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Tjandrarini DH, Kristanti D, Wurisastuti T, Hidayangsih PS, Tuminah S, Paramita A, Kusrini I, Dharmayanti I, Dany F, Ahmadi F, Titaley CR. Pandemic Pressure: Changes in Hypertensive Management Adherence in Indonesia. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:134-140. [PMID: 38685560 DOI: 10.1016/j.anr.2024.04.005] [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: 01/05/2024] [Revised: 03/30/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024] Open
Abstract
PURPOSE This study aimed to determine factors associated with changes in adherence to hypertension management (medication adherence and blood pressure control) in respondents with hypertension before and during the COVID-19 pandemic in Bogor city, Indonesia. METHODS An observational study was conducted using two sources of data (before and during COVID-19 pandemic). Data before the pandemic were derived from the 2019 Cohort Study of non-communicable disease risk factors. Data during the pandemic were derived from an online survey conducted in September and October 2020. Information from 880 participants were analyzed. The dependent variable was the change in adherence to hypertension management before and during the COVID-19 pandemic. Multivariate analysis was performed using logistic polynomial regression. RESULTS Respondents who adhered to hypertension management decreased from 82.0% in 2019 to 47.8% in 2020. The likelihood of non-adherence (respondents who did not adhere to hypertension management both before and during the pandemic) increased in respondents below 55 years old, who did not own any healthcare insurance, who were not obese, and who had no other comorbidities. In the partial adherence group (respondents who did not adhere to hypertension management either before or during the pandemic), we found that most respondents adhered before the pandemic but no longer adhered during the COVID-19 pandemic. We found an increased partial adherence in young and highly educated respondents. CONCLUSIONS Efforts to improve adherence to hypertension management after the COVID-19 pandemic should target those who were young, highly educated, who did not have any healthcare insurance, and who did not perceive themselves as not having comorbidities.
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Affiliation(s)
- Dwi H Tjandrarini
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Dewi Kristanti
- Centre for Health Services Policy, Health Policy Agency, Jakarta, Indonesia
| | - Tri Wurisastuti
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Puti S Hidayangsih
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Sulistyowati Tuminah
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Astridya Paramita
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Ina Kusrini
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Ika Dharmayanti
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Frans Dany
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Feri Ahmadi
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
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Zou KH, Vigna C, Talwai A, Jain R, Galaznik A, Berger ML, Li JZ. The Next Horizon of Drug Development: External Control Arms and Innovative Tools to Enrich Clinical Trial Data. Ther Innov Regul Sci 2024; 58:443-455. [PMID: 38528279 PMCID: PMC11043157 DOI: 10.1007/s43441-024-00627-4] [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: 10/17/2023] [Accepted: 02/04/2024] [Indexed: 03/27/2024]
Abstract
Conducting clinical trials (CTs) has become increasingly costly and complex in terms of designing and operationalizing. These challenges exist in running CTs on novel therapies, particularly in oncology and rare diseases, where CTs increasingly target narrower patient groups. In this study, we describe external control arms (ECA) and other relevant tools, such as virtualization and decentralized clinical trials (DCTs), and the ability to follow the clinical trial subjects in the real world using tokenization. ECAs are typically constructed by identifying appropriate external sources of data, then by cleaning and standardizing it to create an analysis-ready data file, and finally, by matching subjects in the external data with the subjects in the CT of interest. In addition, ECA tools also include subject-level meta-analysis and simulated subjects' data for analyses. By implementing the recent advances in digital health technologies and devices, virtualization, and DCTs, realigning of CTs from site-centric designs to virtual, decentralized, and patient-centric designs can be done, which reduces the patient burden to participate in the CTs and encourages diversity. Tokenization technology allows linking the CT data with real-world data (RWD), creating more comprehensive and longitudinal outcome measures. These tools provide robust ways to enrich the CT data for informed decision-making, reduce the burden on subjects and costs of trial operations, and augment the insights gained for the CT data.
