scholarly journals Effectiveness of individualized inhaler technique training on low adherence (LowAd) in ambulatory patients with COPD and asthma

2022 ◽  
Vol 32 (1) ◽  
Author(s):  
Juan Miguel Sánchez-Nieto ◽  
Roberto Bernabeu-Mora ◽  
Irene Fernández-Muñoz ◽  
Andrés Carrillo-Alcaraz ◽  
Juan Alcántara-Fructuoso ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Behavior Pattern ◽  
Female Gender ◽  
Final Visit ◽  
Inhaler Technique ◽  
Single Group ◽  
Copd Patients ◽  
Ambulatory Patients ◽  
Study Population ◽  
Predicting Factor

AbstractTo analyze whether there is improvement in adherence to inhaled treatment in patients with COPD and asthma after an educational intervention based on the teach-to-goal method. This is a prospective, non-randomized, single-group study, with intervention and before-after evaluation. The study population included 120 patients (67 females and 53 males) diagnosed with asthma (70.8%) and COPD (29.1%). The level of adherence (low and optimal) and the noncompliance behavior pattern (erratic, deliberate and unwitting) were determined by the Test of the adherence to Inhalers (TAI). This questionnaire allows you to determine the level of adherence and the types of noncompliance. Low Adherence (LowAd) was defined as a score less than 49 points. All patients received individualized educational inhaler technique intervention (IEITI). Before the IEITI, 67.5% of the patients had LowAd. Following IEITI, on week 24, LowAd was 55% (p = 0.024). Each patient can present one or more types of noncompliance. The most frequent type was forgetting to use the inhaler (erratic), 65.8%. The other types were deliberate: 43.3%, and unwitting: 57.5%. All of them had decreased on the final visit: 51.7% (p = 0.009), 25.8% (p = 0.002), 39.2% (p = 0.002). There were no significant differences in adherence between asthma and COPD patients at the start of the study. The only predicting factor of LowAd was the female gender. An individualized educational intervention, in ambulatory patients with COPD and asthma, in real-world clinical practice conditions, improves adherence to the inhaled treatment.

scholarly journals Predictor Keberhasilan Pengobatan Tuberkulosis Tahun 2018 di Indonesia

2020 ◽  
Vol 2 (2) ◽  
pp. 62
Author(s):  
Riezky Febiola ◽  
Mondastri Korib Sudaryo ◽  
Sri Ulfa Alriani
Keyword(s):  
Female Gender ◽  
Infectious Agents ◽  
Chi Square ◽  
Tb Treatment ◽  
Complete Treatment ◽  
Cohort Study Design ◽  
Study Population ◽  
New Treatment ◽  
The Relationship ◽  
Hiv Negative

Tuberculosis is still a major cause of health problems and death due to infectious agents. The success rate of TB treatment varies globally where Asia is 81.6% the second highest after Oceania 83.9%. The prevalence of tuberculosis with bacteriological confirmation in Indonesia is 759 per 100,000 population. This study aims to determine the relationship between the independent variabel with the success of TB treatment in Indonesia in 2018. Methods This study was conducted using a retrospective cohort study design. The study population was all TB Drug Sensitive patients who started treatment in 2018 and were recorded on SITT. Data analysis was performed using Chi Square. 392,706 TB patients were included in the analysis of 476,744 patients. With treatment results 45.2% recovered, 43.35% complete treatment, 3% died, 0.8% failed, 5.6% dropped out of treatment, 2.1% people moved. Age> 45 years RR 1,028 (95% CI; 1,009-1,049), female gender 1,022 (95% CI; 1,004-1,041), HIV negative 1,229 (95% CI; 1,169-1,292), patients with new treatment status RR 1,072 (95% CI; 1.033-1.112) and did not have a DM RR comorbid 1.027 (95% CI; 1.003-1.051) were predictors of the success of TB treatment. The results of this study indicate that patients who do not have HIV or DM co-morbidities are more likely to succeed in TB treatment.

scholarly journals Frequency of familial short stature identified in children presenting with short stature at a Tertiary Care Hospital in Multan, Pakistan.

2021 ◽  
Vol 28 (7) ◽  
pp. 993-996
Author(s):  
Waqas Imran Khan ◽  
◽  
Asia Noreen ◽  
Summera Tabasum ◽  
◽  
...  
Keyword(s):  
Short Stature ◽  
Tertiary Care ◽  
Female Gender ◽  
P Value ◽  
Care Hospital ◽  
Pediatric Endocrinology ◽  
Multicenter Studies ◽  
Study Population ◽  
Age Range ◽  
Study Setting

