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Jiang W, Brown KGM, Koh C, Karunaratne S, Solomon M, Beckenkamp PR, Cole R, Steffens D. Outcome Heterogeneity in Prehabilitation Trials-Are We Comparing Apples and Oranges? J Surg Res 2024; 296:366-375. [PMID: 38306943 DOI: 10.1016/j.jss.2023.12.042] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/11/2023] [Accepted: 12/29/2023] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Over the last decade, the number of prehabilitation randomised controlled trials (RCTs) has increased significantly. Therefore, this review aimed to describe the outcomes reported in prehabilitation RCTs in patients undergoing cancer surgery. METHODS A search was conducted in Embase, Allied and Complementary Medicine Database, The Cochrane Library, PsycINFO, MEDLINE, and Cumulated Index to Nursing and Allied Health Literature from inception to July 2021. We included RCTs evaluating the effectiveness of preoperative exercise, nutrition, and psychological interventions on postoperative complications and length of hospital stay in adult oncology patients who underwent thoracic and gastrointestinal cancer surgery. The verbatim outcomes reported in each article were extracted, and each outcome was assessed to determine whether it was defined and measured using a validated tool. Verbatim outcomes were grouped into standardized outcomes and categorized into domains. The quality of outcome reporting in each identified article was assessed using the Harman tool (score range 0-6, where 0 indicated the poorest quality). RESULTS A total of 74 RCTs were included, from which 601 verbatim outcomes were extracted. Only 110 (18.3%) of the verbatim outcomes were defined and 270 (44.9%) were labeled as either "primary" or "secondary" outcomes. Verbatim outcomes were categorized into 119 standardized outcomes and assigned into one of five domains (patient-reported outcomes, surgical outcomes, physical/functional outcomes, disease activity, and intervention delivery). Surgical outcomes were the most common outcomes reported (n = 71 trials, 95.9%). The overall quality of the reported outcomes was poor across trials (median score: 2.0 [IQR = 0.00-3.75]). CONCLUSIONS Prehabilitation RCTs display considerable heterogeneity in outcome reporting, and low outcome reporting quality. The development of standardized core outcome sets may help improve article quality and enhance the clinical utility of prehabilitation following cancer surgery.
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Affiliation(s)
- Wilson Jiang
- Surgical Outcomes Research Centre (SOuRCe), Camperdown, NSW, Australia
| | - Kilian G M Brown
- Surgical Outcomes Research Centre (SOuRCe), Camperdown, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW, Australia; Department of Colorectal Surgery, Camperdown, NSW, Australia
| | - Cherry Koh
- Surgical Outcomes Research Centre (SOuRCe), Camperdown, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW, Australia; Department of Colorectal Surgery, Camperdown, NSW, Australia; Institute of Academic Surgery (IAS), Camperdown, NSW, Australia
| | - Sascha Karunaratne
- Surgical Outcomes Research Centre (SOuRCe), Camperdown, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW, Australia; Institute of Academic Surgery (IAS), Camperdown, NSW, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre (SOuRCe), Camperdown, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW, Australia; Department of Colorectal Surgery, Camperdown, NSW, Australia; Institute of Academic Surgery (IAS), Camperdown, NSW, Australia
| | - Paula R Beckenkamp
- Faculty of Medicine and Health, Discipline of Physiotherapy, The University of Sydney, Camperdown, NSW, Australia
| | - Ruby Cole
- Surgical Outcomes Research Centre (SOuRCe), Camperdown, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Camperdown, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW, Australia; Institute of Academic Surgery (IAS), Camperdown, NSW, Australia.