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Affiliation(s)
| | - Chelsea Vigna
- Medidata Solutions, a Dassault Systèmes Company, Boston, MA, USA
| | - Aniketh Talwai
- Medidata Solutions, a Dassault Systèmes Company, Boston, MA, USA
| | - Rahul Jain
- Medidata Solutions, a Dassault Systèmes Company, Boston, MA, USA
| | - Aaron Galaznik
- Medidata Solutions, a Dassault Systèmes Company, Boston, MA, USA
| | - Marc L Berger
- Medidata Solutions, a Dassault Systèmes Company, Boston, MA, USA
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3
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Solera AR, Supervia M, Medina Inojosa JR, Senon DB, Lopez-Jimenez F, Grace SL. Impact of vaccination education in cardiac rehabilitation on attitudes and knowledge. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002610. [PMID: 38457378 PMCID: PMC10923443 DOI: 10.1371/journal.pgph.0002610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/14/2024] [Indexed: 03/10/2024]
Abstract
Clinical guidelines recommend influenza vaccination for cardiac patients, and COVID-19 vaccination is also beneficial given their increased risk. Patient education regarding vaccination was developed for cardiac rehabilitation (CR); impact on knowledge and attitudes were evaluated. A single-group pre-post design was applied at a Spanish CR program in early 2022. After baseline assessment, a nurse delivered the 40-minute group education. Knowledge and attitudes were re-assessed. Sixty-one (72%) of the 85 participants were vaccinated for influenza, and 40 (47%) for pneumococcus. Most participants perceived vaccines were important, and that the COVID-19 vaccine specifically was important, with three-quarters not influenced by vaccine myths/misinformation. The education intervention resulted in significant improvements in perceptions of the importance of vaccines (Hake's index 69%), understanding of myths (48%), knowledge of the different types of COVID vaccines (92%), and when they should be vaccinated. Vaccination rates are low despite their importance; while further research is needed, education in the CR setting could promote greater uptake.
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Affiliation(s)
- Andrea Rivera Solera
- Department of Physical Medicine and Rehabilitation, Alcala University, Madrid, Spain
- Department of Physical Medicine and Rehabilitation, Gregorio Marañon Health Research Institute, Gregorio Marañon General University Hospital, Madrid, Spain
| | - Marta Supervia
- Department of Physical Medicine and Rehabilitation, Gregorio Marañon Health Research Institute, Gregorio Marañon General University Hospital, Madrid, Spain
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Jose R. Medina Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - David Bedos Senon
- Department of Physical Medicine and Rehabilitation, Gregorio Marañon Health Research Institute, Gregorio Marañon General University Hospital, Madrid, Spain
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Sherry L. Grace
- Faculty of Health, York University, Toronto, Ontario, Canada
- KITE Toronto Rehabilitation Institute and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
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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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Cáceres C, Lora ÁJ, Villabona SJ, Rocha MC, Camacho PA. Adherence to pharmacological treatment in non-communicable chronic diseases in the Colombian population: Systematic review and meta-analysis. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:51-65. [PMID: 38207150 PMCID: PMC10941828 DOI: 10.7705/biomedica.7077] [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: 06/06/2023] [Accepted: 09/26/2023] [Indexed: 01/13/2024]
Abstract
Introduction. Non-communicable chronic diseases represent the leading cause of death worldwide, and their prevalence is increasing due to the epidemiological transition. Despite the advances in their management, control rates are deficient, attributed to multiple factors like adherence to pharmacological treatment, one of the most significant and least studied in the Colombian population. Objective. To calculate adherence to treatment in Colombian patients with arterial hypertension, cerebrovascular disease, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and dyslipidemia between 2005 and 2022. Materials and methods. We performed a systematic literature review and a meta-analysis of studies identified through the Medline and LILACS databases to quantitatively synthesize treatment adherence percentage. Results. Fourteen studies met the inclusion criteria, and 5,658 patients were analyzed. The treatment adherence was 59%, with significant heterogeneity among the included studies (95% CI= 46- 71%; I2 = 98.8%, p< 0.001). Higher adherence rates were observed for diabetes mellitus (79%; 95% CI = 65- 90%) and dyslipidemia (70%; 95% CI = 66- 74%). Adherence to arterial hypertension treatment was 51% (95 %; CI = 31- 72%). Conclusions. This systematic review showed low adherence to recommendations regarding pharmacological management in non-communicable chronic diseases, which can have implications for long-term clinical outcomes and disease burden.
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Affiliation(s)
- Catalina Cáceres
- Unidad de Diseño y Desarrollo, Fundación Oftalmológica de Santander, Floridablanca, Colombia.
| | - Álvaro José Lora
- Unidad de Diseño y Desarrollo, Fundación Oftalmológica de Santander, Floridablanca, Colombia.
| | | | - María Catalina Rocha
- Unidad de Diseño y Desarrollo, Fundación Oftalmológica de Santander, Floridablanca, Colombia.
| | - Paul Anthony Camacho
- Unidad de Diseño y Desarrollo, Fundación Oftalmológica de Santander, Floridablanca, Colombia; Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga,.
