scholarly journals Diagnostic coding of chronic physical conditions in Irish general practice

2021 ◽  
Author(s):  
Ivana Pericin ◽  
James Larkin ◽  
Claire Collins
Keyword(s):  
General Practice ◽  
Chronic Disease ◽  
Adult Population ◽  
Accurate Estimation ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Physical Conditions ◽  
Diagnostic Coding ◽  
Chronic Physical Conditions

Abstract Background Chronic conditions are responsible for significant mortality and morbidity among the population in Ireland. It is estimated that almost one million people are affected by one of the four main categories of chronic disease (cardiovascular disease, chronic obstructive pulmonary disease, asthma, and diabetes). Primary healthcare is an essential cornerstone for individuals, families, and the community and, as such, should play a central role in all aspects of chronic disease management. Aim The aim of the project was to examine the extent of chronic disease coding of four chronic physical conditions in the general practice setting. Methods The design was a descriptive cross-sectional study with anonymous retrospective data extracted from practices. Results Overall, 8.8% of the adult population in the six participating practices were coded with at least one chronic condition. Only 0.7% of adult patients were coded with asthma, 0.3% with COPD, 3% with diabetes, and 3.3% with CVD. Male patients who visited their GP in the last year were more likely to be coded with any of the four chronic diseases in comparison with female patients. A significant relationship between gender and being coded with diabetes and CVD was found. Conclusions For a likely multitude of reasons, diagnostic coding in Irish general practice clinics in this study is low and insufficient for an accurate estimation of chronic disease prevalence. Monitoring of information provided through diagnostic coding is important for patients’ care and safety, and therefore appropriate training and reimbursement for these services is essential.

scholarly journals Breathlessness and opioid prescribing in COPD in general practice: a cross-sectional, observational study

2020 ◽  
Vol 6 (2) ◽  
pp. 00299-2019
Author(s):  
David C. Currow ◽  
Miriam J. Johnson ◽  
Allan Pollack ◽  
Diana H. Ferreira ◽  
Slavica Kochovska ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Pain Patient ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Obstructive Pulmonary Disease ◽  
Health Database

Chronic breathlessness is a disabling syndrome, prevalent in people with advanced chronic obstructive pulmonary disease (COPD). Regular, low-dose, oral sustained-release morphine is approved in Australia to reduce symptomatic chronic breathlessness. We aimed to determine the current prescribing patterns of opioids for chronic breathlessness in COPD in Australian general practice and to define any associated patient and practitioner characteristics.Five years (2011 to 2016) of the Bettering the Evaluation and Care of Health database, an Australian national, continual, cross-sectional study of clinical care in general practice were used. The database included 100 consecutive clinical encounters from almost 1000 general practitioners annually (n=488 100 encounters). Descriptive analyses with subsequent regression models were generated.Breathlessness as a patient-defined reason for encounter was identified in 621 of 4522 encounters where COPD was managed. Opioids were prescribed in 309 of 4522 encounters where COPD was managed (6.8%; (95% CI) 6.1–7.6), of which only 17 were prescribed for breathlessness, and the rest for other conditions almost entirely related to pain. Patient age (45–64 years versus age 80+ years, OR 1.68; 1.19–2.36), Commonwealth Concession Card holders (OR 1.70; 1.23–2.34) and socioeconomic disadvantage (OR 1.30; 1.01–1.68) were associated with increased likelihood of opioid prescription at COPD encounters. The rate of opioid prescriptions rose over the 5 years of study.In primary care encounters for COPD, opioids were prescribed in 6.8% of cases, but almost never for breathlessness. These data create a baseline against which to compare changes in prescribing as the treatment of chronic breathlessness evolves.

