Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study

IntroductionAcute gastroenteritis (AGE) is a highly transmissible condition. Determining characteristics of household transmission will facilitate development of prevention strategies and reduce the burden of this disease.We are carrying out this study to describe household transmission of medically attended AGE, and explore whether there is an increased incidence in households with young children.Methods and analysisThis study used the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network, comprising data from 1 750 167 registered patients (August 2017 database). We conducted a novel analysis using a ’household key', to identify patients within the same household (n=811 027, mean 2.16 people). A 25-year repeated cross-sectional study will explore the incidence of medically attended AGE overall and then a 5-year retrospective cohort study will describe household transmission of AGE. The cross-sectional study will include clinical data for a 25-year period—1 January 1992 until the 31 December 2017. We will describe the incidence of AGE by age-band and gender, and trends in incidence. The 5-year study will use Poisson and quasi-Poisson regression to identify characteristics of individuals and households to predict medically attended AGE transmitted in the household. This will include whether the household contained a child under 5 years and the age category of the first index case (whether adult or child under 5 years). If there is overdispersion and zero-inflation we will compare results with negative binomial to handle these issues.Ethics and disseminationAll RCGP RSC data are pseudonymised at the point of data extraction. No personally identifiable data are required for this investigation. The protocol follows STrengthening the Reporting of OBservational studies in Epidemiology guidelines (STROBE). The study results will be published in a peer-review journal, the dataset will be available to other researchers.

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A Retrospective Cohort Study of SARS-CoV-2 Infection in Hypertenses Patients in a Primary Care Center

SSRN Electronic Journal ◽

10.2139/ssrn.3605259 ◽

2020 ◽

Author(s):

Esther Hernandez Castilla ◽

Lucia Vallejo Serrano ◽

Monica Saenz Ausejo ◽

Beatriz Pax Sanchez ◽

Katharina Ramrath ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Care Center ◽

Primary Care Center

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Treatment of chronic noncancer pain in patients on opioid therapy in primary care: A retrospective cohort study

Canadian Pharmacists Journal / Revue des Pharmaciens du Canada ◽

10.1177/1715163519887766 ◽

2019 ◽

Vol 153 (1) ◽

pp. 52-58

Author(s):

Arden R. Barry ◽

Chantal E. Chris

Keyword(s):

Primary Care ◽

Cohort Study ◽

Back Pain ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Opioid Therapy ◽

Opioid Agonist ◽

Chronic Noncancer Pain ◽

Opioid Dose ◽

Noncancer Pain

Background: This study sought to characterize the real-world treatment of chronic noncancer pain (CNCP) in patients on opioid therapy in primary care. Methods: A retrospective cohort study from 2014-18 was conducted at a multidisciplinary primary care clinic in Chilliwack, British Columbia. Included were adults on daily opioid therapy for CNCP. Patients receiving palliative care or ≤1 visit were excluded. Outcomes of interest included use of opioid/nonopioid pharmacotherapy, number/frequency of visits and proportion of patients able to reduce/discontinue opioid therapy. Results: Seventy patients (mean age 53 years, 53% male, 51% back pain) were included. Median follow-up was 6 visits over 12 months. Sixty-two patients (89%) reduced their opioid dose, 6 patients had no change and 2 patients required a dose increase. Mean opioid dose was reduced from 183 to 70 mg morphine equivalents daily. Twenty-four patients (34%) discontinued opioid therapy, 6 patients (9%) transitioned to opioid agonist therapy and 6 patients (9%) breached their opioid treatment agreement. Nonopioid pharmacotherapy included nonsteroidal anti-inflammatory drugs (64%), gabapentinoids (63%), tricyclic antidepressants (56%) and nabilone (51%). Discussion: Over half of patients were no longer on opioid therapy by the end of the study. Most patients had a disorder (e.g., back pain) for which opioids are generally not recommended. Overall mean opioid dose was reduced from baseline by approximately 60% over 1 year. Lack of access to specialized pain treatments may have accounted for high nonopioid pharmacotherapy usage. Conclusions: This study demonstrates that treatment of CNCP and opioid tapering can successfully be achieved in a primary care setting. Can Pharm J (Ott) 2020;153:xx-xx.

