Factors Associated With Medication Adherence in Vascular Surgery Patients

2020 ◽  
Vol 54 (7) ◽  
pp. 625-632
Author(s):  
Hataka R. Minami ◽  
Mark S. Zemela ◽  
Adam C. Ring ◽  
Michael S. Williams ◽  
Matthew R. Smeds
Keyword(s):  
Medication Adherence ◽  
Vascular Surgery ◽  
Vascular Disease ◽  
Univariate Analysis ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Factors Associated ◽  
Younger Age ◽  
High Adherence ◽  
High Level

Introduction: Patients with vascular disease have higher mortality rates than age-matched peers and medical management of coexisting diseases may alter these outcomes. We sought to understand factors associated with medication nonadherence in vascular surgery patients at a single University vascular surgery clinic over a 3-month period. Materials and Methods: Consecutive vascular surgery patients were surveyed from June to August 2019. The survey included demographic questions, the validated Morisky Medication Adherence Scale, the 4-item Patient Health Questionnaire for Anxiety and Depression scales, and other medication-related questions. Medical and surgical histories were retrospectively collected from charts. Univariate and multivariate analyses were used to compare among high, intermediate, and low adherence. Results: A total of 128 (74%) of 174 patients met study inclusion criteria. On univariate analysis, lower medication adherence was associated with younger age ( P = .004), anxiety and depression ( P = .001), higher daily pain ( P < .001), and patients who believed their medications were less important for treating their vascular disease ( P < .001). Adherence was not associated with symptomatic vascular disease, gender, education level, marital status, employment, insurance, or the use of medication usage reminders. Multivariate analysis significantly predicted high adherence relative to low adherence with 5-year increase in age (odds ratio [OR] = 1.252, P = .021) and low adherence relative to high adherence with greater perceived pain (OR = 0.839, P = .016). Conclusions: Younger age and high level of pain were associated with lower medication adherence. Informing patients of the importance of prescribed medication and addressing anxiety or depression symptoms may improve adherence.

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

scholarly journals Emotional distress in haemophilia: Factors associated with the presence of anxiety and depression symptoms among adults

Haemophilia ◽  
2018 ◽  
Vol 24 (5) ◽  
pp. e344-e353 ◽  
Author(s):  
P. R. Pinto ◽  
A. C. Paredes ◽  
P. Moreira ◽  
S. Fernandes ◽  
M. Lopes ◽  
...  
Keyword(s):  
Emotional Distress ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Factors Associated

scholarly journals A 2-Month Follow-Up Study of Psychological Distress among Italian People during the COVID-19 Lockdown

2020 ◽  
Vol 17 (21) ◽  
pp. 8180 ◽  
Author(s):  
Paolo Roma ◽  
Merylin Monaro ◽  
Marco Colasanti ◽  
Eleonora Ricci ◽  
Silvia Biondi ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Coping Strategies ◽  
Multivariate Regression ◽  
Regression Models ◽  
Anxiety And Depression ◽  
Factors Associated ◽  
Younger Age ◽  
Post Traumatic ◽  
Traumatic Symptoms

The spread of coronavirus disease 2019 (COVID-19) has called for unprecedented measures, including a national lockdown in Italy. The present study aimed at identifying psychological changes (e.g., changes in depression, stress, and anxiety levels) among the Italian public during the lockdown period, in addition to factors associated with these changes. An online follow-up survey was administered to 439 participants (original sample = 2766), between 28 April and 3 May 2020. A paired sample t-test tested for differences in stress, anxiety, and depression over the period. Multivariate regression models examined associations between sociodemographic variables, personality traits, coping strategies, depression, and stress. Results showed an increase in stress and depression over the lockdown, but not anxiety. Negative affect and detachment were associated with higher levels of depression and stress. Higher levels of depression at the start of the lockdown, as well as fewer coping strategies and childlessness, were associated with increased depression at follow-up, whereas higher levels of stress at the start of the lockdown and younger age were associated with higher stress at follow-up. These results may help us to identify persons at greater risk of suffering from psychological distress as a result lockdown conditions, and inform psychological interventions targeting post-traumatic symptoms.

scholarly journals Emotional health concerns of oncology physicians in the United States: fallout during the COVID-19 pandemic

2020 ◽  
Author(s):  
Lauren Thomaier ◽  
Deanna Teoh ◽  
Patricia Jewett ◽  
Heather Beckwith ◽  
Helen Parsons ◽  
...  
Keyword(s):  
United States ◽  
Cancer Care ◽  
Emotional Health ◽  
Well Being ◽  
The United States ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated

