 pandemic (2020-2023) and Russo-Ukrainian war migration. J Med Virol 2024; 96:e29651. [PMID: 38712743 DOI: 10.1002/jmv.29651] [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: 03/04/2024] [Revised: 04/01/2024] [Accepted: 04/25/2024] [Indexed: 05/08/2024]
Abstract
Understanding how the infectious disease burden was affected throughout the COVID-19 pandemic is pivotal to identifying potential hot spots and guiding future mitigation measures. Therefore, our study aimed to analyze the changes in the rate of new cases of Poland's most frequent infectious diseases during the entire COVID-19 pandemic and after the influx of war refugees from Ukraine. We performed a registry-based population-wide study in Poland to analyze the changes in the rate of 24 infectious disease cases from 2020 to 2023 and compared them to the prepandemic period (2016-2019). Data were collected from publicly archived datasets of the Epimeld database published by national epidemiological authority institutions. The rate of most of the studied diseases (66.6%) revealed significantly negative correlations with the rate of SARS-CoV-2 infections. For the majority of infectious diseases, it substantially decreased in 2020 (in case of 83%) and 2021 (63%), following which it mostly rebounded to the prepandemic levels and, in some cases, exceeded them in 2023 when the exceptionally high annual rates of new cases of scarlet fever, Streptococcus pneumoniae infections, HIV infections, syphilis, gonococcal infections, and tick-borne encephalitis were noted. The rate of Clostridioides difficile enterocolitis was two-fold higher than before the pandemic from 2021 onward. The rate of Legionnaires' disease in 2023 also exceeded the prepandemic threshold, although this was due to a local outbreak unrelated to lifted COVID-19 pandemic restrictions or migration of war refugees. The influx of war migrants from Ukraine could impact the epidemiology of sexually transmitted diseases. The present analysis indicates that continued efforts are needed to prevent COVID-19 from overwhelming healthcare systems again and decreasing the control over the burden of other infectious diseases. It also identifies the potential tipping points that require additional mitigation measures, which are also discussed in the paper, to avoid escalation in the future.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Miłosz Parczewski
- Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, Poland
| | - Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, Bialystok, Poland
| | - Barbara Poniedziałek
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
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Odunyemi A, Sohrabi H, Alam K. The evolution of household forgone essential care and its determinants during the COVID-19 pandemic in Nigeria: A longitudinal analysis. PLoS One 2024; 19:e0296301. [PMID: 38564649 PMCID: PMC10986961 DOI: 10.1371/journal.pone.0296301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/09/2023] [Indexed: 04/04/2024] Open
Abstract
Apart from the morbidity and mortality, the Coronavirus disease 2019 (COVID-19) pandemic has increased the predisposition of households in Nigeria to forgone care, thereby increasing their vulnerability to adverse health consequences. Since there is no previous study in Nigeria on the evolution of pandemic-related forgone care and its drivers, our study assess the evolution of the problem using descriptive and nationally representative panel data analyses. We found about a 30% prevalence of forgone care during the lockdown, which declined progressively afterwards, dropping by 69.50 percentage points between April 2020 and April 2022. This decline produced a surge in households needing care from about 35.00% in the early pandemic to greater than 50%, beginning in early 2021. The forgone care was primarily due to financial hindrances, movement restrictions, and supply-side disruptions. Household socioeconomic factors such as income loss had 2.74 [95%CI: 1.45-5.17] times higher odds of forgone care, job loss, food insecurity, and poverty were 87% (OR: 1.87 [95%CI: 1.25-2.79]), 60% (OR: 1.60 [95%CI: 1.12-2.31]) and 76% (OR: 1.76 [95%CI: 1.12-2.75]) more likely to predispose households to forgone care, respectively. Also, geographical location, such as the South-South zone, induced 1.98 [95%CI: 1.09-3.58] times higher odds of forgone care than North-Central. A married female household head increased the odds by 6.07 [95%CI: 1.72-21.47] times compared with an unmarried female head. However, having a married household head, social assistance, and North-East or North-West zone compared with North-Central increased the chance of accessing care by 69% (OR 0.31 [95%CI: 0.16-0.59]), 59%,(OR 0.41 [95%CI: 0.21-0.77]), 72% (OR 0.28 [95%CI: 0.15-0.53]) and 64% (OR 0.36 [95%CI: 0.20-0.65]), respectively. Non-communicable diseases, disability, old age, large household size and rural-urban location did not affect the forgone care. Our study highlights the need to strengthen Nigeria's health system, create policies to promote healthcare accessibility and prepare the country for future pandemic challenges.
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Affiliation(s)
- Adelakun Odunyemi
- Murdoch Business School, Murdoch University, Perth, Western Australia
- Hospitals’ Management Board, Alagbaka Estate, Akure, Ondo State, Nigeria
| | - Hamid Sohrabi
- Centre for Healthy Ageing, Murdoch University, Perth, Western Australia
| | - Khurshid Alam
- Centre for Healthy Ageing, Murdoch University, Perth, Western Australia
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Gillan R, Bachtel G, Webber K, Ezzair Y, Myers NE, Bishayee A. Osteopathic manipulative treatment for chronic inflammatory diseases. J Evid Based Med 2024; 17:172-186. [PMID: 38488211 DOI: 10.1111/jebm.12590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/25/2024] [Indexed: 04/02/2024]
Abstract
Chronic inflammatory diseases (CIDs) are debilitating and potentially lethal illnesses that affect a large proportion of the global population. Osteopathic manipulative treatment (OMT) is a manual therapy technique developed and performed by osteopathic physicians that facilitates the body's innate healing processes. Therefore, OMT may prove a beneficial anti-inflammatory modality useful in the management and treatment of CIDs. This work aims to objectively evaluate the therapeutic benefits of OMT in patients with various CIDs. In this review, a structured literature search was performed. The included studies involving asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, ankylosing spondylitis, and peripheral arterial disease were selected for this work. Various OMT modalities, including lymphatic, still, counterstain, and muscle energy techniques, were utilized. Control treatments included sham techniques, routine care, or no treatment. OMT utilization led to variable patient outcomes in individuals with pathologies linked to CID.
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Affiliation(s)
- Ross Gillan
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Gabrielle Bachtel
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Kassidy Webber
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Yasmine Ezzair
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Nicole E Myers
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
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Singh S, Polavarapu M, Vallerand K, Moore SS. Impact of COVID-19 Pandemic on Health Behaviors and Outcomes by Age Group and Race Ethnicity: Results From Behavioral Risk Factor Surveillance System Data. Am J Health Promot 2024; 38:355-363. [PMID: 37656165 DOI: 10.1177/08901171231199399] [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] [Indexed: 09/02/2023]
Abstract
This study aimed to examine changes in health behaviors and outcomes during early-pandemic (2020) vs pre-pandemic (2019) years by age groups and race/ethnicity. Multivariable logistic regressions were conducted using Behavioral Risk Factor Surveillance System datasets from 2019 (n = 418 268) and 2020 (n = 401 958). All participants reported less likelihood to exercise (aOR, .78; 95% CI: .73-.83) and have poor physical health (aOR, .91; 95% CI: .86-.98) but more likelihood to have excellent general health (aOR, 1.33; 1.17-1.53) during 2020 vs 2019. Compared to 2019, during 2020 (i) Blacks were more likely to exercise (aOR, 1.24; 95% CI: 1.02-1.51) and have excellent general health (aOR, 1.69; 95% CI: 1.13-2.54); (ii) Hispanics were less likely to exercise (aOR, .80; 95% CI: .74-.88), but more likely to have excellent general health (aOR, 2.44; 95% CI: 1.79-3.33) and mental health (aOR, 1.41; 95% CI: 1.15-1.72); and (iii) Whites were less likely to exercise (aOR, .58; 95% CI: .50-.67) and have good physical health (aOR, 0.89; 95% CI: .82-.95). All age groups, except 18-24 years, were less likely to exercise by 18%-39% during 2020 vs 2019. Furthermore, the 55-64 years age-group was 36% more likely to report excellent general health but 14% less likely to have good physical health. Identifying the most vulnerable racial/ethnic and age groups is pivotal to prioritizing public health resources and interventions to mitigate the impact of health crises.
