Medication adherence in stroke patients in Brunei Darussalam Public Hospital: the cross‐sectional study associated with chronic diseases, life style and potential barriers

Abstract BackgroundMultiple chronic diseases (MCDs) and social isolation are independent risk factors related with stroke and disability, but it is unknown whether the combination of these two conditions resulted from ageing related to functional disability in stroke patients. The purpose of this study was to probe the relationship between combination of MCDs, social isolation and functional disability in elderly stroke patients.MethodsA multicentre and cross-sectional study was conducted in the Departments of Rehabilitation Medicine of 103 hospitals located in 23 cities across China. Stroke patients aged over 60 years were selected as participants. Demographic characteristics, lifestyles and clinical information were investigated by questionnaire and medical records. Multi-nominal logistic regression model was used to explore the association of MCDs, social isolation and their combination with functional disability assessed by Barthel Index Scale.ResultsA total of 4281 elderly stroke patients were included in the final analysis. The proportion of social isolation and MCDs (>1) increased by the severity of functional disability. Social isolation was associated with increased risks for mild (33%), moderate (175%), and severe (833%) functional disability significantly in their comparisons with those without social isolation and MCDs. The intragroup odds ratio (OR) of MCDs increased by its number and the intergroup of OR increased by the severity of functional disability significantly. Social isolation and ≥3 MCDs associated the highest risk for severe (OR= 38.24, 95%CI: 14.76-99.07) and moderate (OR = 9.74, 95%CI: 3.62-26.22) functional disability, but not significant for mild group.ConclusionsMCDs, social isolation, and their combination were associated with functional disability in Chinese elderly stroke patients. Future secondary prevention and rehabilitation for functional disability in this population should underscore both social activity and the combined treatments of MCDs.Clinical Trial Registration NOChiCTR2000034067.

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Combined association of multiple chronic diseases and social isolation with the functional disability after stroke in elderly patients: a multicenter cross-sectional study in China

BMC Geriatrics ◽

10.1186/s12877-021-02439-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiangxiang Liu ◽

Hong-jie Yu ◽

Yan Gao ◽

Jing Zhou ◽

Mingchao Zhou ◽

...

Keyword(s):

Elderly Patients ◽

Chronic Diseases ◽

Social Isolation ◽

Functional Disability ◽

Cross Sectional Study ◽

Severe Disability ◽

Sectional Study ◽

Stroke Patients ◽

Cross Sectional ◽

Multiple Chronic Diseases

Abstract Background Multiple chronic diseases (MCDs) and social isolation are independent risk factors related to stroke and disability, but it is unknown whether the combination of these two conditions resulted from aging-related to functional disability in stroke patients. This study aimed to probe the relationship between the combination of MCDs, social isolation, and functional disability after stroke in elderly patients. Methods A multicenter and cross-sectional study was conducted in the Departments of Rehabilitation of 103 hospitals located in 23 cities across China. Stroke patients aged 60–90 years were selected for analysis. Demographic characteristics, lifestyles, and clinical information were investigated by questionnaires and medical records. MCDs (hypertension/ diabetes/ hyperlipidemia/heart disease/kidney disease) were categorized into three levels: 0, 1, and ≥ 2. Functional disability was assessed by the Barthel Index and categorized into four groups: no, mild, moderate, and severe disability. The multi-nominal logistic regression model was used to explore the independent and combined association of MCDs and social isolation with functional disability. Results A total of 4046 elderly stroke patients (55 % males) were included in the final analysis. The prevalence of social isolation, MCDs ≥ 2, and severe disability increased with aging. In the fully adjusted model, patients with social isolation or MCDs had a higher risk of functional disability significantly than those without. Patients with social isolation combined MCDs ≥ 2 were 35 times (95 % CI: 18.89–64.69) more likely to suffer severe disability after stroke, and 8 times (95 % CI: 18.89–64.69) for moderate disability than those without social isolation and MCDs. Conclusions MCDs, social isolation, and their combination were associated with a higher risk of functional disability after stroke in Chinese elderly patients. The elderly population should be encouraged to participate in more social activities, particularly in those with MCDs. Future secondary prevention and rehabilitation treatments to the functional ability of elderly stroke patients should underscore both social activity and the combined treatments of MCDs. Trial registration NO: ChiCTR2000034067.