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Patil A, Gupta S, Venkatesh P, Banerjee M, Kumar V, Chawla R, Azad SV, Kumar A. First contact investigations and compliance to treatment in patients with uveitis. Int J Ophthalmol 2023; 16:1820-1826. [PMID: 38028517 PMCID: PMC10626353 DOI: 10.18240/ijo.2023.11.13] [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: 02/03/2023] [Accepted: 08/18/2023] [Indexed: 12/01/2023] Open
Abstract
AIM To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment. METHODS An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June 2020. Detailed information regarding systemic investigations undertaken by specialists at the time of first contact and the cost of these investigations were reviewed on the first visit to our centre. Compliance with the treatment was determined and reasons behind non-compliance were evaluated on the first follow-up in patients who had no improvement in clinical signs and symptoms. RESULTS The mean age of the study group was 35.35±14.1y and gender composition was 59.7% males and 40.3% females. Anterior uveitis was observed in 45.3% of patients, intermediate uveitis in 31.8% of patients, posterior uveitis in 14.9% of patients and panuveitis in 8.0% of patients. Association with a systemic disease was evident in 17.9% of patients. When compared with standard guidelines and uveitis patterns, systemic investigations were identified to be relevant only in 38.3% of patients. Non-compliance to treatment was documented in 22.4% of patients. Common reasons for non-compliance were inadequate counselling by the treating physician about treatment in 26.7% of patients and a busy schedule at work/school in 22.2% of patients. CONCLUSION Significant number of investigations performed at first contact is found to be contrary to standard guidelines and are not contributory to the care. About a quarter of patients in this study are found to be non-compliant with the treatment. Compliance is more challenging to achieve in school-going children and working adults. The availability of comprehensive, periodically updated, evidence-based guidelines on the role of investigations and the use of trained counsellors may help to channelize proper evaluation and improve compliance to treatment, respectively, in patients with uveitis.
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Affiliation(s)
- Anuja Patil
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sanjeev Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Pradeep Venkatesh
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Mousumi Banerjee
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Vinod Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Shorya Vardhan Azad
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
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Habbash F, Rabeeah A, Huwaidi Z, Abuobaidah H, Alqabbat J, Hayyan F, Almarabheh A, Al Sindi H, Ben Salah A. Telemedicine in non-communicable chronic diseases care during the COVID-19 pandemic: exploring patients' perspectives. Front Public Health 2023; 11:1270069. [PMID: 37818295 PMCID: PMC10560720 DOI: 10.3389/fpubh.2023.1270069] [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: 07/31/2023] [Accepted: 09/07/2023] [Indexed: 10/12/2023] Open
Abstract
Purpose This study aimed to explore challenges facing patients using Telemedicine consultations in non-communicable chronic disease clinics in primary care settings and to evaluate their satisfaction and willingness to use this service in the future. Methods This is an analytical cross-sectional study enrolling participants who were randomly selected from representative primary care centers in Bahrain and providing Telemedicine consultations. A semi-structured questionnaire permitted data collection using telephone interviews. Results A total of 251 individuals participated in the study of whom the majority were Bahraini (90.04%), and the mean age was 54.48 ± 10.78 years. Most of the participants 231 (92.03%) were satisfied with the Telemedicine consultation while only 142 (56.80%) were willing to use this service in the future. The main perceived challenges related to Teleconsultations were the lack of physical examination, inadequate time of TM consultation, fear of medical errors, and lack of privacy. The willingness to use TM consultation in the future was mainly determined by the degree of comfort to tell private information (p < 0.01) and to less extent the ease of the communication tool (p = 0.005) on multivariate analysis. Conclusion TM consultations could be a good complement to conventional consultation formats in the future. The sustainability of this innovative healthcare delivery tool requires addressing acceptability by users, ease of use, patient-centeredness, and technological advances to ensure privacy.
