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O'Donovan B, Malone A, Horgan F, Bennett K. A scoping review protocol of the rehabilitation needs of people with brain tumours. HRB Open Res 2024; 6:45. [PMID: 38304095 PMCID: PMC10831223 DOI: 10.12688/hrbopenres.13773.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
Background Every year 480 people are diagnosed with a primary brain tumour in Ireland. Brain tumours can vary in type, location, treatment, and progression but neurological impairments are a consistent feature. Such neurological disability creates significant symptom burden that can seriously impact peoples' functional ability and quality of life. Rehabilitation can improve functional prognosis (motor and cognitive) and quality of life in people with brain tumours. However, research and experience consistently show that people with brain tumours can have difficulties accessing rehabilitation services. Our scoping review will investigate the research evidence concerning the rehabilitation needs of people with brain tumours. Methods The scoping review will be conducted in line with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidelines. Relevant databases (PubMed, Embase, CINAHL+, PsychINFO, PEDro) and grey literature sources will be searched. Publications relating to international rehabilitation practices will be included. A data extraction table will be created to facilitate narrative synthesis of the results. Conclusions This scoping review will examine the scope of the literature on the rehabilitation needs of people with brain tumours. The findings will inform a research project entitled "Surgery, radiotherapy, chemotherapy, but now what? Exploring the rehabilitation needs of people with brain tumours in Ireland". An article reporting the results of the scoping review will be submitted to a scientific journal and presented at relevant national and international conferences.
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Affiliation(s)
- B. O'Donovan
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - A. Malone
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - F. Horgan
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - K. Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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2
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Waldron C, Hughes J, Wallace E, Cahir C, Bennett K. Contexts and mechanisms relevant to General Practitioner (GP) based interventions to reduce adverse drug events (ADE) in community dwelling older adults: a rapid realist review. HRB Open Res 2023; 5:53. [PMID: 38283368 PMCID: PMC10811420 DOI: 10.12688/hrbopenres.13580.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/30/2024] Open
Abstract
Background Older adults in Ireland are at increased risk of adverse drug events (ADE) due, in part, to increasing rates of polypharmacy. Interventions to reduce ADE in community dwelling older adults (CDOA) have had limited success, therefore, new approaches are required.A realist review uses a different lens to examine why and how interventions were supposed to work rather than if, they worked. A rapid realist review (RRR) is a more focused and accelerated version.The aim of this RRR is to identify and examine the contexts and mechanisms that play a role in the outcomes relevant to reducing ADE in CDOA in the GP setting that could inform the development of interventions in Ireland. Methods Six candidate theories (CT) were developed, based on knowledge of the field and recent literature, in relation to how interventions are expected to work. These formed the search strategy. Eighty full texts from 633 abstracts were reviewed, of which 27 were included. Snowballing added a further five articles, relevant policy documents increased the total number to 45. Data were extracted relevant to the theories under iteratively developed sub-themes using NVivo software. Results Of the six theories, three theories, relating to GP engagement in interventions, relevance of health policy documents for older adults, and shared decision-making, provided data to guide future interventions to reduce ADEs for CDOA in an Irish setting. There was insufficient data for two theories, a third was rejected as existing barriers in the Irish setting made it impractical to use. Conclusions To improve the success of Irish GP based interventions to reduce ADEs for CDOA, interventions must be relevant and easily applied in practice, supported by national policy and be adequately resourced. Future research is required to test our theories within a newly developed intervention.
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Affiliation(s)
- Catherine Waldron
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, D02 DH60, Ireland
| | - John Hughes
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, D02 DH60, Ireland
| | - Emma Wallace
- Department of General Practice, University College Cork, Cork, Ireland
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin 2, D02 DH60, Ireland
| | - Caitriona Cahir
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, D02 DH60, Ireland
| | - K. Bennett
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, D02 DH60, Ireland
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Conlan K, McGrath J, Teeling M, MacAvin MJ, Bennett K, Gallagher L. Antipsychotic prescribing in GMS paediatric and young adult population in Ireland 2005-2015: repeated cross-sectional study. Ir J Psychol Med 2023; 40:343-352. [PMID: 33745473 DOI: 10.1017/ipm.2021.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To examine the rates of antipsychotic prescribing in the Irish paediatric and young adult population enrolled in the Irish General Medical Services Scheme pharmacy claims database from the Health Service Executive Primary Care Reimbursement Services database, with a focus on age and sex differences. To examine concomitant prescribing of certain other related medicines in this population. METHODS Data were obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive (HSE) - Primary Care Reimbursement Services (PCRS). Participants included children aged <16 years and youth aged 16-24 years availing of medicines under the HSE-PCRS GMS scheme between January 2005 and December 2015. Outcome measures included prescribing rates of antipsychotics from 2005 to 2015, differences in prescribing rates between different ages and sexes, and percentage of concomitant prescriptions for antidepressants, psychostimulants, anxiolytics and hypnosedatives. RESULTS Overall the trend in prescribing rates of antipsychotic medications was stable at 3.94/1000 in 2005 compared with 3.97/1000 in 2015 for children <16 years, and 48.37/1000 eligible population in 2005 compared to 39.64/1000 in 2015 for those aged 16-24. There was a significant decrease in prescribing rates for males in the 16-24 age group. CONCLUSIONS While rates of antipsychotic prescribing have decreased or remained stable over the timeframe of the study, we did find a significant proportion of this population were prescribed antipsychotics. This study also shows that co-prescribing of antidepressants increased and highlights the need for guidelines for antipsychotic prescribing in children and youth in terms of clinical indication, monitoring, co-prescribing and treatment duration.
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Affiliation(s)
- K Conlan
- Linn Dara CAMHS Approved Centre, Cherry Orchard Hospital, Dublin 10, Ireland
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - J McGrath
- ADMiRE Service, Lily Suite, Linn Dara CAMHS, Cherry Orchard Hospital, Ballyfermot, Ireland
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - M Teeling
- Department of Pharmacology and Therapeutics, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - M J MacAvin
- Department of Pharmacology and Therapeutics, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - K Bennett
- HRB Research Leader Unit, RCSI, Division of Population Health Sciences, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland
| | - L Gallagher
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- Beechpark Autism Services, Bryan S. Ryan Building, Main Road, Tallaght, Ireland
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4
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O'Donovan B, Kirke C, Pate M, McHugh S, Bennett K, Cahir C. Mapping the Theoretical Domain Framework to the Consolidated Framework for Implementation Research: do multiple frameworks add value? Implement Sci Commun 2023; 4:100. [PMID: 37620981 PMCID: PMC10464139 DOI: 10.1186/s43058-023-00466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 07/03/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Implementation researchers often combine the Theoretical Domain Framework (TDF) and Consolidated Framework for Implementation Research (CFIR) in their studies. However there is some debate on the merits of using multiple frameworks-whether they contribute to results or provide superfluous analysis. Our recent research combined the TDF and CFIR to identify determinants to widespread incorporation of patient held medication lists (PHML) in healthcare practice. The aim of this report is to provide guidance on the use of the TDF and CFIR; by assessing the degree of overlap between the two frameworks in their application to interviews about PHML. METHODS Semi-structured telephone interviews were conducted with healthcare professionals (HCPs) and non HCPs (people taking multiple medicines and caregivers).Interview data were transcribed and analysed using the TDF and CFIR. Within paired domains substantial intersection/overlap across constructs and domains within the two frameworks was classified as > 75% of coding references, consistent intersection/overlap was defined as > 50% and ≤ 75%, average intersection/overlap was defined as ≤ 50% and > 25% and non-substantial intersection/overlap was classified as ≤ 25% of coding references. RESULTS Interview data were collected from 39 participants - 21 HCPs and 18 non HCPs. Mapping of TDF domains to CFIR domains/constructs identified key determinants in six TDF domains: Environmental context & resources, Beliefs about capabilities, Beliefs about consequences, Social influences, Behavioural regulation and Social/professional role & identity; and five CFIR domains: Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individual and Process. A pattern of substantial intersection/overlap in coding emerged with broad TDF domains such as Environmental context & resources often linked to well-defined CFIR domains and constructs (e.g. design quality & packaging within Intervention Characteristics). Broad CFIR constructs such as knowledge & beliefs about intervention within Characteristics of Individuals also linked to more descriptive TDF domains like Beliefs about capabilities. In addition there was some unexpected non-substantial intersection/overlap in coding with the TDF domain Social influences less frequently linked to the CFIR Inner Setting domain and constructs such as networks and communications. CONCLUSIONS Identifying intersections/overlaps in coding between CFIR and TDF can assist interpretation of findings in implementation research. The strengths of each framework were exploited in a reciprocal process which provided more information to broad/poorly defined domains and enabled identification of implementation determinants and innovation determinants.
