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Vu TT, Weiss M, Nguyen LTH, Tran HT, Ho HT, Ngo VK. Adult cancer patients' barriers to and satisfaction with care at a National Cancer Hospital in Vietnam. PLoS One 2024; 19:e0303157. [PMID: 38722943 PMCID: PMC11081246 DOI: 10.1371/journal.pone.0303157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/03/2024] [Indexed: 05/13/2024] Open
Abstract
STUDY OBJECTIVE This study assessed the overall satisfaction with oncological care, including barriers to care, and identified its associated predictors among adult cancer patients in Vietnam. METHODS In this cross-sectional study, we enrolled 300 adult cancer patients receiving inpatient care at a large urban oncological hospital between June and July 2022. Multivariable linear regression analyses examined associations between patient experiences and overall satisfaction ratings with cancer care. RESULTS The mean overall satisfaction with oncological care was 8.82 out of 10, with 98.0% recommending this facility to their friends and family. In an adjusted model, being female (β = 0.29, 95%CI: 0.04, 0.53), endorsing satisfaction with patient-nurse communication (β = 0.33, 95%CI: 0.13, 0.53), patient-doctor communication (β = 0.40, 95%CI: 0.11, 0.70), and psychoeducation about oncological medication management (β = 0.30, 95%CI: 0.14, 0.45) were positively associated with overall ratings. In contrast, individuals with delays in treatment scheduling reported lower overall satisfaction with oncological care (β = -0.38, 95%CI: -0.64, -0.13). Patients perceived health system, social/environmental, and individual barriers to care: worries about income loss due to attending treatment (43.3%); fear, depression, anxiety, and distress (36.8%); concerns about affordability of treatment (36.7%) and transportation problems (36.7%); and excessive waiting times for appointments (28.8%). CONCLUSION This study showed high overall patient satisfaction with cancer care quality. Patient-centered communication strategies and psychoeducation about oncological medication management may be targeted to further enhance the cancer inpatient experience. Raising awareness about treatment options and services, and integrating mental health awareness into oncological care may ameliorate patient distress and facilitate greater satisfaction with oncological treatment processes.
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Affiliation(s)
- Thinh Toan Vu
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, United States of America
- Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, United States of America
| | - Marina Weiss
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, United States of America
| | | | | | - Hien Thi Ho
- Hanoi University of Public Health, Hanoi, Vietnam
| | - Victoria Khanh Ngo
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, United States of America
- Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, United States of America
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He T, Cui W, Feng Y, Li X, Yu G. Digital health integration for noncommunicable diseases: Comprehensive process mapping for full-life-cycle management. J Evid Based Med 2024; 17:26-36. [PMID: 38361398 DOI: 10.1111/jebm.12583] [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: 10/30/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024]
Abstract
AIM To create a systematic digital health process mapping framework for full-life-cycle noncommunicable disease management grounded in key stakeholder engagement. METHODS A triphasic, qualitative methodology was employed to construct a process mapping framework for digital noncommunicable disease management in Shanghai, China. The first phase involved desk research to examine current guidance and practices. In the second phase, pivotal stakeholders participated in focus group discussions to identify prevalent digital touchpoints across lifetime noncommunicable disease management. In the final phase, the Delphi technique was used to refine the framework based on expert insights and obtain consensus. RESULTS We identified 60 digital touchpoints across five essential stages of full-life-cycle noncommunicable disease management. Most experts acknowledged the rationality and feasibility of these touchpoints. CONCLUSIONS This study led to the creation of a comprehensive digital health process mapping framework that encompasses the entire life cycle of noncommunicable disease management. The insights gained emphasize the importance of a systemic strategic, person-centered approach over a fragmented, purely technocentric approach. We recommend that healthcare professionals use this framework as a linchpin for efficient disease management and seamless technology incorporation in clinical practice.