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Affiliation(s)
- Shipra Singh
- Department of Population Health, The University of Toledo, Toledo, OH, USA
| | - Mounika Polavarapu
- Department of Population Health, The University of Toledo, Toledo, OH, USA
| | | | - Sundaye S Moore
- Department of Population Health, The University of Toledo, Toledo, OH, USA
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Villarreal-Zegarra D, Bellido-Boza L, Erazo A, Pariona-Cárdenas M, Valdivia-Miranda P. Impact of the COVID-19 pandemic on the services provided by the Peruvian health system: an analysis of people with chronic diseases. Sci Rep 2024; 14:3664. [PMID: 38351170 PMCID: PMC10864310 DOI: 10.1038/s41598-024-54275-7] [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: 12/13/2023] [Accepted: 02/10/2024] [Indexed: 02/16/2024] Open
Abstract
During the pandemic, many individuals with chronic or infectious diseases other than COVID-19 were unable to receive the care they needed due to the high demand for respiratory care. Our study aims to assess the impact of the COVID-19 pandemic on services provided to people with chronic diseases in Peru from 2016 to 2022. We performed a secondary database analysis of data registered by the comprehensive health insurance (SIS), the intangible solidarity health fund (FISSAL), and private healthcare institutions (EPS), using interrupted time series analysis. Our study identified 21,281,128 individual users who received care. The pooled analysis revealed an average decrease of 1,782,446 in the number of users receiving care in the first month of the pandemic compared with the expected values for that month based on pre-pandemic measurements. In addition, during the pandemic months, there was an average increase of 57,911 in the number of new additional single users who received care per month compared with the previous month. According to the time-series analysis of users receiving care per month based on each chronic disease group, the most significant decreases included people with diabetes without complications and chronic lung disease.
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Affiliation(s)
- David Villarreal-Zegarra
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
| | - Luciana Bellido-Boza
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru.
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
| | - Alfonso Erazo
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
| | - Max Pariona-Cárdenas
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
| | - Paul Valdivia-Miranda
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
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Al Meslamani AZ. Strategies for reducing chronic disease burden during pandemics. Curr Med Res Opin 2024; 40:193-197. [PMID: 38095584 DOI: 10.1080/03007995.2023.2295410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
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11
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Ghanbari‐Jahromi M, Kharazmi E, Bastani P, Shams M, Marzaleh MA, Amin Bahrami M. Factors disrupting the continuity of care for patients with chronic disease during the pandemics: A systematic review. Health Sci Rep 2024; 7:e1881. [PMID: 38384975 PMCID: PMC10879648 DOI: 10.1002/hsr2.1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/21/2023] [Accepted: 01/16/2024] [Indexed: 02/23/2024] Open
Abstract
Background and Aims Continuous routine care is necessary to prevent long-term complications of chronic diseases and improve patients' health conditions. This review study was conducted to determine the factors disrupting continuity of care for patients with chronic diseases during the pandemic. Methods All original articles published on factors disrupting continuity of care for patients with chronic disease during a pandemic between December 2019 and June 28, 2023, in PubMed, Web of Science, Scopus, and ProQuest databases were searched. Selection of articles, data extraction, and qualitative evaluation of articles (through STROBE and COREQ checklist) were done by two researchers separately. Data graphing form was used to extract the data of each study and then the data were classified by thematic analysis method. Results Out of 1708 articles reviewed from the databases, 22 were included. The factors disrupting the continuity of care for patients with chronic diseases during the epidemics were classified into two main categories: patient-side factors and health system-side factors. Patient-side factors including psychological, individual and social, disease-related, and health system-side factors including provider access, health system institutional, and infrastructural and financial problems were among the subcategories disrupting the continuity of care for patients with chronic diseases during the pandemic. Based on the studies, psychological factors and access to the provider were among the most frequent factors affecting the continuity of care for patients with chronic diseases in the pandemic. Conclusion Considering the factors disrupting the continuity of care and applying appropriate interventions based on them, can guarantee the continuity of providing services to chronic patients in health crises.
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Affiliation(s)
- Mohadeseh Ghanbari‐Jahromi
- Department of Healthcare Management, Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Erfan Kharazmi
- Department of Healthcare Management, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | - Peivand Bastani
- College of Business, Government and LawFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Mesbah Shams
- Department of Internal Medicine, Endocrinology and Metabolism Research CenterShiraz University of Medical SciencesShirazIran
| | - Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | - Mohammad Amin Bahrami
- Department of Healthcare Management, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
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Krebs H, Crutcher K, Su Y, Prasun MA. Cardiac Rehabilitation Phase II Outcomes Prior to and During COVID. Heart Lung 2024; 63:13-17. [PMID: 37722255 DOI: 10.1016/j.hrtlng.2023.08.011] [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: 06/06/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND The COVID pandemic limited access to many Cardiac Rehabilitation (CR) outpatient programs. OBJECTIVE The study aimed to examine the outcomes of patients in CR Phase II prior and during the pandemic. METHODS A single-site retrospective review of CR patients during 2019 (pre-COVID) and 2020 (COVID era) was performed. A linear mixed method explored the effect of COVID on 6-minute walk (6MWT), metabolic equivalents (METs), and quality of life (QOL). A generalized linear mixed method was used to explore the effect of COVID and CR on depression (PHQ-9). RESULTS Two-hundred and twelve patients were included. CR significantly improved 6MWT (b = 331.45, 95% CI: 295.62 ∼ 367.36), METs (b = 1.79, 95% CI: 1.55 ∼ 2.03), and QOL (b = 1.46, 95% CI: 0.81 ∼ 2.12). Significant interaction (P interaction = 0.04) between COVID and pre-post intervention was found for PHQ-9. CONCLUSIONS During COVID, patients perceived increased depression and poorer QOL. However, all outcomes improved significantly following CR.
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Affiliation(s)
- Harrison Krebs
- Mennonite College of Nursing, Illinois State University, Normal, IL, USA
| | - Kimberly Crutcher
- Registered Nurse in the Department of Cardiology, Carle BroMenn Medical Center, Normal, IL, USA
| | - Yan Su
- Mennonite College of Nursing, Illinois State University, Normal, IL, USA
| | - Marilyn A Prasun
- Carle BroMenn Medical Center Endowed Professor, Mennonite College of Nursing at Illinois State University, Normal, IL, USA.
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Ou JY, Waters AR, Kaddas HK, Warner EL, Lopez PLV, Mann K, Anderson JS, Ray N, Tsukamoto T, Gill D, Linder L, Fair D, Kirchhoff AC. Financial burdens during the COVID-19 pandemic are related to disrupted healthcare utilization among survivors of adolescent and young adult cancers. J Cancer Surviv 2023; 17:1571-1582. [PMID: 35579665 PMCID: PMC9112649 DOI: 10.1007/s11764-022-01214-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/25/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE We examined whether financial burdens occurring during the COVID-19 pandemic impacted healthcare utilization among survivors of adolescent and young adult cancers. METHODS We surveyed survivors enrolled in a patient navigation program to obtain self-reports of delayed/skipped cancer care or other care, changes to medication obtainment, and changes to medication use since the COVID-19 pandemic began. Reported financial burdens were defined as financial toxicity in the past 4 weeks (COmprehensive Score for financial Toxicity [COST] ≤ median 21) and material hardships (range = 4-11) since March 2020. Adjusted logistic regression models calculated associations and effect modification by gender. RESULTS Survivors (n = 341) were mostly female (61.3%) and non-Hispanic White (83.3%). Nearly 20% delayed/skipped cancer care, 35.2% delayed/skipped other care, 19.1% changed medication obtainment, and 12.6% changed medication use. Greater material hardships were associated with delayed/skipped cancer care (odds ratio (OR) = 3.13, 95% CI = 1.44-6.81) and other care (OR = 2.17, 95% CI = 1.18-3.98), and changed medication obtainment (OR = 2.72, 95% CI = 1.43-5.18) or use (OR = 4.49, 95% CI = 2.05-9.80). Financial toxicity was associated with delayed/skipped other care (OR = 2.53, 95% CI = 1.31-4.89) and changed medication obtainment (OR = 1.96, 95% CI = 1.01-3.83) and medication use (OR = 3.73, 95% CI = 1.59-8.73). The association of material hardships and any changes in healthcare utilization was greater among female compared to male survivors. CONCLUSION Financial burdens experienced during the pandemic impeded survivors' ability to utilize necessary healthcare, with worse impacts among female survivors. IMPLICATIONS FOR CANCER SURVIVORS Delayed or skipped healthcare may lead to an increased cancer mortality or severity of therapy-related conditions. Providing resources that enable survivors experiencing financial burdens to continue critical cancer and preventive care during the COVID-19 pandemic is a priority.
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Affiliation(s)
- Judy Y Ou
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA.