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Affiliation(s)
- B O'Donovan
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - C Kirke
- Quality Improvement Division, Health Service Executive (HSE), Medication Safety, Dublin, Ireland
| | - M Pate
- Quality Improvement Division, Health Service Executive (HSE), Medication Safety, Dublin, Ireland
| | - S McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - K Bennett
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - C Cahir
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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5
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Smith JS, Gebert J, Bennett K, Ebner LS, Flynn R, Mulon PY, Harvill L, Escher OG, Kreuder AJ, Bergman J, Cox S. The pharmacokinetics and pharmacodynamics of esomeprazole in sheep after intravenous dosing. Front Vet Sci 2023; 10:1172023. [PMID: 37215479 PMCID: PMC10196163 DOI: 10.3389/fvets.2023.1172023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/04/2023] [Indexed: 05/24/2023] Open
Abstract
Abomasal (gastric) ulceration is a morbidity in sheep, and currently, there is a paucity of pharmacokinetic and pharmacodynamic data for gastroprotectant drugs reported for this species. The proton pump inhibitor esomeprazole has been used in small animal and human patients for gastroprotection via increasing the gastric pH. The objective of this study was to report the pharmacokinetic parameters and pharmacodynamic effect of esomeprazole in sheep after single intravenous dosing. Four healthy adult Southdown cross ewes had blood collected over a 24 h time period after single intravenous dosing of esomeprazole at 1.0 mg/kg. Abomasal fluid was sampled over 24 h before and after esomeprazole administration. Plasma samples were analyzed for concentrations of esomeprazole and the esomeprazole metabolite, esomeprazole sulfone by high performance liquid chromatography. Pharmacokinetic and pharmacodynamic data were evaluated with specialized software. Esomeprazole was rapidly eliminated after IV administration. Elimination half-life, area under the curve, initial concentration (C0), and clearance were 0.2 h, 1,197 h*ng/mL, 4,321 ng/mL, and 0.83 mL/h/kg, respectively. For the sulfone metabolite elimination half-life, area under the curve and maximum concentration were 0.16 h, 22.5 h*ng/mL, and 65.0 ng/mL, respectively. Abomasal pH was significantly elevated from 1 to 6 h after administration and remained above 4.0 for at least 8 h after administration. No adverse effects were noted in these sheep. Esomeprazole was rapidly eliminated in sheep, similar to goats. Abomasal pH was increased, but future studies will be necessary to develop a clinical management approach to the use of esomeprazole in sheep.
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Affiliation(s)
- Joe S. Smith
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
- Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Jessica Gebert
- Lincoln Memorial University, College of Veterinary Medicine, Harrogate, TN, United States
| | - Kailee Bennett
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
| | - Lisa Sams Ebner
- Lincoln Memorial University, College of Veterinary Medicine, Harrogate, TN, United States
| | - Ryan Flynn
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
| | - Pierre-Yves Mulon
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
| | - Lainey Harvill
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
| | - Olivia Grace Escher
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
| | - Amanda Jo Kreuder
- Veterinary Microbiology and Preventative Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Joan Bergman
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
| | - Sherry Cox
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States
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Myers C, Cahir C, Bennett K. COVID-19, breast cancer care, and social determinants of health: a cross-sectional study to investigate the impact of a pandemic on health and health care. Eur J Cancer 2022. [PMCID: PMC9671786 DOI: 10.1016/s0959-8049(22)01553-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- C. Myers
- Royal College of Surgeons in Ireland, School of Population Health, Dublin, Ireland
| | - C. Cahir
- Royal College of Surgeons in Ireland, School of Population Health, Dublin, Ireland
| | - K. Bennett
- Royal College of Surgeons in Ireland, School of Population Health, Dublin, Ireland
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7
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Sexton E, Fowler K, Byrne E, Bennett K. 125 STROKE SURVIVOR AND CARER EXPERIENCES OF NAVIGATION OF STROKE SERVICES AND INFORMATION IN IRELAND: AN EXPLORATORY QUALITATIVE INTERVIEW STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patient navigation of stroke services is challenging, as survivors have diverse and complex needs, and clear care pathways are often lacking, particularly in the post-acute phase. Exploring the views of stroke survivors and main carers is critical to understanding these navigational challenges.
Methods
In-depth semi-structured interviews were conducted online or by phone with stroke survivors (n=16) and main carers (n=13) recruited through voluntary organisations and social media. Participants with communication or cognitive difficulties were included, and provided with accessible information materials. Interviews were audio-recorded and transcribed. Framework analysis was used, involving data familiarisation, coding, development of an analytic framework, charting and interpretation. Ryvicker’s (2018) behavioral-ecological conceptual framework for patient navigation was used to inform the analytic framework.
Results
Barriers to successful patient navigation at the healthcare system level included complex and unclear eligibility criteria for services and entitlements, including arbitrary age limits; geographical variation; and waiting times for services, particularly rehabilitation. Having a skilled or knowledgeable advocate, such as a family member with experience of the healthcare system, was a key enabling factor. Survivors and carers had to be pro-active and “push” or “battle” for needed services and information. Navigation often involved a substantial administrative burden, which survivors and caregivers had to manage in addition to the demands of the stroke itself, the recovery process, and in many cases other co-morbidities. Healthcare provider factors that supported navigation included clear communication with survivors/carers about services and the stroke itself. Staff who specifically supported care co-ordination were helpful, but this tended to be ad-hoc and limited in availability.
Conclusion
Dedicated staff to support patient navigation across the care continuum could make a significant difference to stroke survivor access to services and consequently outcomes. Clearer, standardised and more person-centred referrals pathways, that are widely publicised and understood, would also improve access.
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Affiliation(s)
- E Sexton
- RCSI University of Medicine and Health Sciences , Dublin, Ireland
| | - K Fowler
- RCSI University of Medicine and Health Sciences , Dublin, Ireland
| | - E Byrne
- RCSI University of Medicine and Health Sciences , Dublin, Ireland
| | - K Bennett
- RCSI University of Medicine and Health Sciences , Dublin, Ireland
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8
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O'Donovan B, Kirke C, Pate M, McHugh S, Bennett K, Cahir C. 145 ASSESSING MEDICINE LISTS: A QUALITATIVE STUDY WITH MULTIPLE STAKEHOLDERS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Multimorbidity and polypharmacy often result in numerous interactions with different Healthcare Professionals (HCPs) and many transitions of care. Keeping up-to-date medications list in people taking medicines and/or carers can reduce medication errors at care transitions. The HSE National Quality Improvement team is working on a national medication safety campaign which encourages people to keep lists. However, there is limited information about perceptions of Patient-Held Medication Lists (PHML) in clinical practice. The aim of this study was to examine attitudes to PHML among people taking/managing multiple medicines, HCPs; and how lists are used in practice.
Methods
Purposive sampling was employed and recruitment through relevant organisations, social media and snowballing methods. Semi-structured telephone interviews were conducted with 39 people; HCPs (N=21), patients/caregivers (N=18). Interviews were transcribed and thematically analysed with behavioural frameworks - the Consolidated Framework for Implementation Research (CFIR) and Theoretical Domains Framework (TDF).
Results
Three core themes were identified: Attitudes to PHML; Function and preferred features of PHML and Barriers and facilitators to future use of PHML. All participants thought keeping medication lists had benefits for both people and HCPs (e.g. empowering, improving adherence). All who were taking medicines used lists and found them useful in particular situations (e.g. emergencies). However, HCPs and patient/caregiver groups expressed concerns about their accuracy. It was felt that some individuals may have difficulties keeping an accurate PHML (e.g. older adults, on multiple/changing medications). The participants also differed on the level of detail that should be included in PHMLs. Most patients favoured simple lists but HCPs reported the lack of detailed information in PHML may be an issue.
Conclusion
Common concerns about the accuracy of PHML and diverging opinions on list content need to be addressed. Health promotion strategies which focus on promotion of lists by key HCPs and provide people with a variety of list options could increase the wider implementation of PHMLs.
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Affiliation(s)
- B O'Donovan
- Royal College of Surgeons Ireland , Dublin, Ireland
| | - C Kirke
- National Quality Improvement team, Health Service Executive , Dublin, Ireland
| | - M Pate
- National Quality Improvement team, Health Service Executive , Dublin, Ireland
| | - S McHugh
- University College Cork , Cork, Ireland
| | - K Bennett
- Royal College of Surgeons Ireland , Dublin, Ireland
| | - C Cahir
- Royal College of Surgeons Ireland , Dublin, Ireland
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9
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Murphy M, Bennett K, Hughes C, Cadogan CA. Potentially inappropriate prescribing in older adults with cancer receiving specialist palliative care: a retrospective analysis of medical records. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac021.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Older adults (≥65 years) with cancer often have existing comorbidities requiring multiple medications (1). Optimising medications in palliative care requires clinicians to consider whether each medication is appropriate in relation to patients’ context, treatment goals and life expectancy. The reported prevalence of potentially inappropriate prescribing (PIP) in general palliative care settings ranges from 15 to 92% (2). However, the application of tools that are specific to populations with limited life expectancy has been lacking in previous research (2).
Aim
To describe and assess the appropriateness of prescribing practices for older adults with cancer in the last seven days of life in an inpatient palliative care setting.
Methods
This was a retrospective observational study of medical records for older adults (≥65 years) with cancer who received inpatient specialist palliative care services in a hospice setting in Ireland in the final week of life over a two-year period. Data were extracted relating to patient demographics and prescribed medications using an electronic pro-forma. Medication appropriateness was assessed using the following tools: STOPPFrail (Version 2; consists of 25 deprescribing criteria for use in frail older adults with limited life expectancy), the OncPal deprescribing guideline (consists of eight medication classes for deprescribing in palliative patients with cancer) and criteria for identifying Potentially Inappropriate Prescribing in older adults with Cancer receiving Palliative Care (PIP-CPC; consists of 24 criteria for identifying potentially inappropriate prescribing of medications for symptomatic relief in older adults with cancer). These tools were retrospectively applied to the extracted data by the lead researcher. Data were analysed (Stata, Version 15) using descriptive statistics, including means (standard deviation, SD), medians (inter-quartile range, IQR) and frequency and percentage.
