scholarly journals Chronic Condition Clusters and Polypharmacy among Adults

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ami Vyas ◽  
Xiaoyun Pan ◽  
Usha Sambamoorthi
Keyword(s):  
Chronic Condition ◽  
Medical Expenditure Panel Survey ◽  
Primary Objective ◽  
Medical Expenditure ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Disease Clusters ◽  
Respiratory Conditions

Objective. The primary objective of the study was to estimate the rates of polypharmacy among individuals with multimorbidity defined as chronic condition clusters and examine their associations with polypharmacy. Methods. Cross-sectional analysis of 10,528 individuals of age above 21, with at least one physical condition in cardiometabolic (diabetes or heart disease or hypertension), musculoskeletal (arthritis or osteoporosis), and respiratory (chronic obstructive pulmonary disease (COPD) or asthma) clusters from the 2009 Medical Expenditure Panel Survey. Chi-square tests and logistic regressions were performed to analyze the association between polypharmacy and multimorbidity. Results. Polypharmacy rates varied from a low of 7.2% among those with respiratory cluster to a high of 64.1% among those with all three disease clusters. Among those with two or more disease clusters, the rates varied from 28.3% for musculoskeletal and respiratory clusters to 41.8% for those with cardiometabolic and respiratory clusters. Individual with cardiometabolic conditions alone or in combination with other disease clusters were more likely to have polypharmacy. Compared to those with musculoskeletal and respiratory conditions, those with cardiometabolic and respiratory conditions had 1.68 times higher likelihood of polypharmacy. Conclusions. Rates of polypharmacy differed by specific disease clusters. Individuals with cardiometabolic condition were particularly at high risk of polypharmacy, suggesting greater surveillance for adverse drug interaction in this group.

scholarly journals Depression treatment in individuals with cancer: a comparative analysis with cardio-metabolic conditions

2013 ◽  
Vol 1 (1) ◽  
pp. 2 ◽  
Author(s):  
Pallavi B. Rane ◽  
Usha Sambamoorthi ◽  
Suresh Madhavan
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Household Survey ◽  
The United States ◽  
Primary Objective ◽  
Medical Expenditure ◽  
Depression Treatment ◽  
Cross Sectional ◽  
Physician Visits ◽  
Lifestyle Risk Factors ◽  
Metabolic Conditions

A clear picture of the current state of nationwide depression treatment practices in individuals with cancer and depression does not exist in the United States (US). Therefore, the primary objective of this study was to examine rates of any depression treatment among individuals with cancer and depression in the US. To better understand the relationship between any treatment for depression and presence of cancer, we used a comparison group of individuals with cardio-metabolic conditions owing to the similar challenges faced in management of depression in individuals with these conditions. We used a retrospective cross-sectional design and data from multiple years of the Medical Expenditure Panel Survey, a nationally representative household-survey on healthcare utilization and expenditures. Study sample consisted of adults aged 21 or older with self-reported depression and cancer (n=528) or self-reported depression and diabetes, heart disease or hypertension (n=1643). Depression treatment comprised of any use of antidepres- sants and/or any use of mental health counseling services. Treatment rates for depression were 78.0% and 81.7% among individuals with cancer and cardio-metabolic conditions respectively. After controlling for socio-demographic, access-to-care, number of physician-visits, health-status, and lifestyle risk-factors related variables; individuals with cancer were less likely to report any treatment for depression (Adjusted Odds Ratio=0.67; 95% Confidence Interval=0.49, 0.92) compared to individuals with cardio-metabolic conditions (P≤0.01). Our findings highlight the possibility that competing demands may crowd out treatment for depression and that cancer diagnosis may be a barrier to depression treatment.

HUBUNGAN FAKTOR RESIKO DENGAN KEJADIAN PADA PENYAKIT PARU OBSTRUKSI KRONIK DI PUSKESMAS MANDALA

2019 ◽  
Vol 1 (2) ◽  
pp. 43-47
Author(s):  
Alamsyah Lukito
Keyword(s):  
Health Center ◽  
Smoke Inhalation ◽  
Chronic Obstructive ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Chi Square Test ◽  
Analytical Research ◽  
Exposure To Secondhand Smoke

The main cause of Chronic Obstructive Pulmonary Disease is smoking or exposure to secondhand smoke from active smokers or smoke inhalation in passive smokers. Other causes are air pollution, workplace exposure, and genetic factors. This type of research is analytical research with a cross sectional approach which aims to study the existence of a variable relationship dynamics. In this study, the sample was 30 patients from the Mandala Health Center. Generally, COPD sufferers are those aged 45 years to 65 years where 21 of the 30 people suffer from risk. The chi-square test results show that there is a relationship between risk factors and the incidence of COPD in the Tembung Mandala 2018 Health Center Working Area.