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Affiliation(s)
- Tianrui He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbin Cui
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxuan Feng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingyi Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangjun Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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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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Keshri VR, Abimbola S, Parveen S, Mishra B, Roy MP, Jain T, Peden M, Jagnoor J. Navigating health systems for burn care: Patient journeys and delays in Uttar Pradesh, India. Burns 2023; 49:1745-1755. [PMID: 37032275 DOI: 10.1016/j.burns.2023.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND India has one of the highest burden of burns. The health systems response to burn care is sometimes patchy and highly influenced by social determinants. Delay in access to acute care and rehabilitation adversely affects recovery outcomes. Evidence on underlying factors for delays in care are limited. In this study, we aim to explore patients' journeys to analyse their experiences in accessing burn care in Uttar Pradesh, India. METHODS We conducted qualitative inquiry using the patient journey mapping approach and in-depth interviews (IDI). We purposively selected a referral burn centre in Uttar Pradesh, India and included a diverse group of patients. A chronological plot of the patient's journey was drawn and confirmed with respondents at the end of the interview. A detailed patient journey map was drawn for each patient based on interview transcripts and notes. Further analysis was done in NVivo 12 using a combination of inductive and deductive coding. Similar codes were categorised into sub-themes, which were distributed to one of the major themes of the 'three delays' framework. RESULTS Six major burns patients (4 female and 2 males) aged between 2 and 43 years were included in the study. Two patients had flame burns, and one had chemical, electric, hot liquid, and blast injury, respectively. Delay in seeking care (delay 1) was less common for acute care but was a concern for rehabilitation. Accessibility and availability of services, costs of care and lack of financial support influenced delay (1) for rehabilitation. Delay in reaching an appropriate facility (delay 2) was common due to multiple referrals before reaching an appropriate burn facility. Lack of clarity on referral systems and proper triaging influenced this delay. Delay in getting adequate care (delay 3) was mainly due to inadequate infrastructure at various levels of health facilities, shortage of skilled health providers, and high costs of care. COVID-19-related protocols and restrictions influenced all three delays. CONCLUSIONS Burn care pathways are adversely affected by barriers to timely access. We propose using the modified 3-delays framework to analyse delays in burns care. There is a need to strengthen referral linkage systems, ensure financial risk protection, and integrate burn care at all levels of health care delivery systems.
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Affiliation(s)
- Vikash Ranjan Keshri
- The George Institute for Global Health, India; The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia; The George Institute for Global Health, Sydney, Australia
| | - Samina Parveen
- The George Institute for Global Health, India; Ipas Development Foundation, New Delhi, India
| | - Brijesh Mishra
- Department of Plastic Surgery, King George's Medical University, Lucknow, India
| | - Manas Pratim Roy
- Directorate General of Health Services, Ministry of Health and Family Welfare, New Delhi, India
| | - Tanu Jain
- Directorate General of Health Services, Ministry of Health and Family Welfare, New Delhi, India
| | - Margie Peden
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health, London, United Kingdom; School of Public Health, Imperial College London, United Kingdom
| | - Jagnoor Jagnoor
- The George Institute for Global Health, India; The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
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Amir A, Alasnag M, Al-Raddadi R, Al-Bassam T, Saeed K, Yazıcıoğlu M, Shabana A. Patient journey for hypertension and dyslipidemia in Saudi Arabia: highlighting the evidence gaps. Arch Public Health 2023; 81:122. [PMID: 37400868 DOI: 10.1186/s13690-023-01121-3] [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: 07/04/2022] [Accepted: 05/30/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND In recent years, Saudi Arabia has witnessed staggering rates of hypertension and dyslipidemia-related cardiovascular (CV) deaths, overburdening the healthcare ecosystem of the country. Appropriate public health interventions can be devised through quantitative mapping of evidence. Identification of potential data gaps can prioritize future research needs and develop a 'best-fit' framework for patient-centric management of hypertension and dyslipidemia. METHODS This review quantified data gaps in the prevalence and key epidemiological touchpoints of the patient journey including awareness, screening, diagnosis, treatment, adherence, and control in patients with hypertension and dyslipidemia in Saudi Arabia. Studies published in English between January 2010 and December 2021 were identified through a structured search on MEDLINE, Embase, BIOSIS, and PubMed databases. An unstructured search on public and government websites, including Saudi Ministry of Health, without date limits was carried out to fill data gaps. After exclusion of studies based on predefined criteria, a total of 14 studies on hypertension and 12 studies and one anecdotal evidence for dyslipidemia were included in the final analyses. RESULTS The prevalence of hypertension was reported to be 14.0%-41.8% while that for dyslipidemia was 12.5%-62.0%. The screening rate for hypertension was 100.0% as revealed by the nationwide surveys. Among hypertensive patients, only 27.6%-61.1% patients were aware of their condition, 42.2% patients underwent diagnosis, 27.9%-78.9% patients received antihypertensive treatment, 22.5% patients adhered to treatment medication, while blood pressure (BP) control was achieved in 27.0%-45.0% patients. Likewise, among patients with dyslipidemia, 10.5%-47.3% patients were aware of their condition, 34.6% patients were screened, and 17.8% underwent diagnosis. Although high treatment rates ranging from 40.0%-94.0% were reported, medication adherence recorded was 45.0%-77.4% among the treated patients. The overall low control rates ranged from 28.0%-41.5%. CONCLUSIONS The study findings highlight evidence gaps along key touchpoints of patient journey. Reinforcing the efforts for high-quality evidence-based research at a national level may pave a path for better resource utilization and provide guidance to practice and amend health policies for patients, healthcare practitioners (HCPs), and healthcare policy makers for better patient outcomes in Saudi Arabia.
