Patient Characteristics and Treatment Patterns in Chronic Heart Failure: Results from a Multinational Real-World Cross Sectional Survey

AimThe aim of this study was to critically analyse and describe gender differences related to self-care among patients with chronic heart failure (HF).Methods and resultsA monocentric real-world cohort of 346 patients with chronic HF in follow-up was used for this cross-sectional study. We report data related to the cohort’s demographic and clinical characteristics. Self-care was assessed using the Self-Care of Heart Failure Index before patients’ discharge. After bivariate analysis, logistical regression models were used to describe the relationship between gender, self-care behaviours and self-care confidence. While men were found to have more than quadruple the risk of poor self-care than women (OR 4.596; 95% CI 1.075 to 19.650), men were also found to be approximately 60% more likely to have adequate self-care confidence than women (OR 0.412; 95% CI 0.104 to 0.962). Considering that self-care confidence is described as a positive predictor of behaviours, our results suggest a paradox. It is possible that the patient–caregiver relationship mediates the effect of confidence on behaviours. Overall, adequate levels of self-care behaviours are a current issue, ranging 7.6%–18.0%.ConclusionThis study sets the stage for future research where elements of the patient–caregiver relationship ought to be considered to inform the planning of appropriate educational interventions. We recommend routinely measuring patients’ self-care behaviours to guide their follow-up and as a basis for any changes in their daily life behaviours.

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Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey

Drug Design Development and Therapy ◽

10.2147/dddt.s166277 ◽

2018 ◽

Vol Volume 12 ◽

pp. 2311-2321 ◽

Cited By ~ 1

Author(s):

James DS Jackson ◽

Sarah E Cotton ◽

Sara Bruce Wirta ◽

Catia C Proenca ◽

Milun Zhang ◽

...

Keyword(s):

Heart Failure ◽

Treatment Patterns ◽

Care Pathways ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Patients With Heart Failure

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Patterns of HPV testing and treatment decision in patients with SCCHN.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e17526 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e17526-e17526

Author(s):

Giovanni Zanotti ◽

Jean-Francois Martini ◽

Roberto Uehara ◽

Pamela Hallworth ◽

Katherine Byrne

Keyword(s):

Real World ◽

Local Level ◽

Treatment Decision ◽

Treatment Patterns ◽

Hpv Testing ◽

Cross Sectional Survey ◽

Real World Data ◽

Cross Sectional ◽

Data Set ◽

Hpv Status

e17526 Background: Human papillomavirus (HPV) is one of the main risk factors associated with squamous cell carcinoma of the head and neck (SCCHN). Although it is a prognostic factor, SCCHN patients are not routinely tested for HPV status because it may not be informative for therapy initiation. The objective of this study was to understand the real world testing patterns, and treatment decision of SCCHN patients. Methods: Real world data was gathered using Adelphi’s Disease-Specific Programme (DSP) - a real world, cross-sectional survey conducted in the USA, France, Germany and the UK (April - September 2016). The DSP incorporated 182 physician interviews (54 US, 128 EU) covering all stages of SCCHN caseloads and treatment patterns. Physicians also provided data for 8 consecutive consulting SCCHN patients regarding treatment patterns, progression, and symptoms. Results: A total of 2193 SCCHN patient cases were captured. HPV testing was carried out in 42% of patients within the DSP data set with no particular difference across the 4 countries. Of those tested, 35% of patients were HPV positive. Testing was mainly performed at the local level (51%, onsite or local hospital) apart from Germany where central testing was higher (73%). In over half of patients cases (54%) , physicians are unaware of the type of test performed for the HPV status determination; in fact, up to 10 different types of tests were used to determine the HPV status in this real world experience. Platinum based cetuximab and fluorouracil was used in 30% of the HPV positive patients while 20% received platinum monotherapy. In 2nd line, docetaxel/paclitaxel monotherapy was used in 22% of the patients. HPV negative patients also mainly received platinum based cetuximab and fluorouracil (27%) in 1st line, while in 2ndline, docetaxel/paclitaxel monotherapy was used in 20% of the patients. Conclusions: This analysis of real world treatment patterns and outcomes among SCCHN patients shows that HPV testing is not widely carried out for either patient characterization or to guide treatment decisions within this disease. Therapy choices were generally consistent standard clinical guidelines.