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Lam L, Czer L, Runyan C, Otarola I, Jang J, Lau J, Gau M, Hernandez K, Ngo T, Cole R, Moriguchi J. Outcome of Enoxaparin Bridging in Left Ventricular Assist Devices (LVAD) in an Ambulatory Setting: A Continuation Study at Cedars Sinai Medical Center (CSMC). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1380] [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: 04/05/2023] Open
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Malas J, Chen Q, Akhmerov A, Tremblay P, Egorova N, Moriguchi J, Kobashigawa J, Czer L, Cole R, Emerson D, Chikwe J, Arabia F, Esmailian F. Does Extracorporeal Membrane Oxygenation Duration as a Bridge to Total Artificial Heart Affect Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.144] [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: 04/05/2023] Open
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Srivastava P, Zhang X, Moriguchi J, Chang D, Czer L, Cole R, Kittleson M, Kransdorf E, Kobashigawa J, Patel J. Extreme HLA Homozygosity Contributing to Extreme HLA Sensitization. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.452] [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: 04/05/2023] Open
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Kobashigawa J, Kittleson M, Kim S, Singer-Englar T, Esmailian G, Runyan C, Cole R, Moriguchi J, Megna D, Czer L, Patel J. The Outcome of Heart Transplant Patients with Severe Rejection Requiring ECMO Support: Is it Futile. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.590] [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: 04/05/2023] Open
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Magua W, Okoh A, Pranav P, Wang J, Karadkhele G, Cole R, Daneshmand M, Gupta D, Larsen C, Morris A. Belatacept-Based Immunosuppression in Heart Transplant Recipients: National Trends with Outcomes from a Single Center. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.564] [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: 04/05/2023] Open
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Kittleson M, Patel J, Moriguchi J, Cole R, Singer-Englar T, Patel N, Runyan C, Welton M, Czer L, Catarino P, Kobashigawa J. Do Older LVAD Patients Have Compromised Outcome after Heart Transplantation: Should They Stay as Destination Therapy? J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.190] [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: 04/05/2023] Open
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Kim D, Youn J, Kim J, Kim I, Choi J, Kransdorf E, Chang D, Kittleson M, Patel J, Cole R, Moriguchi J, Esmailian F, Kobashigawa J. Clinical Outcomes of Heart Transplantation in Desensitized Durable Mechanical Circulatory Support Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.121] [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: 04/05/2023] Open
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Kim I, Youn J, Chang D, Nishihara K, Kransdorf E, Kittleson M, Patel J, Cole R, Nikolova A, Esmailian F, Czer L, Kobashigawa J. The Validation of Cardiac Rehabilitation after Heart Transplantation from Anonymized Patient-Reported Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1262] [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: 04/05/2023] Open
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Rudinsky S, Weissbrod E, Cole R. 109 The Impact of the Patient Role on Medical Student Learning During Peer Simulation. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.133] [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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Fischer JH, Wittmer HU, Kenup CF, Parker KA, Cole R, Debski I, Taylor GA, Ewen JG, Armstrong DP. Predicting harvest impact and establishment success when translocating highly mobile and endangered species. J Appl Ecol 2022. [DOI: 10.1111/1365-2664.14219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- JH Fischer
- School of Biological Sciences Victoria University of Wellington New Zealand
- Aquatic Unit Department of Conservation Wellington
| | - HU Wittmer
- School of Biological Sciences Victoria University of Wellington New Zealand
| | - CF Kenup
- Wildlife Ecology Group Massey University Palmerston North New Zealand
| | | | - R Cole
- Murihiku District Office Department of Conservation Invercargill
| | - I Debski
- Aquatic Unit Department of Conservation Wellington
| | - GA Taylor
- Aquatic Unit Department of Conservation Wellington
| | - JG Ewen
- Institute of Zoology Zoological Society of London London UK
| | - DP Armstrong
- Wildlife Ecology Group Massey University Palmerston North New Zealand