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Risk of exacerbation in chronic obstructive pulmonary disease: a primary care retrospective cohort study

BMC Family Practice ◽

10.1186/s12875-015-0387-6 ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 10

Author(s):

Josep Montserrat-Capdevila ◽

Pere Godoy ◽

Josep Ramon Marsal ◽

Ferran Barbé ◽

Leonardo Galván

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Primary Care ◽

Cohort Study ◽

Pulmonary Disease ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease

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Thoracic muscle cross-sectional area is associated with hospital length of stay post lung transplantation: a retrospective cohort study

Transplant International ◽

10.1111/tri.12961 ◽

2017 ◽

Vol 30 (7) ◽

pp. 713-724 ◽

Cited By ~ 19

Author(s):

Dmitry Rozenberg ◽

Sunita Mathur ◽

Margaret Herridge ◽

Roger Goldstein ◽

Heidi Schmidt ◽

...

Keyword(s):

Cohort Study ◽

Length Of Stay ◽

Lung Transplantation ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Sectional Area ◽

Cross Sectional ◽

Muscle Cross Sectional Area

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Comparison of two methods to estimate adverse events in the IBEAS Study (Ibero-American study of adverse events): cross-sectional versus retrospective cohort design

BMJ Open ◽

10.1136/bmjopen-2017-016546 ◽

2017 ◽

Vol 7 (10) ◽

pp. e016546 ◽

Cited By ~ 3

Author(s):

Jesus Maria Aranaz Andrés ◽

Ramon Limón Ramírez ◽

Carlos Aibar Remón ◽

Maria Teresa Gea-Velázquez de Castro ◽

Francisco Bolúmar ◽

...

Keyword(s):

Cohort Study ◽

Adverse Events ◽

Retrospective Cohort Study ◽

Medical Records ◽

Retrospective Cohort ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Hospital Size ◽

Cohort Design ◽

Cohort Study Design

BackgroundAdverse events (AEs) epidemiology is the first step to improve practice in the healthcare system. Usually, the preferred method used to estimate the magnitude of the problem is the retrospective cohort study design, with retrospective reviews of the medical records. However this data collection involves a sophisticated sampling plan, and a process of intensive review of sometimes very heavy and complex medical records. Cross-sectional survey is also a valid and feasible methodology to study AEs.ObjectivesThe aim of this study is to compare AEs detection using two different methodologies: cross-sectional versus retrospective cohort design.SettingSecondary and tertiary hospitals in five countries: Argentina, Colombia, Costa Rica, Mexico and Peru.ParticipantsThe IBEAS Study is a cross-sectional survey with a sample size of 11 379 patients. The retrospective cohort study was obtained from a 10% random sample proportional to hospital size from the entire IBEAS Study population.MethodsThis study compares the 1-day prevalence of the AEs obtained in the IBEAS Study with the incidence obtained through the retrospective cohort study.ResultsThe prevalence of patients with AEs was 10.47% (95% CI 9.90 to 11.03) (1191/11 379), while the cumulative incidence of the retrospective cohort study was 19.76% (95% CI 17.35% to 22.17%) (215/1088). In both studies the highest risk of suffering AEs was seen in Intensive Care Unit (ICU) patients. Comorbid patients and patients with medical devices showed higher risk.ConclusionThe retrospective cohort design, although requires more resources, allows to detect more AEs than the cross-sectional design.

