Factors associated with refusal or acceptance of older patients (≥ 65 years) to provide consent to participate in clinical research in cardiology: a qualitative study

2019 ◽  
Vol 32 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Fiona Ecarnot ◽  
Nicolas Meunier-Beillard ◽  
Jean-Pierre Quenot ◽  
Nicolas Meneveau
Keyword(s):  
Qualitative Study ◽  
Clinical Research ◽  
Older Patients ◽  
Factors Associated

scholarly journals Gap between real-world data and clinical research within hospitals in China: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038375
Author(s):  
Feifei Jin ◽  
Chen Yao ◽  
Xiaoyan Yan ◽  
Chongya Dong ◽  
Junkai Lai ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Clinical Research ◽  
Real World ◽  
Data Standards ◽  
Medical Record Data ◽  
Real World Data ◽  
World Data ◽  
Electronic Medical Record Data ◽  
Research Platform ◽  
Record Data

ObjectiveTo investigate the gap between real-world data and clinical research initiated by doctors in China, explore the potential reasons for this gap and collect different stakeholders’ suggestions.DesignThis qualitative study involved three types of hospital personnel based on three interview outlines. The data analysis was performed using the constructivist grounded theory analysis process.SettingSix tertiary hospitals (three general hospitals and three specialised hospitals) in Beijing, China, were included.ParticipantsIn total, 42 doctors from 12 departments, 5 information technology managers and 4 clinical managers were interviewed through stratified purposive sampling.ResultsElectronic medical record data cannot be directly downloaded into clinical research files, which is a major problem in China. The lack of data interoperability, unstructured electronic medical record data and concerns regarding data security create a gap between real-world data and research data. Updating hospital information systems, promoting data standards and establishing an independent clinical research platform may be feasible suggestions for solving the current problems.ConclusionsDetermining the causes of gaps and targeted solutions could contribute to the development of clinical research in China. This research suggests that updating the hospital information system, promoting data standards and establishing a clinical research platform could promote the use of real-world data in the future.

scholarly journals The Closure of a Medical Practice Forces Older Patients to Make Difficult Decisions: A Qualitative Study of a Natural Experiment

2008 ◽  
Vol 23 (10) ◽  
pp. 1576-1580 ◽  
Author(s):  
Mary Anne J. Nidiry ◽  
Aysegul Gozu ◽  
Joseph A. Carrese ◽  
Scott M. Wright
Keyword(s):  
Qualitative Study ◽  
Medical Practice ◽  
Older Patients ◽  
Natural Experiment

Experiences of and factors associated with dietary sodium adherence in heart failure from patients’ and their caregivers’ perspectives: A qualitative study

2021 ◽  
Vol 42 (5) ◽  
pp. 1190-1197
Author(s):  
Seongkum Heo ◽  
JinShil Kim ◽  
Jae Lan Shim ◽  
Tammy Barbe ◽  
Vicki Black ◽  
...  
Keyword(s):  
Heart Failure ◽  
Qualitative Study ◽  
Dietary Sodium ◽  
Factors Associated

scholarly journals Antibiotic stewardship program in Pakistan: a multicenter qualitative study exploring medical doctors’ knowledge, perception and practices

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Atif ◽  
Beenish Ihsan ◽  
Iram Malik ◽  
Nafees Ahmad ◽  
Zikria Saleem ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Qualitative Study ◽  
Antibiotic Stewardship ◽  
Antibiotic Prescription ◽  
Successful Implementation ◽  
Rational Use ◽  
Factors Associated ◽  
Prescription Practices ◽  
Stewardship Program ◽  
Rational Use Of Antibiotics

Abstract Background The emerging threat of antibiotic resistance is growing exponentially and antibiotic stewardship programs are cornerstone to fight against this global threat. The study aimed to explore the knowledge, perspectives and practices of physicians regarding various aspects of antibiotic stewardship program including antibiotic stewardship activities, rational use of antibiotics, antibiotic resistance, prescribing practices and factors associated with these practices. Methods In this qualitative study, a total of 17 semi-structured, in-depth interviews with doctors of three tertiary care public sector hospitals in Bahawalpur and Rahim Yar Khan were conducted. The convenient sampling method was adopted to collect the data and the saturation point criterion was applied to determine the sample size. Thematic analysis approach was used to draw conclusions from the data. Results The analysis of data yielded five themes, 12 subthemes and 26 categories. The themes included, (i) perception about antibiotic use and antibiotic stewardship, (ii) antibiotic prescription practices, (iii) antibiotic resistance, (iv) limited strategies adopted by hospital administration to ensure quality and safe distribution of antibiotics, (v) implementation of antibiotic stewardship program: barriers, suggestion and future benefits. Doctors had misconceptions about the rational use of antibiotics. The perception regarding antibiotic stewardship programs was poor. Moreover, very few activities related to ASP existed. The participants gave many suggestions for successful implementation of ASP in order to reduce the burden of antibiotic resistance, including development of guidelines for the use of antibiotics, strict legislation regarding use of antibiotics, active participation of healthcare professionals and awareness program among general public about the use of antibiotics. Conclusion This study concluded that poor knowledge of doctors regarding ASP, non-existence of antibiogram of hospital and lack of rules for the safe use of antibiotics were the main driving factors associated with irrational antibiotic prescription practices and development of AR.