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Faculty Opinions recommendation of Antibiotic susceptibility of Propionibacterium acnes isolated from patients with acne in a public hospital in Southwest China: prospective cross-sectional study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.735131996.793557271 ◽

2019 ◽

Author(s):

Gabriella Fabbrocini

Keyword(s):

Antibiotic Susceptibility ◽

Public Hospital ◽

Southwest China ◽

Propionibacterium Acnes ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-040352 ◽

2021 ◽

Vol 11 (7) ◽

pp. e040352

Author(s):

Avinash Sharma ◽

Olusegun Isaac Alatise ◽

Kelli O'Connell ◽

Samson Gbenga Ogunleye ◽

Adewale Abdulwasiu Aderounmu ◽

...

Keyword(s):

Cancer Screening ◽

Cancer Care ◽

Healthcare Utilisation ◽

Cross Sectional Study ◽

Personal Income ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Potential Barriers ◽

South West

Background/aimsCancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.MethodsIn April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.ResultsWe enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists.ConclusionsDespite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.

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Characteristics, Management, and Case-Fatality of Patients Hospitalized for Stroke with a Diagnosis of COVID-19 in France

Neuroepidemiology ◽

10.1159/000516670 ◽

2021 ◽

pp. 1-7

Author(s):

Amélie Gabet ◽

Clémence Grave ◽

Edouard Chatignoux ◽

Philippe Tuppin ◽

Yannick Béjot ◽

...

Keyword(s):

Case Fatality ◽

Cross Sectional Study ◽

Primary Diagnosis ◽

Index Hospitalization ◽

Sectional Study ◽

Stroke Patients ◽

National Hospital ◽

Cross Sectional ◽

Increased Risk ◽

Systèmes D’Information

Introduction: COVID-19 was found to be associated with an increased risk of stroke. This study aimed to compare characteristics, management, and outcomes of hospitalized stroke patients with or without a hospital diagnosis of COVID-19 at a nationwide scale. Methods: This is a cross-sectional study on all French hospitals covering the entire French population using the French national hospital discharge databases (Programme de Médicalisation des Systèmes d’Information, included in the Système National des Données de Santé). All patients hospitalized for stroke between 1 January and 14 June 2020 in France were selected. A diagnosis of COVID-19 was searched for during the index hospitalization for stroke or in a prior hospitalization that had occurred after 1 January 2020. Results: Among the 56,195 patients hospitalized for stroke, 800 (1.4%) had a concomitant COVID-19 diagnosis. Inhospital case-fatality rates were higher in stroke patients with COVID-19, particularly for patients with a primary diagnosis of COVID-19 (33.2%), as compared to patients hospitalized for stroke without COVID-19 diagnosis (14.1%). Similar findings were observed for 3-month case-fatality rates adjusted for age and sex that reached 41.7% in patients hospitalized for stroke with a concomitant primary diagnosis of COVID-19 versus 20.0% in strokes without COVID-19. Conclusion: Patients hospitalized for stroke with a concomitant COVID-19 diagnosis had a higher inhospital and 3 months case-fatality rates compared to patients hospitalized for stroke without a COVID-19 diagnosis. Further research is needed to better understand the excess of mortality related to these cases.

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Socioeconomic Factors and Health Status Disparities Associated with Difficulty in ADLs and IADLs among Long-Lived Populations in Brazil: A Cross-Sectional Study

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211007264 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110072

Author(s):

Júlia Cristina Leite Nóbrega ◽

Juliana Barbosa Medeiros ◽

Tácila Thamires de Melo Santos ◽

Saionara Açucena Vieira Alves ◽

Javanna Lacerda Gomes da Silva Freitas ◽

...

Keyword(s):

Health Status ◽

Activities Of Daily Living ◽

Socioeconomic Factors ◽

Chronic Diseases ◽

Daily Living ◽

Female Gender ◽

Well Being ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

Objective: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. Method: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil’s Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using “R” statistical software. Results: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. Conclusion: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.

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