- Cancer Biostatistics Shared Resource, Huntsman Cancer Institute, Salt Lake City, UT, USA.
| | - Austin R Waters
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
- Department of Health Policy & Management, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Heydon K Kaddas
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
| | - Echo L Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
- College of Nursing, The University of Utah, Salt Lake City, UT, USA
| | - Perla L Vaca Lopez
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
| | - Karely Mann
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
| | - John S Anderson
- Department of Pediatrics, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Nicole Ray
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
| | | | - David Gill
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Lauri Linder
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
- College of Nursing, The University of Utah, Salt Lake City, UT, USA
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Douglas Fair
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
- Department of Pediatrics, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute at The University of Utah, South 4729, 2000 Circle of Hope Dr., Salt Lake City, UT, 84112, USA
- Department of Pediatrics, The University of Utah School of Medicine, Salt Lake City, UT, USA
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Kieber-Emmons T. Is It Time to Re-Evaluate? Monoclon Antib Immunodiagn Immunother 2023; 42:187-188. [PMID: 38133517 DOI: 10.1089/mab.2023.29016.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
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15
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Bou Malhab S, Haddad C, Sacre H, Hajj A, Zeenny RM, Akel M, Salameh P. Adherence to treatment and harmful effects of medication shortages in the context of severe crises: scale validation and correlates. J Pharm Policy Pract 2023; 16:163. [PMID: 38031177 PMCID: PMC10685472 DOI: 10.1186/s40545-023-00667-5] [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: 07/21/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Medication shortage is a public health problem, affecting patients' outcomes mainly through the difficulty in maintaining adherence, particularly in the context of a severe economic crisis. There is a need for a new scale that assesses the effect of medication shortage on adherence. AIM To develop and validate a scale to evaluate the harmful impact of medication shortage among the general Lebanese population and assess its correlates and association with medication adherence. METHODS A questionnaire was used to assess medication shortage harmful effects and patients' adherence, allowing to generate the Harmful Impact of Medication Shortage scale (HIMS). The factor analysis, convergent validity and reliability of the generated scale were assessed, followed by multivariable regressions to evaluate its correlates. RESULTS The developed HIMS scale is a 9-item tool, used to assess how difficult it was for people to deal with medication shortages and their harmful effects on treatment. It was significantly and inversely linked to treatment adherence and affected by the patients' socioeconomic status and the type of chronic disease. CONCLUSION The Harmful Impact of Medication Shortage scale could be an efficient tool to measure the detrimental effects of medication shortages among the Lebanese adult population with chronic diseases, particularly affecting treatment adherence. Future studies and evidence are still needed to confirm our findings and help build global mitigation policies addressing medication shortages.
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Affiliation(s)
- Sandrella Bou Malhab
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Department of Natural Sciences, School of Arts and Science, Lebanese American University, Beirut, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon.
- School of Medicine, Lebanese American University, Beirut, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon.
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Faculté de Pharmacie, Université Laval, Québec, Canada
- Oncology Division, CHU de Québec Université Laval Research Center, Québec, Canada
| | - Rony M Zeenny
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Department of Pharmacy, American University of Beirut Medical Center, Beirut, Lebanon
| | - Marwan Akel
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- School of Medicine, Lebanese American University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus
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Rong Y, Goswami S, Eriakha O, Ramachandran S, Bentley J, Banahan BF, Kirby T, Smith D, Pittman E, Bhattacharya K. Association of antecedent statin use on 30-day, 60-day and 90-day mortality among Mississippi Medicaid beneficiaries diagnosed with COVID-19. BMJ Open 2023; 13:e076195. [PMID: 37984946 PMCID: PMC10660820 DOI: 10.1136/bmjopen-2023-076195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE To assess if the antecedent statin use was associated with all-cause death among COVID-19 patients enrolled in Medicaid. DESIGN Cohort study. SETTING Mississippi Medicaid population. PARTICIPANTS This study included 10 792 Mississippi Medicaid-enrolled patients between 18 and 64 years of age with a confirmed COVID-19 diagnosis from March 2020 to June 2021. INTERVENTION Antecedent statin use, which was determined by a record of statin prescription in the 90-day period prior to the COVID diagnosis. MAIN OUTCOME MEASURES The outcomes of interest included mortality from all cause within 30 days, 60 days and 90 days after index. RESULTS A total of 10 792 patients with COVID-19 met the inclusion and exclusion criteria, with 13.1% of them being antecedent statin users. Statin users were matched 1:1 with non-users based on age, sex, race, comorbidities and medication use by propensity score matching. In total, the matched cohort consisted of 1107 beneficiaries in each group. Multivariable logistic regression showed that statin users were less likely to die within 30 days (adjusted OR: 0.51, 95% CI: 0.32 to 0.83), 60 days (OR: 0.56, 95% CI: 0.37 to 0.85) and 90 days (OR: 0.55, 95% CI: 0.37 to 0.82) after diagnosis of COVID-19. Those with low-intensity/moderate-intensity statin use had significantly lower mortality risk in the 60-day and the 90-day follow-up period, while the high intensity of statin use was only found to be significantly associated with a lower odd of mortality within 30 days post index. CONCLUSION After COVID infection, Medicaid beneficiaries who had taken statins antecedently could be at lower risk for death. For patients with chronic conditions, continuity of care is crucial when interruptions occur in their medical care. Further research is required to further investigate the potential mechanisms and optimal use of statins in COVID-19 treatment.
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Affiliation(s)
- Yiran Rong
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
- MedTech Epidemiology and Real-World Data Sciences, Johnson and Johnson, New Brunswick, New Jersey, USA
| | - Swarnali Goswami
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
- Real-World Evidence, Complete Health Economics and Outcomes Solutions, LLC, Chalfont, Pennsylvania, USA
| | - Omokhodion Eriakha
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
| | - Sujith Ramachandran
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
- Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, Mississippi, USA
| | - John Bentley
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
- Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, Mississippi, USA
| | - Benjamin F Banahan
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
- Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, Mississippi, USA
| | - Terri Kirby
- Mississippi Division of Medicaid, Office of the Governor, Jackson, Mississippi, USA
| | - Dennis Smith
- Mississippi Division of Medicaid, Office of the Governor, Jackson, Mississippi, USA
| | - Eric Pittman
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
- Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, Mississippi, USA
| | - Kaustuv Bhattacharya
- Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
- Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, Mississippi, USA
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Al-Bataineh R, Al-Hammouri M, Al-Jaraideh W. The accessibility and quality of health services for diabetes mellitus and chronic respiratory disease patients during Covid-19 in Northern Jordan: A mixed method study. PLoS One 2023; 18:e0294655. [PMID: 37972036 PMCID: PMC10653463 DOI: 10.1371/journal.pone.0294655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The catastrophe caused by the Coronavirus disease has affected all services worldwide. A range of policies were introduced to slow the virus spread, which in turn, affected the accessibility and quality of healthcare services. This was a problematic and concerning for patients with chronic diseases, such as patients with diabetes mellitus (DM) and chronic respiratory diseases (CRD), due to their sustained need for ongoing health care. The aims of the study were: 1) assessing the level of both accessibility and quality of healthcare services during the Covid-19 pandemic from the DM and CRD patients' perspectives, 2) assessing the association between the patients' socio-demographics and their perspectives on health services accessibility and quality, and 3) exploring the perspectives of DM and CRD patients on barriers and facilitators of health services accessibility and quality during the era of COVID -19. METHOD Design. A sequential explanatory mixed-method was used in this study. In the quantitative part, a self -administered questionnaire was used to collect data from 300 patients with DM and/or CRD. In the qualitative part, focus group approach was used to collect data from 25 patients. Setting. Public, private and teaching hospitals were involved. Analysis. SPSS Version 25 was used to analyze the quantitative data. Thematic analysis was used to analyze the qualitative data. RESULTS The quantitative findings indicated that almost 99% of the participating patients perceived barriers, ranging from low to high, to accessing health services during COVID-19. Additionally, more than half of the sample perceived low to moderate level of quality of health services. Four themes and nine subthemes related to barriers and facilitators were identified in the qualitative part of the study. CONCLUSION The study revealed that both quality and accessibility of healthcare services for DM and CRD patients were impacted during the era of COVID -19. The findings lay the ground for developing future health programs and establishing or revising policies with the goal of improving healthcare services quality and accessibility for the target population.
