Symptom Burden in Patients With Home Care Who Are at Risk for Malnutrition: A Cross-Sectional Study

2019 ◽  
Vol 35 (2) ◽  
pp. 103-109
Author(s):  
Erika Berggren ◽  
Peter Strang ◽  
Ylva Orrevall ◽  
Ann Ödlund Olin ◽  
Lena Törnkvist
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Home Care ◽  
Older Patients ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significance Level ◽  
Patients At Risk

In Sweden, patients in early palliative stages of illness are cared for in primary care and often offered home care. Many are older and at risk for malnutrition, but little is known about their symptom burden and nutritional problems. This cross-sectional study divided older patients in home care into those with and without risk for malnutrition and compared symptom burden in the 2 groups. Participants were patients in Stockholm County (n = 121) in early palliative stages of disease cared for at home by primary care professionals from 10 health-care centers. The Mini Nutritional Assessment (MNA) was used to identify risk for malnutrition. Symptoms and/or nutritional status in patients with and without risk were assessed with the Functional Assessment of Anorexia/Cachexia Therapy (FAACT), Patient-Generated Subjective Global Assessment Short Form (PG-SGA), and Edmonton Symptom Assessment System (ESAS). Forty-two percent of the patients were at risk for malnutrition (MNA). Appetite ( P = .012), tiredness ( P = .003), and anxiety ( P = .008) were worse in these patients than in those without risk (ESAS; significance level, P ≤ .015). Patients at risk were also more concerned about how thin they looked ( P = .006), agreed more strongly that their family or friends were pressuring them to eat ( P = .000; FAACT; significance level, P ≤ .029), had a higher symptom burden ( P = .005), had lower physical activity ( P = .000), and more lost weight over time ( P = .032; PG-SGA; significance level, P ≤ .040). This study adds a more detailed picture of the symptom burden in older patients at risk for malnutrition. Such information is needed to identify risk for malnutrition earlier and improve patients’ health.

Drug-related problems in a clinical setting: a literature review and cross-sectional study evaluating factors to identify patients at risk

2015 ◽  
Vol 22 (4) ◽  
pp. 229-235 ◽  
Author(s):  
Carli Michèle Wilmer ◽  
Victor Johan Bernard Huiskes ◽  
Stephanie Natsch ◽  
Alexander Johannes Maria Rennings ◽  
Bartholomeus Johannnes Frederikus van den Bemt ◽  
...  
Keyword(s):  
At Risk ◽  
Literature Review ◽  
Clinical Setting ◽  
Cross Sectional Study ◽  
Drug Related Problems ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk

scholarly journals Advance preferences regarding thrombolysis in patients at risk for stroke: a cross-sectional study: Table 1

QJM ◽  
2014 ◽  
Vol 108 (1) ◽  
pp. 27-31 ◽  
Author(s):  
T. Ó Flatharta ◽  
A. Khan ◽  
T. Walsh ◽  
M. O’Donnell ◽  
S.T. O’Keefe
Keyword(s):  
At Risk ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk

scholarly journals A predictive model for identifying patients at risk of delayed transfer of care: a retrospective, cross-sectional study of routinely collected data

2021 ◽  
Vol 33 (3) ◽  
Author(s):  
Andrew Davy ◽  
Thomas Hill ◽  
Sarahjane Jones ◽  
Alisen Dube ◽  
Simon c Lea ◽  
...  
Keyword(s):  
At Risk ◽  
Predictive Model ◽  
Cross Sectional Study ◽  
Early Warning Score ◽  
Sectional Study ◽  
Cross Sectional ◽  
Transfer Of Care ◽  
Routinely Collected Data ◽  
Patients At Risk ◽  
Transfers Of Care

Abstract Background Delays to the transfer of care from hospital to other settings represent a significant human and financial cost. This delay occurs when a patient is clinically ready to leave the inpatient setting but is unable to because other necessary care, support or accommodation is unavailable. The aim of this study was to interrogate administrative and clinical data routinely collected when a patient is admitted to hospital following attendance at the emergency department (ED), to identify factors related to delayed transfer of care (DTOC) when the patient is discharged. We then used these factors to develop a predictive model for identifying patients at risk for delayed discharge of care. Objective To identify risk factors related to the delayed transfer of care and develop a prediction model using routinely collected data. Methods This is a single centre, retrospective, cross-sectional study of patients admitted to an English National Health Service university hospital following attendance at the ED between January 2018 and December 2020. Clinical information (e.g. national early warning score (NEWS)), as well as administrative data that had significant associations with admissions that resulted in delayed transfers of care, were used to develop a predictive model using a mixed-effects logistic model. Detailed model diagnostics and statistical significance, including receiver operating characteristic analysis, were performed. Results Three-year (2018–20) data were used; a total of 92 444 admissions (70%) were used for model development and 39 877 (30%) admissions for model validation. Age, gender, ethnicity, NEWS, Glasgow admission prediction score, Index of Multiple Deprivation decile, arrival by ambulance and admission within the last year were found to have a statistically significant association with delayed transfers of care. The proposed eight-variable predictive model showed good discrimination with 79% sensitivity (95% confidence intervals (CIs): 79%, 81%), 69% specificity (95% CI: 68%, 69%) and 70% (95% CIs: 69%, 70%) overall accuracy of identifying patients who experienced a DTOC. Conclusion Several demographic, socio-economic and clinical factors were found to be significantly associated with whether a patient experiences a DTOC or not following an admission via the ED. An eight-variable model has been proposed, which is capable of identifying patients who experience delayed transfers of care with 70% accuracy. The eight-variable predictive tool calculates the probability of a patient experiencing a delayed transfer accurately at the time of admission.