PREVALENCE OF HYPERTENSION AND ITS SOCIO-DEMOGRAPHIC FACTORS AMONG ADULT POPULATION IN A RURAL COMMUNITY OF KANTI BLOCK, MUZAFFARPUR

2021 ◽  
pp. 22-24
Author(s):  
Vijay Kumar Yadawa ◽  
Kumari Sushma Saroj ◽  
Ravindra Prasad
Keyword(s):  
Rural Population ◽  
Adult Population ◽  
Demographic Factors ◽  
Adult Mortality ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Mortality And Morbidity ◽  
Life Styles ◽  
Cardiovascular Morbidity And Mortality ◽  
Socio Demographic Factors

Hypertension is a major contributor to the cardiovascular morbidity and mortality in industrialized countries. The recent reports suggest that hypertension is rapidly increasing in developing countries like India. Non-communicable diseases (NCDs) are the leading causes of death globally and also the leading cause of adult mortality and morbidity worldwide now days. The NCD like hypertension is emerging as a major health problem in India with increasing prevalence signicantly in both urban and rural population. The objectives of the study were to nd out the prevalence of hypertension and its association with socio-demographic factors among the study subjects, if any. A community-based cross-sectional study was conducted in rural communities of Kanti block, Muzaffarpur, Bihar from May, 2020 to April, 2021. We studied among 671 individuals, aged 21 years or above of both sexes except pregnant and seriously ill subjects. The data were collected about education, type of family, family history of hypertension, income etc. The overall prevalence of hypertension was 25.7% (male 21.7% and female 29.8%). Prevalence increased with increase in age group. Muslim religion, less education and sedentary life styles were found to be signicantly associated with hypertension; while socio-economic status had no association with hypertension. Summary: The prevalence of hypertension in the rural population was found to be on the higher side compared to previous reports from India. Strong public health measures need to be seriously implemented to combat hypertension and its consequences.

scholarly journals Seroprevalence Study of Anti-HEV IgG among Different Adult Populations in Corsica, France, 2019

2019 ◽  
Vol 7 (10) ◽  
pp. 460 ◽  
Author(s):  
Capai ◽  
Masse ◽  
Gallian ◽  
Souty ◽  
Isnard ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Blood Donors ◽  
Adult Population ◽  
Strong Association ◽  
Hepatitis E ◽  
Cross Sectional Study ◽  
Antibody Detection ◽  
P Value ◽  
Cross Sectional

Hepatitis E virus (HEV) is a major cause of acute hepatitis worldwide. In France, hyperendemic areas including Corsica have an anti-HEV Immunoglobulin G (IgG) prevalence higher than 50%. The aim of this study was to determine the seroprevalence of anti-HEV IgG in three adult populations in Corsica and the risk factors associated with antibody detection. Between 2017 and 2019, a total of 930 individuals, including 467 blood donors, 393 students or university staff members and 70 patients from general practice, were tested for the presence of anti-HEV IgG using the Wantai HEV IgG enzyme immunoassay kit and filled a questionnaire. The association between seropositivity and potential risk factors was tested with univariate and multivariate analyses. Out of the 930 samples, 52.3% (486/930) were seropositive—54.4% (254/467) among blood donors, 47.6% (187/393) among university students and 64.3% (45/70) among patients of general practice. Three main risk factors were identified: (i) skinning and butchering (Adjusted Odds Ratio aOR = 2.76, 95% confidence interval [95% CI] [1.51–5.37]; p-value < 10−3), (ii) consumption of a local pork live raw sausage (fittonu) (aOR = 1.95 95% CI [1.45–2.64]; p-value = 10−5), and (iii) increasing age (p-value = 0.003). Seropositivity rates between the different populations were homogeneous after age stratification. This cross-sectional study indicates a high anti-HEV IgG seroprevalence in the Corsican adult population, not significantly different between women and men and increasing with age. This serosurvey also showed homogeneity regarding the exposure to HEV among three different types of populations. Finally, we confirmed the endemicity of Corsica with respect to HEV and identified a strong association between consumption of figatellu/fittonu and the practice of skinning and butchering with the detection of anti-HEV IgG.

scholarly journals Reference Equations for Spirometry Healthy Adult Population in Brazil