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Affiliation(s)
- Fatema Habbash
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
- Department of Family Medicine, University Medical Center King Abdullah Medical City Bahrain, Manama, Bahrain
| | | | | | | | | | | | - Amer Almarabheh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | | | - Afif Ben Salah
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
- Institute Pasteur de Tunis, Department of Medical Epidemiology, Tunis, Tunisia
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Khanali J, Ghasemi E, Rashidi MM, Ahmadi N, Ghamari SH, Azangou-Khyavy M, Malekpour MR, Abbasi-Kangevari M, Hashemi SM, Naderian M, Rezaei N, Dilmaghani-Marand A, Farzi Y, Kazemi A, Yoosefi M, Hajebi A, Rezaei S, Azadnajafabad S, Fattahi N, Nasserinejad M, Abdolhamidi E, Haghshenas R, Rezaei N, Djalalinia S, Larijani B, Farzadfar F. Prevalence of plasma lipid abnormalities and associated risk factors among Iranian adults based on the findings from STEPs survey 2021. Sci Rep 2023; 13:15499. [PMID: 37726324 PMCID: PMC10509214 DOI: 10.1038/s41598-023-42341-5] [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: 03/10/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
The study aimed to estimate the prevalence of lipid abnormalities in Iranian adults by demographic characterization, geographical distribution, and associated risk factors using national and sub-national representative samples of the STEPs 2021 survey in Iran. In this population-based household survey, a total of 18,119 individuals aged over 25 years provided blood samples for biochemical analysis. Dyslipidemia was defined by the presence of at least one of the lipid abnormalities of hypertriglyceridemia (≥ 150 mg/dL), hypercholesterolemia (≥ 200 mg/dL), high LDL-C (≥ 130 mg/dL), and low HDL-C (< 50 mg/dL in women, < 40 mg/dL in men), or self-reported use of lipid-lowering medications. Mixed dyslipidemia was characterized as the coexistence of high LDL-C with at least one of the hypertriglyceridemia and low HDL-C. The prevalence of each lipid abnormality was determined by each population strata, and the determinants of abnormal lipid levels were identified using a multiple logistic regression model. The prevalence was 39.7% for hypertriglyceridemia, 21.2% for hypercholesterolemia, 16.4% for high LDL-C, 68.4% for low HDL-C, and 81.0% for dyslipidemia. Hypercholesterolemia and low HDL-C were more prevalent in women, and hypertriglyceridemia was more prevalent in men. The prevalence of dyslipidemia was higher in women (OR = 1.8), obese (OR = 2.8) and overweight (OR = 2.3) persons, those residents in urban areas (OR = 1.1), those with inappropriate physical activity (OR = 1.2), patients with diabetes (OR = 2.7) and hypertension (OR = 1.9), and participants with a history (OR = 1.6) or familial history of CVDs (OR = 1.2). Mixed dyslipidemia prevalence was 13.6% in women and 11.4% in men (P < 0.05). The prevalence of lipid abnormalities was highly heterogeneous among provinces, and East Azarbaijan with 85.3% (81.5-89.1) and Golestan with 68.5% (64.8-72.2) had the highest and lowest prevalence of dyslipidemia, respectively. Although the prevalence of high cholesterol and LDL-C had a descending trend in the 2016-2021 period, the prevalence of dyslipidemia remained unchanged. There are modifiable risk factors associated with dyslipidemia that can be targeted by the primary healthcare system. To modify these risk factors and promote metabolic health in the country, action plans should come to action through a multi-sectoral and collaborative approach.
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Affiliation(s)
- Javad Khanali
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Mohammadreza Azangou-Khyavy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Seyedeh Melika Hashemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Mohammadreza Naderian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Arezou Dilmaghani-Marand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Ameneh Kazemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
- Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Amirali Hajebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Shahabeddin Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
- Human Nutrition Program, Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Nima Fattahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
- Center for Life Course Health ResearchFaculty of Medicine, University of Oulu, Oulu, Finland
| | - Elham Abdolhamidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran
| | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Suárez Fernández C, Armario P, Cepeda JM, López Carmona MD, Miramontes González JP, Said-Criado I. Recommendations for the care of patients with cardiovascular disease in health emergency situations: a call to action. Curr Med Res Opin 2023; 39:827-832. [PMID: 37129909 DOI: 10.1080/03007995.2023.2201100] [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: 01/19/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023]
Abstract
COVID-19 has had a negative impact on the health care of patients with cardiovascular disease and patients at high risk of cardiovascular disease. The restrictions affecting access to the health care system have conditioned the care received, resulting in poorer control and a higher risk of events. Taking action to improve the care provided during health emergencies is mandatory. It is important to promote the development of telemedicine and patient empowerment by fostering health literacy and a higher degree of self-care. In addition, primary care and coordination between health care levels should be improved. Moreover, the simplification and optimization of treatment, for example, using the cardiovascular polypill, have led to an improvement in adherence, better control of vascular risk factors, and a reduced risk of events. The present document provides specific recommendations for improving the care provided to patients under a health emergency.