ASTHMA IN OLDER PATIENTS: FACTORS ASSOCIATED WITH HOSPITALIZATION

PEDIATRICS ◽  
2003 ◽  
Vol 112 (Supplement_2) ◽  
pp. 477-477
Author(s):  
Allen Adinoff
Keyword(s):  
Older Patients ◽  
Factors Associated

scholarly journals Older patients’ experience of primary hypothyroidism: A qualitative study

2018 ◽  
Vol 21 (3) ◽  
pp. 628-635
Author(s):  
Lorna E. Ingoe ◽  
Janis Hickey ◽  
Simon Pearce ◽  
Tim Rapley ◽  
Salman Razvi ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Older Patients ◽  
Primary Hypothyroidism ◽  
Patients Experience

scholarly journals Factors Associated With Primary Care Physicians’ Recognition of Cognitive Impairment in Their Older Patients

2014 ◽  
Vol 28 (4) ◽  
pp. 320-325 ◽  
Author(s):  
Mary C. Tierney ◽  
Gary Naglie ◽  
Ross Upshur ◽  
Liisa Jaakkimainen ◽  
Rahim Moineddin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Primary Care Physicians ◽  
Older Patients ◽  
Factors Associated

scholarly journals The application of updating PIM-Taiwan criteria in clinic-visiting older patients with polypharmacy

2018 ◽  
Vol 9 (12) ◽  
pp. 699-709 ◽  
Author(s):  
Chirn-Bin Chang ◽  
Hsiu-Yun Lai ◽  
Shinn-Jang Hwang ◽  
Shu-Yu Yang ◽  
Ru-Shu Wu ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Medication Safety ◽  
Older Patients ◽  
Bivariate Analysis ◽  
Potentially Inappropriate Medications ◽  
Safety Review ◽  
Factors Associated ◽  
Logistic Regressions ◽  
Inappropriate Medications ◽  
Country Specific

Background: PIM-Taiwan criteria were first established in 2010 for potentially inappropriate medications (PIMs). Currently, updating of PIM criteria is mandatory because of newly established evidence and newly developed medications. This study aims to evaluate the prevalence of PIM based on country-specific PIM criteria and factors associated with PIM use by applying 2010 version and newly updating PIM-Taiwan criteria in a cohort with polypharmacy. Methods: The baseline data of Medication Safety Review Clinic Taiwan (MSRC–Taiwan) study were used to investigate the prevalence of PIMs. Older patients (aged ⩾65 years) who were either having polypharmacy or visited ⩾3 different physicians were enrolled between August and October 2007. Bivariate analysis and multivariate logistic regressions were used to evaluate the factors associated with PIM use. Results: The prevalence of having at least one PIM was 46.1% for 2010 version and increased to 74.6% for 2018 version. The average number of PIMs generally to be avoided per patient also increased for 2018 version (0.2 versus 1.2, p < 0.0001). In contrast, the average number of PIMs considering chronic conditions per patient decreased (0.6 versus 0.3, p < 0.001). The associated chronic conditions of PIM users were distinct between 2010 and 2018 version. The major leading PIMs were benzodiazepines (BZDs) in both versions of criteria. Conclusions: As there were significant differences in medication lists between PIM-Taiwan version 2010 and 2018, the prevalence of PIM and factors associated with PIM users varied accordingly. Physicians should pay special attention before prescribing BZDs which keep being the major leading PIM.

scholarly journals Factors associated with virological non-suppression among HIV-positive children receiving antiretroviral therapy at the Joint Clinical Research Centre in Lubowa, Kampala Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246140
Author(s):  
Sarah Nabukeera ◽  
Joseph Kagaayi ◽  
Fredrick Edward Makumbi ◽  
Henry Mugerwa ◽  
Joseph K. B. Matovu
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Clinical Research ◽  
Clinical Stage ◽  
Research Centre ◽  
Hiv Positive ◽  
Factors Associated ◽  
Art Initiation ◽  
Stage 4

Background While the proportion of HIV-positive children (under 15 years) enrolled on antiretroviral therapy (ART) has increased in recent years, up to 60% of children started on ART do not achieve virological suppression. We set out to determine the factors associated with virological non-suppression among children living with HIV receiving ART at a peri-urban HIV care clinic in Kampala, Uganda. Method This was a retrospective cohort study conducted at the pediatric HIV/AIDS clinic at the Joint Clinical Research Centre (JCRC) in Kampala, Uganda. Three hundred (300) HIV-positive children (0–14 years) were randomly selected from existing medical records and data on children’s socio-demographic and clinical characteristics (age at ART initiation, WHO clinical staging, and ART-induced side effects) were abstracted using a data abstraction form. Virological non-suppression was defined as a viral load ≥1000 copies/Ml of blood after six months of ART initiation. Incident rate ratios (IRRs) were determined as a measure of association between virological non-suppression and child/patient characteristics. The IRRs were obtained via a modified Poisson regression with corresponding 95% confidence intervals (95%CI). All analyses were done using statistical package, Stata version 15. Results The overall non-suppression rate among HIV-positive children on ART was 23%. Being at WHO clinical stage 4 at ART initiation [adj. IRR 2.74; 95%CI: 1.63, 4.61] and ART-induced side effects [adj. IRR 1.77; 95%CI: 1.06, 2.97] were significantly associated with non-suppression. Older age at ART initiation (age 5–9 years: [adj. IRR 0.42; 95%CI: 0.28, 0.65]; age 10–14 years: [adj. IRR 0.34; 95%CI: 0.18, 0.64] was less likely to be associated with virological non-suppression. Conclusion Nearly a quarter of HIV-positive children on ART had a non-suppressed viral load after six months of treatment. Being at WHO clinical stage 4 at ART initiation and ART-induced side effects were significantly associated with virological non-suppression while older age at ART initiation was protective. Our findings suggest a need for age-specific interventions, particularly those targeting children below five years of age, to improve virological suppression among HIV-positive children receiving ART in this setting.

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