scholarly journals Securing Participant Engagement in Longitudinal Substance Use Disorder Recovery Research: A Qualitative Exploration of Key Retention Factors

2021 ◽  
Author(s):  
Thomas Solgaard Svendsen ◽  
Marius Veseth ◽  
James R. McKay ◽  
Jone Bjornestad ◽  
Aleksander Hagen Erga ◽  
...  
Keyword(s):  
Substance Use ◽  
Cohort Study ◽  
Substance Use Disorder ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Retention Factors ◽  
Recovery Processes ◽  
Long Term Follow Up

Abstract The longitudinal cohort study is the gold standard in observational epidemiology. A central challenge with this design is the risk of attrition over time, especially in studies of inaccessible clinical populations, such as individuals with substance use disorder (SUD). Research on individuals who have achieved stable substance use abstinence and functional recovery is scarce. 30 participants from a longitudinal cohort study (the Stayer study), were interviewed concerning their experiences of participation over several years to explore retention factors. Interviewers with first-hand experience of recovery from SUD conducted the interviews. Data were analyzed using a thematic analytic approach within an interpretative–phenomenological framework. The analyses yielded the following themes: (1) Individuals’ substance use: adaptation to slips and relapses in treatment and research, (2) “Show that you care”: Developing working relationships in research with study participants by negotiating expectations flexibly, and (3) “You don’t just make dropouts”: A long-term focus on study participation and treatment can increase retention. Several factors were perceived as relevant to participation in a long-term follow-up study with diverse recovery routes, including working research relationships and explicit contracts allowing follow-up participation, even during periods of drug use. Longitudinal studies could benefit from including such factors in the tracking procedures in addition to more traditional tracking techniques. Clinical services could benefit from developing interventions that use knowledge of long-term recovery processes as non-linear, heterogeneous trajectories, and proactive approaches to motivate recovery.

scholarly journals Association between prescription of hypnotics/anxiolytics and mortality in multimorbid and non-multimorbid patients: a longitudinal cohort study in primary care

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033545 ◽  
Author(s):  
Kristjan Linnet ◽  
Johann Agust Sigurdsson ◽  
Margret Olafia Tomasdottir ◽  
Emil Larus Sigurdsson ◽  
Larus Steinthor Gudmundsson
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Chronic Conditions ◽  
Reference Group ◽  
Longitudinal Cohort Study ◽  
Dependent Manner ◽  
Longitudinal Cohort ◽  
Multimorbid Patients

ObjectivesTo assess the risk of mortality in primary care patients, multimorbid (≥2 chronic conditions) or not, prescribed hypnotics/anxiolytics.DesignA longitudinal cohort studySettingPrimary healthcare in the Reykjavik area.Participants114 084 individuals (aged 10–79 years, average 38.5, SD 18.4) contacting general practitioners during 2009–2012 (mortality follow-up to 31 December 2016). Of those, the reference group comprised 58 560 persons who were neither multimorbid nor had redeemed prescriptions for hypnotics/anxiolytics. Participants (16 108) redeeming prescriptions for hypnotics/anxiolytics on a regular basis for 3 consecutive years were considered as consistent, long-term users. They were subdivided into low-dose (1–300 defined daily doses (DDD)/3 years), medium-dose (301–1095 DDDs/3 years) and high-dose users (>1095 DDDs/3 years). All six groups taking these drugs were compared with the reference group.Main outcome measuresAll-cause mortality.ResultsHRs were calculated with the no multimorbidity—no drug group as a reference, using Cox proportional hazards regression model adjusting for age, sex and the number of chronic conditions (n=111 767), patients with cancer excluded. During follow-up, 516 358 person-years in total, 1926 persons died. Mean follow-up was 1685 days (4.6 years), range 1–1826 days (5.0 years). For all multimorbid patients who took no drugs the HR was 1.14 (95% CI 1.00 to 1.30) compared with those without multimorbidity. HRs in the non-multimorbid participants varied from 1.49 to 3.35 (95% CI ranging from 1.03 to 4.11) with increasing doses of hypnotics/anxiolytics, and correspondingly from 1.55 to 3.52 (1.18 to 4.29) in multimorbid patients.ConclusionsMortality increased in a dose-dependent manner among both multimorbid and non-multimorbid patients taking hypnotics/anxiolytics. This increase was clearly associated with prescribing of these drugs. Their use should be limited to the recommended period of 2–4 up to 6 weeks; long-term use may incur increased risk and should be re-examined.