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Affiliation(s)
| | - Pedro Armario
- Internal Medicine Department, Complex Hospitalari Universitari Moisès Broggi, Universitat de Barcelona, Barcelona, Spain
| | | | | | - José Pablo Miramontes González
- Internal Medicine Department, Hospital Universitario Río Hortega. Departamento de Medicina, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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Hiko A, Assefa N, Ataro Z, Sertsu A, Yadeta E, Balcha T, Amano A, Asfaw H, Dechasa DB, Nigussie K, Abdisa L. Follow-up conditions of care and associated factors among adult hypertensive patients during COVID-19 at West Arsi public health facilities, Southeastern Ethiopia: A multi-center cross-sectional study. Front Public Health 2022; 10:1018686. [PMID: 36466529 PMCID: PMC9708880 DOI: 10.3389/fpubh.2022.1018686] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background Coronavirus disease (COVID-19) is a viral-borne infection caused by the SARS-CoV-2 virus. Aside from the morbidity and mortality effects, it leaves the majority of hypertensive patients untreated and vulnerable to uncontrolled hypertension. Objective The purpose of this study was to assess follow-up conditions of care and its associated factors among adult hypertensive patients during COVID-19 in public health facilities of West Arsi, Southeastern Ethiopia. Methods A health facility-based retrospective cross-sectional study was conducted among 423 adult hypertensive patients in the West Arsi public health facilities from July 5 to August 6, 2021. A systematic random sampling technique was used to recruit the study participants. A pretested structured face-to-face interviewer and medical records were used to collect sociodemographic variables, basic clinical features, and follow-up data. The follow-up conditions of care were assessed using 12 items with "yes or no" questions. Then, based on the mean value of the items, the follow-up conditions of care were dichotomized into good and poor. As a result, the follow-up condition was good if the score was greater or equal to the mean, and poor unless otherwise. To investigate parameters related with follow-up conditions of care, bivariable and multivariable logistic regression analyses were used. A 95% confidence interval and a p-value of 0.05 were used to indicate a significant association. Results The rate of poor follow-up conditions of care during COVID-19 was 29% (95% confidence interval: 24.9-33.4%), according to this study. Age ≥ 60 years (AOR = 3.55; 95% CI: 2.09-6.03), transportation problem (AOR = 2.43; 95% CI: 1.28-4.61), fear of COVID-19 (AOR = 3.34; 95% CI: 1.59-7.01), co-morbidity (AOR = 1.93; 95% CI: 1.14-3.26) and physical distancing (AOR = 2.43; 95% CI: 1.44-4.12) were significantly associated with poor follow-up conditions of care. Conclusions In our study, 29% of the participants had poor follow-up care conditions. When compared to WHO recommendations, the findings of this study may explain poor follow-up care conditions. To enhance patients' follow-up treatment, evidence-based target interventions should be designed and executed, taking into account individuals at high risks, such as those over the age of 60 and those with comorbidities, and identifying additional risk factors.
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Affiliation(s)
- Ahmed Hiko
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia,*Correspondence: Ahmed Hiko
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Zerihun Ataro
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Elias Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Teganu Balcha
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdulkerim Amano
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Henock Asfaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Deribe Bekele Dechasa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemesa Abdisa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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11
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Malo S, Maldonado L, Rabanaque MJ, Gimeno-Miguel A, Castel-Feced S, Lallana MJ, Aguilar-Palacio I. Patterns of statin adherence in primary cardiovascular disease prevention during the pandemic. Front Pharmacol 2022; 13:980391. [PMID: 36452233 PMCID: PMC9702325 DOI: 10.3389/fphar.2022.980391] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2024] Open
Abstract
Background: Study of medication adherence patterns can help identify patients who would benefit from effective interventions to improve adherence. Objectives: To identify and compare groups of statin users based on their adherence patterns before and during the COVID-19 pandemic, to characterize the profile of users in each group, and to analyze predictors of distinct adherence patterns. Methods: Participants of the CARhES (CArdiovascular Risk factors for HEalth Services research) cohort, comprising individuals aged >16 years, residing in Aragón (Spain), with hypertension, diabetes mellitus and/or dyslipidemia, took part in this observational longitudinal study. Individuals who began statin therapy during January-June 2019 were selected and followed up until June 2021. Those with a cardiovascular event before or during follow-up were excluded. Data were obtained from healthcare system data sources. Statin treatment adherence during the implementation phase was estimated bimonthly using the Continuous Medication Availability (CMA9) function in the AdhereR package. Group-based trajectory models were developed to group statin users according to their adherence pattern during July 2019-June 2021. Group characteristics were compared and predictors of each adherence pattern were analyzed using multinomial logistic regression. Results: Of 15,332 new statin users, 30.8% had a mean CMA9 ≥80% for the entire study period. Four distinct adherence patterns were identified: high adherence (37.2% of the study population); poor adherence (35.6%); occasional use (14.9%); and gradual decline (12.3%). The latter two groups included users who showed a change in adherence (increase or decrease) during the pandemic emergence. Users with suboptimal adherence were likely to be younger, not pensioners, not institutionalized, with low morbidity burden and a low number of comorbidities. Female sex and switching between statins of different intensity increased the likelihood of belonging to the occasional use group, in which improved adherence coincided with the pandemic. Conclusion: We identified four distinct adherence patterns in a population of new statin users; two of them modified their adherence during the pandemic. Characterization of these groups could enable more effective distribution of resources in future similar crisis and the routine implementation of patient-centered interventions to improve medication adherence.