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Affiliation(s)
- Ashraf Amir
- Family Medicine Department, International Medical Center, Jeddah, Saudi Arabia
| | - Mirvat Alasnag
- Cardiac Center, King Fahd Armed Forces Hospital-Jeddah-Saudi Arabia, PO Box 9862, Jeddah, 21159, Saudi Arabia.
| | - Rajaa Al-Raddadi
- Faculty of Medicine, Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tawfik Al-Bassam
- Department of Internal Medicine, Medical Reference Center, Jeddah, Saudi Arabia
| | - Kanwal Saeed
- Research, Development and Medical, Pfizer Upjohn, Dubai, UAE
| | - Mehmet Yazıcıoğlu
- Emerging Markets Medical Portfolio Implementation Lead, Viatris, Istanbul, Turkey
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Donohue JF, Elborn JS, Lansberg P, Javed A, Tesfaye S, Rugo H, Duddi SRD, Jithoo N, Huang PH, Subramaniam K, Ramanjinappa N, Koltun A, Melamed S, Chan JCN. Bridging the "Know-Do" Gaps in Five Non-Communicable Diseases Using a Common Framework Driven by Implementation Science. J Healthc Leadersh 2023; 15:103-119. [PMID: 37416849 PMCID: PMC10320809 DOI: 10.2147/jhl.s394088] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/12/2023] [Indexed: 07/08/2023] Open
Abstract
According to the United Nations High-Level Meeting 2018, five non-communicable diseases (NCDs) including cardiovascular diseases, chronic respiratory diseases, diabetes mellitus, cancer, and mental health conditions accounted for two-thirds of global deaths. These five NCDs share five common risk factors including tobacco use, unhealthy diets, physical inactivity, alcohol use, and air pollution. Low- and middle-income countries (LMICs) face larger burden of NCDs than high-income countries (HICs), due to differences in ecological, technological, socioeconomic and health system development. Based on high-level evidence albeit mainly from HICs, the burden caused by NCDs can be reduced by affordable medicines and best practices. However, "know-do" gaps, ie, gaps between what we know in science and what we do in practice, has limited the impact of these strategies, especially in LMICs. Implementation science advocates the use of robust methodologies to evaluate sustainable solutions in health, education and social care aimed at informing practice and policies. In this article, physician researchers with expertise in NCDs reviewed the common challenges shared by these five NCDs with different clinical courses. They explained the principles of implementation science and advocated the use of an evidence-based framework to implement solutions focusing on early detection, prevention and empowerment, supplemented by best practices in HICs and LMICs. These successful stories can be used to motivate policymakers, payors, providers, patients and public to co-design frameworks and implement context-relevant, multi-component, evidence-based practices. In pursuit of this goal, we propose partnership, leadership, and access to continuing care as the three pillars in developing roadmaps for addressing the multiple needs during the journey of a person with or at risk of these five NCDs. By transforming the ecosystem, raising awareness and aligning context-relevant practices and policies with ongoing evaluation, it is possible to make healthcare accessible, affordable and sustainable to reduce the burden of these five NCDs.