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Affiliation(s)
- Raya Al-Bataineh
- Department of health management and policy, Faculty of Medicine, Jordan university of Science and Technology, Irbid, Jordan
| | - Mohammed Al-Hammouri
- Department of Community and Mental Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Wafa’a Al-Jaraideh
- Department of health management and policy, Faculty of Medicine, Jordan university of Science and Technology, Irbid, Jordan
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18
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Ojewale LY, Mukumbang FC. Access to healthcare services for people with non-communicable diseases during the COVID-19 pandemic in Ibadan, Nigeria: a qualitative study. BMC Health Serv Res 2023; 23:1231. [PMID: 37946244 PMCID: PMC10636991 DOI: 10.1186/s12913-023-10278-0] [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: 07/12/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Desirable outcomes for people with non-communicable diseases (NCDs) are achieved when they access routine monitoring and care services. Expectedly, the COVID-19 pandemic severely impacted access to healthcare services, leading to poor health outcomes among people with NCDs. We aimed to [1] explore the delays in accessing healthcare services and [2] understand alternative actions adopted by people with NCDs to overcome these delays. METHODS We conducted an exploratory qualitative research guided by the "Three Delays" model to unpack the barriers to healthcare access for people living with NCDs in Ibadan, Nigeria. The "Three Delays" model conceptualizes the reasons for negative/adverse healthcare outcomes related to the patient's decision-making to seek healthcare, reaching an appropriate healthcare facility, and receiving adequate care at the healthcare facility. Twenty-five (25) people with NCDs were purposively selected from the University College Hospital's medical outpatient department to participate in in-depth interviews. Interview recordings were transcribed verbatim and analyzed using a deductive-inductive hybrid thematic analysis. RESULTS At the level of individual decision-making, delays were related to fear of contracting COVID-19 in the hospital (considered a hotspot of the COVID-19 pandemic). Regarding reaching an appropriate healthcare facility, delays were mainly attributed to the intra- and inter-city lockdowns, limiting the movements of persons. For those who successfully arrived at the healthcare facilities, delays were related to the unavailability of healthcare professionals, prioritization of COVID-19 patients, and mandatory adherence to COVID-19 protocols, including COVID-19 testing. To overcome the delays mentioned above, people with NCDs resorted to (i) using private healthcare facilities, which were more costly, (ii) using virtual consultation through mobile phone Apps and (iii) self-management, usually by repeating previously prescribed prescriptions to obtain medication. CONCLUSION Pandemic conditions provide unique challenges to people with chronic illnesses. Recognizing the need for continuous access to monitoring and care services under such conditions remains critical. Alternative health service provision approaches should be considered in pandemic situations, including remote healthcare services such as Mobile health apps (mHealth) that can help manage and prevent NCDs.
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García-Peña ÁA, Pineda-Posada M, Páez-Canro C, Cruz C, Samacá-Samacá D. Analysis of the evolocumab (Repatha®) patient support program for patients with cardiovascular disease in Colombia. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:280-289. [PMID: 37277296 DOI: 10.1016/j.arteri.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Cardiovascular diseases are considered the leading cause of death globally. This study describes the demographic characteristics, treatment patterns, self-reported compliance and persistence, and to explore variables related to non-adherence of patients enrolled in the cardiovascular patient support program (PSP) for evolocumab treatment in Colombia. METHODS This retrospective observational of the data registry of patients who entered the evolocumab PSP program. RESULTS The analysis included 930 patients enrolled in the PSP (2017-2021). Mean age was 65.1 (SD±13.1) and49.1% patients were female. The mean compliance rate to evolocumab treatment was 70.5% (SD±21.8). A total of 367 patients (40.5%) reported compliance higher than 80%. Persistence analysis included 739 patients (81.5%) where 87.8% of these patients were considered persistent to treatment. A total of 871 patients (93.7%) reported the occurrence of at least one adverse event during the follow-up period (mostly non-serious). CONCLUSION This is the first real-life study describing patient characteristics, compliance and continuity of treatment for dyslipidemia in a patient support program in Colombia. The overall adherence found was higher than 70%; similar to findings reported in other real-life studies with iPCSK9. However, the reasons for low compliance were different, highlighting the high number of administrative and medical reasons for suspension or abandonment of treatment with evolocumab.
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Affiliation(s)
| | | | | | - César Cruz
- Amgen Biotecnológica SAS, Bogotá, Colombia
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Fuller-Thomson E, Dolhai H, MacNeil A, Li G, Jiang Y, De Groh M. Depression during the COVID-19 pandemic among older Canadians with peptic ulcer disease: Analysis of the Canadian Longitudinal Study on Aging. PLoS One 2023; 18:e0289932. [PMID: 37851639 PMCID: PMC10584121 DOI: 10.1371/journal.pone.0289932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 07/29/2023] [Indexed: 10/20/2023] Open
Abstract
The COVID-19 pandemic and associated public health measures have exacerbated many known risk factors for depression that may be particularly concerning for individuals with chronic health conditions, such as peptic ulcer disease (PUD). In a large longitudinal sample of older adults with PUD, the current study examined the incidence of depression during the pandemic among those without a pre-pandemic history of depression (n = 689) and the recurrence of depression among those with a history of depression (n = 451). Data came from four waves of the Canadian Longitudinal Study on Aging (CLSA). Multivariate logistic regression analyses were conducted to identify factors associated with incident and recurrent depression. Among older adults with PUD and without a history of depression, approximately 1 in 8 (13.0%) developed depression for the first time during the COVID-19 pandemic. Among those with a history of depression, approximately 1 in 2 (46.6%) experienced depression during the pandemic. The risk of incident depression and recurrent depression was higher among those who were lonely, those with functional limitations, and those who experienced an increase in family conflict during the pandemic. The risk of incident depression only was higher among women, individuals whose income did not satisfy their basic needs, those who were themselves ill and/or those whose loved ones were ill or died during the pandemic, and those who had disruptions to healthcare access during the pandemic. The risk of recurrent depression only was higher among those with chronic pain and those who had difficulty accessing medication during the pandemic. Implications for interventions are discussed.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada
| | - Hannah Dolhai
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada
| | - Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada
| | - Grace Li
- Department of Sociology, University of Victoria, Victoria, British Columbia, Canada
| | - Ying Jiang
- Applied Research Division, Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Margaret De Groh
- Applied Research Division, Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Rao D, Stevenson B, Shiyanbola OO. Using the integrated theory of health behavior change to assess factors affecting diabetes medication adherence among black adults during COVID-19: an explanatory sequential mixed methods design. ETHNICITY & HEALTH 2023; 28:983-1005. [PMID: 37031348 DOI: 10.1080/13557858.2023.2198683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES (1) Evaluate changes in medication adherence and the role of psychosocial and interpersonal factors on adherence. (2) Explain the changes in medication adherence based on patient perceptions of adherence behaviors. DESIGN We used an explanatory sequential mixed methods design for surveys at baseline and 1-year follow-up, followed by interviews. The Integrated Theory of Health Behavior Change guided the design of a questionnaire including self-reported measures of medication adherence, psychosocial factors such as illness and medication beliefs, self-efficacy, and depressive symptoms, interpersonal factors including social support and patient-provider communication, and socio-demographic and clinical factors. A convenience sample (n = 228) of adult patients with type 2 diabetes who self-identified as Black/African American completed the mail/telephone surveys. Nine semi-structured interviews were conducted with respondents of both surveys who had changes in medication adherence. Descriptive, mean differential, bivariate correlational analyses, and content analysis was conducted. Data integration merged quantitative and qualitative results as a joint display. RESULTS Response rates for the baseline and follow-up survey were 28% and 47% respectively. Medication adherence scores were significantly correlated with illness perceptions (r = .30) and depression (r = .25) at baseline, and self-efficacy (r = -.51) and depression (r = .37) at follow-up. Qualitative themes included patient perceptions of adherence behaviors, impact of the COVID-19 pandemic, health literacy and self-efficacy. Mixed methods integration showed contrasting perceptions of the same themes including adherence behaviors, medication beliefs, social support, and patient-provider communication among participants whose medication adherence increased and decreased overtime. CONCLUSION Self-efficacy, diabetes beliefs, and depressive symptoms were key psychosocial factors that affected medication adherence among Blacks/African Americans. Contrasting perceptions of beliefs in medicines, social support, provider relationships and communication among increased and decreased adherence participant groups explained the changes in adherence, which can be used to adapt existing interventions.
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Affiliation(s)
- Deepika Rao
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
- Center for Technology and Behavioral Health, Dartmouth College, Hanover, USA
| | - Bailey Stevenson
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
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Hummel B, Yerkes MA, Harskamp RE, Galenkamp H, Kunst AE, Lok A, van Valkengoed IGM. The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study. SSM Popul Health 2023; 23:101432. [PMID: 37234865 PMCID: PMC10195766 DOI: 10.1016/j.ssmph.2023.101432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011-2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (-0.65 mmol/mol, -0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.
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Affiliation(s)
- Bryn Hummel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Mara A Yerkes
- Department of Interdisciplinary Social Sciences, Utrecht University, Heidelberglaan 8, 3584, CS, Utrecht, the Netherlands
| | - Ralf E Harskamp
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam University Medical Centre, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Irene G M van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
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Crnković I, Lončarek K, Železnik D, Ledinski Fičko S, Vlahović T, Režan R, Knežević G. Relationships between Physical Activity and Selected Chronic Diseases among Functionally Independent Long-Term Care Residents during the Post-Lockdown Period in Croatia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6301. [PMID: 37444148 PMCID: PMC10341333 DOI: 10.3390/ijerph20136301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/26/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023]
Abstract
The aim of this observational study was to investigate the level and association of physical activity and selected chronic diseases in functionally independent LTC residents after prolonged physical and social isolation during COVID-19 in Croatia. Adhering to the inclusion criteria, 180 functionally independent residents were included in the study. Assessment of physical activity was carried out by 7-day motor monitoring. Prolonged physical and social isolation negatively affected the achieved level of physical activity of LTC residents (x¯ = 5058.74). Major depressive disorder resulted in significantly lower residents' physical activity scores, demonstrating a shrinking effect ranging from 0.42 to 0.45. A significant negative impact on the residents' physical activity was also found in the presence of osteoarthritis and iron deficiency anemia, where a downward effect was present in the range from 0.66-0.72 and 0.64 to 0.66. The presence of comorbidities has a significant negative impact on the residents' physical activity, where a downward effect is present in the range from 0.91-0.92.