Results
One hundred and eighty older adults with cancer were included in this study. The majority were male (60.6%) and the median age was 74 years (range 65-94 years). The most common primary cancer diagnoses affected the digestive organs (31.7%), respiratory and intrathoracic organs (18.8%) and male genital organs (10%). Almost all patients (94.5%) had at least one comorbid condition (median 3, IQR 2-5). The median number of medications increased from five (IQR 3-7) seven days before death, to 11 medications on the day of death (IQR 9-15). The most prevalent drug classes were opioids, antipsychotics, antispasmodics, benzodiazepines and paracetamol. More than half of patients had at least one PIP identified by the tools (n=97, 53.9%). The identified prevalence of PIP per tool in the patient cohort was: STOPPFrail V2 (20.6%), OncPal (12.7%), PIP-CPC (32.8%). However, several criteria could not be applied due to the absence of clinical information.
Conclusion
This study highlights that the number of medications prescribed to older adults with cancer increased as time to death approached, and that more than half of patients received at least one medication which was considered potentially inappropriate during their last week of life. The absence of electronic prescribing records and retrospective nature of the study limited the applicability of some criteria. Interventions are needed to optimise medication prescribing and use in palliative care settings.
References
(1) Sharma M, Loh KP, Nightingale G, Mohile SG, Holmes HM. Polypharmacy and potentially inappropriate medication use in geriatric oncology. J Geriatr Oncol. 2016;7(5):346-53.
(2) Cadogan CA, Murphy M, Boland M, Bennett K, McLean S, Hughes C. Prescribing practices, patterns, and potential harms in patients receiving palliative care: A systematic scoping review. Expl Res Clinic Soc Pharm. 2021;1(3):100050.
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Affiliation(s)
- M Murphy
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K Bennett
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - C Hughes
- School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
| | - C A Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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Sexton E, Hickey A, Williams DJ, Horgan F, Byrne E, Macey C, Cuffe P, Timmons S, Collins R, Bennett K. Identifying priority interventions for stroke in Ireland through stakeholder engagement to inform population-based modelling: a mixed methods protocol. HRB Open Res 2021; 4:109. [PMID: 38567097 PMCID: PMC10985459 DOI: 10.12688/hrbopenres.13413.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 04/04/2024] Open
Abstract
Introduction Improvements in stroke survival have resulted in increasing numbers of people living with stroke, and with a rapidly evolving evidence-base for stroke prevention and management, there is a need for robust data and evidence to inform future policy decision-making. Population-based modelling and economic evaluation of alternative policy options is a useful tool to support decision making. However, this process must be aligned to key stakeholder priorities. The aim of the proposed research is to engage with stakeholders in Ireland to identify their priorities for the development of stroke prevention and management strategies and policies. Methods The design is iterative, based on mixed methods. Phase 1 involves a qualitative approach for initial priority gathering, based on an open-ended online survey (target sample: 100-120) and interviews (target sample: 34-40). Stakeholders will include: 1) stroke survivors and family member/main carers, 2) healthcare professionals (HCPs) providing stroke care and 3) people working in stroke research, policy and advocacy. These data will be analysed qualitatively, with the aim of identifying a long-list of specific interventions. Phase 2 involves an interim priority-setting exercise, based on a quantitative online survey. Participants will be asked to rank the interventions on the initial long-list. These rankings will be used to inform a final priority-setting workshop (Phase 3), where a small stakeholder group will decide on the final set of priorities. Discussion The rich and detailed quantitative and qualitative data, based on the views of diverse stakeholders, will be directly relevant to policy makers and service planners involved in developing and improving stroke care in Ireland. The information provided will also be essential to inform the Scenario and Intervention Modelling in Ireland for Stroke (SIMI-Stroke) project, a population-based economic and epidemiological modelling study aimed at identifying cost-effective interventions for stroke across the prevention, acute and post-acute care continuum.
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Affiliation(s)
- Eithne Sexton
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anne Hickey
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David J. Williams
- Department of Geriatric and Stroke Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Geriatric and Stroke Medicine, Beaumont Hospital, Dublin, Ireland
| | - F. Horgan
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Elaine Byrne
- Graduate School of Healthcare Management, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Padraic Cuffe
- Irish Heart Foundation, Dublin, Ireland
- Patient collaborator, Sligo, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
- National Dementia Office, Health Service Executive, Tullamore, Co Offaly, Ireland
| | - Rónán Collins
- National Clinical Programme for Stroke, Health Service Executive, Dublin, Ireland
- Age-Related Health Care and Stroke Service, Tallaght University Hospital, Dublin, Ireland
| | - K. Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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Scott RHH, Glize K, Antonelli L, Khan M, Theobald W, Wei M, Betti R, Stoeckl C, Seaton AG, Arber TD, Barlow D, Goffrey T, Bennett K, Garbett W, Atzeni S, Casner A, Batani D, Li C, Woolsey N. Shock Ignition Laser-Plasma Interactions in Ignition-Scale Plasmas. Phys Rev Lett 2021; 127:065001. [PMID: 34420313 DOI: 10.1103/physrevlett.127.065001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
We use a subignition scale laser, the 30 kJ Omega, and a novel shallow-cone target to study laser-plasma interactions at the ablation-plasma density scale lengths and laser intensities anticipated for direct drive shock-ignition implosions at National Ignition Facility scale. Our results show that, under these conditions, the dominant instability is convective stimulated Raman scatter with experimental evidence of two plasmon decay (TPD) only when the density scale length is reduced. Particle-in-cell simulations indicate this is due to TPD being shifted to lower densities, removing the experimental back-scatter signature and reducing the hot-electron temperature. The experimental laser energy-coupling to hot electrons was found to be 1%-2.5%, with electron temperatures between 35 and 45 keV. Radiation-hydrodynamics simulations employing these hot-electron characteristics indicate that they should not preheat the fuel in MJ-scale shock ignition experiments.
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Affiliation(s)
- R H H Scott
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire OX11 OQX, United Kingdom
| | - K Glize
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire OX11 OQX, United Kingdom
| | - L Antonelli
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - M Khan
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - W Theobald
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - M Wei
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - R Betti
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - C Stoeckl
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - A G Seaton
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - T D Arber
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - D Barlow
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - T Goffrey
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - K Bennett
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - W Garbett
- AWE, Aldermaston, Reading, Berkshire RG7 4PR, United Kingdom
| | - S Atzeni
- Dipartimento SBAI, Università di Roma "La Sapienza", Roma 00161, Italy
| | - A Casner
- CELIA, University of Bordeaux, Bordeaux F-33405, France
| | - D Batani
- CELIA, University of Bordeaux, Bordeaux F-33405, France
| | - C Li
- MIT, Cambridge, Massachusetts 02139, USA
| | - N Woolsey
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
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Murphy M, Bennett K, Ryan S, Hughes C, Lavan A, Cadogan C. Interventions to optimise medication prescribing and adherence in older people with cancer: A systematic scoping review. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Older adults with cancer often require multiple medications (polypharmacy) comprising cancer-specific treatments, supportive care medications (e.g. analgesics) and medications for pre-existing conditions. The reported prevalence of polypharmacy in older adults with cancer ranges from 13–92% (1). Increasing numbers of medications pose risks of potentially inappropriate prescribing and medication non-adherence.
Aim
The aim of this scoping review was to provide an overview of evaluations of interventions to optimise medication prescribing and/or adherence in older adults with cancer, with a particular focus on the interventions, study populations and outcome measures that have been assessed in previous evaluations.
Methods
Four databases (PubMed, EMBASE, CINAHL, PsycINFO) were searched from inception to 29th November 2019 using relevant search terms (e.g. cancer, older adults, prescribing, adherence). Eligible studies evaluated interventions seeking to improve medication prescribing and/or adherence in older adults (≥65 years) with an active cancer diagnosis using a comparative evaluation (e.g. inclusion of a control group). All outcomes for studies that met inclusion criteria were included in the review. Two reviewers independently screened relevant abstracts for inclusion and performed data extraction. As a scoping review aims to provide a broad overview of existing literature, formal assessments of methodological quality of included studies were not undertaken. Extracted data were collated using tables and accompanying narrative descriptive summaries. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines (2).
Results
The electronic searches yielded 21,136 citations (Figure 1). Nine studies met inclusion criteria. Included studies consisted of five randomised controlled trials (RCTs), including one cluster RCT, and four before-and-after study designs. Studies were primarily conducted in oncology clinics, ranging from single study sites to 109 oncology clinics. Sample sizes ranged from 33 to 4844 patients. All studies had a sample population with a mean/median age of ≥65 years, however, only two studies focused specifically on older populations. Interventions most commonly involved patient education (n=6), and were delivered by pharmacists or nurses. Five studies referred to the intervention development process and no studies reported any theoretical underpinning. Three studies reported on prescribing-related outcomes and seven studies reported on adherence-related outcomes, using different terminology and a range of assessments. Prescribing-related outcomes comprised assessments of medication appropriateness (using Beers criteria), drug-related problems and drug interactions. Adherence-related outcomes included assessments of self-reported medication adherence and calculation of patients’ medication possession ratio.
