scholarly journals Moving beyond categorization to understand affective influences on real world health decisions

2019 ◽  
Vol 13 (11) ◽  
Author(s):  
Rebecca A. Ferrer ◽  
Erin M. Ellis
Keyword(s):  
Real World ◽  
World Health ◽  
Health Decisions ◽  
Affective Influences

scholarly journals Coadministration of tizanidine and ciprofloxacin: a retrospective analysis of the WHO pharmacovigilance database

2021 ◽  
Author(s):  
Annette Rudolph ◽  
Hendrike Dahmke ◽  
Hugo Kupferschmidt ◽  
Andrea Burden ◽  
Stefan Weiler
Keyword(s):  
Real World ◽  
Safety Issue ◽  
Demographic Data ◽  
Fatal Outcome ◽  
Individual Case ◽  
World Health ◽  
Global Database ◽  
The Usa ◽  
Pharmacovigilance Database ◽  
The Impact

Abstract Purpose Tizanidine, an alpha-adrenergic substance with antinociceptive and antihypertensive effects, is extensively metabolized via cytochrome P450 (CYP) 1A2. Therefore, coadministration with potent CYP1A2 inhibitors, such as ciprofloxacin, is contraindicated. However, both drugs are broadly utilized in various countries. Their concomitant use bears an inherent high risk for clinically significant symptoms, especially in multimorbid patients experiencing polypharmacy. This study aims to investigate the impact of coadministration of tizanidine and ciprofloxacin using real-world pharmacovigilance data and to raise awareness of this potentially underestimated safety issue. Methods We conducted a retrospective study including Individual Case Safety Reports (ICSR) registered until March 1, 2017, in the World Health Organization (WHO) global database. Demographic data, drug administration information, the course of the adverse drug reaction (ADR), its severity, and outcomes were analyzed for cases reporting ciprofloxacin comedication. Results In 91 (2.0%) of the identified 4192 worldwide ICSR on tizanidine, coadministration of ciprofloxacin was reported. Most of the patients were female (n = 59, 64.8%) with a median age of 54 years (range 13–85 years). The countries contributing most reports were the USA (n = 54, 59.3%) and Switzerland (n = 16, 17.6%). ADRs reported most often affected the nervous system and the cardiac function, especially with large tizanidine doses or drugs with CNS and cardiovascular depressant effects. In two cases, a fatal outcome was reported. Conclusion Despite the existing formal contraindication, the concomitant use of tizanidine and ciprofloxacin can be observed in real-world clinical practice. Reactions mainly affected the central nervous and the cardiovascular system resulting in potentially severe adverse effects. The concomitant use of tizanidine and ciprofloxacin should absolutely be avoided.

scholarly journals Transdisciplinary Translational Science for Youth Health and Wellness: Introduction to a Special Issue

2021 ◽  
Author(s):  
Ashley T. Scudder ◽  
Gregory J. Welk ◽  
Richard Spoth ◽  
Constance C. Beecher ◽  
Michael C. Dorneich ◽  
...  
Keyword(s):  
Real World ◽  
Social Needs ◽  
Research Network ◽  
World Health ◽  
Translational Science ◽  
Community Practice ◽  
Health And Wellness ◽  
Youth Health ◽  
Special Issue ◽  
Interdisciplinary Approaches

Abstract Background Transdisciplinary translational science applies interdisciplinary approaches to the generation of novel concepts, theories and methods involving collaborations among academic and non-academic partners, in order to advance the translation of science into broader community practice. Objective This paper introduces a special issue on transdisciplinary translational science for youth health and wellness. We provide an overview of relevant research paradigms, share the related goals of the Iowa State University Translational Research Network (U-TuRN), and introduce the specific papers in the issue. Method Authors were asked to submit empirical reports, programmatic reviews or policy-related papers that examined youth health issues from a transdisciplinary translational perspective. Results The papers included in this special issue each involve direct and fully-integrated community-university partnerships and collaborations between academic and non-academic partners in scholarship and research. Reports emphasize the value of the applied nature of the work with a research agenda driven primarily by real-world health and social needs. Conclusions There is growing acceptance of the need for transdisciplinary, community-university collaborative research approaches as a means to meet both the requirements posed by real-world problems as well as goals of advancing scientific knowledge and innovation. In this issue, readers will find papers that show the promise of rethinking existing conceptual frameworks to incorporate transdisciplinary approaches as a catalyst to addressing translational science questions related to the field of children and youth care.