scholarly journals HUBUNGAN FAKTOR RESIKO DENGAN KEJADIAN PADA PENYAKIT PARU OBSTRUKSI KRONIK DI PUSKESMAS MANDALA

2019 ◽  
Vol 1 (2) ◽  
pp. 43-47
Author(s):  
Alamsyah Lukito
Keyword(s):  
Health Center ◽  
Smoke Inhalation ◽  
Chronic Obstructive ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Chi Square Test ◽  
Analytical Research ◽  
Exposure To Secondhand Smoke

The main cause of Chronic Obstructive Pulmonary Disease is smoking or exposure to secondhand smoke from active smokers or smoke inhalation in passive smokers. Other causes are air pollution, workplace exposure, and genetic factors. This type of research is analytical research with a cross sectional approach which aims to study the existence of a variable relationship dynamics. In this study, the sample was 30 patients from the Mandala Health Center. Generally, COPD sufferers are those aged 45 years to 65 years where 21 of the 30 people suffer from risk. The chi-square test results show that there is a relationship between risk factors and the incidence of COPD in the Tembung Mandala 2018 Health Center Working Area.

scholarly journals Analysis of Risk Factors Affecting The Occurrence of Chronic Obstructive Pulmonary Disease in Indonesia

2021 ◽  
Vol 9 (1) ◽  
pp. 18
Author(s):  
Nurul Layly Firdausi ◽  
Kurnia Dwi Artanti ◽  
Chung-Yi Li
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Urban Areas ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Factors Affecting

Background: Chronic obstructive pulmonary disease (COPD) is a lung disease caused by the occurrence of airflow limitation in the lungs and also causes 60% of all deaths in Indonesia. Purpose: This study aimed to analyze the risk factors that affect the incidence of COPD in Indonesia. Methods: This study was conducted in July–August 2019 in Indonesia as an analytic research study with a cross-sectional design, using data from the Indonesia Family Life Survey-5. The sample consisted of respondents aged >15 years, giving a total of 34,231 respondents. Data analysis was partially carried out using the chi-square test to analyze the relationships between the variables. Results: The majority of respondents were female, were aged <40 years, and had a low level of education. Risk factors for the development of COPD included, among others, an age of >40 years (p = 0.02; PR = 1.20; 95% CI = 1.02–1.41), male gender (p = 0.01; PR = 1.26; 95% CI = 1.07–1.49), smoking (p = 0.01; PR = 1.22 ; 95% CI = 1.03–1.44), first smoking age < 40 years (p = 0.02; PR = 1.22; 95% CI = 1.03–1.44), residence in urban areas (p = 0.01; PR = 1.43; 95% CI = 1.20–1.70), being underweight (p = 0.01; PR = 2.17; 95% CI = 1.76–2.66). Conclusions: The risk factors that affect the incidence of COPD include being aged >40 years, being male, smoking, taking up smoking when aged <40 years, urban residence, and being underweight.

scholarly journals Co-Occurring Depression and Associated Healthcare Utilization and Expenditure in Individuals with Respiratory Condition: A Population-Based Study

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 157
Author(s):  
Prashant Sakharkar ◽  
Thanh Mai
Keyword(s):  
Healthcare Utilization ◽  
Medical Expenditure Panel Survey ◽  
Population Based ◽  
Medical Expenditure ◽  
Healthcare Use ◽  
Chi Square ◽  
Expenditure Data ◽  
Prevalence Of Depression ◽  
Chi Square Test ◽  
Respiratory Conditions

The existing literature is limited on the prevalence of depression among people with respiratory conditions and person-level factors that are associated with increased healthcare utilization and expenditures. The aim of this study was to explore the prevalence, pattern of healthcare use, and expenditures in noninstitutionalized individuals having co-occurring depression with respiratory conditions. The Medical Expenditure Panel Survey (MEPS) data from 2011 to 2017 was used in this study. Our sample included individuals having respiratory conditions (asthma, emphysema, and chronic bronchitis) with and without depression. Healthcare use and expenditure data were analyzed using a chi-square test, t-tests, and multiple linear regression analyses. There were 8848 individuals in the study. The prevalence of comorbid depression was 20%. Individuals with co-occurring depression with respiratory conditions differed significantly from individuals without co-occurring depression for age ≥ 45 years, white, and with ≤2 chronic disease conditions. Depressed individuals with respiratory conditions had higher healthcare utilization and expenditures. The presence of co-occurring depression with respiratory conditions increases the treatment complexity, healthcare utilization, and expenditure. Better treatment and management of these patients may reduce healthcare use and expenditures in the future.

scholarly journals Prevalence and clinical features of most frequent phenotypes in the Italian COPD population: the CLIMA Study

