scholarly journals 99. Presence of Chronic Diseases and Compliance with Québec Provincial Guidelines for Outpatient Antibiotic Prescription, Québec, Canada, 2010-2017

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S164-S164
Author(s):  
Elise Fortin ◽  
Geneviève Deceuninck ◽  
Caroline Sirois ◽  
Caroline Quach ◽  
Marc Simard ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Obstructive ◽  
Age Group ◽  
Obstructive Pulmonary Disease ◽  
Urinary Infections ◽  
Children With Asthma ◽  
Additional Support ◽  
Robust Poisson Regression ◽  
The Impact

Abstract Background In Québec primary care, antimicrobial use is higher in patients with chronic diseases, but it is unclear whether this utilization may be reduced. We aimed to measure the proportion of compliant antimicrobial prescriptions according to the provincial guidelines for the treatment of common respiratory and urinary infections and measure variations in this proportion with certain chronic diseases. Methods Antimicrobial dispensing covered by the public drug insurance plan between April 2010 and March 2017, delivered within 2 days of an outpatient consultation for an infection was included. Infections targeted by provincial guidelines were studied: otitis media, pharyngitis, pneumonia, sinusitis, bronchitis and chronic obstructive pulmonary disease exacerbations, cystitis, and acute pyelonephritis. The proportion of prescriptions compliant with guidelines (right antimicrobial for children, and right antimicrobial and dosage for adults) was computed by age group (children or adults) and per category of chronic disease (respiratory, cardiovascular, diabetes, mental disorder, none of previous). For each infection and age group, multivariate robust Poisson regression was used to measure the impact of categories of chronic diseases on proportions of prescriptions compliant with guidelines. Results Between 14 677 and 312 786 prescriptions were included, for each infection. Compliance to guidelines was above 87% in children and was significantly lower (≤ 3% bellow) in children with asthma. In adults, the choice of agent was compliant for at least 73% of prescriptions, except for cases of pharyngitis (between 53% and 61%). Accounting for dosage led to lower proportions of compliance, which varied between 19% (cystitis with diabetes) and 77% (pyelonephritis with none of the studied chronic disease categories). Compliant prescriptions were 2,4% to 20,4% less frequent in the presence of chronic diseases (statistically significant). Conclusion Non-compliant prescriptions could still be appropriate, but their high frequency suggests there is room for improvement. Dosage seems particularly problematic. Additional support could be offered to clinicians for the prescription of antimicrobials to patients with chronic diseases. Disclosures All Authors: No reported disclosures

scholarly journals Use of heated tobacco products by people with chronic diseases: The 2019 JASTIS study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260154
Author(s):  
Chikako Nakama ◽  
Takahiro Tabuchi
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Internet Survey ◽  
Chronic Obstructive ◽  
Dual Use ◽  
Tobacco Products ◽  
Obstructive Pulmonary Disease ◽  
Quit Smoking ◽  
Quitting Smoking ◽  
Internet Study

Heated tobacco products (HTPs) have become popular recently. People with chronic disease, such as diabetes, cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD) and cancer, should quit smoking for treatment and recurrence of tobacco-related diseases. However, they have difficulty in quitting smoking, and they may start HTPs use to quit smoking. The purpose of this study is to examine the use of HTPs in people with chronic disease. We used data from an internet study, the Japan Society and New Tobacco Internet Survey (JASTIS). We analyzed 9,008 respondents aged 15–73 years in 2019 using logistic regression. Current use of tobacco products was defined as use within the previous 30 days. Prevalence of current HTP use including dual use and dual use with cigarettes was 9.0% and 6.1% respectively in total. By disease: hypertension 10.2% and 7.4%, diabetes 15.9% and 12.3%, CVD 19.2% and 15.7%, COPD 40.5% and 33.3%, and cancer 17.5% and 11.9%. Diabetes, CVD, COPD, and cancer were positively associated with current use of HTPs (odds ratios (ORs) and 95% confidence intervals (CIs): 1.48 (1.06, 2.07), 2.29 (1.38, 3.80), 3.97(1.73, 9.11), and 3.58(1.99, 6.44), respectively) and dual use of cigarettes and HTPs (ORs and 95% CIs: 2.23 (1.61, 3.09), 3.58 (2.29, 5.60), 7.46 (3.76, 14.80), and 2.57 (1.46, 4.55), respectively) after adjusting for confounders. People with chronic disease were more likely to use HTPs and HTPs together with cigarettes. Further research on the smoking situation of HTPs in patients with chronic diseases is necessary.