Diagnosis of deep-vein thrombosis: Adherence to guidelines and outcomes in real-world health care

2009 ◽  
Vol 102 (12) ◽  
pp. 1234-1240 ◽  
Author(s):  
Horst Gerlach ◽  
Viola Hach-Wunderle ◽  
Eberhard Rabe ◽  
Hanno Riess ◽  
Heike Carnarius ◽  
...  
Keyword(s):  
Health Care ◽  
Deep Vein Thrombosis ◽  
Ambulatory Care ◽  
Real World ◽  
Diagnostic Methods ◽  
World Health ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Work Up ◽  
Current Guidelines

SummaryCurrent guidelines recommend optimised algorithms for diagnosis of suspected deep-vein thrombosis (DVT). There is little data to determine to what extent real-world health care adheres to guidelines, and which outcome in terms of diagnostic efficiency and safety is achieved. This registry involved patients with clinically suspected DVT of the leg recruited in German ambulatory care between October and December 2005. Registry items were: diagnostic methods applied; diagnostic categories at day 1; and venous thromboembolic events up to 90 days in patients without firmly established DVT. A total of 4,976 patients were recruited in 326 centres. Venous ultrasonography was performed in 4,770 patients (96%), D-dimer assay in 1,773 patients (36%) and venography in 288 patients (6%). At day 1, DVT was confirmed in 1,388 patients (28%), and ruled out in 3,389 patients (68%), and work-up was inconclusive in 199 patients (4%).The rate of venous thromboembolism at 90 days was 0.34% (95% confidence interval [CI]: 0.09 to 0.88) in patients in whom the diagnosis of DVT had been ruled out, and 2.50% (95% CI: 0.69 to 6.28) in patients with inconclusive diagnostic workup. This nationwide evaluation in German ambulatory care revealed that the diagnostic work-up for suspected DVT did not adhere to current guidelines. However, the overall diagnostic safety was excellent, although there is potential for improvement in a well defined minority of patients.The TULIPA registry was funded by GlaxoSmithKline GmbH und Co KG, Munich.

scholarly journals One-On-One: Kathleen Noonan

2019 ◽  
pp. 14-19
Keyword(s):  
Patient Safety ◽  
Health Policy ◽  
Policy Change ◽  
Chief Executive Officer ◽  
Real World ◽  
Healthcare Providers ◽  
Chief Executive ◽  
Social Needs ◽  
World Health ◽  
The City

Kathleen Noonan is chief executive officer of the Camden Coalition of Healthcare Providers, a nonprofit, multidisciplinary healthcare innovator in Camden, New Jersey. A former corporate lawyer, Noonan previously was co-director of PolicyLab at Children’s Hospital of Philadelphia, which she co-founded in 2008 to ensure clinical research was connected to and influencing real-world health policy change. Noonan recently spoke with Cait Allen, MPH, director of Engagement at the Patient Safety Authority, about the Camden Coalition’s efforts to improve care for people with complex health and social needs in in the city of Camden, regionally, and across the country.

Abstract 24: Health Status Differences Between Early Invasive and Non Invasive Treatment Strategies in Patients With Peripheral Artery Disease: Insights From Portrait Registry

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Suveen Angraal ◽  
Vittal Hejjaji ◽  
Laith Derbas ◽  
Manesh R Patel ◽  
Jan Heyligers ◽  
...  
Keyword(s):  
Health Status ◽  
Peripheral Artery Disease ◽  
Real World ◽  
Medical Management ◽  
World Health ◽  
Peripheral Artery ◽  
Supervised Exercise ◽  
Early Revascularization ◽  
Artery Disease

Background: In patients with symptomatic peripheral artery disease (PAD), a key treatment goal is to improve their health status; their symptoms, function, and quality of life (QoL). While medical therapy with lifestyle changes is recommended in all, revascularization can be a consideration to alleviate PAD symptoms. We sought to compare the real-world impact of either treatment strategy on patients’ health status improvement. Methods: Patients with new or worsening PAD symptoms (Rutherford category 1-3), from 10 U.S. specialty vascular clinics between 2011-2015, who either underwent early revascularization (using stent, angioplasty or surgery within 3 months of enrolment) or medical management alone (statin, aspirin, cilostazol, supervised exercise therapy, risk factor (diabetes, hypertension) management) were identified from the Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) registry. The Peripheral Artery Questionnaire (PAQ) was used to assess patients’ disease-specific health status at enrollment and at 3, 6 and 12 months of follow up. The differences in PAQ overall summary scores, and each subdomain, were compared using an adjusted generalized linear model for repeated measures (Figure 1). Results: Among 797 patients (mean age of 68.6 years, 58.1% male), 226 underwent early revascularization and 571 were managed medically. At baseline, patients in the revascularization vs. medical management cohort had lower PAQ summary scores (mean ± SD; 42.6 ± 20.7 vs. 48.5 ± 22.3, P<0.001) and QoL scores (43.4 ± 23.9 vs. 50.4 ± 26.4, P<0.001). Over 1 year of follow-up, patients who underwent revascularization reported significantly higher health status over time than patients managed medically without revascularization (P <0.001 for all PAQ sub-domains; Figure 1). Conclusion: Patients with PAD who received early revascularization had worse health status at baseline, but they reported a greater degree of improvement over 1 year of follow-up when compared to patients managed medically without revascularization. Summarizing real-world health status benefits following a PAD diagnosis is critical to help guide preference-sensitive decisions on PAD management.