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Affiliation(s)
- Ivana Crnković
- Department of Physiotherapy, University of Applied Health Sciences, 10 000 Zagreb, Croatia
| | - Karmen Lončarek
- Department of Ophthalmology, Faculty of Medicine, University of Rijeka, 51 000 Rijeka, Croatia;
| | - Danica Železnik
- Faculty of Health and Social Sciences Slovenj Gradec, 2 380 Slovenj Gradec, Slovenia
| | - Sanja Ledinski Fičko
- Department of Nursing, University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10 000 Zagreb, Croatia
| | - Tomislav Vlahović
- Clinic for Traumatology, Clinical Hospital Center Sestre Milosrdnice, 10 000 Zagreb, Croatia
- Department of Clinical Medicine, University of Applied Health Sciences, 10 000 Zagreb, Croatia
| | - Robert Režan
- Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia
| | - Goran Knežević
- Faculty of Humanities and Social Sciences, University of Zagreb, 10 000 Zagreb, Croatia
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24
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Kline GA. Poorly Controlled Blood Pressure: The Virus and the Elephant. Mayo Clin Proc 2023; 98:644-646. [PMID: 37137636 PMCID: PMC10150204 DOI: 10.1016/j.mayocp.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/21/2023] [Indexed: 05/05/2023]
Affiliation(s)
- Gregory A Kline
- Division of Endocrinology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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25
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Narasimmaraj PR, Oseran A, Tale A, Xu J, Essien UR, Kazi DS, Yeh RW, Wadhera RK. Out-of-Pocket Drug Costs for Medicare Beneficiaries With Cardiovascular Risk Factors Under the Inflation Reduction Act. J Am Coll Cardiol 2023; 81:1491-1501. [PMID: 37045519 PMCID: PMC11129895 DOI: 10.1016/j.jacc.2023.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/02/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND High out-of-pocket prescription drug costs contribute to financial toxicity, medication nonadherence, and adverse cardiovascular (CV) outcomes. Policymakers recently passed the Inflation Reduction Act, which will cap Medicare out-of-pocket drug costs at $2,000/year and expand full low-income subsidies (LIS). It is unclear how these provisions will affect Medicare beneficiaries with CV risk factors and/or conditions. OBJECTIVES The authors sought to characterize the population of Medicare beneficiaries with CV risk factors/conditions experiencing out-of-pocket prescription drug costs >$2,000/year and estimate their potential savings under the Inflation Reduction Act's spending cap; identify sociodemographic characteristics associated with out-of-pocket costs >$2,000/year; and characterize beneficiaries newly eligible for LIS under the Inflation Reduction Act. METHODS This was a cross-sectional study of Medicare beneficiaries aged ≥65 years with ≥1 CV risk factor/condition from 2016 to 2019. RESULTS An annual estimated 34,056,335 ± 855,653 Medicare beneficiaries (mean ± SE) had ≥1 CV risk factor/condition, of whom 1,020,484 ± 77,055 experienced out-of-pocket drug costs >$2,000/year. The likelihood of experiencing out-of-pocket drug costs >$2,000/year was lower among adults ≥75 years vs 65 to 74 years (adjusted OR: 0.67; 95% CI: 0.49-0.93) and for low-income vs higher-income adults. Among beneficiaries currently spending >$2,000/year, estimated median out-of-pocket drug savings would be $855/year and total annual savings $1,723,031,307 ± $91,150,609 under the Inflation Reduction Act. An estimated 1,289,861 beneficiaries would also become newly eligible for LIS. CONCLUSIONS More than 1 million older adults with CV risk factors and/or conditions spend >$2,000/year out-of-pocket on prescription drugs and will likely benefit from the Inflation Reduction Act's cap, with estimated total out-of-pocket savings of $1.7 billion/year, while another 1.3 million will also become newly eligible for LIS.
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Affiliation(s)
- Prihatha R Narasimmaraj
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew Oseran
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA; Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Archana Tale
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Jiaman Xu
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Utibe R Essien
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Dhruv S Kazi
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Robert W Yeh
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Rishi K Wadhera
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
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Pittman J, Congdon HB, Rowe GC, Nathanson B, McShane P, Shields R. Piloting a Telehealth Interprofessional Diabetes Clinic During Covid 19: Continuing patient care and student learning. SOCIAL WORK IN HEALTH CARE 2023; 62:59-72. [PMID: 36907184 DOI: 10.1080/00981389.2023.2183927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Due to the COVID-19 pandemic, a team of faculty from dietetics, nursing, pharmacy, and social work converted a long-standing effective Interprofessional Team Care Clinic (IPTCC) at two outpatient health centers to a telehealth clinic during 2020 and 2021. Preliminary data suggest that this pilot telehealth clinic for patients with diabetes or prediabetes was effective in significantly lowering average hemoglobin A1C levels and increasing students' perceived interprofessional skills. This article describes the pilot telehealth interprofessional model used to educate students and provide patient care, outlines preliminary data about its effectiveness, and makes recommendations for future research and practice.
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Affiliation(s)
- Joan Pittman
- School of Social Work, University of Maryland Baltimore, Baltimore, Maryland, United States
| | - Heather Brennan Congdon
- University of Maryland Baltimore School of Pharmacy, Center for Interprofessional Education, University of Maryland, Baltimore, Maryland, United States
| | - Gina C Rowe
- Doctor of Nursing Practice Program, Texas A&M University School of Nursing, Bryan, Texas, United States
| | - Barbara Nathanson
- School of Social Work, University of Maryland Baltimore, Baltimore, Maryland, United States
| | - Phyllis McShane
- Nutrition and Food Science, University of Maryland College Park, College Park, Maryland, United States
| | - Rhonique Shields
- Medical Affairs and Practice Operations, Holy Cross Health Network, Gaithersburg, Maryland, United States
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Gómez-Escalonilla Lorenzo S, Martínez I, Notario Pacheco B. Influence of COVID-19 on treatment adherence and psychological well-being in a sample of hypertensive patients: a cross-sectional study. BMC Psychiatry 2023; 23:121. [PMID: 36823568 PMCID: PMC9947937 DOI: 10.1186/s12888-022-04473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 12/14/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic has caused a global health crisis. This situation has affected the general population, especially the most vulnerable populations such as individuals with cardiovascular diseases. The main objective of this study was to analyse adherence to treatment and psychological well-being in hypertensive patients before and after the COVID-19 lockdown in Spain. METHODS A cross-sectional study was performed in a Basic Health Area of Toledo, Spain. Adherence and psychological well-being (resilience, self-esteem, and health-related quality of life [HRQoL]) were measured in hypertensive patients, a group of patients before the COVID-19 lockdown and, in another group after the COVID-19 lockdown using a heteroadministered and anonymous questionnaire. A factorial multivariate analysis of variance (MANOVA) was applied for the outcome variables using pre- and post-COVID-19 lockdown assessment, gender, and age (< 65 years-old vs. ≥ 65 years-old) as independent variables. Univariate F follow-up tests were conducted within the multivariate significant overall differences. RESULTS The sample of the present study included 331 hypertensive patients. The mean age was 67.68 years (SD = 10.94). Women comprise 53.5% of the sample and men account for the remaining 46.5%. A total of 144 questionnaires were collected before the COVID-19 pandemic and 187 questionnaires were collected after the onset of the pandemic and once the lockdown was over. MANOVA showed significant main effects for pandemic lockdown (F = 13.383, p < 0.001,) age group (F = 3.74, p = 0.003) and gender (F = 8.85, p < 0.001). Therapeutic adherence decreased after the lockdown (F = 15.393, p < 0.001). However, scores on resilience (F = 17.771, p < 0.001), self-esteem (F = 4.789, p = 0.029), and physical component of HRQoL (F = 13.448, p < 0.001) increased after the lockdown. Regarding age, the univariate test showed a significant effect for the physical component of HRQoL, with scores decreasing in those aged ≥ 65 years (F = 9.375, p = 0.002). Regarding gender, women scored lower on resilience (F = 20.280 p < 0.001), self-esteem (F = 18.716, p < 0.001), the physical component of HRQoL (F = 5.722, p = 0.017), and the mental component of HRQoL (F = 28.912, p < 0.001). CONCLUSIONS The COVID-19 pandemic had a negative effect on treatment adherence of hypertensive patients in Spain. However, variables related to psychological well-being have increased in these patients, which may serve as a protective factor against pandemic stress.