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Affiliation(s)
| | | | | | - Afzal Javed
- Warwick Medical School, University of Warwick, Warwick, UK & Pakistan Psychiatric Research Centre, Coventry, UK
| | - Solomon Tesfaye
- Sheffield Teaching Hospitals and the University of Sheffield, Sheffield, UK
| | - Hope Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA, USA
| | - Sita Ratna Devi Duddi
- International Alliance of Patients’ Organisations, London, United Kingdom
- DakshamA Health and Education, Delhi, India
| | | | | | | | | | | | | | - Juliana C N Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Regions of the People’s Republic of China
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Fazal F, Shahani HA, Gondal MF, Tanveer U, Haider M, Us Sabah N, Shahzad F, Ur Rehman ME. Attitudes and Factors Determining the Practice of Routine Medical Checkups in the People of Rawalpindi, Pakistan: A Cross-Sectional Study. Cureus 2023; 15:e38843. [PMID: 37303352 PMCID: PMC10256253 DOI: 10.7759/cureus.38843] [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] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Abstract
INTRODUCTION Routine medical checkup (RMC) is a screening and preventive technique that is implied to detect non-communicable diseases (NCDs). This study aims to assess the awareness in public regarding RMC, the association between education level and level of familiarity regarding RMC, and factors that prevent and encourage the practice of RMC by the public. METHODS This is a cross-sectional study carried out in Rawalpindi, Pakistan. Health professionals and individuals who refused to consent were excluded from the study. Data was collected using a mixed-mode questionnaire, and convenient sampling was used. The sample size was calculated to be 355 according to the WHO sample size calculator. A total of 356 individuals participated in this study after giving informed consent. Both male and female adults aged 18 or older and residents of Rawalpindi were included in the study. Individuals younger than 18 were excluded. Results: Among the 356 study participants, 160 (45%) were males, and 196 (55%) were females. The mean age was 27.57±10.027. Among the total participants, 33 (9.3%) individuals had primary-level education, 100 (28.1%) individuals had secondary-level education, and 233 (62.6%) had graduate-level education. A total of 329 (92.9%) participants knew that RMCs could help in early diagnosis and treatment. On the contrary, only 154 (43.3%) people knew that RMCs involve screening all body tissues. Only 329 (92.4%) participants said that they were aware that timely diagnosis through RMC can lead to early treatment. Graduates were generally more aware of different aspects of RMCs, especially in the domains of awareness regarding what an RMC is and that RMC can help in timely diagnosis compared to participants who had primary or secondary level of education (p<0.001). Females had a greater overall awareness of RMCs than males (p<0.001). Graduates were more likely to undergo RMCs than people educated till the primary or secondary level (p<0.001). The most common reason for undergoing RMC was "just concerned about health," which was selected by 130 (36.5%) participants. The most common reason mentioned by participants for not having an RMC was ''heavy cost,'' mentioned by 104 (29.2%) participants. Conclusion: Most of the participants of this study were well educated and were students in terms of profession. The majority of the study population knew that RMCs could help in early diagnosis and treatment. Awareness regarding RMCs was linked to educational level. Females had overall better knowledge regarding RMCs than men. The most common reported reason to have an RMC was a health concern, and the most common reported reason for not having an RMC was its high cost.
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Affiliation(s)
- Faizan Fazal
- Department of Medicine, Holy Family Hospital, Rawalpindi, PAK
| | | | | | - Usama Tanveer
- Department of Medicine, Holy Family Hospital, Rawalpindi, PAK
| | - Muhammad Haider
- Department of Orthopaedics, Holy Family Hospital, Rawalpindi, PAK
| | - Noor Us Sabah
- Department of Pediatric Surgery, Holy Family Hospital, Rawalpindi, PAK
| | - Faizan Shahzad
- Department of Medicine, Holy Family Hospital, Rawalpindi, PAK
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Meleiro A, Teng CT, Demetrio FN, Batista VC, Vieira LF, Elorza PM. Understanding the journey of patients with depression in Brazil: A systematic review. Clinics (Sao Paulo) 2023; 78:100192. [PMID: 37031663 PMCID: PMC10120295 DOI: 10.1016/j.clinsp.2023.100192] [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: 08/29/2022] [Revised: 02/26/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Despite having an organized mental health law and policy, a majority of patients with depression remain underreported and undertreated in Brazil. The study aimed to quantitatively map and identify the deficiencies in patient journey touchpoints in terms of awareness, screening, diagnosis, treatment, adherence, and control for depression in Brazil using a semi-systematic approach highlighting the knowledge gaps in the existing literature. A structured search of Embase, MEDLINE, and BIOSIS databases was conducted to identify the relevant studies published in English, Portuguese, and Spanish from 2006 to 2021. An unstructured search was also conducted on Google or government websites with no restrictions. To address the data gaps, anecdotal data were also considered. Weighted or simple means were calculated for the pooled data. Of 3175 articles retrieved, 10 articles met the inclusion criteria. Synthesized evidence indicates that the pooled prevalence of depression in Brazil ranged from 4.1% to 21.8%; 42.4% of patients had awareness of depression, 37.5% underwent screening, 18.7% had a diagnosis, and 54.4% received treatment. No data on adherence and control were available. The study findings highlight the need for more research to accurately estimate the common patient journey touchpoints for depression to achieve better clinical outcomes in Brazil.