AbstractIntroductionCancer care is significantly impacted by the Coronavirus Disease 2019 (COVID-19) pandemic. Our objective was to evaluate the effect of the pandemic on the emotional well-being of oncology providers across the United States and explore factors associated with anxiety and depression symptoms.Methods and MaterialsA cross-sectional survey was administered to United States cancer-care physicians recruited over a two-week period (3/27/2020 – 4/10/2020) using snowball-convenience sampling through social media. Symptoms of anxiety and depression were measured using the Patient Health Questionnaire (PHQ-4).ResultsOf 486 participants, 374 (77.0%) completed the PHQ-4: mean age 45.7±9.6 years; 63.2% female; all oncologic specialties were represented. The rates of anxiety and depression symptoms were 62.0% and 23.5%, respectively. Demographic factors associated with anxiety included female sex, younger age, and less time in clinical practice. Perception of inadequate PPE (68.6% vs. 57.4%, p=0.03) and practicing in a state with more COVID-19 cases (65.8% vs. 51.1%, p=0.01) were associated with anxiety symptoms. Factors significantly associated with both anxiety and depression included: degree to which COVID-19 has interfered with the ability to provide treatment to cancer patients and concern that patients will not receive the level of care needed for non-COVID-19 illness (all p-values <0.01).ConclusionThe prevalence of anxiety and depression symptoms among oncology physicians in the United States during the COVID-19 pandemic is high. Our findings highlight factors associated with and sources of psychological distress to be addressed to protect the well-being of oncology physicians.

Preoperative Psychological Burdens in Patients with Vestibular Schwannoma

2021 ◽  
pp. 000348942110189
Author(s):  
Yufeng Li ◽  
Guo Ran ◽  
Kaizheng Chen ◽  
Xia Shen
Keyword(s):  
Risk Factors ◽  
Psychological Stress ◽  
Vestibular Schwannoma ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Psychological Burden ◽  
Factors Associated ◽  
Clinically Significant

Objective: To assess preoperative psychological burden in patients with vestibular schwannoma (VS). Methods: A total of 100 patients undergoing VS resection between September 2019 and June 2020 completed preoperative psychological screening. The Hospital Anxiety and Depression Scale (HADS) was applied the day before surgery, and a score >14 was considered clinically important. Univariate and multivariate logistic regression analyzes were used to identify risk factors associated with increased preoperative psychological stress. Results: Of the 100 patients who underwent VS resection, 44% were male, with a mean age of 45.9 years. Twenty-two (22%) had HADS scores >14. For the univariate analysis, risk factors associated with elevated psychological burden included time since diagnosis, number of symptoms, headache, vertigo, and nausea and/or vomiting. In the regression analysis, the number of symptoms and greater time from diagnosis to treatment correlated with higher preoperative psychological stress. Conclusion: Nearly 1 in 4 patients with VS experienced clinically significant emotional burden preoperatively. Number of symptoms and greater time from diagnosis to treatment contributed to this psychological burden.

scholarly journals Psychosocial Impact of COVID-19 Among Healthcare Workers

2021 ◽  
Author(s):  
Syed Muhammad Ali ◽  
Sidrah Nausheen
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Healthcare Workers ◽  
Well Being ◽  
Anxiety Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Paramedical Staff ◽  
High Level

Objectives: To assess anxiety and depression symptoms during the coronavirus pandemic among health care professionals in Pakistan. Methods: This is a cross-sectional study where a questionnaire containing demographics, and a validated fear scale, depression, and anxiety scale was made on Google drive and was sent to health care workers as doctors, nurses, and paramedical staff working in six different hospitals in Pakistan, through What's app on smartphones from May 1 to Jun 30, 2020. Data was analyzed on SPSS. Results: The response rate was 80%. Of 400 participants, 263 (65.8%) were physicians, and 137 (34.0%) were nurses and paramedical staff.  57.0% were less than 40 years, whereas 18.3% were more than 50 years of age. Majority of participants 65.5 % (n= 262) experienced moderate level of fear and 16.5% (n= 66) had high level of fear. 19% feared death. 57.0% reported social media to be responsible for increasing their fear. On the depression and anxiety scale, 22.0% (n=87) reported moderate to severe depression and anxiety symptoms. A significant relationship was demonstrated between the depression level and age, education, profession (p < 0.001). Similarly, anxiety and depression scores were strongly related to the availability of Personal Protective Equipment (p< 0.001). Conclusion: 22.0% of healthcare professionals are suffering from moderate to severe anxiety and depression symptoms, whereas 65.0% had moderate symptoms of fear. The predictors are age, education level, and co-morbidities. A high level of fear, anxiety, and depression raises concern for their psychological well-being through different programs. Keywords: COVID-19; Healthcare workers; Psychosocial

scholarly journals Emotional health concerns of oncology physicians in the United States: Fallout during the COVID-19 pandemic

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242767
Author(s):  
Lauren Thomaier ◽  
Deanna Teoh ◽  
Patricia Jewett ◽  
Heather Beckwith ◽  
Helen Parsons ◽  
...  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Cancer Care ◽  
Emotional Health ◽  
Well Being ◽  
The United States ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cross Sectional Survey ◽  
Factors Associated