scholarly journals Association between Suicidal Ideation and Causes of Primary Care Visits: A Cross-Sectional Study to Identify Patients with Suspected Suicidal Ideation

2020 ◽  
Vol 17 (7) ◽  
pp. 667-673 ◽  
Author(s):  
Gyeongsil Lee ◽  
Jung-Ha Kim
Keyword(s):  
Primary Care ◽  
Suicidal Ideation ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk ◽  
Primary Care Patients

Objective Suicide victims are likely to visit a primary care provider within 1 month of the suicide attempt. However, it is impossible for primary care providers to screen all patients for suicidal ideation or attempts. We, therefore, aimed to investigate potential differences in the chief diagnoses received by primary care patients with and without suicidal ideation, as this information may provide clues and predict patients at risk of suicide.Methods This cross-sectional study included 1,211 Korean adults aged ≥20 years who had participated in the Korea National Health and Nutrition Examination Survey during 2014 and provided information about their histories of suicidal ideation and visits to primary care providers. Multiple logistic regression analyses were used to examine whether suicidal ideation was associated with specific diseases after controlling for age, sex, household income, education, occupation, marital status, smoking, alcohol consumption, and physical activity.Results Among primary care patients, the sample-weighted percentage of suicidal ideation was approximately 12%. The diagnoses of neoplasm and mental disorder were associated with a higher likelihood of suicidal ideation {odds ratio (OR) [95% confidence interval (CI)] 8.32 (1.01–68.56) and 6.19 (1.72–22.33), respectively}. Notably, diseases of the musculoskeletal system and connective tissue were also associated with suicidal ideation [OR (95% CI): 1.93 (1.09–3.43)].Conclusion The observed visit patterns and correlations of certain diagnoses with suicidal ideation suggest that primary care physicians should pay attention to patients with relevant disorders, consider screening suicidal ideation, and properly consult to a psychiatrist.

scholarly journals Physician and patient-related factors associated with inappropriate prescribing to older patients within primary care: a cross-sectional study in Brazil

2021 ◽  
Vol 139 (2) ◽  
pp. 107-116
Author(s):  
Welma Wildes Amorim ◽  
Luiz Carlos Passos ◽  
Romana Santos Gama ◽  
Renato Morais Souza ◽  
Lucas Teixeira Graia ◽  
...  
Keyword(s):  
Primary Care ◽  
Older Patients ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated

scholarly journals Comorbidity of dementia: a cross-sectional study of primary care older patients

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Beatriz Poblador-Plou ◽  
Amaia Calderón-Larrañaga ◽  
Javier Marta-Moreno ◽  
Jorge Hancco-Saavedra ◽  
Antoni Sicras-Mainar ◽  
...  
Keyword(s):  
Primary Care ◽  
Older Patients ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Association between suicidal ideation and causes of primary care visits: A cross-sectional study to identify patients with suspected suicidal ideation

2019 ◽  
Author(s):  
Gyeongsil Lee ◽  
Jung-Ha Kim
Keyword(s):  
Primary Care ◽  
Suicidal Ideation ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Care Physician ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk ◽  
Primary Care Patients

Abstract Background: Evidence increasingly suggests that suicide victims are highly likely to visit a primary care provider within one month of the suicide event. However, it would be impossible for primary care providers to act as gatekeepers and thus screen all patients for suicidal ideation or attempts. Therefore, we aimed to investigate potential differences in the chief diagnoses received by primary care patients with and without suicidal ideation, as this information may provide clues and predict patients at risk of committing suicide. Methods: This cross-sectional study included 1,211 Korean adults aged ≥20 years who had participated in the Korea National Health and Nutrition Examination Survey during 2014 and provided information about their histories of suicidal ideation and visits to primary care providers. Multiple logistic regression analyses were used to examine whether suicidal ideation was associated with specific diseases after controlling for age, household income, education, occupation, marital status, smoking, alcohol consumption and physical activity. Results: Among primary care patients, the sample-weighted percentage of suicidal ideation was 11.8%. The diagnoses of neoplasm and mental disorder were associated with a higher likelihood of suicidal ideation (odds ratio; OR [95% confidence interval, CI]: 8.32 [1.01–68.56] and 6.19 [1.72–22.33], respectively). Notably, diseases of the musculoskeletal system and connective tissue were also associated with suicidal ideation (OR [95% CI]: 1.93 [1.09–3.43]). Conclusions: The observed visit patterns and correlations of certain diagnoses with suicidal ideation suggest that primary care physician should pay careful attention to their patients with mood or musculoskeletal disorders and consider screening to determine the risk of suicide.

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