scholarly journals Genetic and epigenetic heterogeneity of chronic obstructive pulmonary disease

2020 ◽  
Vol 131 (2) ◽  
pp. 15-22
Author(s):  
M.A. Sadvokasova ◽  
◽  
B.A. Azimkhanova ◽  
А.А. Аripova ◽  
A.Yu. Akparova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Dna Methylation ◽  
Chronic Disease ◽  
Pulmonary Disease ◽  
Tobacco Smoke ◽  
Chronic Obstructive ◽  
Pathological Changes ◽  
Genetic Determinants ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Chronic obstructive pulmonary disease (COPD) is a global chronic disease of the respiratory system. The formation of pathological changes in the lungs is primarily associated with the impact of harmful chemicals of the tobacco smoke on the epithelium of the respiratory tract. In addition to the activation of key COPD processes, an important role in the development of the disease played by genetic determinants and disruption of epigenetic regulation, including changes in DNA methylation, histone modification, and microRNA expression. The article discusses the genetic and epigenetic aspects of COPD as a heterogeneous disease with a complex pathogenesis.

Hazards for Construction Workers

2017 ◽  
Author(s):  
Gavin H. West ◽  
Laura S. Welch
Keyword(s):  
Heavy Metals ◽  
Prevention And Control ◽  
Respiratory Diseases ◽  
Noise Exposure ◽  
Engineered Nanomaterials ◽  
Construction Workers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
And Control ◽  
The Impact

This chapter describes the hazards for construction workers, with a particular focus on injuries as well as exposures to hazardous chemicals and dusts. A section describes hazardous exposures to lead and other heavy metals. Another section describes noise exposure. The impact of musculoskeletal disorders among construction workers is then discussed. A section on respiratory diseases focuses on asbestosis, silicosis, chronic obstructive pulmonary disease, and asthma. Exposures known to cause dermatitis and cancer are reviewed. There is a discussion of engineered nanomaterials as a potential emerging hazard. Various approaches to prevention and control, including regulations and health services, are described.

scholarly journals Digital Interventions for Psychological Comorbidities in Chronic Diseases—A Systematic Review

2021 ◽  
Vol 11 (1) ◽  
pp. 30
Author(s):  
Marta Maisto ◽  
Barbara Diana ◽  
Sonia Di Tella ◽  
Marta Matamala-Gomez ◽  
Jessica Isbely Montana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Design Elements ◽  
Digital Interventions ◽  
Digital Contents ◽  
Psychological Comorbidities ◽  
Quantitative Synthesis ◽  
Meta Analyses

Chronic diseases represent one of the main causes of death worldwide. The integration of digital solutions in clinical interventions is broadly diffused today; however, evidence on their efficacy in addressing psychological comorbidities of chronic diseases is sparse. This systematic review analyzes and synthesizes the evidence about the efficacy of digital interventions on psychological comorbidities outcomes of specific chronic diseases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, PsycInfo, Scopus and Web of Science databases was conducted. Only Randomized Controlled Trials (RCTs) were considered and either depression or anxiety had to be assessed to match the selection criteria. Of the 7636 identified records, 17 matched the inclusion criteria: 9 digital interventions on diabetes, 4 on cardiovascular diseases, 3 on Chronic Obstructive Pulmonary Disease (COPD) and one on stroke. Of the 17 studies reviewed, 14 found digital interventions to be effective. Quantitative synthesis highlighted a moderate and significant overall effect of interventions on depression, while the effect on anxiety was small and non-significant. Design elements making digital interventions effective for psychological comorbidities of chronic diseases were singled out: (a) implementing a communication loop with patients and (b) providing disease-specific digital contents. This focus on “how” to design technologies can facilitate the translation of evidence into practice.