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Cole R, Moriguchi J, Kittleson M, Patel J, Chang D, Patel N, Singer-Englar T, Azarbal B, Emerson D, Czer L, Kobashigawa J. Do Temporary Mechanical Circulatory Support Devices Activate Sensitization Pathways in Patients Awaiting Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1184] [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: 10/18/2022] Open
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Akhmerov A, Emerson D, Megna D, Cole R, Moriguchi J, Esmailian F, Ramzy D. Extracorporeal Membrane Oxygenation as a Bridge to Total Artificial Hearts. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1604] [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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Emerson D, Patel N, Singer-Englar T, Megna D, Catarino P, Ramzy D, Moriguchi J, Cole R, Chikwe J, Kobashigawa J, Esmailian F. Complexities of Explanting Durable LVADs (Done at Outside Facilities) at the Time of Heart Transplant Surgery. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1538] [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: 10/18/2022] Open
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Kobashigawa J, Patel J, Kittleson M, Cole R, Patel N, Singer-Englar T, Runyan C, Geft D, Czer L, Esmailian F. Intra-Aortic Balloon Placement without Inotropes: A Shift in Practice for Higher Urgency Status for Patients Awaiting Heart Transplant? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1382] [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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Singer-Englar T, Kittleson M, Patel J, Tor K, Patel N, Velleca A, Chang D, Cole R, Czer L, Ramzy D, Esmailian F, Kobashigawa J. Use of Declined Donor Hearts: Is Quality Important? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1777] [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: 11/26/2022] Open
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Lam L, Czer L, Cole R, Zhao M, Chen S, Le T, Kasper L, Singer-Englar T, Aguillon M, Knabe K, Huie N, Chen W, Runyan C, Moriguchi J, Zabner R, Kobashigawa J, Esmailian F. Incidence of Surgical-Related Infections in Temporary Mechanical Circulatory Support Patients Using Narrow Spectrum versus Broad Spectrum Peri-Operative Antibiotic Prophylaxis. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1158] [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: 10/21/2022] Open
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Ramzy D, Akhmerov A, Esmailian F, Megna D, Emerson D, Levine R, Cole R, Runyan C, Kobashigawa J, Moriguchi J. Landscape of Heart Transplantation Following Changes in UNOS Donor Allocation Policy. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.362] [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: 11/25/2022] Open
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Volod O, Cole R, Esmailian F, Emerson D, Halprin C, Hayes C, Lam L, Kitahara S, Martin-Stone S, Megna D, Moriguchi J, Ramzy D, Yur J, Czer L. Incidence of Heparin Induced Thrombocytopenia in Patients Undergoing Implantation of Durable and Non-Durable Mechanical Circulatory Support Devices. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1954] [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: 10/21/2022] Open
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Patel J, Kittleson M, Cole R, Patel N, Singer-Englar T, Runyan C, Geft D, Czer L, Ramzy D, Esmailian F, Moriguchi J, Kobashigawa J. The Impact of Renal Dysfunction in Mechanical Circulatory Support Device Patients on Post-Heart Transplant Outcomes. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1198] [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: 11/16/2022] Open
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Kittleson M, Patel J, Patel N, Singer-Englar T, Kim S, Kissling N, Chang D, Cole R, Trento A, Czer L, Kobashigawa J. In the Current Era, Do We Have Improved Outcomes in Hemodynamic Compromise Rejection after Heart Transplantation? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.843] [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: 10/21/2022] Open
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Pinnelas R, Cole R, Megna D, Lorber J, Ramzy D, Emerson D, Benck L, Sedrak S, Czer L, Chang D, Esmailian F, Kobashigawa J, Moriguchi J. Heparin-Induced Thrombocytopenia and Thrombosis with Axillary Impella 5.5 as Bridge-to-Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bukhari A, Cole R, Champagne C, McGraw S, Moylan E, Armstrong N. Nutrition Interventions in Military Dining Facilities Can Enhance Diet Quality and Meal Satisfaction. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.086] [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: 11/26/2022]