scholarly journals Echocardiographic features in antiphospholipid-negative Sneddon’s syndrome and potential association with severity of neurological symptoms or recurrence of strokes: a longitudinal cohort study

2020 ◽  
Vol 22 (1) ◽  
pp. 119-128
Author(s):  
Florence Assan ◽  
Dominique de Zuttere ◽  
Laure Bottin ◽  
Sebastian Tavolaro ◽  
Delphine S Courvoisier ◽  
...  
Keyword(s):  
Cohort Study ◽  
Neurological Symptoms ◽  
Longitudinal Cohort Study ◽  
Antithrombotic Treatment ◽  
Longitudinal Cohort ◽  
Sneddon's Syndrome ◽  
Sneddon’S Syndrome ◽  
Potential Association

Abstract Aims Sneddon’s syndrome (SS) may be classified as antiphospholipid positive (aPL+) or negative (aPL− SS). An association between Libman–Sacks (LS) endocarditis and strokes has been described in aPL+ patients. To describe cardiac involvement in aPL− SS and assess the potential association between LS endocarditis and severity or recurrence of neurological symptoms. Methods and results This longitudinal cohort study included aPL− SS patients followed in our departments between 1991 and June 2018. All patients underwent transthoracic 2D and Doppler echocardiography at diagnosis. Follow-up echocardiography was performed annually and the potential relationship between LS endocarditis development and neurovascular relapse as well as long-term cardiac worsening was prospectively assessed. We included 61 patients [52 women; median age 45 (range 24–60)]. For valvular involvement, 36 (59%) patients showed leaflet thickening; 18 (29.5%) had LS endocarditis at baseline. During a median follow-up of 72 months, LS endocarditis developed in eight (17.4%) patients, and 13 (28.3%) showed significant worsening of their cardiac status, including two who needed valvular replacement. After adjusting for baseline antithrombotic treatment regimen, neither the presence of LS endocarditis at baseline nor development during follow-up was associated with neurological relapse [hazard ratio (HR): 1.06, 95% confidence interval (CI): 0.33–4.74, P = 0.92] and [HR: 0.38, 95% CI: 0.02–1.89, P = 0.31], respectively. Conclusion A long-term follow-up is needed to detect cardiac complications in aPL− SS. No change in neurological relapse was observed in patients presenting LS endocarditis occurrence during follow-up without any modification in antithrombotic treatment. Further research is necessary to assess the usefulness of treatment escalation in these patients.

Outcome of admission to a medium secure psychiatric unit

1999 ◽  
Vol 175 (4) ◽  
pp. 313-316 ◽  
Author(s):  
A. Maden ◽  
S. Rutter ◽  
T. McClintock ◽  
C. Friendship ◽  
J. Gunn
Keyword(s):  
Cohort Study ◽  
Longitudinal Cohort Study ◽  
Long Term Outcomes ◽  
Readmission Rates ◽  
Royal Hospital ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Secure Unit

BackgroundThis is the first long-term follow-up of patients discharged from a medium secure unit.AimsTo describe the short– and long-term outcomes of admission for all patients discharged during a 14-year period.MethodA longitudinal cohort study of all 234 patients discharged from the Denis Hill Unit, Bethlem Royal Hospital, between 1980 and 1994, followed for an average 6.6 years.ResultsAlthough 48% of admissions were from prison, only 8% returned there, with most being transferred to another psychiatric bed. One-fifth of patients spent none of the follow-up time in the community; 75% of patients had at least one readmission; only 24% were convicted of further offences.ConclusionsRe-offending rates are comparable with those for patients discharged from high-security hospitals, and much lower than those for released prisoners. The high readmission rates indicate the need for a range of services to maintain former patients in the community.

scholarly journals Long-term use of CPAP in patients with obstructive sleep apnea: a prospective longitudinal cohort study

2021 ◽  
Author(s):  
Margareta Møkleby ◽  
Britt Øverland
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Sleep Apnea ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Obstructive Sleep ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

AbstractContinuous positive airway pressure (CPAP) is an efficient treatment for obstructive sleep apnea (OSA). Reports of long-term usage vary, as do the factors that predict long-term usage. The aim of this study was to explore long-term CPAP usage and identify potential predictors. This prospective longitudinal cohort study included all patients referred to an outpatient clinic for CPAP treatment during an eight-month period. Clinical data were collected at baseline. Follow-ups were scheduled after one week, three months and two years. Use data were downloaded from the CPAP device at each follow-up. Of 163 included patients, 112 were available for long-term follow-up 2–4 years after starting CPAP, and use data were downloaded for 99 patients. Median duration of CPAP use was 6 h/night (IQR 4.2–7.1). The only significant variable predicting long-term usage was usage at three months. Nearly half (43%) of the patients needed extra consultations beyond the standard treatment plan. Most patients (69%) did not contact the clinic for their recommended two-year follow-up but were instead called into the clinic specifically for the study. There was no significant difference in long-term CPAP usage between patients who initiated contact themselves and those who were called in and would otherwise have been lost for follow-up. Most patients adhere well to CPAP in the long term, although many need extra follow-up. Patients lost for follow-up should not necessarily be considered non-adherent as their reason for not attending could be that they are managing treatment well on their own.