Objectives: The objective of my study was to determine the frequency of familial short height in children aged 3 to 14 years with short height. Study Design: Descriptive study. Setting: Department of Pediatric Endocrinology at The Children Hospital & Institute of Child health Multan (CH& ICH). Period: 1st November 2018 to 31st October 2019. Material & Methods: Eighty four patients were enrolled after taking informed consent from parents/guardians. Heights of all patients, parental heights, mid parental heights were plotted on CDC growth charts. Patients having familial short stature were noted down. Results: Out of 84 patients, 59 (70.2%) were males and 25 (29.85%) were females. Age range was 3-14 years. Mean age of the population was 8.68 ± 3.42 years and mean height and weight were 114.29 ± 24.62cm and 28.95±10.01 kg, respectively. Mean height for mother and father of the patients were 154.39 ±4.56cm and 171.10 ± 3.52cm, respectively. Out of 84 children, 21 (25%) patients had FSS. In our study population FSS was more seen in children < 8 years of age, female gender and families with income of > 20K/months with p value of 0.879, 0.129 and 0.592 respectively. Conclusion: Majority of children presenting with short stature have FSS and CDG and do not have an endocrine disorder. In our study, frequency of familial short stature in children aged 3 to 14 years was 25%. The results should be validated in multicenter studies.

Abstract 355: Relationship between Female Gender and Mortality after Isolated Aortic Valve Replacement

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Xiumei Sun ◽  
Jennifer Ellis ◽  
Louis Kanda ◽  
Robert Lowery ◽  
Steven W Boyce ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Coronary Artery Bypass Surgery ◽  
Operative Mortality ◽  
Artery Bypass ◽  
Female Gender ◽  
Operative Outcomes ◽  
Study Population

Background: Previous studies have shown that female gender is an independent predictor of increased operative mortality after coronary artery bypass surgery. It remains inconsistent whether female gender is associated with increased mortality after aortic valve replacement (AVR). The purpose of this study is to investigate the role of female gender inoperative mortality after AVR. Methods: The study population included isolated AVR performed between January 2003 and December 2012 at a single Instituation. Results: During this period, 1,262 patients underwent isolated AVR. The major preoperative characteristics and operative outcomes are detailed in the following table. R>Conclusions: In this study, female patients had increased operative mortality after isolated AVR.

scholarly journals Prevalence and Risk of Polypharmacy among Community-Dwelling, Elderly Kuwaiti Patients

2019 ◽  
Vol 29 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Nabil Ahmed Badawy ◽  
Shokria Adely Labeeb ◽  
Mawaheb Falah Alsamdan ◽  
Badria Faleh Alazemi
Keyword(s):  
Risk Factors ◽  
Hospital Admissions ◽  
Antihypertensive Drugs ◽  
Female Gender ◽  
Community Dwelling ◽  
Older Individuals ◽  
Cross Sectional ◽  
Factors Associated ◽  
High Prevalence ◽  
Study Population

Objectives: To estimate the prevalence of polypharmacy in community-dwelling, older Kuwaiti patients, describe the number and types of drugs used, and identify risk factors associated with polypharmacy. Subjects and Methods: This was a descriptive cross-sectional questionnaire-based survey in which we interviewed 500 community-dwelling Kuwaiti adults over 65 years of age. The data collection occurred during a 4-month period from March to July 2017. Results: Fifty-two percent (n = 260) of the patients were males, with a mean age of 71.73 ± 5.32 years. The prevalence of polypharmacy (5–8 drugs) and excessive polypharmacy (>8 drugs) was 58.4% (n = 292) and 10.2% (n = 51), respectively. The risk factors associated with an increased number of medicines used were: female gender (p = 0.019), a lower level of education (p = 0.003), a high number of hospital admissions (p = 0.000), clinics visited by the patient (p =0.000), and number of comorbidities (p = 0.000). The most commonly used medications (82.6% of the study population) were blood glucose-lowering agents, excluding insulin. Other commonly used medications were antihypertensive drugs and lipid-modifying agents. Conclusion: A significant sector of the older Kuwaiti patient population has a high prevalence of polypharmacy and is thus exposed to its potential hazards. The current study highlights the need to revise the drug-dispensing policy among community-dwelling, older Kuwaiti people, as well as to initiate educational programs among healthcare practitioners concerning prescribing issues in older individuals.

scholarly journals Inhaler Technique and Adherence to Inhaled Medications among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam

2019 ◽  
Vol 16 (2) ◽  
pp. 185 ◽  
Author(s):  
Chau Ngo ◽  
Dung Phan ◽  
Giap Vu ◽  
Phu Dao ◽  
Phuong Phan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medication Adherence ◽  
Pulmonary Disease ◽  
Associated Factors ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Sub-optimal chronic obstructive pulmonary disease (COPD) management has been found largely due to patients’ medication non-adherence and incorrect inhaler technique. This study aimed to examine inhaler use technique and medication adherence among Vietnamese COPD patients as well as potential associated factors. A cross-sectional study involving 70 COPD exacerbators was conducted. Inhaler technique and adherence were evaluated by the 10-item and 12-item Test of Adherence to Inhaler (TAI). Data on the history of COPD, home prescription of inhalers and duration of hospitalization were also collected. Generalized linear regression models were used to determine the associated factors with inhaler use and medication adherence. The results showed that the proportion of patients with good inhaler technique was 22.7% for metered-dose inhalers (MDI), 30.4% for dry powder inhalers (DPI) and 31.8% for soft-mist inhalers (SMI). Full exhalation was the most common mistake. The rates of non-compliance patterns were: “ignorant” (77.1%), “sporadic” (58.6%), and “deliberate” (55.7%). Worse dyspnea, greater health condition impairment, and an increased frequency of exacerbations and hospitalizations were found to be associated negatively with correct inhaler use and treatment adherence. Instructions to COPD patients about using inhalers should focus on correct inhaler technique and adherence even when feeling healthy.