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Youn J, Seguchi O, Cole R, Geft D, Nishihara K, Shen A, Sharoff R, Ramzy D, Kobashigawa J, Moriguchi J. Desensitization in Mechanical Circulatory Support Patients Awaiting Heart Transplantation: What is the Post-Transplant Outcome? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.269] [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: 11/25/2022] Open
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Ramzy D, Esmailian F, Emerson D, Megna D, Levine R, Cole R, Passano E, Runyan C, Velleca A, Kobashigawa J, Moriguchi J. The New UNOS Heart Allocation Changes Significantly Changed the Landscape of Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Gerhard E, Singh R, Psotka M, Cavallo K, Genovese L, Cooper L, Edwards L, May C, Cole R, Sinha S, Desai S, Shah P. Long-Term Cardiac Remodeling after LVAD Deactivation for Myocardial Recovery. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Runyan C, Zabner R, Ramzy D, Esmailian F, Emerson D, Megna D, Passano E, Hajj J, Huie N, Lindsay M, Aguillon M, Lam L, Chang D, Kobashigawa J, Moriguchi J, Cole R. Increased Incidence of Cholecystitis with Total Artificial Heart versus Left Ventricular Assist Device. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.053] [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: 12/01/2022] Open
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Emerson D, Megna D, Cole R, Levine R, Esmailian F, Chikwe J, Trento A, Ramzy D, Kransdorf E, Kobashigawa J. Does Brain Death Related to Underlying Donor Disease Correlate with Adverse Outcomes after Heart Transplant? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.580] [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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Seguchi O, Youn J, Geft D, Cole R, Shen A, Nishihara K, Mersola S, Runyan C, Hajj J, Ramzy D, Kobashigawa J, Moriguchi J. The Burden of Total Artificial Heart Patients and Complications after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.158] [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] Open
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Sandau K, Williams M, Canakes K, Martinez B, Barone H, Aronow H, Hajj J, Huie N, Lindsay M, Aguillon M, Runyan C, Cole R, Coleman B. Patient Perspectives of Managing Life with a Left Ventricular Assist Device: “I Could Connect How I Felt with What Was Going on.” A Qualitative Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Megna D, Emerson D, Cole R, Levine R, Chikwe J, Esmailian F, Trento A, Ramzy D, Kobashigawa J. Orthotopic Heart Transplantation in the Diabetic Patient, are We Still Worried? A Review of 952 Consecutive Patients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.545] [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: 11/17/2022] Open
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Lane D, Alghamdi R, Muscat M, Kaur MS, Davis T, Cole R, Patel P, Tomaszewski M, Gupta P. 1424The diagnosis of non-adherence in hypertension using a urine biochemical screen is unaffected by drug pharmacokinetics. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Suboptimal drug adherence in hypertension is pandemic and traditional diagnostic tools to detect non-adherence have lacked accuracy and robustness. The inability to identify non-adherence has therefore driven the development of biochemical drug screening by liquid chromatography tandem mass spectrometry (LC- MS/MS) in urine and blood, which are the most accurate metrics presently available. Urinary antihypertensive testing is evidenced to improve non-adherence rates, significantly decrease blood pressure after physician intervention, and be cost effective. The European Society of Cardiology (ESC) and European Society of Hypertension (ESH) 2018 guidelines have recommended the use of biochemical testing for non-adherence diagnosis. However, it has been argued that the variable pharmacokinetic parameters of the medication (such as their half-lives and clearance rates) may affect the detection of medications in urine and hence the determination of adherence. We hypothesized that pharmacokinetic parameters do not affect the detection of antihypertensive medications in urine.
Aim
This study compared the pharmacokinetic parameters of the most commonly prescribed antihypertensive medications against their detection in urine by LC-MS/MS.
Methods
Results of urinary drug screens from 463 hypertensive patients (total prescribed medications N=1709) were collated. An adherence score termed as the C score (number of detected vs. prescribed medication) was generated for each of the 27 common antihypertensive medications. Pharmacokinetic parameters such as bioavailability, plasma concentration, volume of distribution, half-life, plasma clearance and urinary excretion values for each drug were obtained from published literature. Partial linear correlation was conducted between the C score of all the medications and each pharmacokinetic parameter studied.