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Affiliation(s)
- Sara Malo
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, Health Promotion (RICAPPS), ISCIII, Madrid, Spain
| | - Lina Maldonado
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Department of Applied Economics, University of Zaragoza, Zaragoza, Spain
| | - María José Rabanaque
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, Health Promotion (RICAPPS), ISCIII, Madrid, Spain
| | - Antonio Gimeno-Miguel
- Network for Research on Chronicity, Primary Care, Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
| | - Sara Castel-Feced
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - María Jesús Lallana
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Primary Care Pharmacy Service, Sector Zaragoza III, Servicio Aragonés de Salud (SALUD), Zaragoza, Spain
| | - Isabel Aguilar-Palacio
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, Health Promotion (RICAPPS), ISCIII, Madrid, Spain
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Enhanced Patient-Centricity: How the Biopharmaceutical Industry Is Optimizing Patient Care through AI/ML/DL. Healthcare (Basel) 2022; 10:healthcare10101997. [PMID: 36292444 PMCID: PMC9602573 DOI: 10.3390/healthcare10101997] [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: 07/06/2022] [Revised: 09/19/2022] [Accepted: 10/07/2022] [Indexed: 11/04/2022] Open
Abstract
Technologies utilizing cutting-edge methodologies, including artificial intelligence (AI), machine learning (ML) and deep learning (DL), present powerful opportunities to help evaluate, predict, and improve patient outcomes by drawing insights from real-world data (RWD) generated during medical care. They played a role during and following the Coronavirus Disease 2019 (COVID-19) pandemic by helping protect healthcare providers, prioritize care for vulnerable populations, predict disease trends, and find optimal therapies. Potential applications across therapeutic areas include diagnosis, disease management and patient journey mapping. Use of fit-for-purpose datasets for ML models is seeing growth and may potentially help additional enterprises develop AI strategies. However, biopharmaceutical companies often face specific challenges, including multi-setting data, system interoperability, data governance, and patient privacy requirements. There remains a need for evolving regulatory frameworks, operating models, and data governance to enable further developments and additional research. We explore recent literature and examine the hurdles faced by researchers in the biopharmaceutical industry to fully realize the promise of AI/ML/DL for patient-centric purposes.
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Smolić Š, Blaževski N, Fabijančić M. Remote Healthcare During the COVID-19 Pandemic: Findings for Older Adults in 27 European Countries and Israel. Front Public Health 2022; 10:921379. [PMID: 35910874 PMCID: PMC9337840 DOI: 10.3389/fpubh.2022.921379] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/15/2022] [Indexed: 12/01/2022] Open
Abstract
The COVID-19 pandemic exacerbated issues regarding access to healthcare for older people, by far the most vulnerable population group. In particular, older adults avoided seeking medical treatment for fear of infection or had their medical treatments postponed or denied by health facilities or health professionals. In response, remote medical services were recognized as an essential adjustment mechanism to maintain the continuity of healthcare provision. Using the SHARE Corona Survey data, we estimate logistic and multilevel regression models for the remote care of 44,152 persons aged 50 and over in 27 European countries and Israel. Our findings suggest that those aged 80+ were the least likely to use remote healthcare. However, women, better educated individuals, older adults who lived in urban areas, those with no financial strain, and active Internet users used remote medical consultations more often. Those who reported poor or fair health status, two or more chronic diseases, or hospitalization in the last 12 months were significantly more likely to use remote healthcare. Furthermore, remote medical consultations were more frequent for those who had their healthcare postponed or went without it due to fear of coronavirus infection. Finally, older adults used remote care more frequently in countries with less healthcare coverage and lower health expenditures. Health systems should prioritize vulnerable groups in maintaining continuity in access to healthcare, despite the availability of remote care. Policymakers should improve telemedicine regulation and offer incentives for providers of remote healthcare services by adapting reimbursement policies. Remote medical care could play an important role in maintaining healthcare access for older adults and increasing health systems' preparedness in future health emergencies.