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Characterization and Treatment Goals of Patients on Long-Acting Injectable vs Oral Antipsychotics: Results from a Patient/Caregiver/Psychiatrist Survey

CNS Spectrums ◽

10.1017/s109285292000245x ◽

2021 ◽

Vol 26 (2) ◽

pp. 154-154

Author(s):

Heather M. Fitzgerald ◽

Jason Shepherd ◽

Hollie Bailey ◽

Mia Berry ◽

Jack Wright ◽

...

Keyword(s):

Real World ◽

Sufficient Evidence ◽

Treatment Goals ◽

Full Time ◽

Medication Regimen ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Course Of Illness ◽

Current Medication ◽

Long Acting

AbstractBackgroundPatient preferences in schizophrenia (SCZ), including identification of key goals and outcomes for treatment and relative importance of certain treatment goals to patients, have been assessed by several studies. However, there continues to be a lack of sufficient evidence on US patient attitudes and perceptions towards treatment goals and pharmacotherapy options in SCZ, especially taking into context long-acting injectable antipsychotics (LAIs) in this disease area. This lack of evidence is further pronounced in caregivers of individuals with SCZ. The objective of this analysis was to characterize patients with SCZ on LAIs vs patients on oral antipsychotics (OAPs) and evaluate the treatment goals of patients in each group.MethodsThis was a real-world, cross-sectional survey of US psychiatrists, patients =18 years old with a diagnosis of SCZ, and caregivers. Data was collected using the Disease Specific Programme (DSP) methodology, which has been previously published. Psychiatrists (n=120) completed detailed record forms for next 8 consecutive outpatients and 2 inpatients matching inclusion criteria, including non-interventional clinical and subjective assessments. The same patients and their caregivers, if present, were invited by their psychiatrist to voluntarily complete a separate survey.ResultsOf 1135 patients on treatment where the physician provided survey data; 251 were on an LAI, and 884 were on an OAP. Mean (SD) time to SCZ diagnosis for those on an LAI was 10.3 (12.0) years vs 7.8 (10.5) years for those on OAPs. More patients in the LAI vs OAP group were being treated as an inpatient (27.1% vs 15.7%, respectively; p<0.0001). Patients on an LAI reported being on their current medication regimen for less time (mean 1.7 years) vs those on OAPs (mean 2.5 years) (p=0.0093). More patients on LAIs were unemployed due to disability vs those on OAPs (56.1% vs 39.5%, respectively), and less patients on LAIs were able to work part-time or full-time (21.1% or 4.1%) vs those on OAPs (23.2% or 11.4%). More patients on an LAI had a caregiver vs those on OAPs (37.3% vs 26.1%, respectively; p=0.0011). Regarding the most important treatment goals reported by patients, both groups reported similar preferences for decrease in disease symptoms (62% on LAI vs 65% on OAPs) and thinking more clearly (53% on LAI vs 46% on OAPs); however, a numerically higher proportion of LAI patients reported that the current medication helped decrease hospitalizations due to relapse vs those on OAPs (38% vs 32%, respectively).DiscussionGiven the characteristics of patients participating in this real-world survey, those on LAIs exhibited qualities which indicate a higher severity of illness vs those on OAPs. Results suggest that treatment with LAIs is still mainly being provided to patients later in the disease course and/or who have adherence problems, despite a growing body of evidence of utility in younger patients earlier in the course of illness.FundingOtsuka Pharmaceutical Development & Commercialization, Inc. and Lundbeck LLC

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Real-world evidence of cancer immunotherapy (CIT) combination treatment in first-line (1L) extensive-stage small cell lung cancer (ES-SCLC).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.8561 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 8561-8561

Author(s):

Eric S. Nadler ◽

Anupama Vasudevan ◽

Kalatu Davies ◽

Yunfei Wang ◽

Ann Johnson ◽

...