Results
40% of patients were non-adherent. The average number of prescribed medications was high (N=3.7, SD: 1.5), and the average number of drugs detected was lower (N=2.5, SD: 1.6). Amlodipine was the most prescribed (N=224), and clonidine was the least (N=10). The half-lives ranged from 0.87 to 39 hours for bumetanide and amlodipine respectively. The urinary excretion percentage varied from <1% for nifedipine, and 94% for benfroflumethiazide. No significant correlation was found between any drug C score and their respective pharmacokinetic variables such as the medication half-lives (figure1).
Half-life versus adherence score
Conclusion
This study reports no significant correlation between drug pharmacokinetics and adherence. To the best of our knowledge this is the first study of its kind. Urinary biochemical testing by LC-MS/MS for non-adherence remains a valid tool for diagnosis although further detailed pharmacokinetic studies are needed to confirm this finding.
Acknowledgement/Funding
None
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Affiliation(s)
- D Lane
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - R Alghamdi
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - M Muscat
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - M S Kaur
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - T Davis
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - R Cole
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - P Patel
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - M Tomaszewski
- University of Manchester, Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - P Gupta
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
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Fischer JH, Taylor GA, Cole R, Debski I, Armstrong DP, Wittmer HU. Population growth estimates of a threatened seabird indicate necessity for additional management following invasive predator eradications. Anim Conserv 2019. [DOI: 10.1111/acv.12516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- J. H. Fischer
- School of Biological Sciences Victoria University of Wellington Wellington New Zealand
| | - G. A. Taylor
- Aquatic Unit Department of Conservation Wellington New Zealand
| | - R. Cole
- Murikihu District OfficeDepartment of Conservation Invercargill New Zealand
| | - I. Debski
- Aquatic Unit Department of Conservation Wellington New Zealand
| | - D. P. Armstrong
- Wildlife Ecology Group Massey University Palmerston North New Zealand
| | - H. U. Wittmer
- School of Biological Sciences Victoria University of Wellington Wellington New Zealand
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Kittleson M, Patel J, Cole R, Geft D, Dimbil S, Levine R, Mersola S, Czer L, Azarbal B, Zabner R, Zakowski P, Kobashigawa J. Does Thymoglobulin Induction Lead to Increased CMV Infection after Heart Transplantation in the Current Tacrolimus Era. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.783] [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: 10/27/2022] Open
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Barone H, Olman M, Fishman A, Olanisa L, Runyan C, Hajj J, Huie N, Lindsay M, Passano E, Kobashigawa J, Moriguchi J, Cole R, Esmailian F, Chung J, Ramzy D. The Value of Licensed Clinical Social Worker Pre-Implant Assessment in Predicting Non-Compliance in Durable Mechanical Circulatory Support Device Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.219] [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: 10/27/2022] Open
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Patel J, Kittleson M, Chang D, Kransdorf E, Levine R, Dimbil S, Kao T, Czer L, Cole R, Esmailian F, Kobashigawa J. 5-Year Outcome of Photopheresis in Heart-Transplantation with Refractory/Persistent Rejection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Patel J, Kittleson M, Chang D, Cole R, Levine R, Dimbil S, Jain A, Kearney B, Czer L, Hage A, Esmailian F, Kobashigawa J. The Evolving Long-Term Outcome of Heart Transplantation in Amyloid Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.525] [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: 10/27/2022] Open
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38
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McGlinchey L, Cole R, Caldwell FJ. Reoccurrence of a paranasal osteoma following surgical removal in a 6‐month‐old Warmblood filly. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L. McGlinchey
- Department of Veterinary Clinical Sciences Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - R. Cole
- Department of Veterinary Clinical Sciences Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - F. J. Caldwell
- Department of Veterinary Clinical Sciences Auburn University College of Veterinary Medicine Auburn Alabama USA
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Burns AD, Lane D, Cole R, Patel P, Gupta P. Cardiovascular Medication Stability in Urine for Non-Adherence Screening by LC–MS-MS. J Anal Toxicol 2018; 43:325-329. [DOI: 10.1093/jat/bky090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/21/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- A D Burns