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Affiliation(s)
| | - Chei Tung Teng
- Collaborating Professor, Department of Psychiatry, Institute of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Frederico Navas Demetrio
- Project Mood Disorders (GRUDA), Anxiety and Depression Ward (EAND), Institute of Psychiatry, Instituto de Psiquiatria Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | | | - Luiz Fernando Vieira
- Research, Development and Medical, Upjohn - a Pfizer Division, São Paulo, SP, Brazil
| | - Paola Marina Elorza
- Research, Development and Medical, Upjohn - a Pfizer Division, Latin America, Argentina
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Hung PM, Thanh VH, Sy HV, Duc DQ, Tuan VA, Tran ATQ, Brizuela GE, Tran HB. Adherence to hypertension and dyslipidemia treatment and its implication on control of cardiovascular disease in Vietnam: A semi-systematic review. Medicine (Baltimore) 2022; 101:e32137. [PMID: 36595786 PMCID: PMC9794305 DOI: 10.1097/md.0000000000032137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/10/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To understand the prevalent issues and challenges in the provision of care for dyslipidemia and hypertension in Vietnamese adults, quantification of patient journey stages (awareness, screening, diagnosis, treatment, adherence, and control) was performed in this semi-systematic review. METHODS The EMBASE and MEDLINE databases were searched for English articles published between 2010 and 2019. Thesis abstracts, letters to the editor, editorials, case studies, and studies on patient subgroups or nationally unrepresentative studies, were excluded. Articles from Google, the Incidence and Prevalence Database, the World Health Organization, Vietnam's Ministry of Health, and those suggested by the authors were also included. The last search was run on December 10, 2019 for dyslipidemia and hypertension. RESULTS A reviewer independently screened 586 retrievals for dyslipidemia and 177 retrievals for hypertension, and extracted data from 2 articles on dyslipidemia and 6 articles on hypertension that were included in the final synthesis. CONCLUSION The data generated in this review will help overcome these issues and barriers to patient care in populations with these 2 conditions.
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Affiliation(s)
- Pham Manh Hung
- Vietnam Heart Institute, Bach Mai Hospital, 78 Giai Phong, and Hanoi Medical University, Hanoi, Vietnam
| | - Vu Huy Thanh
- Vietnam Heart Institutes, Bach Mai Hospital, Hanoi, Vietnam
| | - Hoang Van Sy
- Cardiovascular Center, Cho Ray Hospital, 201B Nguyen Chi Thanh, and Internal Faculty, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Dang Quy Duc
- Cardiovascular Center, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Vuong Anh Tuan
- Cardiovascular Center, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Anh T Q Tran
- Viatris Vietnam Limited, Ho Chi Minh City, Vietnam
| | - Grace E Brizuela
- Research, Development and Medical, Viatris, Makati, Metropolitan Manila, Viatris, Manila, Philippines
| | - Hieu B Tran
- Coronary Care Unit, Vietnam Heart Institutes, Bach Mai Hospital, 78 Giai Phong, Hanoi, Vietnam
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Sadler AE, Belcastro F, Yarleque CR. Hypertension and Dyslipidaemia in Argentina: Patient Journey Stages. Int J Gen Med 2022; 15:7799-7808. [PMID: 36258799 PMCID: PMC9572553 DOI: 10.2147/ijgm.s358476] [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] [Received: 03/10/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular disease (CVD) leads to one-third of all deaths in Argentina. To implement patient-centric strategies for reducing CVD burden, available data on hypertension and hypercholesterolemia patients at different stages of their journey: awareness, screening, diagnosis, treatment, adherence, and control were analysed. A semi-systematic review in peer-reviewed databases (EMBASE and MEDLINE) and unstructured sources such as Google Scholar, Argentine Ministry of Health, and World Health Organization websites was conducted till 06.07.2021 for hypertension and dyslipidemia. English articles published in 2010-2021, depicting patient journey data for hypertension or hypercholesterolemia of the nationally representative adult population of Argentina were included. Thesis abstracts, letters to the editor, editorials, and case studies were excluded. No limits were used for unstructured sources. Weighted or simple means were estimated for patient journey stages. Out of 296 and 1257 articles retrieved for hypertension and hypercholesterolemia, respectively, five articles were retained for each of the conditions. The estimates for hypertension and hypercholesterolemia, respectively, were 46.6% and 30.7% for prevalence, 61.6% and 37.3% for awareness, 97.5% and ≥80% for screening, 64.1% and 28.9% for diagnosis, and 49.7% and 36.6% for treatment, and 19.9% and 20% for overall control. Adherence data were not available for hypercholesterolemia, while the same for hypertension was 50.4%. Various determinants are responsible for low adherence such as patient-level barriers, physician-related barriers, and health system-related issues. The review reveals that hypertension and hypercholesterolemia are poorly controlled in Argentina. Although further studies with more accurate data are needed to confirm these results, they should alert the medical community and the public health institutions to take urgent corrective actions.