2021 ◽  
Vol 16 ◽  
Author(s):  
Roberto W. Dal Negro ◽  
Mauro Carone ◽  
Giuseppina Cuttitta ◽  
Luca Gallelli ◽  
Massimo Pistolesi ◽  
...  
Keyword(s):  
Lung Function ◽  
Smoking Habit ◽  
Daily Practice ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Chi Square ◽  
Recurrent Wheezing ◽  
Total Blood ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) is a complex, progressive respiratory condition characterized by heterogeneous clinical presentations (phenotypes). The aim of this study was to assess the prevalence of the main COPD phenotypes and match each phenotype to the most fitting clinical and lung function profile.Methods: The CLIMA (Clinical Phenotypes in Actual Clinical Practice) study was an observational, cross-sectional investigation involving twenty-four sites evenly distributed throughout Italy. Patients were tentatively grouped based on their history and claimed prevailing symptoms at recruitment: chronic cough (CB, suggesting chronic bronchitis); dyspnoea (possible emphysema components, E); recurrent wheezing (presuming asthma components, A). Variables collected were: anagraphics; smoking habit; history of asthma; claim of >1 exacerbations in the previous year; blood eosinophil count; total blood IgE and alpha1 anti-trypsin (α1-AT) levels; complete lung function, and the chest X-ray report. mMRC, CAT, BCS, EQ5d-5L were also used. The association between variables and phenotypes were checked by Chi-square test and multinomial logistic regression.Results: The CB phenotype was prevalent (48.3%), followed by the E and the A phenotypes (38.8% and 12.8%, respectively). When dyspnea was the prevailing symptom, the probability of belonging to the COPD-E phenotype was 3.40 times higher. Recurrent wheezing was mostly related to the COPD-A phenotype. Lung function proved more preserved in the COPD-CB phenotype. Smoke; n. exacerbations/year; VR, and BODE index were positively correlated with the COPD-E phenotype, while SpO2, FEV1/FVC, FEV1/VC, and FEV1 reversibility were negatively correlated. Lower DLco values were highly probative for the COPD-E phenotype (p<0.001). Conversely, smoke, wheezing, plasma eosinophils, FEV1 reversibility, and DLco were positively correlated with the COPD-A phenotype. The probability of belonging to the COPD-A phenotype raised by 2.71 times for any increase of one unit in % plasma eosinophils (p<0.001). Also multiparametrical scores contributed to discriminate the three phenotypes.Conclusion: the recognition of the main phenotypes of COPD can be effectively pursued by means of a few clinical and instrumental parameters, easy to obtain also in current daily practice. The phenotypical approach is crucial in the management of COPD as it allows to individualize the therapeutic strategy and to obtain more effective clinical outcomes

ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R
Keyword(s):  
Illness Perceptions ◽  
Pharmacist Intervention ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Post Test ◽  
Knowledge Practice ◽  
And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

scholarly journals Association between Physical Activity and Comorbidities in Spanish People with Asthma-COPD Overlap

2021 ◽  
Vol 13 (14) ◽  
pp. 7580
Author(s):  
Sheila Sánchez Castillo ◽  
Lee Smith ◽  
Arturo Díaz Suárez ◽  
Guillermo Felipe López Sánchez
Keyword(s):  
Physical Activity ◽  
Short Form ◽  
National Health Survey ◽  
Lumbar Pain ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Logistic Regression Models ◽  
Adjusted Model ◽  
Activity Questionnaire

Asthma and chronic obstructive pulmonary disease (COPD) are important conditions which often coexist. Higher rates of comorbidities among people with asthma-COPD overlap (ACO) may complicate clinical management. The aim of this study was to determine the prevalence of 30 different comorbidities and to analyze associations between these comorbidities and physical activity (PA) in Spanish people with ACO. Cross-sectional data from the Spanish National Health Survey 2017 were analyzed. A total of 198 Spanish people with ACO aged 15–69 years (60.6% women) were included in this study. PA was measured with the International Physical Activity Questionnaire (IPAQ) short form. Diagnosis of chronic conditions were self-reported. Associations between PA and comorbidities were analyzed using multivariable logistic regression models. The most prevalent comorbidities were chronic allergy (58.1%), chronic lumbar pain (42.4%), chronic cervical pain (38.4%), hypertension (33.3%) and arthrosis (31.8%). A PA level lower than 600 MET·min/week was significantly associated with urinary incontinence (OR = 3.499, 95% CI = 1.369–8.944) and osteoporosis (OR = 3.056, 95% CI = 1.094–8.538) in the final adjusted model. Therefore, the potential influence of PA on reducing the risk of these conditions among people with ACO should be considered, not only because of the health benefits, but also because PA can contribute to a more sustainable world.

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