The impact of implementing national hypertension guidelines on prevalence and workload in primary care: a population-based survey of older people

Introduction: Very little is known about the impact of vision impairment (VI) on physical health in late-life in sub-Saharan Africa populations, whereas many older people experience it. We investigated the association between self-reported VI and frailty in Central African older people with low cognitive performance. Methods: It was cross-sectional analysis of data from the Epidemiology of Dementia in Central Africa (EPIDEMCA) population-based study. After screening for cognitive impairment, older people with low cognitive performance were selected. Frailty was assessed using the Study of Osteoporotic Fracture index. Participants who met one of the 3 parameters assessed (unintentional weight loss, inability to do 5 chair stands, and low energy level) were considered as pre-frail, and those who met 2 or more parameters were considered as frail. VI was self-reported. Associations were investigated using multinomial logistic regression models. Results: Out of 2,002 older people enrolled in EPIDEMCA, 775 (38.7%) had low cognitive performance on the screening test. Of them, 514 participants (sex ratio: 0.25) had available data on VI and frailty and were included in the analyses. In total, 360 (70%) self-reported VI. Prevalence of frailty was estimated at 64.9% [95% confidence interval: 60.9%–69.1%] and 23.7% [95% CI: 20.1%–27.4%] for pre-frailty. After full adjustment, self-reported VI was associated with frailty (adjusted odds ratio = 2.2; 95% CI: 1.1–4.3) but not with pre-frailty (adjusted odds ratio = 1.8; 95% CI: 0.9–3.7). Conclusion: In Central African older people with low cognitive performance, those who self-reported VI were more likely to experience frailty. Our findings suggest that greater attention should be devoted to VI among this vulnerable population in order to identify early frailty onset and provide adequate care management.

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Primary Care Consultations after Hospitalisation for Pneumonia: A Large Population-based Cohort Study

British Journal of General Practice ◽

10.3399/bjgp.2020.0890 ◽

2020 ◽

pp. BJGP.2020.0890

Author(s):

Vadsala Baskaran ◽

Fiona Pearce ◽

Rowan H Harwood ◽

Tricia McKeever ◽

Wei Shen Lim

Keyword(s):

Primary Care ◽

Cohort Study ◽

Large Population ◽

Significant Proportion ◽

Antibiotic Use ◽

Population Based ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Respiratory Disorder ◽

The Impact

Background: Up to 70% of patients report ongoing symptoms four weeks after hospitalisation for pneumonia, and the impact on primary care is poorly understood. Aim: To investigate the frequency of primary care consultations after hospitalisation for pneumonia, and the reasons for consultation. Design: Population-based cohort study. Setting: UK primary care database of anonymised medical records (Clinical Practice Research Datalink, CPRD) linked to Hospital Episode Statistics (HES), England. Methods: Adults with the first ICD-10 code for pneumonia (J12-J18) recorded in HES between July 2002-June 2017 were included. Primary care consultation within 30 days of discharge was identified as the recording of any medical Read code (excluding administration-related codes) in CPRD. Competing-risks regression analyses were conducted to determine the predictors of consultation and antibiotic use at consultation; death and readmission were competing events. Reasons for consultation were examined. Results: Of 56,396 adults, 55.9% (n=31,542) consulted primary care within 30 days of discharge. The rate of consultation was highest within 7 days (4.7 per 100 person-days). The strongest predictor for consultation was a higher number of primary care consultations in the year prior to index admission (adjusted sHR 8.98, 95% CI 6.42-12.55). The commonest reason for consultation was for a respiratory disorder (40.7%, n=12,840), 12% for pneumonia specifically. At consultation, 31.1% (n=9,823) received further antibiotics. Penicillins (41.6%, n=5,753) and macrolides (21.9%, n=3,029) were the commonest antibiotics prescribed. Conclusion: Following hospitalisation for pneumonia, a significant proportion of patients consulted primary care within 30 days, highlighting the morbidity experienced by patients during recovery from pneumonia.

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Use of Information and Communication Technologies Among Older People With and Without Frailty: A Population-Based Survey

Journal of Medical Internet Research ◽

10.2196/jmir.5507 ◽

2017 ◽

Vol 19 (2) ◽

pp. e29 ◽

Cited By ~ 37

Author(s):

Niina Susanna Keränen ◽

Maarit Kangas ◽

Milla Immonen ◽

Heidi Similä ◽

Heidi Enwald ◽

...

Keyword(s):

Older People ◽

Information And Communication Technologies ◽

Communication Technologies ◽

Population Based ◽

Information And Communication ◽

Population Based Survey

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A cross-sectional population-based survey looking at the impact of cancer survivorship care plans on meeting the needs of cancer survivors in the posttreatment stage

Supportive Care in Cancer ◽

10.1007/s00520-019-04685-5 ◽

2019 ◽

Vol 27 (10) ◽

pp. 3785-3792 ◽

Cited By ~ 2

Author(s):

Soleil Chahine ◽

Robin Urquhart

Keyword(s):

Cancer Survivors ◽

Cancer Survivorship ◽

Population Based ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Cross Sectional ◽

Care Plans ◽

The Impact ◽

Population Based Survey

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The impact of chemotherapy use on financial strain among stage III colorectal cancer patients: A population-based survey.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.505 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 505-505

Author(s):

Christine Marie Veenstra ◽

Scott E. Regenbogen ◽

Sarah T. Hawley ◽

Mousumi Banerjee ◽

Ikuko Kato ◽

...