P3452Differential implication of gender on future thromboembolic risk in patients with and without atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K.-J Choi ◽  
M S Cho ◽  
U Do ◽  
J Kim ◽  
G B Nam ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Thromboembolic Event ◽  
Stroke Risk ◽  
Holter Monitoring ◽  
Female Gender ◽  
Thromboembolic Events ◽  
Thromboembolic Risk ◽  
Study Population ◽  
Multivariable Adjustment

Abstract Background Gender difference in stroke risk by the presence of atrial fibrillation was not well evaluated. Purpose We hypothesized that the gender showed different impacts on future thromboembolic risk in patients with and without atrial fibrillation. Methods The study population comprised of 26,226 patients (mean 56.3 years old, 52.6% male) with (n=3147, 12.0%) or without (n=23079, 88.0%) atrial fibrillation who underwent cardiac evaluations consisted of electrocardiography, echocardiography, and holter monitoring in our center. The main study outcomes were thromboembolic events defined as composite of ischemic stroke and systemic embolism. Results During mean follow-up period of 2.8 years, thromboembolic event occurred in 610 patients (2.3%). In the overall population, the 3-year rate of thromboembolic event of female patients was lower than males (2.2% vs. 2.8%, P=0.011). However, when the population was divided according to the presence of AF, females showed higher rate of thromboembolic events in those with AF (6.7% vs 3.1%, P<0.001), whereas lower rate in those without AF (1.7% vs. 2.7%, P<0.001, P for interaction between gender and AF <0.001). After multivariable adjustment, female gender was at higher risk of future thromboembolic events in those with AF (HR 1.61, 95% CI 1.13–2.29, P<0.001), whereas at lower risk in those without AF (HR 0.75, 95% CI 0.62–0.91, P=0.003). The interaction between gender and AF was significant in those who had one or more components of CHA2DS2-VASc score other than gender (CHA2DS2-VA score ≥1, P for interaction = 0.001), but not in those without (P for interaction = 0.196) Conclusion Female gender demonstrated differential thromboembolic risk according to the presence of AF. Acknowledgement/Funding None

scholarly journals Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

2017 ◽  
Vol 27 (1) ◽  
Author(s):  
Sven L. Klijn ◽  
Mickaël Hiligsmann ◽  
Silvia M. A. A. Evers ◽  
Miguel Román-Rodríguez ◽  
Thys van der Molen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Success Factors ◽  
Inhaler Technique ◽  
Copd Patients

scholarly journals The Impact of Nationally Coordinated Pharmacy-Based Asthma Education Intervention

2001 ◽  
Vol 8 (4) ◽  
pp. 261-265 ◽  
Author(s):  
Shelley Anne Diamond ◽  
Kenneth Ross Chapman
Keyword(s):  
Asthma Control ◽  
Educational Intervention ◽  
Self Management ◽  
Community Pharmacies ◽  
Inhaler Technique ◽  
Short Acting ◽  
Management Behaviour ◽  
Preventive Medication ◽  
The Impact

OBJECTIVE: To assess the impact of a nationally coordinated pharmacy-based educational intervention on self-management behaviour and markers of asthma control in self-referred patients with asthma.DESIGN: An asthma clinic day was set up by a national chain of community pharmacies whereby pharmacists used a structured questionnaire to assess asthma control and self-care among self-referred patients with doctor-diagnosed asthma. In a one-on-one counselling session, each patient's educational needs were identified and the appropriate education offered. A telephone follow-up 30 days later assessed the impact of teaching.SETTING: Community pharmacies across Canada.OUTCOME MEASURES: The follow-up questionnaire quantified the number of wheezing episodes or other symptoms per week, the number of night-time awakenings per week, and the frequency of use of reliever and preventive medications.RESULTS: Of 4080 patients assessed, 22.2% used an inadequate inhaler technique, 16.4% used a short acting beta2-agonist excessively and 21.0% were not using an inhaled corticosteroid daily despite a frequency of symptoms that would suggest that it was needed. Common educational interventions included a review of inhaler technique (41.9%), a recommendation for regular inhaled corticosteroids (31.5%) and a referral to the primary care physician (21.0%). Thirty days after the educational intervention, patients reported significant decreases in the frequency of daytime asthma symptoms, the frequency of nocturnal symptoms and the frequency with which short acting beta2-agonists were used, while reporting significant increases in their use of preventive medication.CONCLUSIONS: A brief assessment and an educational intervention in the community pharmacy can produce significant short term improvements in patient-reported symptom control and appropriate self-management behaviour.

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