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Affiliation(s)
- Alberto E Sadler
- Department of Internal Medicine, Instituto Argentino de Diagnóstico y Tratamiento, Buenos Aires, Argentina,Correspondence: Alberto E Sadler, Larrea 1065 PB B, 1117 CABA, Buenos Aires, Argentina, Email
| | - Fernando Belcastro
- Vascular medicine,Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Carlos R Yarleque
- Research, Development, and Medical, Upjohn - A Division of Pfizer, Lima, Peru
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Biswas S, Podder D, Jha SS, Kathuria P, Paul B. Exploring Challenges of Access to Non-Communicable Disease (NCD) Prevention, Treatment and Care: A Qualitative Study on People Living with NCDs (PLWNCDs) in West Bengal, India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:251. [PMID: 36325236 PMCID: PMC9621386 DOI: 10.4103/jehp.jehp_1296_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND People living with noncommunicable diseases (PLWNCDs) are often disproportionately affected due to adverse interaction with socioecological and biological factors. Hence, it is imperative to learn from their lived experience to gain a greater understanding of interactions as well as explore their priorities and needs in accessing care and identify areas of priority action through multistakeholder engagement. MATERIALS AND METHODS The qualitative study with grounded theory approach was conducted between October and December 2020. An online key-informant interview with the health policymaker, virtual group discussion with eight PLWNCDs, and in-depth telephonic interviews with five PLWNCDs were conducted, after obtaining informed consent using interview guide, developed, and validated by the experts. Data collection continued till data saturation was achieved. Transcripts generated from the interview recordings were coded using hand-code technique and analyzed thematically. RESULTS Challenges faced by PLWNCDs in accessing care were lack of empathy and support from health-care professionals, stigma, financial hardship, and hospital overcrowding. Caregivers emphasized on the felt need to involve civil society organizations (CSOs) in raising awareness toward noncommunicable diseases (NCDs) at family, community, and policymaking levels. The need for home-based NCD care and rehabilitation centers was voiced by the PLWNCDs. Impediments toward effective implementation of NCD policies were adoption of a "top-down" approach, poor awareness about government health insurance schemes, skewed distribution of empanelled hospitals in and around cities, nonavailability of qualified health-care professionals in underserved areas, aggravated allocation-utilization disparity during COVID-19 pandemic, and lack of robust information technology infrastructure to support access to telemedicine services. CONCLUSION The collective role of governments, CSOs, and health-care providers, along with meaningful involvement of PLWNCDs, would help to create an enabling environment for overcoming the challenges of access to care and thus achieve universal health coverage.
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Affiliation(s)
- Sutapa Biswas
- Cancer Foundation of India, Kolkata, West Bengal, India
| | - Debayan Podder
- Department of Health and Family Welfare, Government of West Bengal, West Bengal, India
| | - Sweety Suman Jha
- Dr. B.C. Roy Multi-Speciality Medical Research Centre, IIT Kharagpur, West Bengal, India
| | | | - Bobby Paul
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
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Faria-Neto JR, Yarleque C, Vieira LF, Sakane EN, Santos RD. Challenges faced by patients with dyslipidemia and systemic arterial hypertension in Brazil: a design of the patient journey. BMC Cardiovasc Disord 2022; 22:237. [PMID: 35597901 PMCID: PMC9124411 DOI: 10.1186/s12872-022-02669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Non-communicable diseases like systemic arterial hypertension (SAH) and dyslipidemia are poorly studied in terms of patient journey aspects. This semi-systematic review provides evidence synthesis for the management of SAH and dyslipidemia in Brazil and also discusses challenges faced by patients at the local level along with a suggested care approach by local experts. METHODS A semi-systematic review using both structured literature databases (Embase and Medline) and unstructured scientific records (WHO, IPD, MOH and Google) on hypertension and dyslipidemia in the English language from 2010 to 2019 was performed by reviewers. After two-level screening based on pre-defined criteria, patient journey touchpoints and prevalence information were extracted from the included articles. Data gaps were bridged through the insights of local experts. RESULTS Prevalence of hypertension and dyslipidemia in Brazil were 23% and 40.8%, respectively. Awareness of dyslipidemia was found in a larger proportion (58.1%) than in SAH (22.2%). Similarly, screening for hypertension (97%) and dyslipidemia (55.4%) were found to be effective, while treatment was (62.9%) and (30.0%) for hypertension and dyslipidemia, respectively. CONCLUSION There were important gaps on patient awareness and treatment of dyslipidemia and hypertension. Limited patient education, regional disease distribution, and treatment allocation, along with limited resources for diagnosis and treatment are the key challenges.