- Department of Chemical Pathology and Metabolic Diseases, Level 4, Sandringham Building, Leicester Royal Infirmary, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - D Lane
- Department of Chemical Pathology and Metabolic Diseases, Level 4, Sandringham Building, Leicester Royal Infirmary, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | | | - P Patel
- Department of Chemical Pathology and Metabolic Diseases, Level 4, Sandringham Building, Leicester Royal Infirmary, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - P Gupta
- Department of Chemical Pathology and Metabolic Diseases, Level 4, Sandringham Building, Leicester Royal Infirmary, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
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Colnel J, Ravenel N, Nouailletas R, Caulier G, Moreau P, Treutterer W, Lueddecke K, Cole R. Adapting DCS real time framework for WEST plasma control. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.02.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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41
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Esmailian F, Arabia F, Czer L, Kittleson M, Geft D, Cole R, Esmailian G, Rafiei M, Passano E, Barone H, Moriguchi J. Does the Type of Mechanical Circulatory Support as a Bridge to Heart Transplant Affect Outcome after Transplant? J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.729] [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: 11/24/2022] Open
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42
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Stains M, Harshman J, Barker MK, Chasteen SV, Cole R, DeChenne-Peters SE, Eagan MK, Esson JM, Knight JK, Laski FA, Levis-Fitzgerald M, Lee CJ, Lo SM, McDonnell LM, McKay TA, Michelotti N, Musgrove A, Palmer MS, Plank KM, Rodela TM, Sanders ER, Schimpf NG, Schulte PM, Smith MK, Stetzer M, Van Valkenburgh B, Vinson E, Weir LK, Wendel PJ, Wheeler LB, Young AM. Anatomy of STEM teaching in North American universities. Science 2018; 359:1468-1470. [PMID: 29599232 PMCID: PMC6310123 DOI: 10.1126/science.aap8892] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
National and local initiatives focused on the transformation of STEM teaching in higher education have multiplied over the last decade. These initiatives often focus on measuring change in instructional practices, but it is difficult to monitor such change without a national picture of STEM educational practices, especially as characterized by common observational instruments. We characterized a snapshot of this landscape by conducting the first large scale observation-based study. We found that lecturing was prominent throughout the undergraduate STEM curriculum, even in classrooms with infrastructure designed to support active learning, indicating that further work is required to reform STEM education. Additionally, we established that STEM faculty’s instructional practices can vary substantially within a course, invalidating the commonly-used teaching evaluations based on a one-time observation. Although lecture is prominent throughout the undergraduate STEM curriculum, STEM faculty employ varied teaching practices within the same course.
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Affiliation(s)
- M Stains
- The list of author affiliations is provided in the supplementary materials.
| | - J Harshman
- The list of author affiliations is provided in the supplementary materials
| | - M K Barker
- The list of author affiliations is provided in the supplementary materials
| | - S V Chasteen
- The list of author affiliations is provided in the supplementary materials
| | - R Cole
- The list of author affiliations is provided in the supplementary materials
| | | | - M K Eagan
- The list of author affiliations is provided in the supplementary materials
| | - J M Esson
- The list of author affiliations is provided in the supplementary materials
| | - J K Knight
- The list of author affiliations is provided in the supplementary materials
| | - F A Laski
- The list of author affiliations is provided in the supplementary materials
| | - M Levis-Fitzgerald
- The list of author affiliations is provided in the supplementary materials
| | - C J Lee
- The list of author affiliations is provided in the supplementary materials
| | - S M Lo
- The list of author affiliations is provided in the supplementary materials
| | - L M McDonnell
- The list of author affiliations is provided in the supplementary materials
| | - T A McKay
- The list of author affiliations is provided in the supplementary materials
| | - N Michelotti
- The list of author affiliations is provided in the supplementary materials
| | - A Musgrove
- The list of author affiliations is provided in the supplementary materials
| | - M S Palmer
- The list of author affiliations is provided in the supplementary materials
| | - K M Plank
- The list of author affiliations is provided in the supplementary materials
| | - T M Rodela
- The list of author affiliations is provided in the supplementary materials
| | - E R Sanders
- The list of author affiliations is provided in the supplementary materials
| | - N G Schimpf
- The list of author affiliations is provided in the supplementary materials