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Affiliation(s)
| | - Isabel Martínez
- grid.8048.40000 0001 2194 2329Department of Psychology, University of Castilla-La Mancha, Cuenca, Spain
| | - Blanca Notario Pacheco
- grid.8048.40000 0001 2194 2329Universidad of Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain ,grid.8048.40000 0001 2194 2329Universidad of Castilla-La Mancha, Social and Health Research Center, Cuenca, Spain
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28
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Li Y, Xu S, Yin J, Huang G. Effect of air pollution on adult chronic diseases: Evidence from a quasi-natural experiment in China. Front Public Health 2023; 10:1105965. [PMID: 36711355 PMCID: PMC9880427 DOI: 10.3389/fpubh.2022.1105965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
We utilize a quasi-experiment derived from China's Huai River policy to investigate the effect of air pollution on adult chronic diseases. The policy led to higher pollution exposure in cities north of the river boundary because they received centralized coal-based heating supply from the government during winter, whereas cities in the south did not. By applying a geographic regression discontinuity design based on distance from the Huai River, we determine that a 10 μg/m3 increase in fine particulate matter (PM2.5) raises chronic diseases rates by 3.2% in adults, particularly cardiorespiratory system diseases. Furthermore, the same effects are observed on multiple chronic disease rates, but the rates are reduced to 1.3%. The effect of pollution exposure varies depending on age, gender, and urban/rural status. Our findings imply that reducing 10 μg/m3 of the average nationwide level of PM2.5 concentration will save 27.46 billion CNY (4.16 billion USD) in chronic disease costs.
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Affiliation(s)
- Yan Li
- College of Management, Guangdong AIB Polytechnic, Guangzhou, China
| | - Sheng Xu
- School of Health Management, Southern Medical University, Guangzhou, China,*Correspondence: Sheng Xu ✉
| | - Jinghua Yin
- School of Insurance, Guangdong University of Finance, Guangzhou, China,Department of Economics, Jinan University, Guangzhou, China
| | - Guan Huang
- Wenlan School of Business, Zhongnan University of Economics and Law, Wuhan, China
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29
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Impact of COVID-19 pandemic on medication use in the older Italian population. Aging Clin Exp Res 2023; 35:443-453. [PMID: 36469252 PMCID: PMC9734516 DOI: 10.1007/s40520-022-02303-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aims to analyse the impact of the pandemic on the amount of use and new medication dispensation for chronic diseases in the Italian population aged 65 years and older (almost 14 million inhabitants). METHODS The "Pharmaceutical Prescriptions database", which gathers data on medications, reimbursed by the National Health Service and dispensed by community pharmacies, was employed. Data were analysed as amount of use (defined daily dose-DDD per 1000 inhabitants); variation in DDD between 2020 and 2019 was calculated for the 30 categories with major consumption in 2020. Trends in prevalence and incidence of dispensations between 2020 and 2019 were calculated for four categories: antidiabetics, antihypertensives, antidepressants and drugs for respiratory diseases. RESULTS All medications showed a negative variation in DDD/1000 inhabitants between 2020 and 2019 except for anticoagulants (+ 5%). The percentage variation ranged from - 27.7% for antibiotics to - 6.4% for antipsychotics in 85 + year-old persons, but increased for most classes in the youngest (65-69 years). On the other hand, a decrease of the dispensation incidence of antidiabetics, antihypertensives, antidepressants and drugs for pulmonary disease was high, especially in the two extreme age groups, the youngest and the oldest one. CONCLUSIONS AND RELEVANCE Great variation in medication use between 2020 and 2019 was observed probably reflecting the low rate of infectious diseases due to the widespread use of protective devices and self-isolation, reduced healthcare access because of the lockdowns and the fear of going to hospital, and the reduction of screening and diagnostics due to health-care system overload.
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30
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Bartlett Ellis RJ, Andrews A, Elomba CD, Remy LM, Ruggeri SY, Russell CL, Ruppar TM. Managing Medications and Medication Adherence Among US Adults During the Early Phase of the COVID-19 Pandemic. Patient Prefer Adherence 2023; 17:369-383. [PMID: 36819643 PMCID: PMC9930569 DOI: 10.2147/ppa.s393749] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/25/2023] [Indexed: 02/13/2023] Open
Abstract
PURPOSE Before the COVID-19 pandemic and the disruptions it brought, medication adherence was already a challenging and complex health behavior. The purpose of this study was to describe patients' interactions in clinic, pharmacy, and home contexts and associated medication management and adherence during the early phase of the COVID-19 pandemic. PATIENTS AND METHODS A survey questionnaire was developed using the Medication Adherence Context and Outcomes framework and distributed via social media between May and July 2020 targeting adults taking a daily prescribed medication. Survey questions assessed sociodemographics, interactions with healthcare providers, clinics, pharmacies, medication management experiences, habit strength, and life chaos perceptions during the pandemic. Medication adherence was assessed by the self-report BAASIS© scale to measure implementation, discontinuation, and overall nonadherence. RESULTS A total of 134 adults from the United States, mean age 50.0 (SD 16.1) years were included in this analysis. Respondents took a median of 3.50 (interquartile range 4) daily medications. Delays in seeing a provider were reported by 47 (35.1%). Pharmacy encounters were impacted; 25 (18.7%) indicated their method for obtaining medication changed. Medication nonadherence was reported among 62 (46.3%) and was significantly greater among those who delayed prescription refills (p=0.032), pillbox users (p=0.047), and those who experienced greater life chaos (p=0.040) and lower habit strength (p<0.001) in the early phase of the pandemic. CONCLUSION Although the early phase of the pandemic affected access to care for nearly one-third of the sample, distance-accessible care options and strategies to obtain needed services without being in-person supported respondents medication management. Helpful strategies included provider accessibility, telehealth, home delivery/mail-order, drive-thru's, 90-day supplies, and online/automatic refills. Methods to develop and reestablish habits are critical. Care providers in clinic and pharmacy settings can educate and remind patients about services like distance-accessible technologies and online ordering of medications and establishing routines to support medication adherence.
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Affiliation(s)
- Rebecca J Bartlett Ellis
- Science of Nursing Care Department, Indiana University, Indianapolis, IN, USA
- Correspondence: Rebecca J Bartlett Ellis, Science of Nursing Care Department, Indiana University, 600 Barnhill Drive, NU 120, Indianapolis, IN, 46202, USA, Tel +1 317 274 0047, Email
| | - Angela Andrews
- Primary Care and Health Systems, Southern Illinois University-Edwardsville, Edwardsville, IL, USA
| | - Charles D Elomba
- Science of Nursing Care Department, Indiana University, Indianapolis, IN, USA
| | | | - Sunny Yoo Ruggeri
- School of Nursing and Health Studies, Kansas City, Missouri, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Cynthia L Russell
- School of Nursing and Health Studies, Kansas City, Missouri, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Todd M Ruppar
- Department of Adult Health and Gerontological Nursing, Rush University, Chicago, IL, USA
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31
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Maeda M, Hasegawa Y, Tsukioka R, Oishi M. [Effect of a Family Pharmacist System on Medication Adherence of Patients with Dyslipidemia during a COVID-19 Epidemic]. YAKUGAKU ZASSHI 2023; 143:765-775. [PMID: 37661442 DOI: 10.1248/yakushi.23-00068] [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] [Indexed: 09/05/2023]
Abstract
The pharmacy pharmacist's function as a family pharmacist is expected to improve adherence to medication in patients suffering from chronic diseases, including dyslipidemia. This is true even in infectious disease epidemics. In this study, using anonymously processed receipt data from 700 insurance pharmacies in our group, we evaluated medication adherence in patients taking statin drugs before, during the first and second years of coronavirus disease 2019 (COVID-19) epidemic in terms of medication persistence and medication possession, and compared the results between the family pharmacist group (FP group) and non-family pharmacist group (NoFP group). The odds ratios of good medication adherence (medication persistence and medication possession) rates for the FP group relative to the NoFP group were 1.446 [95% confidence interval (CI): 1.210-1.727] in the pre-epidemic period, 1.428 (1.192-1.710) in the first year of the epidemic, and 1.270 (1.113-1.450) in the second year of the epidemic. The FP group was significantly higher in all time periods. Therefore, it is suggested that the family pharmacist function improves adherence to statins not only before but also during the COVID-19 epidemic.