Conclusion
The main strength of this scoping review is that it provides a broad overview of the existing literature on interventions aimed at optimising medication prescribing and adherence in older adults with cancer. The review highlights a lack of robust studies specifically targeting this patient population and limited scope to pool outcome data across included studies. Limitations of the review were that searches were restricted to English language publications and no grey literature was searched. Future research should focus specifically on older patients with cancer, and exercise rigour during intervention development, evaluation and reporting in order to generate findings that could inform future practice.
References
1. Maggiore RJ, Gross CP, Hurria A. Polypharmacy in older adults with cancer. The oncologist. 2010;15(5):507–22.
2. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.
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Affiliation(s)
- M Murphy
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K Bennett
- Population Health Sciences Division, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - S Ryan
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - C Hughes
- School of Pharmacy, Queen’s University Belfast, Belfast, UK
| | - A Lavan
- Geriatric Medicine, Cork University Hospital, Cork, Ireland
- Department of Medicine for the Elderly, St James’s Hospital, Dublin, Ireland
| | - C Cadogan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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14
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Rindfleish S, Bennett K, Marsh A, Chachay V. Outcomes of dietary management approaches in active ulcerative colitis: A systematic review. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Syed S, Kingsbury M, Bennett K, Manion I, Colman I. Adolescents' knowledge of a peer's non-suicidal self-injury and own non-suicidal self-injury and suicidality. Acta Psychiatr Scand 2020; 142:366-373. [PMID: 32885408 DOI: 10.1111/acps.13229] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Some research suggests that suicidal ideation and attempt among adolescents may be contagious - that is adolescents who are exposed to peers' suicidal behaviour are more likely to experience suicidal ideation or attempt suicide themselves. Less is known about the potential contagion effect of non-suicidal self-injury (NSSI). Our objective was to determine whether knowledge of a friend's NSSI is associated with adolescent's own non-suicidal self-injury and suicidal behaviours. METHODS Data from 1483 youth ages 14-17 years were obtained from the 2014 Ontario Child Health Study, a cross-sectional population-based survey of children and adolescents in Ontario, Canada. Logistic regression models were used to examine associations between knowledge of a friend's NSSI and adolescents' own self-reported self-injurious and suicidal behaviours. Interactions with gender, age group and presence of a mental disorder were investigated. RESULTS Knowledge of a friend's non-suicidal self-injury was significantly associated with the adolescent's own non-suicidal self-injury (OR = 2.03, 95% CI 1.05-3.90), suicidal ideation (OR = 3.08, 95% CI 1.50-6.30) and suicide attempt (OR = 2.87, 95% CI 1.20-6.87). CONCLUSION These findings suggest an apparent contagion effect for non-suicidal self-injury. Awareness of a friend's self-injurious behaviours is associated with an adolescent's own self-injury and suicidality. Interventions aimed at preventing NSSI and suicidality should consider prevention of possible contagion at the school and/or community level.
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Affiliation(s)
- S Syed
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - M Kingsbury
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - K Bennett
- Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics) and the Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - I Manion
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - I Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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16
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Tatum T, Curry P, Dunne B, Walsh K, Bennett K. Polypharmacy Rates among Patients over 45 years. Ir Med J 2019; 112:893. [PMID: 31045333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Polypharmacy, defined as receipt of ≥5 medications in any one month, is often associated with potentially inappropriate prescribing and adverse drug interactions. High levels of polypharmacy have been observed internationally and in Ireland. The Health Service Executive Primary Care Reimbursement Services (HSE-PCRS) pharmacy claims database for the GMS eligible population was used. We conducted Chi-square tests to determine the statistical significance of perceived differences in medication use among patients aged ³ 45 years. Our results establish a national benchmark for polypharmacy in gender and various age categories in the HSE-PCRS. Of the 794,628 individuals aged ≥45 years with at least one claim in 2013, 64.3% (510,946) had polypharmacy, with higher rates among women (67.0% - 293,886 - compared to 60.8% of men - 216,444). Patients aged 45-54 years were less likely to have polypharmacy (38.6% - 69,934) compared to those aged 75 years old (82.6% - 197,565). The high levels of polypharmacy are of interest, and suggest that monitoring and evaluation of patients’ medication regimes may be required to ensure appropriateness.
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Affiliation(s)
- T Tatum
- UCD Geary Institute for Public Policy, University College Dublin
| | - P Curry
- School of Social Work and Social Policy, Trinity College Dublin
| | - B Dunne
- UCD Geary Institute for Public Policy, University College Dublin
| | - K Walsh
- UCD Geary Institute for Public Policy, University College Dublin
| | - K Bennett
- RCSI Population and Health Sciences, Royal College of Surgeons in Ireland
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17
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Madden JM, Duffy MJ, Zgaga L, Bennett K. Trends in vitamin D supplement use in a general female and breast cancer population in Ireland: A repeated cross-sectional study. PLoS One 2018; 13:e0209033. [PMID: 30543699 PMCID: PMC6292595 DOI: 10.1371/journal.pone.0209033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/27/2018] [Indexed: 12/22/2022] Open
Abstract
Background Vitamin D has been linked with improved survival after breast cancer diagnosis but little is known about prescribing rates. This study investigates trends in vitamin D supplement use in both a general female and breast cancer population. Methods Women with a breast cancer diagnosis were identified from the National Cancer Registry of Ireland (n = 19870). Women who had any vitamin D claim between 2005 and 2011 were identified from pharmacy claims data (n = 8556). Prevalence rates were calculated as a proportion of all eligible women and by age (< 55 years, ≥ 55 years). Poisson regression was used to compare rates of vitamin D prescribing across years (risk ratio (RR), 95% CI). Results There was a statistically significant increase in women with a claim for vitamin D between 2005–2011, with the largest increase among breast cancer patients aged ≥ 55 years (RR = 2.26; 95% CI, 2.11–2.42). Conclusion This may have significant public health implications if associations between vitamin D and improved breast cancer survival prove to be causal.
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Affiliation(s)
- J. M. Madden
- Population Health Sciences Division, Royal College of Surgeons in Ireland, Dublin, Ireland
- * E-mail:
| | - M. J. Duffy
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - L. Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - K. Bennett
- Population Health Sciences Division, Royal College of Surgeons in Ireland, Dublin, Ireland
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18
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Bennett K. UTILISING THE ECOLOGICAL MODEL OF RESILIENCE TO UNDERSTAND VULNERABILITY IN OLDER WIDOWED. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Bennett
- University of Liverpool, Liverpool, England, United Kingdom
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19
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Wu PZ, Liberman LD, Bennett K, de Gruttola V, O'Malley JT, Liberman MC. Primary Neural Degeneration in the Human Cochlea: Evidence for Hidden Hearing Loss in the Aging Ear. Neuroscience 2018; 407:8-20. [PMID: 30099118 DOI: 10.1016/j.neuroscience.2018.07.053] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 01/18/2023]
Abstract
The noise-induced and age-related loss of synaptic connections between auditory-nerve fibers and cochlear hair cells is well-established from histopathology in several mammalian species; however, its prevalence in humans, as inferred from electrophysiological measures, remains controversial. Here we look for cochlear neuropathy in a temporal-bone study of "normal-aging" humans, using autopsy material from 20 subjects aged 0-89 yrs, with no history of otologic disease. Cochleas were immunostained to allow accurate quantification of surviving hair cells in the organ Corti and peripheral axons of auditory-nerve fibers. Mean loss of outer hair cells was 30-40% throughout the audiometric frequency range (0.25-8.0 kHz) in subjects over 60 yrs, with even greater losses at both apical (low-frequency) and basal (high-frequency) ends. In contrast, mean inner hair cell loss across audiometric frequencies was rarely >15%, at any age. Neural loss greatly exceeded inner hair cell loss, with 7/11 subjects over 60 yrs showing >60% loss of peripheral axons re the youngest subjects, and with the age-related slope of axonal loss outstripping the age-related loss of inner hair cells by almost 3:1. The results suggest that a large number of auditory neurons in the aging ear are disconnected from their hair cell targets. This primary neural degeneration would not affect the audiogram, but likely contributes to age-related hearing impairment, especially in noisy environments. Thus, therapies designed to regrow peripheral axons could provide clinically meaningful improvement in the aged ear.
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Affiliation(s)
- P Z Wu
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA; Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - L D Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA
| | - K Bennett
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - V de Gruttola
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - J T O'Malley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA
| | - M C Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA.
