P068 Improving patient streaming for Chronic insomnia: Single centre retrospective cohort study

Abstract Background Insomnia is a common sleep disorder associated with significant morbidity and psychological distress. Cognitive Behavioural Therapy for insomnia (CBTi) is the gold standard intervention typically delivered by sleep psychologists. High demand has driven an interest in determining the case mix and characteristics of patients referred with insomnia to identify patients that may be suitable for an alternative direct-to-psychology model of care. Methods A retrospective cohort study was performed, including cases referred to the Princess Alexandra Hospital Sleep Centre in 2016 – 2020. Patients were categorised as either “suitable for direct-to-psychology” or “required medical review”. “Direct to psychology” patients were defined as (i) referred for insomnia; or (ii) Insomnia Severity Index score ≥15/28; or (iii) diagnosed with insomnia per ICSD-3 by treating specialist; or (iv) patients referred for sleep psychology. Exclusion criteria were significant sleep disordered breathing (mean SpO2 <85%, Epworth sleepiness scale >16, driving inattention), highly co-morbid patients (neuromuscular weakness, COPD) and diagnosis of hypersomnia. These patients were categorised as “requiring medical review”. The demographic and polysomnographic characteristics of these two groups were then compared. Progress The study protocol is complete, ethical approval obtained (EX/2021QMS/76783), and data extraction has been competed. Analysis underway currently. Intended outcome/impact We aim to establish the characteristics of patients suitable for a direct to psychology pathway. This data will be used for service provision planning, could reduce patient waiting list times, and improve patient care. This model could then be explored for safety and efficacy and form the basis of future service provision work.

Download Full-text

Acceptability, tolerability, and potential efficacy of cognitive behavioural therapy for Insomnia Disorder subtypes defined by polysomnography: A retrospective cohort study

Scientific Reports ◽

10.1038/s41598-018-25033-3 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 7

Author(s):

Christopher B. Miller ◽

Colin A. Espie ◽

Delwyn J. Bartlett ◽

Nathaniel S. Marshall ◽

Christopher J. Gordon ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Behavioural Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Behavioural Therapy ◽

Insomnia Disorder ◽

Cognitive Behavioural ◽

Potential Efficacy

Download Full-text

Characterizing inpatient care for adults with schizophrenia using the Health Quality Ontario indices: A single-centre retrospective cohort study

Clinical & Investigative Medicine ◽

10.25011/cim.v41i4.32222 ◽

2019 ◽

Vol 41 (4) ◽

pp. E196-E203

Author(s):

Anees Bahji ◽

Jennifer L Pikard ◽

Dane Mauer-Vakil ◽

Tariq Munsh ◽

Farooq Naeem

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Inpatient Care ◽

Average Length ◽

Medication Management ◽

Standard Of Care ◽

Quality Standard ◽

Behavioural Therapy ◽

Health Quality

Purpose: This single-center retrospective cohort study is one of the first reports to evaluate the inpatient care provided to persons diagnosed with schizophrenia in Canada. Methods: This study examined all admissions for adults diagnosed with schizophrenia over a 6-month period in 2017 to an inpatient psychiatric unit situated in a nonprofit general hospital in Kingston, Ontario, Canada. The Health Quality Ontario standards for the inpatient care of adults with schizophrenia were used to assess the quality of care provided in hospital. Standards were determined to have been met by doing a thorough chart review for each patient, reviewing all documentation in progress notes, admission notes, discharge notes and emergency room notes for quality standard completion. Results: The average length of stay per patient was 18.64 days. The treatment at this facility largely focused on medication management of schizophrenia; however, it was found that several areas of care did not meet the standard of care as set by the Health Quality Ontario Quality Standards for Schizophrenia Care for Adults in Hospitals, which was set in 2016. Problematic areas were promoting physical activity and healthy eating (4.9% compliance), treatment with clozapine (13.1% compliance) and cognitive behavioural therapy (9.8% compliance). The study site is fully accredited and attending physicians were all psychiatrists. How pervasive these deficiencies are in other settings is not known.

Download Full-text

Retrospective cohort study demonstrates that modified CT Severity Index directly correlates with lipase values at or above 600

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2020.06.023 ◽

2020 ◽

Vol 56 ◽

pp. 169-172

Author(s):

John F. Hamer

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Severity Index

Download Full-text

Predictors of mortality among TB-HIV co-infected children attending anti-retroviral therapy clinics of selected public hospitals in southern, Ethiopia: retrospective cohort study

Archives of Public Health ◽

10.1186/s13690-021-00713-1 ◽

2022 ◽

Vol 80 (1) ◽

Author(s):

Jifare Gemechu ◽

Bereket Gebremichael ◽

Tewodros Tesfaye ◽

Alula Seyum ◽

Desta Erkalo

Keyword(s):

Cohort Study ◽

Mortality Rate ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Survival Curve ◽

Data Extraction ◽

Public Hospitals ◽

Southern Ethiopia ◽

Predictors Of Mortality ◽

Common Opportunistic Infection

Abstract Background Co-infection of tuberculosis and HIV has a significant impact on public health. TB is the most common opportunistic infection and the leading cause of death in HIV-positive children worldwide. But there is paucity of studies concerning the predictors of mortality among TB-HIV co-infected children. This study aimed to determine the predictors of mortality among TB-HIV co-infected children attending ART clinics of public hospitals in Southern Nation, Nationalities and Peoples Region (SNNPR), Ethiopia. Methods A hospital-based retrospective cohort study design was used among 284 TB-HIV co-infected children attending ART clinics at selected public hospitals in SNNPR, Ethiopia, from January 2009 to December 2019. Then, medical records of children who were TB/HIV co-infected and on ART were reviewed using a structured data extraction tool. Data were entered using Epidata 4.6 and analyzed using SPSS version 23. The Kaplan Meier survival curve along with log rank tests was used to estimate and compare survival time. Bivariable and multivariable analyses were conducted to identify predictors of mortality among TB/HIV co-infected children. Adjusted Hazard Ratio with p value < 0.05 and 95% confidence interval was considered statistically significant. Result A total of 284 TB/HIV co-infected children were included in the study. Among these, 35 (12.3%) of them died during the study period. The overall mortality rate was 2.78 (95%CI = 1.98-3.99) per 100 child years of observation. The predictors of mortality were anemia (AHR = 3.6; 95%CI: 1.39-9.31), fair or poor ART drug adherence (AHR = 2.9; 95%CI = 1.15-7.43), extrapulmonary TB (AHR = 3.9; 95%CI: 1.34-11.45) and TB drug resistance (AHR = 5.7; 95%CI: 2.07-15.96). Conclusion Mortality rate of TB/HIV co-infected children in selected public hospitals in SNNPR, Ethiopia was documented as 2.78 per child years of observation as a result of this study. Moreover, Anemia, drug resistant tuberculosis, extrapulmonary TB and poor adherence to ART drugs were identified as the predictors of mortality among these children.

Download Full-text