A Real-World Health Insurance Claims Analysis of Oral Prostacyclin Class Therapy Utilization and Outcomes

2019 ◽  
Author(s):  
D. Stafkey-Mailey ◽  
V. Saundankar ◽  
B.B. Dean ◽  
P. Classi ◽  
K. Gordon ◽  
...  
Keyword(s):  
Health Insurance ◽  
Real World ◽  
World Health ◽  
Insurance Claims ◽  
Claims Analysis ◽  
Health Insurance Claims

scholarly journals Real-world utilization and outcomes of the Veterans Health Administration’s smoking cessation text message program

2020 ◽  
Author(s):  
Dana E Christofferson ◽  
Paul A Dennis ◽  
Jeffrey S Hertzberg ◽  
Jean C Beckham ◽  
Jennifer Knoeppel ◽  
...  
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Real World ◽  
Primary Outcome ◽  
Text Message ◽  
Safety Net ◽  
World Health ◽  
Veterans Health ◽  
Female Population ◽  
Health Care Settings

Abstract Introduction Smoking cessation mobile health (mHealth) programs are effective and have been recommended for integration into health care services but have not been evaluated in real-world health care settings. The Veterans Health Administration (VHA), a safety net health care provider, provides health care for 9 million U.S. military veterans. VHA implemented the SmokefreeVET text message program in 2013. Methods A retrospective evaluation of 6,153 SmokefreeVET subscribers was conducted. The primary outcome was 30-day self-reported abstinence at 6 months. Secondary outcomes included percentage of opt outs, program completers, and 30-day self-reported abstinence at 3 months. Results SmokefreeVET subscribers were on average 47.5 years old and 71.4% male. Smoking cessation medication use was reported by 11.5% of subscribers at the start of their quit attempt and subscribers enrolled in the program for an average of 29 days. Subscribers who were younger, female, and heavier smokers were more likely to opt out of the six-week program early. The abstinence rate for the primary outcome, self-reported 30-day abstinence at 6 months among all subscribers was 3.7%. Conclusions SmokefreeVET enrolled a younger and more female population of subscribers than other studies of veterans interested in tobacco treatment. The mHealth program was generally acceptable to veterans, yet strategies to increase retention may improve completion rates and outcomes. In this real-world setting, nearly half of the mHealth program subscribers combined use of the text program with smoking cessation medication. Further study of the optimal combination of mHealth with smoking cessation treatments is needed. Implications mHealth smoking cessation programs can be effectively implemented within real-world health care settings, even in those serving disadvantaged populations. Further research to improve mHealth program efficacy and integration into clinical settings will increase the population-level impact of these effective smoking cessation programs.

scholarly journals Real-World Health Outcomes of Insulin Glargine 300 U/mL vs Insulin Glargine 100 U/mL in Adults With Type 1 and Type 2 Diabetes in the Canadian LMC Diabetes Patient Registry: The REALITY Study

2019 ◽  
Vol 43 (7) ◽  
pp. 504-509.e1 ◽  
Author(s):  
Alexander Abitbol ◽  
Ruth E. Brown ◽  
Dishay Jiandani ◽  
Luc Sauriol ◽  
Ronnie Aronson
Keyword(s):  
Type 2 Diabetes ◽  
Health Outcomes ◽  
Insulin Glargine ◽  
Real World ◽  
Diabetes Patient ◽  
World Health ◽  
Patient Registry

scholarly journals Differences in Real-World Health and Economic Outcomes Among Patients with COPD Treated with Combination Tiotropium/Olodaterol Versus Triple Therapy

2020 ◽  
Vol 26 (10) ◽  
pp. 1363-1374 ◽  
Author(s):  
Swetha R. Palli ◽  
Monica Frazer ◽  
Mary DuCharme ◽  
Ami R. Buikema ◽  
Amy J. Anderson ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Real World ◽  
Economic Outcomes ◽  
World Health
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