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20
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Blaiss M, Petroni D, Tilles S, Zigmont E, Bennett K, Venugopal A, Cassese M, Georgitseas N, Lieberman J. P338 Current management and use of oral immunotherapy (OIT) for peanut allergy in US patients. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Teeling M, MacAvin MJ, Bennett K. Impact of safety warnings on domperidone prescribing in Ireland. Ir J Med Sci 2017; 187:281-285. [PMID: 28730460 DOI: 10.1007/s11845-017-1657-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 07/05/2017] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to investigate the impact of the 2014 safety warnings on use of domperidone, on subsequent prescribing patterns in Ireland. METHODS The Irish HSE-PCRS pharmacy claims database was used to identify the study cohort (aged 18+), prescribed domperidone from Jan 2014 to Oct 2015. Dosage was available for each claim; concomitant prescription with the following drug classes was identified and calculated as a percentage of the total number of claims: anti-arrhythmics, macrolide antimicrobials and the selective serotonin receptor inhibitors (SSRIs) citalopram and escitalopram. Segmented regression analysis was used to examine the changes in prescribing before and after the issue of safety warnings in May 2014. RESULTS A total of 397,572 claims for domperidone were identified from Jan 2014 to Oct 2015. Overall, there was a significant decline in numbers receiving domperidone during the study period (from 22,226 to 15,691 claims, p = 0.012), with no significant change over time. In addition, no significant change in co-prescribed SSRIs or anti-arrhythmic agents was observed over time; co-prescribed macrolide antimicrobials significantly increased after the safety advisory compared to trends before (p = 0.031). In those aged 60+ years, 10% of claims (n = 1332) were for doses >30 mg/day at the start of the study with no significant change in dose after the May advisory. CONCLUSIONS Safety warnings concerning domperidone appeared to have had little effect on prescribing patterns in Ireland. Of concern is the continuing co-prescription with drugs known to increase the risk of QT prolongation, in all ages, including the 60+ year age group.
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Affiliation(s)
- M Teeling
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland.
| | - M J MacAvin
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - K Bennett
- Population Health Sciences Division, Royal College of Surgeons in Ireland, Dublin, Ireland
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22
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Williams AM, Lester L, Bulsara C, Petterson A, Bennett K, Allen E, Joske D. Patient Evaluation of Emotional Comfort Experienced (PEECE): developing and testing a measurement instrument. BMJ Open 2017; 7:e012999. [PMID: 28122833 PMCID: PMC5278251 DOI: 10.1136/bmjopen-2016-012999] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/19/2016] [Accepted: 12/14/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The Patient Evaluation of Emotional Comfort Experienced (PEECE) is a 12-item questionnaire which measures the mental well-being state of emotional comfort in patients. The instrument was developed using previous qualitative work and published literature. DESIGN Instrument development. SETTING Acute Care Public Hospital, Western Australia. PARTICIPANTS Sample of 374 patients. INTERVENTIONS A multidisciplinary expert panel assessed the face and content validity of the instrument and following a pilot study, the psychometric properties of the instrument were explored. MAIN OUTCOME MEASURES Exploratory and confirmatory factor analysis assessed the underlying dimensions of the PEECE instrument; Cronbach's α was used to determine the reliability; κ was used for test-retest reliability of the ordinal items. RESULTS 2 factors were identified in the instrument and named 'positive emotions' and 'perceived meaning'. A greater proportion of male patients were found to report positive emotions compared with female patients. The instrument was found to be feasible, reliable and valid for use with inpatients and outpatients. CONCLUSIONS PEECE was found to be a feasible instrument for use with inpatient and outpatients, being easily understood and completed. Further psychometric testing is recommended.
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Affiliation(s)
- A M Williams
- School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - L Lester
- Health Promotion Evaluation Unit, School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - C Bulsara
- School of Nursing and Midwifery, Institute of Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - A Petterson
- SolarisCare Foundation, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - K Bennett
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - E Allen
- School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - D Joske
- Department of Haematology, Sir Charles Gairdner Hospital, The University of Western Australia, Crawley, Western Australia, Australia
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23
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O'Donnell S, Cheung R, Bennett K, Lagacé C. The 2014 Survey on Living with Chronic Diseases in Canada on Mood and Anxiety Disorders: a methodological overview. Health Promot Chronic Dis Prev Can 2016; 36:275-288. [PMID: 27977083 PMCID: PMC5387795 DOI: 10.24095/hpcdp.36.12.02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION There is a paucity of information about the impact of mood and anxiety disorders on Canadians and the approaches used to manage them. To address this gap, the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorders Component (SLCDC-MA) was developed. The purpose of this paper is to describe the methodology of the 2014 SLCDC-MA and examine the sociodemographic characteristics of the final sample. METHODS The 2014 SLCDC-MA is a cross-sectional follow-up survey that includes Canadians from the 10 provinces aged 18 years and older with mood and/or anxiety disorders diagnosed by a health professional that are expected to last, or have already lasted, six months or more. The survey was developed by the Public Health Agency of Canada (PHAC) through an iterative, consultative process with Statistics Canada and external experts. Statistics Canada performed content testing, designed the sampling frame and strategies and collected and processed the data. PHAC used descriptive analyses to describe the respondents' sociodemographic characteristics, produced nationally representative estimates using survey weights provided by Statistics Canada, and generated variance estimates using bootstrap methodology. RESULTS The final 2014 SLCDC-MA sample consists of a total of 3361 respondents (68.9% response rate). Among Canadian adults with mood and/or anxiety disorders, close to twothirds (64%) were female, over half (56%) were married/in a common-law relationship and 60% obtained a post-secondary education. Most were young or middle-aged (85%), Canadian born (88%), of non-Aboriginal status (95%), and resided in an urban setting (82%). Household income was fairly evenly distributed between the adequacy quintiles; however, individuals were more likely to report a household income adequacy within the lowest (23%) versus highest (17%) quintile. Forty-five percent reported having a mood disorder only, 24% an anxiety disorder only and 31% both kinds of disorder. CONCLUSION The 2014 SLCDC-MA is the only national household survey to collect information on the experiences of Canadians living with a professionally diagnosed mood and/or anxiety disorder. The information collected offers insights into areas where additional support or interventions may be needed and provides baseline information for future public health research in the area of mental illness.
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Affiliation(s)
- S O'Donnell
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - R Cheung
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - K Bennett
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - C Lagacé
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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Sadlier C, O'Dea S, Bennett K, Dunne J, Conlon N, Bergin C. Immunological efficacy of pneumococcal vaccine strategies in HIV-infected adults: a randomized clinical trial. Sci Rep 2016; 6:32076. [PMID: 27580688 PMCID: PMC5007521 DOI: 10.1038/srep32076] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 07/18/2016] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to compare the immunologic response to a prime-boost immunization strategy combining the 13-valent conjugate pneumococcal vaccine (PCV13) with the 23-valent polysaccharide pneumococcal vaccine (PPSV23) versus the PPSV23 alone in HIV-infected adults. HIV-infected adults were randomized to receive PCV13 at week 0 followed by PPSV23 at week 4 (n = 31, prime-boost group) or PPSV23 alone at week 4 (n = 33, PPSV23-alone group). Serotype specific IgG geometric mean concentration (GMC) and functional oposonophagocytic (OPA) geometric mean titer (GMT) were compared for 12 pneumococcal serotypes shared by both vaccines at week 8 and week 28. The prime-boost vaccine group were more likely to achieve a ≥2-fold increase in IgG GMC and a GMC >1 ug/ml at week 8 (odds ratio (OR) 2.00, 95% confidence interval (CI) 1.46–2.74, p < 0.01) and week 28 (OR 1.95, 95% CI 1.40–2.70, p < 0.01). Similarly, the prime-boost vaccine group were more likely to achieve a ≥4-fold increase in GMT at week 8 (OR 1.71, 95% CI 1.22–2.39, p < 0.01) and week 28 (OR 1.6, 95% CI 1.15–2.3, p < 0.01). This study adds to evidence supporting current pneumococcal vaccination recommendations combining the conjugate and polysaccharide pneumococcal vaccines in the United States and Europe for HIV-infected individuals.
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Affiliation(s)
- C Sadlier
- Department of GU Medicine and Infectious Diseases (GUIDE), St James's Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S O'Dea
- Department of GU Medicine and Infectious Diseases (GUIDE), St James's Hospital, Dublin, Ireland
| | - K Bennett
- Population Health Sciences Division, Royal College of Surgeons in Ireland, St Stephens Green, Dublin 2, Ireland
| | - J Dunne
- Department of Immunology, St James's Hospital, Dublin, Ireland
| | - N Conlon
- Department of Immunology, St James's Hospital, Dublin, Ireland
| | - C Bergin
- Department of GU Medicine and Infectious Diseases (GUIDE), St James's Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
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Erkoyun E, Sözmen K, Bennett K, Unal B, Boshuizen HC. Predicting the health impact of lowering salt consumption in Turkey using the DYNAMO health impact assessment tool. Public Health 2016; 140:228-234. [PMID: 27545691 DOI: 10.1016/j.puhe.2016.04.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/16/2016] [Accepted: 04/26/2016] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To estimate the impact of three daily salt consumption scenarios on the prevalence and incidence of ischaemic heart disease (IHD) and cerebrovascular disease in 2025 in the Turkish population aged ≥30 years using the DYNAMO Health Impact Assessment tool. STUDY DESIGN Statistical disease modelling study. METHODS DYNAMO health impact assessment was populated using data from Turkey to estimate the prevalence and incidence of IHD and cerebrovascular disease in 2025. TurkSTAT data were used for demographic data, and national surveys were used for salt consumption and disease-specific burden. Three salt consumption scenarios were modelled: (1) reference scenario: mean salt consumption stays the same from 2012-2013 until 2025; (2) gradual decline: daily salt intake reduces steadily by 0.47 g per year by lowering salt intake from bread by 50% and from table salt by 40% by 2025; and (3) World Health Organization (WHO) advice: daily salt intake of 5 g per day from 2013 until 2025. RESULTS The gradual decline scenario would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.3% and 0.2%, respectively, and a decrease in the incidence by 0.6 and 0.4 per 1000, respectively. Following WHO's advice would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.8% and 0.5%, respectively, and a decrease in the incidence by 1.0 and 0.7 per 1000, respectively. CONCLUSION This model indicates that Turkey can lower its future cardiovascular disease burden by following the gradual decline scenario. Following WHO's advice would achieve an even greater benefit.