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Influence of weekday of admission and level of distress on length of hospital stay in patients with low back pain: a retrospective cohort study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04529-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Emanuel Brunner ◽

André Meichtry ◽

Davy Vancampfort ◽

Reinhard Imoberdorf ◽

David Gisi ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Low Back Pain ◽

Back Pain ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Negative Binomial ◽

Length Of Hospital Stay ◽

Binomial Model ◽

Low Back

Abstract Background Low back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. Providing inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during weekends. Delays in therapeutic procedures may result in a prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates the influence of weekday of admission and distress on LoS of inpatients with LBP. Methods This retrospective cohort study was conducted between 1 February 2019 and 31 January 2020. In part 1, a negative binomial model was fitted to LoS with weekday of admission as a predictor. In part 2, the same model included weekday of admission, distress level, and their interaction as covariates. Planned contrast was used in part 1 to estimate the difference in log-expected LoS between group 1 (admissions Friday/Saturday) and the reference group (admissions Sunday-Thursday). In part 2, the same contrast was used to estimate the corresponding difference in (per-unit) distress trends. Results We identified 173 patients with LBP. The mean LoS was 7.8 days (SD = 5.59). Patients admitted on Friday (mean LoS = 10.3) and Saturday (LoS = 10.6) had longer stays, but not those admitted on Sunday (LoS = 7.1). Analysis of the weekday effect and planned contrast showed that admission on Friday or Saturday was associated with a significant increase in LoS (log ratio = 0.42, 95% CI = 0.21 to 0.63). A total of 101 patients (58%) returned questionnaires, and complete data on distress were available from 86 patients (49%). According to the negative binomial model for LoS and the planned contrast, the distress effect on LoS was significantly influenced (difference in slopes = 0.816, 95% CI = 0.03 to 1.60) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday). Conclusions Delays in interdisciplinary LBP management over the weekend may prolong LoS. This may particularly affect patients reporting high levels of distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.

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LDL-cholesterol change and goal attainment following statin intensity titration among Asians in primary care: a retrospective cohort study

Lipids in Health and Disease ◽

10.1186/s12944-020-01427-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Hao Sen Andrew Fang ◽

Qiao Gao ◽

Mong Li Lee ◽

Wynne Hsu ◽

Ngiap Chuan Tan

Keyword(s):

Primary Care ◽

Clinical Trials ◽

Cohort Study ◽

Real World ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Goal Attainment ◽

Real World Data ◽

World Data ◽

Asian Patients

Abstract Background Clinical trials have demonstrated that either initiating or up-titrating a statin dose substantially reduce Low-Density Lipoprotein-Cholesterol (LDL-C) levels. However, statin adherence in actual practice tends to be suboptimal, leading to diminished effectiveness. This study aims to use real-world data to determine the effect on LDL-C levels and LDL-C goal attainment rates, when selected statins are titrated in Asian patients. Methods A retrospective cohort study over a 5-year period, from April 2014 to March 2019 was conducted on a cohort of multi-ethnic adult Asian patients with clinical diagnosis of Dyslipidaemia in a primary care clinic in Singapore. The statins were classified into low-intensity (LI), moderate-intensity (MI) and high-intensity (HI) groups according to the 2018 American College of Cardiology and American Heart Association (ACC/AHA) Blood Cholesterol Guidelines. Patients were grouped into “No statin”, “Non-titrators” and “Titrators” cohorts based on prescribing patterns. For the “Titrators” cohort, the mean percentage change in LDL-C and absolute change in LDL-C goal attainment rates were computed for each permutation of statin intensity titration. Results Among the cohort of 11,499 patients, with a total of 266,762 visits, there were 1962 pairs of LDL-C values associated with a statin titration. Initiation of LI, MI and HI statin resulted in a lowering of LDL-C by 21.6% (95%CI = 18.9–24.3%), 28.9% (95%CI = 25.0–32.7%) and 25.2% (95%CI = 12.8–37.7%) respectively. These were comparatively lower than results from clinical trials (30 to 63%). The change of LDL-C levels due to up-titration, down-titration, and discontinuation were − 12.4% to − 28.9%, + 13.2% to + 24.6%, and + 18.1% to + 32.1% respectively. The improvement in LDL-C goal attainment ranged from 26.5% to 47.1% when statin intensity was up-titrated. Conclusion In this study based on real-world data of Asian patients in primary care, it was shown that although statin titration substantially affected LDL-C levels and LDL-C goal attainment rates, the magnitude was lower than results reported from clinical trials. These results should be taken into consideration and provide further insight to clinicians when making statin adjustment recommendations in order to achieve LDL-C targets in clinical practice, particularly for Asian populations.

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