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Affiliation(s)
- Jose Rocha Faria-Neto
- School of Medicine, Pontificial Catholic University of Parana (PUCPR), Curitiba, Brazil
| | - Carlos Yarleque
- Research, Development and Medical, Upjohn - A Division of Pfizer, Lima, Peru
| | | | | | - Raul D Santos
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, São Paulo, Brazil.
- Academic Research Organization, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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Benson M, Albanese A, Bhatia KP, Cavillon P, Cuffe L, König K, Reinhard C, Graessner H. Development of a patient journey map for people living with cervical dystonia. Orphanet J Rare Dis 2022; 17:130. [PMID: 35313909 PMCID: PMC8935780 DOI: 10.1186/s13023-022-02270-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/20/2022] [Indexed: 01/18/2023] Open
Abstract
Background Patient journey maps are increasingly used as a tool that enables healthcare providers to refine their service provision to best meet patient needs. We developed a cervical dystonia patient journey map (CDPJM) that describes the holistic patient experience from pre-diagnosis through to long-term treatment. Methods The CDPJM was developed in 2 stages; a patient survey (open questions and multichoice) of 15 patients with CD was conducted to inform the design of the CDPJM, which was then refined and validated by an expert-patient focus group. Results Qualitative analysis of the patient survey supported five key stages of the patient journey: symptom onset, diagnosis and therapeutic relationship with healthcare professionals, initiation of care for CD, start of CD treatment, and living with treated CD. Following symptom onset, survey respondents described having multiple visits to their family doctor who prescribed strong pain killers and muscle relaxants and referred their patient to up to 10 different specialists for diagnosis. Over half (53.3%) of respondents had received ≥ 1 misdiagnosis. Respondents reported relief at having a diagnosis but a lack of understanding of the prognosis and treatment options; 46.7% said their neurologist did not spend enough time addressing their concerns. Survey respondents reported using a variety of alternative sources of information, including the internet (86.7%), self-help groups (66.7%) and information leaflets provided by health care professionals (60.0%). While botulinum toxin (BoNT) was consistently discussed as the main treatment option, some neurologists also mentioned physiotherapy, counselling, and other complementary approaches. However, patients were often left to seek complementary services themselves. Patients reported a ‘rollercoaster’ of relief with BoNT treatment with symptoms (and subsequent impact on daily life) returning towards the end of an injection cycle. “When BoNT works well I can return to an almost normal life … when the injections stop working so well, I have to rest more and avoid going to work and experience life restrictions.” Conclusions We present the first patient journey map for CD that can be used to guide local service mapping and to compare current provision with what patients say they want and need. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02270-4.