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Affiliation(s)
- E Erkoyun
- Department of Public Health, Dokuz Eylul University, Izmir, Turkey.
| | - K Sözmen
- Department of Public Health, Izmir Katip Celebi University, Izmir, Turkey
| | - K Bennett
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, Dublin, Ireland
| | - B Unal
- Department of Public Health, Dokuz Eylul University, Izmir, Turkey
| | - H C Boshuizen
- Department of Statistics and Mathematical Modelling, National Institute of Public Health and the Environment, Bilthoven, The Netherlands; Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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26
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Khan S, Gilligan K, O’Brien K, Moloney B, Miller I, Ramphul E, Barron T, Bennett K, Byrne A, Kerin M, Dwyer R. Impact of Aspirin on factors associated with breast cancer lymph node metastasis. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61325-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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O'Flaherty M, Bandosz P, Critchley J, Capewell S, Guzman-Castillo M, Aspelund T, Bennett K, Kabir K, Björck L, Bruthans J, Hotchkiss JW, Hughes J, Laatikainen T, Palmieri L, Zdrojewski T. Exploring potential mortality reductions in 9 European countries by improving diet and lifestyle: A modelling approach. Int J Cardiol 2016; 207:286-91. [PMID: 26812643 PMCID: PMC4766942 DOI: 10.1016/j.ijcard.2016.01.147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 01/05/2016] [Accepted: 01/06/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) death rates have fallen across most of Europe in recent decades. However, substantial risk factor reductions have not been achieved across all Europe. Our aim was to quantify the potential impact of future policy scenarios on diet and lifestyle on CHD mortality in 9 European countries. METHODS We updated the previously validated IMPACT CHD models in 9 European countries and extended them to 2010-11 (the baseline year) to predict reductions in CHD mortality to 2020(ages 25-74years). We compared three scenarios: conservative, intermediate and optimistic on smoking prevalence (absolute decreases of 5%, 10% and 15%); saturated fat intake (1%, 2% and 3% absolute decreases in % energy intake, replaced by unsaturated fats); salt (relative decreases of 10%, 20% and 30%), and physical inactivity (absolute decreases of 5%, 10% and 15%). Probabilistic sensitivity analyses were conducted. RESULTS Under the conservative, intermediate and optimistic scenarios, we estimated 10.8% (95% CI: 7.3-14.0), 20.7% (95% CI: 15.6-25.2) and 29.1% (95% CI: 22.6-35.0) fewer CHD deaths in 2020. For the optimistic scenario, 15% absolute reductions in smoking could decrease CHD deaths by 8.9%-11.6%, Salt intake relative reductions of 30% by approximately 5.9-8.9%; 3% reductions in saturated fat intake by 6.3-7.5%, and 15% absolute increases in physical activity by 3.7-5.3%. CONCLUSIONS Modest and feasible policy-based reductions in cardiovascular risk factors (already been achieved in some other countries) could translate into substantial reductions in future CHD deaths across Europe. However, this would require the European Union to more effectively implement powerful evidence-based prevention policies.
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Affiliation(s)
- M O'Flaherty
- Department of Public Health, University of Liverpool, L69 3GB, UK, 2.
| | - P Bandosz
- Department of Public Health, University of Liverpool, L69 3GB, UK, 2
| | - J Critchley
- Population Health Research Institute, St Georges, University of London, UK
| | - S Capewell
- Department of Public Health, University of Liverpool, L69 3GB, UK, 2
| | - M Guzman-Castillo
- Department of Public Health, University of Liverpool, L69 3GB, UK, 2
| | | | - K Bennett
- Department of Pharmacology & Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
| | - K Kabir
- Department of Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - L Björck
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Sweden
| | - J Bruthans
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic
| | - J W Hotchkiss
- School of Veterinary Medicine, University of Glasgow, UK
| | - J Hughes
- UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, UK
| | - T Laatikainen
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - L Palmieri
- National Center of Epidemiology, Istituto Superiore di Sanità, Rome, Italy
| | - T Zdrojewski
- Medical University of Gdansk, Department of Hypertension and Diabetology, Poland
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Grimes RT, Bennett K, Canavan R, Tilson L, Henman MC. The impact of initial antidiabetic agent and use of monitoring agents on prescription costs in newly treated type 2 diabetes: A retrospective cohort analysis. Diabetes Res Clin Pract 2016; 113:152-9. [PMID: 26810270 DOI: 10.1016/j.diabres.2015.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/28/2015] [Accepted: 12/26/2015] [Indexed: 12/21/2022]
Abstract
AIMS To measure the costs associated with the use of antidiabetic agents, monitoring materials and cardiovascular disease (CVD) agents in the management of newly treated type 2 diabetes, and to investigate the factors associated with these costs. METHODS A population-based retrospective cohort study was conducted using the Irish national pharmacy claims database. Newly treated patients were identified for 2012 and followed for one year post treatment initiation. Factors associated with costs were assessed using a generalised linear model with gamma family and log-link function. Cost ratios (CR) and 95% CIs were used to determine the contributors of prescription costs. Adjusted odd ratios (OR) and 95% CIs were used to investigate factors associated with high frequency self-monitoring of blood glucose (SMBG). RESULTS Mean prescription costs for the 12,941 subjects was €871, while total costs were €11 million. CVD agents accounted for 58% of total costs; 22% of costs were for SMBG; antidiabetic agents accounted for 17% of costs. SMBG resulted in costs that were 80% higher than those without, CR 1.80 (95% CI 1.76-1.84). No significant differences were observed between initiation on metformin or sulphonylureas and high frequency SMBG (OR 1.01 95% CI 0.97-1.04 vs reference). Initiation on newer antidiabetic agents was a significant positive predictors of prescription costs (CR 2.36 95% CI 2.21-2.51 vs metformin). CONCLUSIONS Type of initial antidiabetic agent, and SMBG were significant predictors of prescription costs. SMBG represent a major proportion of total costs; however, its use in combination with antidiabetic agents that do not cause hypoglycaemia is questionable.
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Affiliation(s)
- R T Grimes
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Ireland.
| | - K Bennett
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
| | - R Canavan
- Consultant Diabetologist, St Vincent's University Hospital and HSE National Clinical Lead in Diabetes, Ireland
| | - L Tilson
- National Centre for Pharmacoeconomics, St James's Hospital, Dublin 8, Ireland
| | - M C Henman
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Ireland
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Matthews LT, Smit JA, Moore L, Milford C, Greener R, Mosery FN, Ribaudo H, Bennett K, Crankshaw TL, Kaida A, Psaros C, Safren SA, Bangsberg DR. Periconception HIV Risk Behavior Among Men and Women Reporting HIV-Serodiscordant Partners in KwaZulu-Natal, South Africa. AIDS Behav 2015; 19:2291-303. [PMID: 26080688 PMCID: PMC4926315 DOI: 10.1007/s10461-015-1050-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
HIV-infected men and women who choose to conceive risk infecting their partners. To inform safer conception programs we surveyed HIV risk behavior prior to recent pregnancy amongst South African, HIV-infected women (N = 209) and men (N = 82) recruited from antenatal and antiretroviral clinics, respectively, and reporting an uninfected or unknown-HIV-serostatus pregnancy partner. All participants knew their HIV-positive serostatus prior to the referent pregnancy. Only 11 % of women and 5 % of men had planned the pregnancy; 40 % of women and 27 % of men reported serostatus disclosure to their partner before conception. Knowledge of safer conception strategies was low. Around two-thirds reported consistent condom use, 41 % of women and 88 % of men reported antiretroviral therapy, and a third of women reported male partner circumcision prior to the referent pregnancy. Seven women (3 %) and two men (2 %) reported limiting sex without condoms to peak fertility. None reported sperm washing or manual insemination. Safer conception behaviors including HIV-serostatus disclosure, condom use, and ART at the time of conception were not associated with desired pregnancy. In light of low pregnancy planning and HIV-serostatus disclosure, interventions to improve understandings of serodiscordance and motivate mutual HIV-serostatus disclosure and pregnancy planning are necessary first steps before couples or individuals can implement specific safer conception strategies.