2020 ◽  
Author(s):  
mariane campos ◽  
Wagner Luis Ripka ◽  
Leandra Ulbricht
Keyword(s):  
Prediction Models ◽  
Adult Population ◽  
The Body ◽  
Metropolitan Region ◽  
World Health ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
White Skin ◽  
Selection Of Variables ◽  
Effective Diagnosis

Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a set of diseases, has as its main characteristics a limitation of the ventilatory flow. The World Health Organization (WHO) estimates that by 2030, COPD will be the third-largest cause of death. However, for the effective diagnosis, it is necessary to use reference curves appropriate to the population in which the individual belongs, thus it is possible to identify probable limits and abnormalities.Methods This is a cross-sectional and retrospective study conducted in a metropolitan region comprising 29 municipalities in southern Brazil. Individuals of both genders aged between 18 and 59 years, non-smokers, self-identified with white skin, participated in the study. The spirometric collections were done following the American Thoracic Society guidelines. And beyond them, mass and height were collected for determination of the Body Mass Index. The correlations between pulmonary and anthropometric variables were tested by regression analysis univariate after the selection of variables through multivariate analysis and logarithmic regression.Results In this sample, 800 participants were evaluated, of these 533 females and 267 males. Both sexes had considerable spirometry variables values as FVC, FEV6, and FEV1, used in the development of prediction models. The only variable, with a positive correlation in both genders, was height. For the males model, the best fit variable was FVC, with R 2 = 0.417 and for females FEV, with R 2 = 0.462. Among males, was seeing a lower value for all individuals in both variables. Whereas women had similar behavior, for CVS, with slight differences in the ends of the curves, comparing FEV1, the values were higher in all evaluated.Conclusion The prediction equations showed the previous curves were very restrictive and could be leading to false-positives. Thus, this update in the reference values would support clinical decisions on the prevention, diagnosis, and treatment of COPD.

scholarly journals Digital Recruitment and Acceptance of a Stepwise Model to Prevent Chronic Disease in the Danish Primary Care Sector: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Lars Bruun Larsen ◽  
Jens Sondergaard ◽  
Janus Laust Thomsen ◽  
Anders Halling ◽  
Anders Larrabee Sønderlund ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Low Cost ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Cross Sectional ◽  
Interaction Detection ◽  
Health Checks

BACKGROUND During recent years, stepwise approaches to health checks have been advanced as an alternative to general health checks. In 2013, we set up the Early Detection and Prevention project (Tidlig Opsporing og Forebyggelse, TOF) to develop a stepwise approach aimed at patients at high or moderate risk of a chronic disease. A novel feature was the use of a personal digital mailbox for recruiting participants. A personal digital mailbox is a secure digital mailbox provided by the Danish public authorities. Apart from being both safe and secure, it is a low-cost, quick, and easy way to reach Danish residents. OBJECTIVE In this study we analyze the association between the rates of acceptance of 2 digital invitations sent to a personal digital mailbox and the sociodemographic determinants, medical treatment, and health care usage in a stepwise primary care model for the prevention of chronic diseases. METHODS We conducted a cross-sectional analysis of the rates of acceptance of 2 digital invitations sent to randomly selected residents born between 1957 and 1986 and residing in 2 Danish municipalities. The outcome was acceptance of the 2 digital invitations. Statistical associations were determined by Poisson regression. Data-driven chi-square automatic interaction detection method was used to generate a decision tree analysis, predicting acceptance of the digital invitations. RESULTS A total of 8814 patients received an invitation in their digital mailbox from 47 general practitioners. A total of 40.22% (3545/8814) accepted the first digital invitation, and 30.19 % (2661/8814) accepted both digital invitations. The rates of acceptance of both digital invitations were higher among women, older patients, patients of higher socioeconomic status, and patients not diagnosed with or being treated for diabetes mellitus, chronic obstructive pulmonary disease, or cardiovascular disease. CONCLUSIONS To our knowledge, this is the first study to report on the rates of acceptance of digital invitations to participate in a stepwise model for prevention of chronic diseases. More studies of digital invitations are needed to determine if the acceptance rates seen in this study should be expected from future studies as well. Similarly, more research is needed to determine whether a multimodal recruitment approach, including digital invitations to personal digital mailboxes will reach hard-to-reach subpopulations more effectively than digital invitations only.