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Olmastroni E, Galimberti F, Catapano AL, Tragni E, Casula M. Beta-blockers in post-acute myocardial infarction patients: Drug prescription patterns from 2018 to Italy's first wave of the COVID-19 pandemic. Front Pharmacol 2022; 13:1040710. [PMID: 36569305 PMCID: PMC9768333 DOI: 10.3389/fphar.2022.1040710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Major guidelines recommend the initiation of a beta-blocker therapy after an acute myocardial infarction (AMI). We aimed to map the treatment pathway of beta-blockers for AMI survivors during the first wave of COVID-19 pandemic in Italy and to investigate predictors for treatment non-initiation. Methods: Healthcare utilization databases of Lombardy Region were investigated. Subjects aged ≥18 years who were hospitalised with AMI in the period February-March-April of 2018, 2019, and 2020 were included, and followed for 30 days from the discharge date, to investigate whether they presented a first prescription of beta-blockers. A multivariate logistic model was performed to evaluate the effect of several covariates on the probability of not receiving a post-AMI beta-blocker therapy. Results: The cohorts comprised 2259, 2383, and 1932 individuals who were hospitalised with AMI in the 3-month period in 2018, 2019, and 2020, respectively. Overall in 2020, about 58-60% of individuals with AMI received a prescription of beta-blockers within 1 month after the discharge. A continuous decreasing trend over time was observed. Men were 30% more likely to start the treatment than women, increasing age was associated with significant increasing probability of not receiving a post-infarction beta-blocker therapy, while having received an antihypertensive or lipid-lowering treatment, or having been hospitalized for heart failure prior to the AMI hospitalization reduced the likelihood of not being treated with beta-blockers. Conclusion: The initiation of beta-blocker treatment after AMI remains an under-prescribed practice, that does not seem to have been further affected by the first wave of the COVID-19 pandemic.
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Affiliation(s)
- Elena Olmastroni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy,*Correspondence: Elena Olmastroni,
| | | | - Alberico L. Catapano
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy,IRCCS MultiMedica, Sesto S. Giovanni, MI, Italy
| | - Elena Tragni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Manuela Casula
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy,IRCCS MultiMedica, Sesto S. Giovanni, MI, Italy
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Fenton D, Choi NK, Garcia NM, Dyer EC, Cohen NA, Rubin DT. Factors Associated With Fecal Calprotectin Sample Collection Compliance: An IBD Center Quality Improvement Project. CROHN'S & COLITIS 360 2022; 4:otac042. [PMID: 36778515 PMCID: PMC9802166 DOI: 10.1093/crocol/otac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Indexed: 12/05/2022] Open
Abstract
Background Fecal calprotectin (Fcal) is a noninvasive, inexpensive biomarker of disease activity. However, patient compliance with this test is variable and incompletely described. We assessed compliance rates with Fcal tests and identified factors associated with noncompliance. Methods A retrospective chart review of patients with inflammatory bowel disease (IBD) who had a Fcal test ordered through our center between August 2021 and December 2021 was conducted. Demographic, clinical, disease, and test-related information were recorded. Patients with incomplete Fcal orders were sent a survey to better understand their reasons for noncompliance. Simple statistical analysis and and multivariable logistic regression modeling were performed. Results Of 303 patients, 165 (54.4%) had an order for Fcal. Of the Fcal tests ordered, 55 (33.3%) were not completed. Remission of IBD, no prior Fcal completion, and tests ordered at a distant site were all associated with test noncompletion. A multivariable logistic regression revealed that history of a prior completed Fcal test is associated with subsequent test completion (odds ratio = 2.1, 95% confidence interval 1.9-35.5, P = .004). Patients who did not complete the test described the pandemic and third-party testing center issues as the most common reasons for noncompliance. Conclusions In this single center experience with Fcal testing in patients with IBD, we identified that a history of incomplete Fcal testing and distant location of lab testing were significantly associated with noncompletion of the test. We provide practical guidance for future utilization and compliance, including the impact of home-based testing.
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Affiliation(s)
- David Fenton
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Natalie K Choi
- Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois, USA
| | - Nicole M Garcia
- Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois, USA
| | - Emma C Dyer
- Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois, USA
| | | | - David T Rubin
- Address correspondence to: David T. Rubin, MD, University of Chicago, Section of Gastroenterology, Digestive Diseases Center, 5841 South Maryland Ave, MC 4076, Chicago, IL 60637, USA ()
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Medication Adherence in Medicare-Enrolled Older Adults with Chronic Obstructive Pulmonary Disease before and during the COVID-19 Pandemic. J Clin Med 2022; 11:jcm11236985. [PMID: 36498558 PMCID: PMC9741303 DOI: 10.3390/jcm11236985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Medication adherence to controller inhalers was unknown in older Medicare patients with chronic obstructive pulmonary disease (COPD) before and during the pandemic. This study evaluated changes in medication adherence to controller medications and factors associated with high adherence. This retrospective cohort study included older Medicare patients with COPD. The proportion of days covered (PDC) reflected changes in medication adherence from January to July in 2019 and in 2020. Paired t-test evaluated changes in adherence. Logistic regression determined the association of patient characteristics with high adherence (PDC ≥ 80%). Mean adherence decreased (p < 0.001) for long-acting beta-agonists, long-acting muscarinic antagonists, and inhaled corticosteroids in 2020. The percentage of patients with high adherence dropped from 74.4% to 58.1% (p < 0.001). The number of controllers, having ≥3 albuterol fills, and a 90-day supply were associated with high adherence in 2019 and 2020 (p < 0.001). The COVID-19 pandemic may negatively impact medication adherence. Patients with evidence of more severe diseases and a 90-day supply were more likely to adhere to therapy. Healthcare professionals should prioritize prescribing 90-day supplies of medications and monitor drug-related problems as components of pharmacovigilance to enhance adherence to therapies and the desired clinical outcomes among patients with COPD.
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Delgado MXL, González ÁRA, Reyes LAB, Campos LFR, Ángel LFV, Rodríguez LIH, Granados MAL, Salazar LVG. [Grief and palliative home-care services for patients at the end of life during the COVID-19 pandemic in Colombia. Analysis from the relatives´ perspective]. REVISTA COLOMBIANA DE PSIQUIATRIA 2022:S0034-7450(22)00116-0. [PMID: 36311343 PMCID: PMC9595366 DOI: 10.1016/j.rcp.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION End-of-life care is one of the most crucial experiences for both the patient and their loved ones. However, as a result of the changes generated by the COVID 19 pandemic, the dynamics of the end-of-life process has undergone changes at both the family, social and health levels. In turn, this has altered the perception and development of the grief of relatives of patients who died during the pandemic regardless of the cause of death. Then, the aim of this study is to analyze the perceptions and some aspects of bereavement of died patients` relatives during the pandemic of Covid 19. METHODS Through the admission evaluation and follow-up of the relatives with an adapted version of the international Care Of the Dying Evaluation (iCODE) questionnaire. RESULTS 239 relatives were surveyed, of which 112 completed the follow-up questionnaire. Most of the patients died at home and their family members were highly involved in their care. Medical attention was considered adequate and the symptom with the highest perception was pain. 87% of those surveyed participated in funeral rites, and 42% rated them as very sober. Regarding grief, the scale of personal growth predominates, however, in the negative aspects, the feeling of pressure in the chest and frequent crying predominates. CONCLUSIONS The end of life of home-care patients during the pandemic was perceived as adequate, allowing family support and symptom control. The grieving process shows no complications. The training of health professionals in these fundamental aspects of patient care is important.