Keyword(s):

Brain Metastases ◽

Real World ◽

Performance Status ◽

Descriptive Analysis ◽

Patient Characteristics ◽

Treatment Patterns ◽

Combination Regimen ◽

Duration Of Treatment ◽

The Real

8561 Background: Atezolizumab plus chemotherapy was the first CIT combination regimen approved for 1L treatment of ES-SCLC in 2019. This study investigated patient characteristics and treatment patterns for patients with ES-SCLC receiving this regimen in the real-world community oncology setting. Methods: This was a retrospective study including adult patients diagnosed with ES-SCLC between 01-Oct-2018 (after IMpower 133 publication in NEJM Sep-2018) and 31-Dec-2019, with follow-up through 31-March-2020 using The US Oncology Network electronic health records data. Descriptive analyses of patient characteristics and treatment patterns were conducted, with Kaplan-Meier (K-M) methods used to assess time to treatment discontinuation (TTD) and time to next treatment/death (TTNT). Results: Of the 408 patients included in this study, 267 (71.4%) received atezo+carboplatin+etoposide (Atezo+Chemo), 80 (21.4%) received carboplatin+etoposide (Chemo only) and the rest received other regimens. The Atezo+Chemo patients in the real-world cohort compared with the IMpower 133 trial (n = 201) were older (median age 68 vs. 64 years) and included fewer males (45% vs. 64%), fewer white race (73% vs. 81%), more patients with brain metastases at baseline (23% vs. 9%), and more patients with worse ECOG (2/3) performance-status score (24% vs. 0%). The median follow-up, TTD, and TTNT in months (mo) for the real-world cohort are presented in the table alongside the best comparable measures reported for the trial. Conclusions: Most patients in this real-world ES-SCLC cohort received the Atezo+Chemo regimen in the 1L setting. While the follow-up was much shorter and patients had worse baseline characteristics (age, brain metastases, ECOG) in the real-world setting compared to the IMpower 133 trial, the real-world median TTD in this descriptive analysis was found to be in line with the median duration of treatment in the trial. Further research with longer follow-up comparing the real-world effectiveness of the CIT and chemo regimens is needed.[Table: see text]

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Abstract 17275: Evaluating the Convergent and Discriminant Validity of Four Frailty Instruments in Adults With Heart Failure: Results From the Frame-HF Study

Circulation ◽

10.1161/circ.138.suppl_1.17275 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Julee McDonagh ◽

Yenna Salamonson ◽

Roslyn Prichard ◽

Sunita R Jha ◽

Caleb Ferguson ◽

...

Keyword(s):

Heart Failure ◽

Discriminant Validity ◽

Survey Design ◽

Karnofsky Performance Scale ◽

Cross Sectional Survey ◽

Frailty Phenotype ◽

Cross Sectional ◽

Frailty Status ◽

Convergent And Discriminant Validity ◽

Nyha Classification

Introduction: Frailty assessment has become increasingly common in those with heart failure. The most frequently used frailty instrument is the Frailty Phenotype (FP). The validity of this instrument in those with heart failure is yet to be determined. Aim: To examine the convergent and discriminant validity of four frailty instruments: i) the FP ii) a Questionnaire-only version of FP [q-FP]; iii) St. Vincent’s Frailty [SVF]; and iv) the Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe [SHARE-FI] for assessing the frailty status of adults with heart failure. Methods: Using a cross-sectional survey design, individuals aged ≥ 18 years, diagnosed with heart failure were recruited from the inpatient cardiology ward and outpatient heart failure clinic of a metropolitan academic hospital. In addition to assessing all items of the frailty instruments, other data collected included: a) NYHA classification; b) quality of life and health status using the EQ-5D-5L; c) physical status using the Australian-modified Karnofsky Performance Scale (AKPS); and d) 10-item Depression in Medically Ill (DMI) measure. Results: A total of 131 participants were recruited and included in the analyses, there were wide variations in frailty status across the four frailty instruments (Figure 1). Inter-correlations were highest between SVF and SHARE-FI instruments ( r = 0.62). The NYHA classification were correlated with SVF ( r = 0.46) and SHARE-FI ( r = 0.42). Similarly, all EQ-5D-5L dimensions were correlated with both SVF and SHARE-FI but not with FP or q-FP. The SVF differentiated between high and low AKPS scores (χ 2 = 11.70, df : 2, p = 0.003) and DMI scores (χ 2 = 7.28, df : 2, p = 0.026). Similarly, the SHARE-FI also had good discriminant validity using AKPS scores (χ 2 = 9.25, df : 2, p = 0.010) and DMI scores (χ 2 = 14.32, df : 2, p = 0.001). Conclusions: The SVF and SHARE-FI demonstrated good convergent and discriminant validity. Both instruments provide a valid alternative to the FP for the assessment of frailty in those with heart failure. Figure 1: Classification of frailty categories: FP, Questionnaire-only FP, SVF and SHARE-FI

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