scholarly journals Burden of chronic physical conditions and mental disorders in primary care

2010 ◽  
Vol 196 (4) ◽  
pp. 302-309 ◽  
Author(s):  
Anna Fernández ◽  
Juan Ángel Bellón Saameño ◽  
Alejandra Pinto-Meza ◽  
Juan Vicente Luciano ◽  
Jaume Autonell ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Mood Disorders ◽  
Short Form ◽  
World Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physical Conditions ◽  
Primary Care Patients ◽  
Chronic Physical Conditions

BackgroundThe World Health Organization (WHO) has stated that the three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depression and ischaemic heart disease.AimsTo estimate health-related quality of life (HRQoL) and quality-adjusted life-year (QALY) losses associated with mental disorders and chronic physical conditions in primary healthcare using data from the diagnosis and treatment of mental disorders in primary care (DASMAP) study, an epidemiological survey carried out with primary care patients in Catalonia (Spain).MethodA cross-sectional survey of a representative sample of 3815 primary care patients. A preference-based measure of health was derived from the 12-item Short Form Health Survey (SF–12): the Short Form–6D (SF–6D) multi-attribute health-status classification. Each profile generated by this questionnaire has a utility (or weight) assigned. We used non-parametric quantile regressions to model the association between both mental disorders and chronic physical condition and SF–6D scores.ResultsConditions associated with SF–6D were: mood disorders, β =−0.20 (95% CI −0.18 to −0.21); pain, β = −0.08 (95%CI −0.06 to −0.09) and anxiety, β =−0.04 (95% CI −0.03 to −0.06). The top three causes of QALY losses annually per 100 000 participants were pain (5064), mood disorders (2634) and anxiety (805).ConclusionsEstimation of QALY losses showed that mood disorders ranked second behind pain-related chronic medical conditions.

scholarly journals Smoking behaviour and its influencing factors among adult population in selected communities of rural Bangladesh

2021 ◽  
Vol 8 (6) ◽  
pp. 2653
Author(s):  
Kazi R. Islam ◽  
M. I. R. Rume ◽  
Liton Roy ◽  
Shahnaz Rahman ◽  
M. S. Rahman
Keyword(s):  
Low Income ◽  
Adult Population ◽  
Smoking Behavior ◽  
Cross Sectional Study ◽  
Smoking Behaviour ◽  
Personal Life ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Positive Comment

Background: Tobacco is a leading cause of preventable mortality and morbidity in the majority of high-income countries, and it is becoming increasingly prevalent in low-income countries. This study aims to assess the smoking behavior among adult population in a selected community of Mymensing district.Methods: This descriptive type of cross sectional study was conducted to assess the smoking behavior among the adult population in a selected community of Mymensing district. The study period was four months starting from June 2018 to September 2018. One hundred and eighty two (182) people were selected considering the inclusion and exclusion criteria. The study taken informed written consent from all the participants. All the data were entered and analyzed by using statistical packages for social science (SPSS) software version 16.0 (Chicago).Results: This study revealed that the highest 53.3% of the respondents were smoking daily 11-15 cigarette/day. The highest 45.6% of the respondents were smoking for 6-10 years. 52.2% of the respondents were thinking depression influence on smoking. 66.5% of the respondents were thinking personal life problem influence on smoking. 42% start and continue smoking due to friends followed by 27% were due to stress and anxiety, 12% were for relaxation, 10% were personal life problem and 4% were start and continue smoke for pleasure and fun.Conclusions: It was observed that all of the respondents have given positive comment about the influence of television (TV)/media on cessation of tobacco use.

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