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Haque MMA, Jahan Y, Khair Z, Moriyama M, Rahman MM, Sarker MHR, Shaima SN, Chowdhury S, Matin KF, Karim IJ, Ahmed MT, Hossain SZ, Masud MAH, Nabi MG, Aziz AB, Sharif M, Chowdhury MFI, Shams KL, Nizam NB, Ananta TT, Amin MR, Hawlader MDH. Perceptions about Telemedicine among Populations with Chronic Diseases amid COVID-19: Data from a Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074250. [PMID: 35409932 PMCID: PMC8998658 DOI: 10.3390/ijerph19074250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 12/27/2022]
Abstract
Chronic diseases, including non-communicable diseases (NCDs), have arisen as a severe threat to health and socio-economic growth. Telemedicine can provide both the highest level of patient satisfaction and the lowest risk of infection during a pandemic. The factors associated with its usage and patient adherence are not visible in Bangladesh’s resource-constrained settings. Therefore, this study aimed to identify perceptions about telemedicine among populations with chronic diseases amid the COVID-19 pandemic. A closed-ended self-reported questionnaire was created, and the questionnaire was written, reviewed, and finalized by a public health investigator, a psychiatrist, and an epidemiologist. The data for this study were collected from individuals using simple random sampling and snowball sampling techniques. Ethics approval was granted, and written/verbal consent was taken before interviews. Most of the participants showed a positive attitude towards telemedicine. People aged 35–54 years old and a higher level of education were less frequently associated with willingness to receive telemedicine services for current chronic disease (WRTCCD) than their counterparts. People living in urban areas and lower-income participants were more strongly associated with WRTCCD. Additionally, people who did not lose their earnings due to the pandemic were less strongly associated with WRTCCD. However, the main strength of this research is that it is a broad exploration of patient interest in several general forms of telehealth. In Bangladesh, there are many opportunities for telemedicine to be integrated into the existing healthcare system, if appropriate training and education are provided for healthcare professionals.
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Affiliation(s)
- Miah Md. Akiful Haque
- Department of Public Health, North South University, Dhaka 1229, Bangladesh; (M.M.A.H.); (K.F.M.); (M.D.H.H.)
- Public Health Professional Development Society (PPDS), Dhaka 1215, Bangladesh
| | - Yasmin Jahan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (Y.J.); (Z.K.); (M.M.); (M.H.R.S.); (S.C.)
| | - Zara Khair
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (Y.J.); (Z.K.); (M.M.); (M.H.R.S.); (S.C.)
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (Y.J.); (Z.K.); (M.M.); (M.H.R.S.); (S.C.)
| | - Md. Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (Y.J.); (Z.K.); (M.M.); (M.H.R.S.); (S.C.)
- Correspondence: ; Tel.: +81-82-257-5391
| | - Mohammad Habibur Rahman Sarker
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (Y.J.); (Z.K.); (M.M.); (M.H.R.S.); (S.C.)
| | - Shamsun Nahar Shaima
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh;
| | - Sajeda Chowdhury
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (Y.J.); (Z.K.); (M.M.); (M.H.R.S.); (S.C.)
| | - Kazi Farhana Matin
- Department of Public Health, North South University, Dhaka 1229, Bangladesh; (M.M.A.H.); (K.F.M.); (M.D.H.H.)
- Public Health Professional Development Society (PPDS), Dhaka 1215, Bangladesh
| | - Ishrat Jahan Karim
- Sylhet MAG Osmani Medical College, Sylhet 3100, Bangladesh; (I.J.K.); (M.T.A.)
| | | | - Syed Zakir Hossain
- Dhaka Medical College, Dhaka 1000, Bangladesh; (S.Z.H.); (M.S.); (M.R.A.)
| | - Md. Adnan Hasan Masud
- Haematology Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka 1000, Bangladesh;
| | | | - Asma Binte Aziz
- International Vaccine Institute, Seoul 08826, Korea; (A.B.A.); (M.F.I.C.)
| | - Mohiuddin Sharif
- Dhaka Medical College, Dhaka 1000, Bangladesh; (S.Z.H.); (M.S.); (M.R.A.)
| | | | - Kaniz Laila Shams
- Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka 1207, Bangladesh; (K.L.S.); (N.B.N.)
| | - Nusrat Benta Nizam
- Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka 1207, Bangladesh; (K.L.S.); (N.B.N.)
| | | | - Md. Robed Amin
- Dhaka Medical College, Dhaka 1000, Bangladesh; (S.Z.H.); (M.S.); (M.R.A.)