scholarly journals The Impact of the COVID-19 Pandemic on Self-Reported Management of Chronic Conditions

2021 ◽  
Vol 8 ◽  
pp. 237437352110076
Author(s):  
Hyllore Imeri ◽  
Erin Holmes ◽  
Shane Desselle ◽  
Meagen Rosenthal ◽  
Marie Barnard
Keyword(s):  
Locus Of Control ◽  
Chronic Conditions ◽  
Online Survey ◽  
Health Locus Of Control ◽  
Patient Activation ◽  
Survey Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Chronic conditions (CCs) management during the COVID-19 pandemic and the impact of the pandemic on patient activation (PA) and health locus of control (HLOC) remain unknown. This cross-sectional online survey study examined the role of COVID-19 pandemic-related worry or fear in PA and HLOC among patients with CCs. Individuals with CCs (n = 300) were recruited through MTurk Amazon. The questionnaire included sociodemographic questions, the Patient Activation Measure, and the Multidimensional Health Locus of Control–Form B. Out of the 300 participants, 9.7% were diagnosed with COVID-19, and 7.3% were hospitalized. Patients with cancer, chronic kidney disease, chronic obstructive pulmonary disease, drug abuse/substance abuse, and stroke reported significant difficulties in managing their CCs due to worry or fear because of COVID-19. More than half of the sample (45.7%) reported COVID-19-related worry or fear about managing their CCs, and these patients had lower PA and lower external HLOC compared to patients not affected by COVID-19-related worry or fear. Health professionals should provide more support for patients facing difficulties in managing their CCs during the COVID-19 pandemic.

scholarly journals Determinants of COVID-19 preventive behaviours among adults with chronic diseases in the USA: an analysis of the nationally representative COVID-19 impact survey

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044600
Author(s):  
Jessica Y. Islam ◽  
Denise C. Vidot ◽  
Marlene Camacho-Rivera
Keyword(s):  
Chronic Diseases ◽  
Rural Areas ◽  
Prevalence Ratio ◽  
Face Mask ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
High School Degree ◽  
The Usa ◽  
Nationally Representative

BackgroundPreventive behaviours have been recommended to control the spread of SARS-CoV-2. Adults with chronic diseases (CDs) are at higher risk of COVID-19-related mortality compared to the general population. Our objective was to evaluate adherence to COVID-19 preventive behaviours among adults without CDs compared with those with CDs and identify determinants of non-adherence to COVID-19 preventive behaviours.Study designCross-sectional.Setting and participantsWe used data from the nationally representative COVID-19 Impact Survey (n=10 760) conducted in the USA.Primary measuresAdults with CDs were categorised based on a self-reported diagnosis of diabetes, high blood pressure, heart disease/heart attack/stroke, asthma, chronic obstructive pulmonary disease (COPD), bronchitis or emphysema, cystic fibrosis, liver disease, compromised immune system, or cancer (54%).ResultsCompared with adults without CDs, adults with CDs were more likely to adhere to preventive behaviours including wearing a face mask (χ2-p<0.001), social distancing (χ2-p<0.001), washing or sanitising hands (χ2-p<0.001), and avoiding some or all restaurants (χ2-p=0.002) and public or crowded places (χ2-p=0.001). Adults with a high school degree or below [Adjusted prevalence ratio (aPR):1.82, 95% Confidence interval (CI)1.04 to 3.17], household income <US$50 000 (aPR:2.03, 95% CI 1.34 to 2.72), uninsured (aPR:1.65, 95% CI1.09 to 2.52), employed (aPR:1.48, 95% CI 1.02 to 2.17), residing in rural areas (aPR:1.70, 95% CI 1.01 to 2.85) and without any CD (aPR:1.78, 95% CI 1.24 to 2.55) were more likely to not adhere to COVID-19 preventive behaviours.ConclusionAdults with CDs are more likely to adhere to recommended COVID-19 preventive behaviours. Public health messaging targeting specific demographic groups and geographic areas, such as adults without CD or adults living in rural areas, should be prioritised.