Keyword(s):

Colorectal Cancer ◽

Social Services ◽

Credit Card ◽

Financial Burden ◽

Population Based ◽

Financial Strain ◽

Stage Iii ◽

Catchment Areas ◽

The Impact ◽

Population Based Survey

505 Background: Many colorectal cancer (CRC) patients suffer personal financial hardship from the disease and its treatment. We hypothesized that chemotherapy use is associated with even greater financial burden and worry. Methods: We analyzed data from a population-based survey of patients with stage III CRC in the Georgia and Detroit SEER catchment areas focusing on the effects of CRC and its treatment on personal finances. The primary outcomes were financial burden, assessed with a seven-component composite measure, and financial worry, assessed with a 5 point Likert scale. The primary independent variable was chemotherapy use. We evaluated relationships between chemotherapy use and individual components of financial burden, as well as composite financial burden and worry, using chi square analyses. Logistic regression was used to examine the effect of chemotherapy use on financial burden and worry, after controlling for patient characteristics. Results: Financial burden scores and financial worry were significantly higher among chemotherapy users (P<0.001). Financial burden and worry were associated with younger age, lack of insurance, and lower education. After controlling for these factors, chemotherapy use remained significantly associated with both financial burden and financial worry. 717/844 respondents (85%) reported chemotherapy use. Chemotherapy users were more likely to use savings (34% vs 20%, P=0.001), borrow money/take out loans (14% vs 4%, P=0.001), fail to make credit card payments (14% vs 5%, P=0.003), reduce spending for food and/or clothing (31% vs 14%, P<0.0001), decrease recreational activities (38% vs 15%, P<0.0001), and reduce general expenses (51% vs 24%, P<0.0001) than those who did not use chemotherapy. Conclusions: Adjuvant chemotherapy confers significant survival benefit in stage III colorectal cancer (CRC), but is associated with significantly increased personal financial burden and worry. Because financial stress has the potential to preclude adherence to recommended care, CRC patients who receive chemotherapy may require additional social services and economic support.

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A Population-Based Survey of Factors Relating to the Prevalence of Falls in Older People

Gerontology ◽

10.1159/000086372 ◽

2005 ◽

Vol 51 (5) ◽

pp. 340-345 ◽

Cited By ~ 116

Author(s):

Tiffany Gill ◽

Anne W. Taylor ◽

Ann Pengelly

Keyword(s):

Older People ◽

Population Based ◽

Population Based Survey

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Access to primary care and other health care use among western Canadians with chronic conditions: a population-based survey

CMAJ Open ◽

10.9778/cmajo.20130045 ◽

2014 ◽

Vol 2 (1) ◽

pp. E27-E34 ◽

Cited By ~ 5

Author(s):

R. G. Weaver ◽

B. J. Manns ◽

M. Tonelli ◽

C. Sanmartin ◽

D. J. T. Campbell ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Chronic Conditions ◽

Population Based ◽

Health Care Use ◽

Access To Primary Care ◽

Population Based Survey

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Advanced Access scheduling in general practice and use of primary care: a Danish population-based matched cohort study

BJGP Open ◽

10.3399/bjgpopen20x101091 ◽

2020 ◽

Vol 4 (5) ◽

pp. bjgpopen20X101091

Author(s):

Maria Bang ◽

Henrik Schou Pedersen ◽

Bodil Hammer Bech ◽

Claus Høstrup Vestergaard ◽

Jannik Falhof ◽

...

Keyword(s):

Primary Care ◽

General Practice ◽

Cohort Study ◽

Population Based ◽

Matched Cohort ◽

Face To Face ◽

Matched Cohort Study ◽

Adjusted Incidence Rate ◽

Advanced Access ◽

The Impact

BackgroundAdvanced access scheduling (AAS) allows patients to receive care from their GP at the time chosen by the patient. AAS has shown to increase the accessibility to general practice, but little is known about how AAS implementation affects the use of in-hours and out-of-hours (OOH) services.AimTo describe the impact of AAS on the use of in-hours and OOH services in primary care.Design & settingA population-based matched cohort study using Danish register data.MethodA total of 161 901 patients listed in 33 general practices with AAS were matched with 287 837 reference patients listed in 66 reference practices without AAS. Outcomes of interest were use of daytime face-to-face consultations, and use of OOH face-to-face and phone consultations in a 2-year period preceding and following AAS implementation.ResultsNo significant differences were seen between AAS practices and reference practices. During the year following AAS implementation, the number of daytime face-to-face consultations was 3% (adjusted incidence rate ratio [aIRR] = 1.03; 95% confidence interval [CI] = 0.99 to 1.07) higher in the AAS practices compared with the number in the reference practices. Patients listed with an AAS practice had 2% (aIRR = 0.98; 95% CI = 0.92 to 1.04) fewer OOH phone consultations and 6% (aIRR = 0.94; 95% CI = 0.86 to 1.02) fewer OOH face-to-face consultations compared with patients listed with a reference practice.ConclusionThis study showed no significant differences following AAS implementation. However, a trend was seen towards slightly higher use of daytime primary care and lower use of OOH primary care.

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