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Pharmacological Adherence Behavior Changes during COVID-19 Outbreak in a Portugal Patient Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031135. [PMID: 35162159 PMCID: PMC8835016 DOI: 10.3390/ijerph19031135] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023]
Abstract
Concerns, behaviours, and beliefs influence how people deal with COVID-19. Understanding the factors influencing adherence behaviour is of utmost importance to develop tailored interventions to increase adherence within this context. Hence, we aimed to understand how COVID-19 affected adherence behaviour in Portugal. A cross-sectional online survey was conducted between 1 March and 3 April 2021. Descriptive statistics were performed, as well as univariable and multivariable regression models. Of the 1202 participants, 476 who were taking at least one medication prescribed by the doctor were selected. Of these, 78.2% were female, and the mean age was 40.3 ± 17.9 years old. About 74.2% were classified as being highly adherent. During the pandemic, 8.2% of participants reported that their adherence improved, while 5.9% had worsened adherence results. Compared with being single, widowers were 3 times more prone to be less adherent (OR:3.390 [1.106–10.390], p = 0.033). Comorbid patients were 1.8 times (OR:1.824 [1.155–2.881], p = 0.010) more prone to be less adherent. Participants who reported that COVID-19 negatively impacted their adherence were 5.6 times more prone to be less adherent, compared with those who reported no changes (OR:5.576 [2.420–12.847], p < 0.001). None of the other variables showed to be significantly associated with pharmacological adherence.
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Imperato JS, Zou KH, Li JZ, Hassan TA. Clinical Practice Management of Primary Open-Angle Glaucoma in the United States: An Analysis of Real-World Evidence. Patient Prefer Adherence 2022; 16:2213-2227. [PMID: 36003802 PMCID: PMC9394656 DOI: 10.2147/ppa.s367443] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate clinical management of primary open-angle glaucoma (POAG) in the United States using real-world evidence and to examine healthcare resource utilization (HCRU), medication adherence/persistence, and procedure use. DESIGN A cross-sectional, retrospective analysis of Optum's de-identified Market Clarity Dataset (July 1, 2013-December 31, 2019). PATIENTS AND METHODS Patients ≥18 years with POAG diagnosis and continuous enrollment for 1-year pre- and post-index were eligible and categorized into four mutually exclusive cohorts: CH1, treated with antiglaucoma medication(s) only; CH2, underwent glaucoma procedure(s) only; CH3, treated with antiglaucoma medication(s) and underwent procedure(s); and CH4, received no treatment for POAG. Adherence and persistence with antiglaucoma medications, and disease-specific HCRU were analyzed. Pairwise two-sample comparisons and multivariate regressions were conducted. RESULTS Examined 232,572 eligible patients (CH1=60,895; CH2=4330; CH3=6027; CH4=161,320). Prostaglandin analogs were most prescribed antiglaucoma medications (CH1: 69.7%; CH3: 62.7%), of which latanoprost was most common (CH1: 51.3%; CH3: 46.1%). Disease-specific office visits occurred in 26.3%, 78.2%, 75.0%, 23.8%, and surgical services visits occurred in 3.8%, 36.3%, 42.5%, 3.3%, in CH1-CH4, respectively. Adherence was higher (medication possession ratio: 47.1% vs 39.4%; P<0.0001), and more patients remained persistent across 1-year post-index period in CH1 vs CH3 (25.4% vs 16.1%; P<0.0001). Positive predictors of medication persistence included being female, ≥55 years, and history of dyslipidemia or thyroid disease (all P≤0.0003). CONCLUSION Overall, 70% POAG patients might not have received antiglaucoma treatment. Since POAG is a slowly progressive blinding disease, the lack of antiglaucoma treatment and suboptimal adherence/persistence with medications are of major concerns. Targeted screening and educational approaches are needed to improve POAG management.
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Affiliation(s)
- Joseph S Imperato
- Global Medical Analytics and Real-World Evidence, Viatris Inc., Canonsburg, PA, USA
| | - Kelly H Zou
- Global Medical Analytics and Real-World Evidence, Viatris Inc., Canonsburg, PA, USA
| | - Jim Z Li
- Global Medical Analytics and Real-World Evidence, Viatris Inc., Canonsburg, PA, USA
| | - Tarek A Hassan
- Global Medical Affairs, Ophthalmology, Viatris Inc, Canonsburg, PA, USA
- Correspondence: Tarek A Hassan, Global Medical Affairs, Ophthalmology, Viatris Inc, 1000 Mylan Boulevard, Canonsburg, PA, 15317, USA, Tel +1 347 443 2850, Email
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