Smoking and its associations with sociodemographic and clinical characteristics and quality of life in patients with schizophrenia treated in primary care in China

Objective We aimed to describe the clinical characteristics of chronic pancreatitis (CP) and patient quality of life (QOL) in a resource-limited setting. Methods We performed a cross-sectional study including patients with clinical and radiological features of CP. We collected clinical data and assessed QOL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire. Results We included 103 patients (median age 44 years, 84 men). Median age at symptom onset was 36 (4–78) years. Around 70% of patients had diabetes mellitus and 62.1% had consumed alcohol; 36 (35%) were current smokers. The mean overall global QOL score was 68.7. Most patients (91.3%) sought treatment from multiple centers. Nineteen (18.5%) had pancreatic stone disease, 38 (36.9%) had persistent abdominal pain (median severity 7.8/10, 59 (57.3%) had steatorrhea, and 56 (54.4%) had jaundice. Poor QOL was significantly associated with weight loss, loss of appetite, and intractable pain. No correlation with age, sex, or alcohol consumption was noted. Conclusion A considerable proportion of patients with CP had troublesome symptoms. Intractable pain, loss of appetite, and weight loss were significantly associated with poor QOL. Further assessment is needed of patients’ psychosocial well-being and its association with QOL.

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Carpal and cubital tunnel syndromes

InnovAiT Education and inspiration for general practice ◽

10.1177/17557380211018239 ◽

2021 ◽

pp. 175573802110182

Author(s):

Richard Mayne ◽

Neil Heron

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Upper Limb ◽

Cubital Tunnel ◽

Hand Dominance ◽

Affected Person ◽

Wrist Function ◽

Tunnel Syndromes ◽

Huge Variety

Tingling, pain and numbness in the hand can be a major cause of morbidity for many people. Adequate hand and wrist function are required for a huge variety of daily tasks, therefore disorders of the hand and wrist can have significant detrimental effects on the quality of life for affected individuals. With any upper limb issue, it is important to consider hand dominance, occupation and pastimes of the affected person. This article focuses on the optimal diagnosis and management of carpal and cubital tunnel syndromes from a primary care perspective.

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Characteristics and health status of patients with and without confirmed HFpEF

European Heart Journal ◽

10.1093/ehjci/ehaa946.3139 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Deaton ◽

F Forsyth ◽

J Mant ◽

D Edwards ◽

R Hobbs ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Cohort Study ◽

Health Status ◽

Functional Impairment ◽

Funding Source ◽

Walk Distance ◽

Minute Walk Distance ◽

Minute Walk

Abstract Aims Patients with heart failure with preserved ejection fraction (HFpEF) are usually older and multi-morbid and diagnosis can be challenging. The aims of this cohort study were to confirm diagnosis of HFpEF in patients with possible HFpEF recruited from primary care, to compare characteristics and health status between those with and without HFpEF, and to determine factors associated with health status in patients with HFpEF. Methods Patients with presumed HFpEF were recruited from primary care practices and underwent clinical assessment and diagnostic evaluation as part of a longitudinal cohort study. Health status was measured by Montreal Cognitive Assessment (MOCA), 6-minute walk test, symptoms, and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and quality of life (QoL) by EQ-5D-5L visual analogue scale (VAS). Results 151 patients (mean age 78.5±8.6 years, 40% women, mean EF 56% + 9.4) were recruited and 93 (61.6%) were confirmed HFpEF (those without HFpEF had other HF and cardiac diagnoses). Patients with and without HFpEF did not differ by age, MOCA, blood pressure, heart rate, NYHA class, proportion with atrial fibrillation, Charlson Comorbidity Index, or NT-ProBNP levels. Patients with HFpEF were more likely to be women, overweight or obese, frail, and to be more functionally impaired by 6 minute walk distance and gait speed than those without. Although not statistically significant, patients with HFpEF had clinically significant differences (>5 points) on the physical limitations, symptom burden and clinical summary subscales of the KCCQ, but did not differ by other subscales or by EQ-5D-5L VAS (70±17 vs 73±19, p=0.385). More patients with HFpEF reported daytime dyspnoea (63% vs 46%, p=0.035) and fatigue (81% vs 61%, p=0.008), but not other symptoms compared to those without HFpEF. For both groups BMI was moderately negatively correlated with KCCQ subscale scores, and 6 minute walk distance was positively correlated with KCCQ subscales. Conclusions Nearly 40% were not confirmed as HFpEF indicating the challenges of diagnosis. Patients with confirmed HFpEF differed by sex, overweight/obesity, frailty, functional impairment, and symptoms but not by age or comorbidities from those without HFpEF. These differences were reflected in some subscale scores of the KCCQ, but not how patients reported their quality of life on the KCCQ QoL subscale and EQ-5D-5L VAS. Older patients with HFpEF reported relatively high QoL despite poor health status by functional impairment, frailty and symptoms. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research School of Primary Care Research

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Dyspareunia

InnovAiT Education and inspiration for general practice ◽

10.1177/17557380211030299 ◽

2021 ◽

pp. 175573802110302

Author(s):

Charlotte Morris ◽

Catherine Briggs ◽

Manju Navani

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Healthcare Professionals ◽

Persistent Pain ◽

Differential Diagnoses ◽

Relationship Problems

Dyspareunia is persistent pain on attempted or successful vaginal penetration. It is under-reported, infrequently asked about by healthcare professionals, and affects quality of life and relationships. Dyspareunia is multifactorial and possesses biopsychosocial components. Pain may be distinct and localised, deep or persistent. Among the symptoms, women describe sensations of aching, throbbing and tearing. Disinterest in sex and relationship problems can result. This article discusses dyspareunia, its common differential diagnoses and aims to improve clinician confidence in assessing and managing dyspareunia in primary care.

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Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life?

Journal of Patient Experience ◽

10.1177/2374373520967798 ◽

2020 ◽

Vol 7 (6) ◽

pp. 989-993

Author(s):

Andrew Thomas ◽

Annie Thomas

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Health Care ◽

Health Care Providers ◽

The United States ◽

Care Providers ◽

Physician Visits ◽

Digestive Diseases ◽

Care Specialist

Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.

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