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Reda A, Ragy H, Saeed K, Alhussaini MA. A semi-systematic review on hypertension and dyslipidemia care in Egypt-highlighting evidence gaps and recommendations for better patient outcomes. JOURNAL OF THE EGYPTIAN PUBLIC HEALTH ASSOCIATION 2021; 96:32. [PMID: 34851468 PMCID: PMC8634749 DOI: 10.1186/s42506-021-00096-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 11/16/2021] [Indexed: 12/25/2022]
Abstract
Background Both hypertension and dyslipidemia are considered as major modifiable risk factors of cardiovascular diseases (CVDs), and their prevalence in Egypt has increased in recent years. Evidence-based systematic evaluation of data on hypertension and dyslipidemia is critical for effective patient-centric management to reduce the overall risk of CVDs in Egypt. This semi-systematic review aimed to quantify and identify data gaps in the prevalence and distribution of patient journey touchpoints including awareness, screening, diagnosis, treatment, adherence, and control of hypertension and dyslipidemia to provide the basis for research prioritization, practice guidance, and health care reforms in Egypt. Main body Structured search was conducted on MEDLINE and Embase to identify articles published in English between January 2010 and December 2019 that reported key patient journey touchpoints in hypertension and dyslipidemia management. Unstructured search was conducted on public or government websites with no date restriction. Data from all sources were extracted and presented descriptively. In total, 22 studies published between 1995 and 2020 on hypertension and dyslipidemia were included in the final analyses. The prevalence of hypertension in Egypt ranged from 12.1 to 59%. Studies reported awareness (37.5% and 43.9%), diagnosis (42% and 64.7%), treatment (24% and 54.1%), and adherence to antihypertensive medication (51.9%) to be low. Furthermore, the percentage of patients who had their blood pressure controlled ranged from 8 to 53.2%. The prevalence of dyslipidemia varied in the general population (range 19.2–36.8%) but was higher in patients with acute coronary syndrome (ACS) (50.9% and 52.5%) and coronary artery disease (58.7%). A national report indicated that 8.6% of the general population was screened for dyslipidemia; however, no data was available on the diagnosis and treatment rates. Among ACS patients, 73.9% were treated for dyslipidemia. Data indicated low levels of medication adherence (59%) among dyslipidemia patients, with overall low control rates ranging from 5.1 to 34.4% depending on CVD risk in populations including ACS patients. Conclusion Data on patient journey touchpoints of hypertension and dyslipidemia are limited in Egypt, indicating the need for more systematic and high-quality evidence-based studies covering different aspects of patient-centric management for better management of CVD and its risk factors. Supplementary Information The online version contains supplementary material available at 10.1186/s42506-021-00096-9.
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Affiliation(s)
- Ashraf Reda
- Department of Cardiology, Menoufia University, Shebin El Kom, Egypt.
| | - Hany Ragy
- Department of Cardiology, National Heart Institute, Cairo, Egypt
| | - Kanwal Saeed
- Legacy employee, Research, Development and Medical, Pfizer Upjohn, Dubai, United Arab Emirates
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Amir AA, Khader SA, El Chami Z, Bahlas SM, Bakir M, Arifeen S. Management of neuropathic pain in patients with diabetic peripheral neuropathy and low back pain in Saudi Arabia: Evidence and gaps. J Family Community Med 2021; 28:155-163. [PMID: 34703375 PMCID: PMC8496701 DOI: 10.4103/jfcm.jfcm_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/10/2021] [Accepted: 07/23/2021] [Indexed: 11/04/2022] Open
Abstract
We report existing evidence and gaps in neuropathic pain management in Saudi Arabia, the prevalence and patient management stages in diabetic peripheral neuropathy (DPN) and low back pain (LBP) with a neuropathic component. A semi-systematic approach was adopted to identify data on neuropathic pain. A structured search was conducted through MEDLINE, Embase, and BIOSIS databases to identify articles published in English between January 2010 and December 2019. Unstructured search was conducted through various sources including Google Scholar and Saudi Arabia's Ministry of Health website. Studies including populations ≥18 years and neuropathic pain were included; data gaps were supplemented with anecdotal data from local experts. Weighted or simple means were calculated for overall data; synthesized evidence was represented as an evidence gap map. Of 37 articles retrieved from structured search, none were eligible for final analyses. Thirteen articles from unstructured search and two anecdotal data sources were included for final analyses. The majority of articles included were of cross-sectional design (n = 10) in diabetes patients. The mean (range; number of articles) DPN prevalence was estimated as 33.6% (5.6%-65.3%; n = 8). Data on DPN patient management stages were limited; synthesized evidence indicated that 37.2% (0.41%-80.0%; n = 3) of patients had DPN awareness, 17.8% (n = 1) underwent screening, 22.4% (18.4%-65.3%; n = 2) had DPN diagnosis, and 45.1% (0.0%-62.7%; n = 2) received treatment for pain management. Data on LBP with neuropathic component were scarce (prevalence, 41.0% [n = 1]; diagnosis, 54.7% [n = 1]). Data are limited, so more studies are needed to accurately estimate the prevalence and stages of patient management for neuropathic pain in the country.
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Affiliation(s)
- Ashraf A Amir
- Department of Family Medicine, International Medical Center Hospital, Salam Home Health Care (Geriatric Care), Riyadh, Saudi Arabia
| | - Said A Khader
- Department of Diabetes and Endocrine, Dr. Suliaman Alhabib Medical Group, Riyadh, Saudi Arabia
| | - Ziad El Chami
- Advanced Neuro- Musculoskeletal Care Center, Dr. Samir Abbas Hospital, Riyadh, Saudi Arabia
| | | | | | - Shams Arifeen
- Africa and Middle East Clusters, Upjohn Pfizer Africa and Middle East, Dubai, UAE
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