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Affiliation(s)
- L T Matthews
- Division of Infectious Disease and Center for Global Health, Massachusetts General Hospital, 100 Cambridge Street, 15th Floor, Boston, MA, 02114, USA.
| | - J A Smit
- MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
- School of Pharmacy and Pharmacology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - L Moore
- MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - C Milford
- MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - R Greener
- MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - F N Mosery
- MatCH Research [Maternal, Adolescent and Child Health Research], Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - H Ribaudo
- Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA, USA
| | - K Bennett
- Bennett Statistical Consulting, Inc., Ballston Lake, NY, USA
| | - T L Crankshaw
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - A Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - C Psaros
- Behavioral Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - S A Safren
- Behavioral Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - D R Bangsberg
- Division of Infectious Disease and Center for Global Health, Massachusetts General Hospital, 100 Cambridge Street, 15th Floor, Boston, MA, 02114, USA
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Fadahunsi O, Iluyomade A, Talabi T, Bennett K. BIVENTRICULAR PACING VERSUS RIGHT VENTRICULAR PACING IN PATIENTS WITH NORMAL LEFT VENTRICULAR EJECTION FRACTION REQUIRING VENTRICULAR PACING: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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O'Sullivan K, Boland F, Reulbach U, Motterlini N, Kelly D, Bennett K, Fahey T. Antidepressant prescribing in Irish children: secular trends and international comparison in the context of a safety warning. BMC Pediatr 2015; 15:119. [PMID: 26362648 PMCID: PMC4567806 DOI: 10.1186/s12887-015-0436-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/26/2015] [Indexed: 11/13/2022] Open
Abstract
Background In 2003, the Irish Medicines Board (IMB) warned against the treatment of childhood depression with selective serotonin reuptake inhibitors (SSRIs) due to increased risk of suicide. This study examined the effect of this warning on the prevalence of anti-depressants in Irish children and compared age and gender trends and international comparisons of prescription rates. Methods A retrospective cohort study of the Irish Health Service Executive (HSE) pharmacy claims database for the General Medical Services (GMS) scheme for dispensed medication. Data were obtained for 2002–2011 for those aged ≤15 years. Prevalence of anti-depressants per 1000 eligible population, along with 95 % confidence intervals, were calculated. A negative binomial regression analysis was used to investigate trends and compare rates across years, sex and age groups (0–4, 5–11, 12–15 years). International prescribing data were retrieved from the literature. Results The prevalence of anti-depressants decreased from 4.74/1000 population (95 % CI: 4.47-5.01) in 2002 to 2.61/1000 population (95 % CI: 2.43-2.80) in 2008. SSRI rates decreased from 2002 to 2008. Prescription rates for contra-indicated SSRIs paroxetine, sertraline and citralopram decreased significantly from 2002 to 2005, and, apart from paroxetine, only small fluctuations were seen from 2005 onwards. Fluoxetine was the most frequently prescribed anti-depressant and rates increased between 2002 and 2011. Anti-depressant rates were higher for younger boys and older girls. The Irish prevalence was lower than the US, similar to the U.K. and higher than Germany and Denmark. Conclusions The direction and timing of these trends suggest that medical practitioners followed the IMB advice.
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Affiliation(s)
- K O'Sullivan
- HRB Centre for Primary Care Research, Division of Population Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
| | - F Boland
- HRB Centre for Primary Care Research, Division of Population Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
| | - U Reulbach
- HRB Centre for Primary Care Research, Division of Population Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland. .,Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Trinity College Dublin, Dublin 2, Ireland.
| | - N Motterlini
- HRB Centre for Primary Care Research, Division of Population Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland
| | - D Kelly
- Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Trinity College Dublin, Dublin 2, Ireland.
| | - K Bennett
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland.
| | - T Fahey
- HRB Centre for Primary Care Research, Division of Population Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
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Cahir C, Guinan E, Dombrowski SU, Sharp L, Bennett K. PP08 Identifying the determinants of adjuvant hormonal therapy medication taking behaviour in women with stage i-iii breast cancer: a systematic review and meta-analysis. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Grimes RT, Bennett K, Henman MC. OP35 Patterns of antidiabetic and cardiovascular medication use in early onset type 2 diabetes: a retrospective observational cohort study. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Grimes RT, Bennett K, Henman MC. PP78 Age disparities in the use of cardiovascular medicines: a retrospective cohort analysis of newly treated type 2 diabetes patients. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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King G, Byrne D, Bennett K, Norris S, Daly C, Murphy RT. 9 Left atrial force as a precise haemodynamic monitor in patients with hereditary haemochromatosis pre and post venesection. Heart 2015. [DOI: 10.1136/heartjnl-2015-308621.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Byrne D, O'Connor L, Jennings S, Bennett K, Murphy AW. A Survey of GPs Awareness and Use of Risk Assessment Tools and Cardiovascular Disease Prevention Guidelines. Ir Med J 2015; 108:204-207. [PMID: 26349349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide. This study aimed to benchmark awareness and use of CVD risk assessment (RA) tools and prevention guidelines in Irish general practice. 493 (18%) Irish general practitioners (GPs) were invited to participate in a cross-sectional study in 2011. 213 (43%) GPs responded with most being male (n = 128, 58.2%) and aged ≥ 45 years (n = 124, 56.8%). While 197 (92.5%) GPs were aware of at least one RA tool, only 69 (32.4%) GPs reported frequent use. 187 (87.8%) GPs were aware of one or more CVD prevention guidelines with 115 (54.0%) GPs reporting frequent use of at least one guideline. No age or gender difference observed. Barriers to implementation of CVD prevention guidelines were lack of remuneration, too many CVD guidelines and time constraints. Most Irish GPs were aware of RA tools and CVD prevention guidelines with half reporting frequent use of guidelines.
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O'Sullivan K, Reulbach U, Boland F, Motterlini N, Kelly D, Bennett K, Fahey T. Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland. BMJ Open 2015; 5:e007070. [PMID: 26059522 PMCID: PMC4466624 DOI: 10.1136/bmjopen-2014-007070] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To examine the prevalence and secular trends in benzodiazepine (BZD) prescribing in the Irish paediatric population. In addition, we examine coprescribing of antiepileptic, antipsychotic, antidepressant and psychostimulants in children receiving BZD drugs and compare BZD prescribing in Ireland to that in other European countries. SETTING Data were obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive (HSE)--Primary Care Reimbursement Services (PCRS). PARTICIPANTS Children aged 0-15 years, on the HSE-PCRS database between January 2002 and December 2011, were included. PRIMARY AND SECONDARY OUTCOME MEASURES Prescribing rates were reported over time (2002-2011) and duration (≤ or >90 days). Age (0-4, 5-11, 12-15) and gender trends were established. Rates of concomitant prescriptions for antiepileptic, antipsychotics, antidepressants and psychostimulants were reported. European prescribing data were retrieved from the literature. RESULTS Rates decreased from 2002 (8.56/1000 GMS population: 95% CI 8.20 to 8.92) to 2011 (5.33/1000 GMS population: 95% CI 5.10 to 5.55). Of those children currently receiving a BZD prescription, 6% were prescribed BZD for >90 days. Rates were higher for boys in the 0-4 and 5-11 age ranges, whereas for girls they were higher in the 12-15 age groups. A substantial proportion of children receiving BZD drugs are also prescribed antiepileptic (27%), antidepressant (11%), antipsychotic (5%) and psychostimulant (2%) medicines. Prescribing rates follow a similar pattern to that in other European countries. CONCLUSIONS While BZD prescribing trends have decreased in recent years, this study shows that a significant proportion of the GMS children population are being prescribed BZD in the long term. This study highlights the need for guidelines for BZD prescribing in children in terms of clinical indication and responsibility, coprescribing, dosage and duration of treatment.
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Affiliation(s)
- K O'Sullivan
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland
| | - U Reulbach
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - F Boland
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland
| | - N Motterlini
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland
| | - D Kelly
- Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - K Bennett
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
| | - T Fahey
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland
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Kieran J, Bennett K, Coghlan M, Bergin C, Barry M. The Budget Impact of Hepatitis C Treatment in Ireland 2001-2012. Ir Med J 2015; 108:166-169. [PMID: 26182797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Chronic Hepatitis C (HCV) is estimated to infect 20,000 to 50,000 people in Ireland. National estimates of the number of patients who have been treated for HCV, their demographics and the cost associated with that treatment have not been published. Prescriptions for the treatment of HCV from 2000-2012 were established by interrogating the records of the High-Tech Drug Scheme and the pharmacy records of the Genitourinary Medicine and Infectious Diseases department of St. James Hospital. 2320 patients were initiated on treatment for HCV. Over €27 million was spent on HCV treatment. €25.5 million was spent on anti-viral therapy and €2 million was spent on haematological growth factor support for the management of adverse effects. The budget impact of HCV treatment has been significant in Ireland. New agents for HCV will have a greater budget impact but should require less spend on adverse event management.