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Affiliation(s)
- Marta Ximena León Delgado
- Médica Anestesióloga, especialista en Dolor y Cuidados Paliativos, Jefe del Departamento de Anestesia, Dolor y Cuidados Paliativos, Profesora Titular Facultad de Medicina Universidad de la Sabana, Chía, Colombia
| | - Ángela Rocío Acero González
- Médica Psiquiatra, MMF, PhD, Profesora asistente, Grupo de Investigación Psiquiatría y Salud Mental, Departamento de Psiquiatría, Facultad de Medicina, Universidad de La Sabana, Chía, Colombia
| | - Lina Angélica Buitrago Reyes
- Estadística, MSc en Epidemiología Clínica, PhD(c) en Ciencias-Estadística. Universidad Nacional de Colombia. Facultad de Ciencias. Departamento de Estadística, Colombia
| | - Luisa Fernanda Rodríguez Campos
- Médica Familiar y Comunitaria, especialista en Dolor y Cuidados Paliativos, profesora asistente Departamento de Anestesia, Dolor y Cuidados Paliativos, Facultad de Medicina, Universidad de La Sabana, Chía, Colombia
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Zhu Y, Liu Y, Jiang H. Geriatric Health Care During the COVID-19 Pandemic: Managing the Health Crisis. Clin Interv Aging 2022; 17:1365-1378. [PMID: 36158515 PMCID: PMC9491878 DOI: 10.2147/cia.s376519] [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: 05/28/2022] [Accepted: 08/20/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 pandemic significantly threatens the health and well-being of older adults. Aging-related changes, including multimorbidity, weakened immunity and frailty, may make older people more susceptible to severe infection and place them at higher risk of morbidity and mortality from COVID-19. Various quarantine measures have been implemented to control the spread of COVID-19. Nevertheless, such social distancing has disrupted routine health care practices, such as accessibility of medical services and long-term continuous care services. The medical management of older adults with multimorbidity is significantly afflicted by COVID-19. Older persons with frailty or multiple chronic disease may poorly adapt to the altered health care system, having detrimental consequences on their physical and mental health. COVID-19 pandemic has posed great challenges to the health of older adults. We highlighted the difficulties and obstacles of older adults during this unprecedented time. Also, we provided potential strategies and recommendations for actions to mitigate the COVID-19 pandemic threats. Certain strategies like community primary health care, medication delivery and home care support are adopted by many health facilities and caregivers, whereas other services such as internet hospital and virtual medical care are promoted to be accessible in many regions. However, guidelines and policies based on high-quality data are still needed for better health promotion of older groups with increasing resilience during the COVID-19 pandemic.
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Affiliation(s)
- Yingqian Zhu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
| | - Yue Liu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
| | - Hua Jiang
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
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Casula M, Galimberti F, Iommi M, Olmastroni E, Rosa S, Altini M, Catapano AL, Tragni E, Poluzzi E. Impact of the COVID-19 Pandemic on the Therapeutic Continuity among Outpatients with Chronic Cardiovascular Therapies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912101. [PMID: 36231403 PMCID: PMC9566639 DOI: 10.3390/ijerph191912101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 05/13/2023]
Abstract
The COVID-19 pandemic poses major challenges to healthcare systems. We aimed to investigate the impact of the pandemic on prescription and adherence patterns of chronic cardiovascular therapies (lipid-lowering [LL], oral antidiabetic drugs [AD], and antihypertensives [AH]) using administrative pharmaceutical databases. For each treatment, two cohorts of prevalent cases in 2019 and 2020 were compared. We evaluated the percentage change in dispensed packages and treatment adherence as a proportion of days covered (PDC). For all therapies, an increase was observed during March-April 2020 (LL: +4.52%; AD: +2.72%; AH: +1.09%), with a sharp decrease in May-June 2020 (LL: -8.40%; AD: -12.09%; AH: -10.54%) compared to 2019. The impact of the COVID-19 pandemic on chronic cardiovascular treatments appears negligible on adherence: 533,414 patients showed high adherence to LL (PDC ≥ 80%) in January-February 2020, and 2.29% became poorly adherent (PDC < 20%) in the following four-month period (vs. 1.98% in 2019). A similar increase was also observed for AH (1.25% with poor adherence in 2020 vs. 0.93% in 2019). For AD, the increase was restrained (1.55% with poor adherence in 2020 vs. 1.37% in 2019). The rush to supply drugs at the beginning of lockdown preserved the continuity of chronic cardiovascular therapies.
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Affiliation(s)
- Manuela Casula
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
- IRCCS MultiMedica, Via Milanese 300, Sesto S. Giovanni, 20099 Milan, Italy
| | | | - Marica Iommi
- Department of Medical and Surgical Sciences-Pharmacology Unit, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Elena Olmastroni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
- Correspondence:
| | - Simona Rosa
- Department of Biomedical and Neuromotor Sciences-Hygiene and Biostatistics Unit, University of Bologna, Via San Giacomo, 40126 Bologna, Italy
| | - Mattia Altini
- Romagna Local Health Authority, Emilia-Romagna Region, Via A. De Gasperi 8, 48121 Ravenna, Italy
| | - Alberico L. Catapano
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
- IRCCS MultiMedica, Via Milanese 300, Sesto S. Giovanni, 20099 Milan, Italy
| | - Elena Tragni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Elisabetta Poluzzi
- Department of Medical and Surgical Sciences-Pharmacology Unit, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
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COVID-19 and Cardiometabolic Health: Lessons Gleaned from the Pandemic and Insights for the Next Wave. Curr Atheroscler Rep 2022; 24:607-617. [PMID: 35773565 PMCID: PMC9247906 DOI: 10.1007/s11883-022-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/24/2022]
Abstract
Purpose of Review
To review the current evidence regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiometabolic health, with a focus on strategies to help mitigate adverse effects on population health. Recent Findings Individuals with cardiometabolic disease are particularly vulnerable to worse outcomes with COVID-19 infection. In addition, the pandemic itself has had significant deleterious impact on the cardiometabolic health of the population, including declines in physical activity, increases in smoking and alcohol use, worsening blood pressure and glycemic control, and detrimental effects on mental health. Targeted interventions at the patient and community level will be needed to mitigate the long-term consequences of the COVID-19 pandemic on population cardiometabolic health. Summary The COVID-19 pandemic has worsened cardiometabolic health, but there are several opportunities and enhanced tools available to counteract these changes.
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Tang L, Gao Y, Qi S, Cui J, Zhou L, Feng Y. Prevalence of post-traumatic stress disorder symptoms among patients with mental disorder during the COVID-19 pandemic. BMC Psychiatry 2022; 22:156. [PMID: 35232421 PMCID: PMC8886345 DOI: 10.1186/s12888-022-03790-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic has caused extensive public health concerns, posing significant challenges to healthcare services. One particular area of concern is the mental health of patients with mental disorder, who are often a neglected group. The aim of this study was to investigate the prevalence of, and associated factors for symptoms of post-traumatic stress disorder (PTSD) among patients with mental disorder in China during the COVID-19 pandemic. METHODS Self-reported questionnaires were distributed to patients in four psychiatric hospitals in Beijing, China, between April 28th and May 30th, 2020. Information regarding sociodemographic characteristics, COVID-19 related factors, support, psychosomatic factors, and PTSD symptoms were collected using a series of scales, such as the Impact of Event Scale-Revised, the 7-item Generalized Anxiety Disorder Scale, the 9-item Patient Health Questionnaire depression scale, and so on. Multivariate regression was used to identify factors related to PTSD symptoms. RESULTS A total of 1,055 patients with mental disorder were included in the final sample. The prevalence of PTSD symptoms was 41.3%. Hierarchical linear regression demonstrated that fear of the pandemic and anxiety were shared associated factors for both symptoms of PTSD and their subscales. Additionally, age was an associated factor for the total PTSD (β = 0.12, p < 0.01), intrusion (β = 0.18, p < 0.001), and avoidance (β = 0.1, p < 0.05) symptoms; depression was an associated factor for the total PTSD (β = 0.13, p < 0.001), intrusion (β = 0.11, p < 0.01), and hyperarousal (β = 0.19, p < 0.001) symptoms. CONCLUSIONS The prevalence of PTSD symptoms was high among patients with mental disorder during the COVID-19 pandemic in China. This study found that age, fear of the pandemic, anxiety and depression are significant associated factors of PTSD symptoms in patients with mental disorder during the pandemic. We call for higher awareness and introduction of PTSD interventions to relieve the psychological stress in these patients.
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Affiliation(s)
- Lirong Tang
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yue Gao
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Shuangyi Qi
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jie Cui
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Zhou
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, 39 South College Road, Haidian District, 100081, Beijing, China. .,Faculty of Psychology, Beijing Normal University, Beijing, China.
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Ahoto AT, Wang W. Effects of COVID-19 Outbreak on Persons with Chronic Health Conditions in Anglophone West Africa: A Qualitative Study Involving Key Stakeholders. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221092830. [PMID: 35522190 PMCID: PMC9083033 DOI: 10.1177/00469580221092830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has increased the suffering of persons with chronic health conditions due to the increased demand for healthcare services in the pandemic. Globally, the COVID-19 pandemic has become a key determinant of how health systems function, with most existing health conditions being given less attention. This study focused on the effects of the COVID-19 pandemic on persons with chronic diseases in four Anglophone West African countries (Ghana, Liberia, Nigeria, and Sierra Leone) using in-depth interviews of a qualitative method to collect data from key stakeholders in chronic disease issues. The finding shows that COVID-19 caused fear, anxiety, and affected planned health delivery and resource location to interventions designed for chronic disease patients. The study also suggested training, improved technology in health delivery, increased resource location, and factoring persons with chronic health conditions into emergency health decision-making to mitigate the effects of COVID-19 and other future pandemics on persons with chronic health conditions.
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Affiliation(s)
| | - WenXin Wang
- Department of Public Administration, Law School/ Institute of Local Government Development, Shantou University, Shantou, China
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