Introduction Cancer care is significantly impacted by the Coronavirus Disease 2019 (COVID-19) pandemic. Our objective was to evaluate the early effects of the pandemic on the emotional well-being of oncology providers across the United States and explore factors associated with anxiety and depression symptoms. Materials and methods A cross-sectional survey was administered to United States cancer-care physicians recruited over a two-week period (3/27/2020–4/10/2020) using snowball-convenience sampling through social media. Symptoms of anxiety and depression were measured using the Patient Health Questionnaire (PHQ-4). Results Of 486 participants, 374 (77.0%) completed the PHQ-4: median age was 43 years; 63.2% female; all oncologic specialties were represented. The rates of anxiety and depression symptoms were 62.0% and 23.5%, respectively. Demographic factors associated with anxiety included female sex, younger age, and less time in clinical practice. Perception of inadequate personal protective equipment (68.6% vs. 57.4%, p = 0.03) and practicing in a state with more COVID-19 cases (65.8% vs. 51.1%, p = 0.01) were associated with anxiety symptoms. Factors significantly associated with both anxiety and depression included the degree to which COVID-19 has interfered with the ability to provide treatment to cancer patients and concern that patients will not receive the level of care needed for non-COVID-19 illness (all p-values <0.01). Conclusion The perceived degree of interference with clinical practice along with personal concerns about COVID-19 were significantly associated with both anxiety and depression among oncology physicians in the United States during the COVID-19 pandemic. Our findings highlight factors associated with and sources of psychological distress to be addressed to protect the well-being of oncology physicians.

Interpersonal Difficulties as an Underlying Mechanism in the Anxiety-Depression Association

2013 ◽  
Vol 30 (4) ◽  
pp. 273-282 ◽  
Author(s):  
Andres G. Viana ◽  
Erin N. Stevens
Keyword(s):  
Interpersonal Problems ◽  
Underlying Mechanism ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Late Adolescents ◽  
Interpersonal Difficulties ◽  
Underlying Mechanisms ◽  
High Level ◽  
Anxiety Depression ◽  
The Relationship

Objectives: Interpersonal difficulties have been implicated in both anxiety and depression. However, much less is known about whether interpersonal difficulties may account for, in part, the high level of comorbidity between mood and anxiety symptoms. This study examined whether various interpersonal difficulties, assessed with the Inventory of Interpersonal Problems, Short Circumplex (IIP-SC), were underlying mechanisms in the relationship between anxiety and depression symptoms in a high-risk sample of late adolescents with clinical levels of anxiety. Methods: 144 late adolescents with clinical levels of anxiety (mean age = 18.63 years; SD = 0.92) reported on their trait anxiety, worry, anxiety and depressive symptoms, and interpersonal problems. Results: Consistent with hypotheses, the IIP-SC overly nurturant subscale partially accounted for the relationship between anxiety and depression. The IIP-SC non-assertive and social avoidant subscales did not significantly account for the anxiety-depression relationship. Conclusions: Findings suggest that interpersonal behaviours characterised by excessive attempts to please and accommodate others may ultimately contribute to our understanding of the anxiety-depression association. We discuss the implications of our findings and how they may be applied to evidence-based assessment and treatment of anxiety problems.

scholarly journals Increases in Anxiety and Depression During COVID-19: A Large Longitudinal Study From China

2021 ◽  
Vol 12 ◽  
Author(s):  
Shizhen Wu ◽  
Keshun Zhang ◽  
Elizabeth J. Parks-Stamm ◽  
Zhonghui Hu ◽  
Yaqi Ji ◽  
...  
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Factors Associated ◽  
Self Rating ◽  
Development Of Students

Although accumulating evidence suggests the COVID-19 pandemic is associated with costs in mental health, the development of students' mental health, including the change from their previous levels of depression and anxiety and the factors associated with this change, has not been well-studied. The present study investigates changes in students' anxiety and depression from before the pandemic to during the lockdown and identifies factors that are associated with these changes. 14,769 university students participated in a longitudinal study with two time points with a 6-month interval. Students completed the Anxiety and Depression subscales of the Symptom Checklist 90 (SCL-90) before the COVID-19 outbreak (October 2020, Time 1), and the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) during the pandemic (April 2020, Time 2). The prevalence of anxiety and depression symptoms were 1.44 and 1.46% at Time 1, and 4.06 and 22.09% at Time 2, respectively, showing a 181.94% increase in anxiety and a 1413.01% increase in depression. Furthermore, the increases in anxiety and depression from pre-pandemic levels were associated with students' gender and the severity of the pandemic in the province where they resided. This study contributes to the gap in knowledge regarding changes in students' mental health in response to the pandemic and the role of local factors in these changes. Implications for gender and the Typhoon Eye effect are discussed.

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