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Fontaine C, Bennett K, Nunn R, Dasgupta D, Dart R. The RCP toolkit for out-of-hours handover improves weekend handover: notes from a district general hospital. Future Hosp J 2015. [DOI: 10.7861/futurehosp.2-2-s35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fontaine C, Bennett K, Nunn R, Dasgupta D, Dart R. The RCP toolkit for out-of-hours handover improves weekend handover: notes from a district general hospital. Future Hosp J 2015; 2:s35. [PMID: 31098163 PMCID: PMC6460153 DOI: 10.7861/futurehosp.2-2s-s35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
| | - K Bennett
- Homerton University Hospital, London, UK
| | | | | | - Robin Dart
- Homerton University Hospital, London, UK
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Spillane S, Bennett K, Barry M. Initiation of Oral Anticoagulant Drugs: Identification of Drivers of Prescribing of New Agents Versus Warfarin. Value Health 2014; 17:A499-A500. [PMID: 27201507 DOI: 10.1016/j.jval.2014.08.1500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Spillane
- HSE Medicines Management Programme, Dublin, Ireland
| | - K Bennett
- Trinity College Dublin, Dublin, Ireland
| | - M Barry
- HSE Medicines Management Programme, Dublin, Ireland
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Moriarty F, Cahir C, Fahey T, Bennett K. Potentially Inappropriate Medicines and Potential Prescribing Omissions in Older People and Their Association With Health Care Utilization: A Retrospective Cohort Study. Value Health 2014; 17:A520. [PMID: 27201625 DOI: 10.1016/j.jval.2014.08.1620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- F Moriarty
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - C Cahir
- Trinity College Dublin, Dublin 8, Ireland
| | - T Fahey
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K Bennett
- Trinity College Dublin, Dublin, Ireland
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Cruise SM, Hughes J, Bennett K, Kouvonen A, Kee F. Understanding coronary heart disease-related disability in older adults in the Republic of Ireland and Northern Ireland in 2010/2011. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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McNamara G, Millwood J, Rooney YM, Bennett K. Forget me not - the role of the general dental practitioner in dementia awareness. Br Dent J 2014; 217:245-8. [PMID: 25213527 DOI: 10.1038/sj.bdj.2014.760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 11/09/2022]
Abstract
This paper examines the role of the general dental practitioner (GDP) in dementia awareness, using the close patient-practitioner relationship to spot the early signs and plan for future oral healthcare. Each and every member of the dental team plays an important role in the patient journey through their dental visit and helps address the barriers they face. The significance of promoting dementia friendly environments cannot be undervalued and the GDP has a key role in maintaining their patients' quality of life.
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Affiliation(s)
- G McNamara
- Head of Policy and Public Affairs, Alzheimer's Society, Devon House, 58 St Katherine's Way, London, E1W 1LB
| | - J Millwood
- Specialist in Special Care Dentistry, Committee member of the British Society of Gerodontology, Derbyshire Community Health Services, Dental Clinic Loughborough Hospital, Epinal Way, Loughborough, LE11 5JY
| | - Y M Rooney
- Speciality Registrar Special Care Dentistry, King's College NHS Foundation Trust, Department of Community Special Care Dentistry, C/O 161 Denmark Hill, Camberwell, London, SE5 8EF
| | - K Bennett
- Press Officer, Alzheimer's Society, Devon House, 58 St Katherine's Way, London, E1W 1LB
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Bandosz P, Aspelund T, Basak P, Bennett K, Bjorck L, Bruthans J, Guzman-Castillo M, Hughes J, Hotchkiss J, Kabir Z, Laatikainen T, Leyland A, O’Flaherty M, Palmieri L, Rosengren A, Bjork R, Vartiainen E, Zdrojewski T, Capewell S, Critchley J. OP72 EUROHEART II - comparing policies to reduce future coronary heart disease mortality in nine European countries: modelling study. Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jennings S, Bennett K, Shelley E, Kearney P, Daly K, Fennell W. Trends in percutaneous coronary intervention and angiography in Ireland, 2004-2011: Implications for Ireland and Europe. Int J Cardiol Heart Vessel 2014; 4:35-39. [PMID: 29450183 PMCID: PMC5802397 DOI: 10.1016/j.ijchv.2014.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/01/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND/OBJECTIVES To study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004-2011. METHODS Two data sources were used: a) a survey of publicly and privately funded hospitals with cardiac catheter laboratories to obtain the annual number of procedures performed and b) anonymised data from the Hospital In-Patient Enquiry (HIPE) for angiography and PCI in acute publicly funded hospitals; age standardised rates were calculated to study trends over time. RESULTS From 2004 to 2011 the crude rate of angiography and PCI increased by 47.8% and 35.9% respectively, with rates of 6689 and 1825 per million population in 2011. Following age standardisation, however, PCI activity showed a non-significant decrease over time. The PCI to angiography ratio decreased from 30% to 27% and PCI was performed predominantly for stable coronary heart disease (54%) in 2011. CONCLUSION Angiography and PCI rates have increased in Ireland but PCI crude and age adjusted rates show divergent trends. While Ireland differs from USA and UK, with a higher proportion of PCI being performed for stable CHD in recent years, little systematic surveillance of cardiological interventions within Europe is available to benchmark improvements in Ireland.
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Affiliation(s)
- S. Jennings
- Department of Public Health, HSE, Dublin, Ireland
| | - K. Bennett
- Department of Pharmacology and Therapeutics, St James Hospital, Dublin, Ireland
| | - E. Shelley
- Department of Public Health, HSE, Dublin, Ireland
| | - P. Kearney
- Cardiology Department, Cork University Hospital, Cork, Ireland
| | - K. Daly
- Cardiology Department, University College Hospital Galway, Galway, Ireland
| | - W. Fennell
- Cardiology Department, Bon Secours Hospital, Cork, Ireland
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Critchley J, Capewell S, O’Flaherty M, Abu-Rmeileh N, Sozmen K, Husseini A, Fouaud F, Saidi O, Romdhane H, Unal B, Bandosz P, Bennett K, Maziak W, Unwin N, Phillimore P, Bjork R, Vartiainen E, Zdrojewski T. OP53 Contrasting cardiovascular mortality trends in Eastern Mediterranean populations – contributions from risk factor changes and treatments: modelling study. Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Coleman N, Rom FM, Brennan A, Bennett K, Jayaram A, Kennedy M. Does Baseline Absolute Neutrophil-To-Lymphocyte Ratio (Nlr) Correlate with Pathological Complete Response (Pcr) in Neoadjuvant Breast Cancer (Bc)? Ann Oncol 2014. [DOI: 10.1093/annonc/mdu328.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
BACKGROUND Aspirin use has been associated with reduced mortality from cancer including prostate cancer in some studies. A number of anti-cancer mechanisms of aspirin have been proposed, including the inhibition of the cyclooxygenase enzymes, through which aspirin mediates both anti-platelet and anti-inflammatory activities. This cohort study examines associations between pre-diagnostic aspirin use (overall and by dose and dosing intensity) and mortality in men with localised prostate cancer. PATIENTS AND METHODS Men with stage I-III prostate cancer were identified from Irish National Cancer Registry records, which have been linked to national prescribing data from the Irish General Medical Services scheme. Aspirin use in the year preceding prostate cancer diagnosis was identified from this linked prescription-claims data. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for associations between aspirin use and all-cause and prostate cancer-specific mortality. Associations between prescribed dose and dosing intensity were examined. The presence of effect modification by the type of treatment received and tumour characteristics was also assessed. RESULTS Two thousand nine hundred and thirty-six men with a diagnosis of stage I-III prostate cancer (2001-2006) were identified (aspirin users, n = 1131). The median duration of patient follow-up was 5.5 years. In adjusted analyses, aspirin use was associated with a small, but non-significant, reduced risk of prostate cancer-specific mortality (HR = 0.88, 95% CI 0.67-1.15). In dose-response analyses, stronger associations with prostate cancer-specific mortality were observed in men with higher aspirin dosing intensity (HR = 0.73, 95% CI 0.51-1.05) and in men receiving >75 mg of aspirin (HR = 0.61, 95% CI 0.37-0.99). Analyses of effect modification by treatment type or tumour characteristics were non-significant. CONCLUSIONS Consistent with prior studies, aspirin use was associated with a non-significant reduced risk of prostate cancer-specific mortality in men with localised prostate cancer. Men receiving higher doses of aspirin had a statistically significant reduced risk of prostate cancer-specific mortality. These findings regarding an aspirin dose require further investigation.
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Affiliation(s)
- E M Flahavan
- Department of Pharmacology and Therapeutics, Trinity College, University of Dublin, Dublin, Ireland
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O'Shea MP, Teeling M, Bennett K. Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland. Ir J Med Sci 2014; 184:403-10. [PMID: 24859371 DOI: 10.1007/s11845-014-1132-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/28/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Few studies have investigated regional variation in medication-taking behaviour. The purpose of this study was to investigate whether there are regional differences in non-persistence and non-adherence to oral anti-hyperglycaemic agents in patients initiating therapy and examine if any association exists between different types of comorbidity in terms of medication-taking behaviour. METHODS The Irish Health Services Executive (HSE) pharmacy claims database was used to identify new users of metformin or sulphonylureas, aged ≥25 years, initiating therapy between June 2009 and December 2010. Non-persistence and non-adherence were examined up to 12 months post-initiation. Comorbidity was assessed using modified RxRisk and RxRisk-V indices, and classified as either concordant and/or discordant with diabetes. Adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for non-persistence were determined in relation to both HSE region and comorbidity type using Cox proportional hazards model, adjusting for age, sex and initial OAH prescribed. Logistic regression analysis, adjusting for these covariates, was used to determine the adjusted odds ratios (ORs) and 95% CIs for non-adherence for both HSE region and comorbidity type. RESULTS Results showed little overall difference between regions. The largest reduction for both non-persistence (HR 0.86, 95% CI 0.80, 0.94) and non-adherence (OR 0.83, 95% CI 0.74, 0.93) was observed in the south. Any comorbidity was associated with a reduced risk of non-persistence and non-adherence. CONCLUSIONS Interventions to optimise medication-taking in patients with T2DM should be implemented nationally to improve the overall level of adherence and persistence, especially in patients with no comorbidity.
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Affiliation(s)
- M P O'Shea
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Science, St James's Hospital, Dublin 8, Ireland,
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