scholarly journals ‘I’m fine!’: Assertions of lack of support need among patients with chronic obstructive pulmonary disease: A mixed-methods study

2021 ◽  
pp. 174239532110003
Author(s):  
A Carole Gardener ◽  
Caroline Moore ◽  
Morag Farquhar ◽  
Gail Ewing ◽  
Efthalia Massou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Mixed Method ◽  
Self Report ◽  
Design Stage ◽  
Chronic Obstructive ◽  
Support Needs ◽  
Obstructive Pulmonary Disease ◽  
Stage 1 ◽  
The Impact

Objectives To understand how people with Chronic Obstructive Pulmonary Disease (COPD) disavow their support needs and the impact on care. Methods Two stage mixed-method design. Stage 1 involved sub-analyses of data from a mixed-method population-based longitudinal study exploring the needs of patients with advanced COPD. Using adapted criteria from mental health research, we identified 21 patients who disavowed their needs from the 235 patient cohort. Qualitative interview transcripts and self-report measures were analysed to compare these patients with the remaining cohort. In stage 2 focus groups (n = 2) with primary healthcare practitioners (n = 9) explored the implications of Stage 1 findings. Results Patients who disavowed their support needs described non-compliance with symptom management and avoidance of future care planning (qualitative data). Analysis of self-report measures of mental and physical health found this group reported fewer needs than the remaining sample yet wanted more GP contact. The link between risk factors and healthcare professional involvement present in the rest of the sample was missing for these patients. Focus group data suggested practitioners found these patients challenging. Discussion This study identified patients with COPD who disavow their support needs, but who also desire more GP contact. GPs report finding these patients challenging to engage.

scholarly journals The Association of Healthy Aging with Multimorbidity: IKARIA Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1386
Author(s):  
Alexandra Foscolou ◽  
Christina Chrysohoou ◽  
Kyriakos Dimitriadis ◽  
Konstantina Masoura ◽  
Georgia Vogiatzi ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Clinical Characteristics ◽  
Healthy Aging ◽  
Chronic Obstructive ◽  
Younger Adults ◽  
Obstructive Pulmonary Disease ◽  
Aging Index ◽  
Unit Increase ◽  
Depression Symptomatology ◽  
Study Participants

The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimorbidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled in the IKARIA study. Multimorbidity was defined as the combination of at least two of the following chronic diseases: hypertension; hypercholesterolemia; diabetes; obesity; cancer; CVD; osteoporosis; thyroid, renal, and chronic obstructive pulmonary disease. A healthy aging index (HAI) ranging from 0 to 100 was constructed using 4 attributes, i.e., depression symptomatology, cognitive function, mobility, and socializing. The prevalence of multimorbidity was 51% among men and 65.5% among women, while the average number of comorbidities was 1.7 ± 1.4 for men and 2.2 ± 1.4 for women. The most prevalent chronic diseases among men with multimorbidity were hypertension, hypercholesterolemia, and obesity while among women they were hypertension, hypercholesterolemia, and thyroid disease. Multimorbidity was correlated with HAI (Spearman’s rho = −0.127, p < 0.001) and for every 10-unit increase in HAI, participants had 20% lower odds of being multimorbid. Multimorbidity in relation to HAI revealed a different trend across aging among men and women, coinciding only in the seventh decade of life. Aging is usually accompanied by chronic diseases, but multimorbidity seems to also be common among younger adults. However, healthy aging is a lifelong process that may lead to limited co-morbidities across the lifespan.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

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