| | - P M Schulte
- The list of author affiliations is provided in the supplementary materials
| | - M K Smith
- The list of author affiliations is provided in the supplementary materials
| | - M Stetzer
- The list of author affiliations is provided in the supplementary materials
| | - B Van Valkenburgh
- The list of author affiliations is provided in the supplementary materials
| | - E Vinson
- The list of author affiliations is provided in the supplementary materials
| | - L K Weir
- The list of author affiliations is provided in the supplementary materials
| | - P J Wendel
- The list of author affiliations is provided in the supplementary materials
| | - L B Wheeler
- The list of author affiliations is provided in the supplementary materials
| | - A M Young
- The list of author affiliations is provided in the supplementary materials
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Hatch A, Cole R, McGraw S, DiChiara A, Merrill E, Wright A, Lieberman H, Bukhari A. Increased Dietary Supplement Use by Soldiers Suggests a Need to Promote Food-Based Strategies for Optimal Nutrition. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.257] [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: 10/19/2022]
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Gupta P, Patel P, Strauch B, Lai F, Akbarov A, Gulsin G, Maresova V, Rosa J, Cole R, Smith P, Widimsky J, Samani N, Williams B, Tomaszewski M. 3894Predictors of non-adherence to antihypertensive treatment: insights from liquid chromatography tandem mass spectrometry based analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3894] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kim J, Pekarek A, Nguyen D, Vega J, Cole R, Morris A, Smith A, Laskar S, Gupta D. (1297) Elevated Pre-Operative Creatinine Is a Risk Factor for Late-Onset Right Heart Failure After Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1209] [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: 10/19/2022] Open
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46
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Yin M, Esmaeeli A, Morris A, Gupta D, Vega D, Laskar R, Smith A, Cole R. Early Exposure to ISHLT Grade 1R Rejection Reduces Long-Term Mortality in Heart Transplant Recipients Surviving the First Year. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1445] [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: 11/24/2022] Open
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47
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Kim J, Pekarek A, Nguyen D, Vega J, Cole R, Morris A, Smith A, Laskar S, Gupta D. Late-Onset Right Heart Failure After Left Ventricular Assist Device Implantation Is Associated with Poor Prognosis. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1223] [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: 10/19/2022] Open
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48
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Jolley CJ, Healey A, Cole R, Baker-Wilding R, Tas B, Moxham J, Strang J, Kelleher M. P214 The prevalence of respiratory symptoms and lung disease in a south london “lung health in addictions” service. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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49
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Issa S, Cole R, Alcock A, Sajjanhar T, Selby N. PILOTING A RAPID ASSESSMENT TOOL IN CHILDREN'S ED. Arch Emerg Med 2016. [DOI: 10.1136/emermed-2016-206402.3] [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: 11/04/2022]
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50
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Kinnell A, Cole R, Thakrar R, Smith PR, Patel P, Gupta P. Reply to "A Novel 'Dilute-and-Shoot' Liquid Chromatography-Tandem Mass Spectrometry Method for the Screening of Antihypertensive Drugs in Urine". J Anal Toxicol 2016; 41:80. [PMID: 27650309 DOI: 10.1093/jat/bkw094] [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] [Received: 08/20/2016] [Revised: 05/18/2016] [Accepted: 06/19/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Kinnell
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals Leicester NHS Trust, Level 4, Sandringham Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
| | - R Cole
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals Leicester NHS Trust, Level 4, Sandringham Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK
| | - R Thakrar
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals Leicester NHS Trust, Level 4, Sandringham Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK
| | - P R Smith
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals Leicester NHS Trust, Level 4, Sandringham Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK
| | - P Patel
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals Leicester NHS Trust, Level 4, Sandringham Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK
| | - P Gupta
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals Leicester NHS Trust, Level 4, Sandringham Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK
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