scholarly journals Impact of a culturally tailored parenting programme on the mental health of Somali parents and children living in Sweden: a longitudinal cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045067
Author(s):  
Fatumo Osman ◽  
Linda Vixner ◽  
Renee Flacking ◽  
Marie Klingberg-Allvin ◽  
Ulla-Karin Schön ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Longitudinal Cohort Study ◽  
Parenting Programme ◽  
Longitudinal Cohort ◽  
Parenting Support ◽  
Support Programme ◽  
Culturally Tailored

ObjectivesThis study aimed to evaluate the long-term impact (3-year follow-up) of a culturally tailored parenting support programme (Ladnaan) on the mental health of Somali-born parents and their children living in Sweden.MethodsIn this longitudinal cohort study, Somali-born parents with children aged 11–16 were followed up 3 years after they had participated in the Ladnaan intervention. The Ladnaan intervention comprises two main components: societal information and the Connect parenting programme delivered using a culturally sensitive approach. It consists of 12 weekly group-based sessions each lasting 1–2 hours. The primary outcome was improved mental health in children, as measured by the Child Behaviour Checklist (CBCL). The secondary outcome was improved mental health in parents, as measured by the General Health Questionnaire-12. Data were collected from the parent’s perspective.ResultsOf the 60 parents who were originally offered the intervention, 51 were included in this long-term follow-up. The one-way repeated measures (baseline to the 3-year follow-up) analysis of variance for the CBCL confirmed maintenance of all the treatment gains for children: total problem scores (95% CI 11.49 to 18.00, d=1.57), and externalising problems (95% CI 2.48 to 5.83, d=0.86). Similar results were observed for the parents’ mental health (95% CI 0.40 to 3.11, d=0.46).ConclusionPositive changes in the mental health of Somali-born parents and their children were maintained 3 years after they had participated in a parenting support programme that was culturally tailored and specifically designed to address their needs. Our findings highlight the long-term potential benefits of these programmes in tackling mental health issues in immigrant families.Trial registration numberNCT02114593.

scholarly journals Association between polymorphism at IGF-1 rs35767 gene locus and long-term decline in renal function: a Japanese retrospective longitudinal cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kosuke Honda ◽  
Satoru Kuriyama ◽  
Kimiyoshi Ichida ◽  
Tomoko Nakano ◽  
Naoki Sugano ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Renal Function ◽  
Uric Acid ◽  
Cohort Study ◽  
Serum Uric Acid Level ◽  
Human Growth ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort

Abstract Background Insulin-like growth factor-1 (IGF-1) acts on glucose and protein metabolism and human growth and also influences blood pressure and renal function. This study investigated whether the single-nucleotide polymorphism of IGF-1, rs35767, plays a role in metabolic syndrome indicators, including blood pressure, glucose metabolism, uric acid levels, and renal function. Methods In this retrospective longitudinal cohort study, blood samples from 1506 Japanese individuals were collected and used for genotyping for variant rs35767: T > C in the IGF-1 upstream promoter. Data were analyzed to identify associations between IGF-1 genotypes and patient biochemical parameters, including the components of metabolic syndrome and the long-term change in renal function. Results The cohort rs35767 genotypes included 650 CC carriers (43.2%), 687 TC carriers (45.6%), and 169 TT carriers (11.2%). Multiple regression analysis revealed no association between IGF-1 genotype and blood pressure, glycated hemoglobin level, and serum uric acid level. However, in females, blood pressure was negatively correlated with the TT genotype. Longitudinal observation revealed that the decline in eGFR over 10 years was greater in TT (− 18.51 ± 1.04 mL/min/1.73m2) than in CC carriers (− 16.38 ± 0.52 mL/min/1.73m2; P < 0.05). Conclusion The present study suggests that renal function declines faster in individuals with the TT genotype at the IGF-1 rs35767 locus than in those with the CC genotype, suggesting that the TT genotype is associated with the long-term chronological decline in renal function.

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