scholarly journals Increasing exercise adherence among elderly patients with chronic disease in primary care: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seth VanDerVeer ◽  
Ronald Markert ◽  
Brant Bickford ◽  
Joseph Yuhas ◽  
Paul Pikman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Heart Rate ◽  
Cohort Study ◽  
Chronic Disease ◽  
Health Status ◽  
Treatment Group ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Exercise Adherence

Abstract Background Currently, the evidence for exercise in maintaining health, well-being, and physical functioning is overwhelming. Despite these benefits, more than 50% of the population fails to meet the recommended exercise requirements for age and health status. In our study, we sought to provide a method to increase exercise adherence that was both effective and time-efficient for physicians and their patients. Methods The primary objective of this research study was to evaluate the effectiveness of a graded exercise protocol and biweekly monitoring on increasing the duration of aerobic exercise to 150 min per week in a population of elderly individuals with chronic disease. Secondarily, we evaluated for improvement in resting heart rate, blood pressure, body mass index (BMI), and cardiorespiratory fitness. The overall study design was a randomized, prospective cohort study with assessor blinding. Forty-five patients aged ≥60 years with multiple comorbidities were recruited from the Internal Medicine Clinic at Wright-Patterson AFB. Participants were randomized into a treatment or control arm and observed over a period of 34 weeks. Those in the treatment arm were given a graded walking protocol and received biweekly phone calls to evaluate compliance. Those in the control arm did not receive an intervention or biweekly monitoring. Measurements of heart rate, blood pressure, and BMI were taken quarterly in both groups. At the beginning and conclusion of the study, each participant completed a modified Balke treadmill test and Physical Activity Scale for the Elderly (PASE). Continuous variables were evaluated with the independent samples t-test, whereas categorical variables were evaluated with the chi-squared test. Results A greater percentage of the treatment group achieved the primary outcome (41.6% vs. 0%; p = 0.003). Those in the treatment group also had favorable improvements in heart rate response (− 2.4 beats/min vs. + 5.3 beats/min; p = 0.038) and PASE (+ 66 vs.-20; p < 0.001). No significant differences were observed between groups for mean change in heart rate, blood pressure, or BMI. Conclusion Guided, independent exercise and surveillance can be an effective tool in primary care practice to help patients reach the recommended levels of exercise for both age and health status.

scholarly journals Comparison of Hemodynamic Response following Spinal Anesthesia between Controlled Hypertensive and Normotensive Patients Undergoing Surgery below the Umbilicus: An Observational Prospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Leake Gebrargs ◽  
Bereket Gebremeskel ◽  
Bacha Aberra ◽  
Assefa Hika ◽  
Yusuf Yimer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Spinal Anesthesia ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Study Groups ◽  
Categorical Variables ◽  
Time Interval ◽  
Significant Difference

Background. Hypotension and bradycardia are the most common complications associated with spinal anesthesia and more common in patients with a history of hypertension. Regular use of antihypertensive medications can prevent these complications. The occurrence of hypotension under spinal anesthesia among controlled hypertensive and normotensive patients with age 40 years and above is still debated. The objective of the study was to compare blood pressure and heart rate changes following spinal anesthesia between controlled hypertensive and normotensive patients undergoing surgery below the umbilicus at Black lion hospital, Addis Ababa, Ethiopia, 2020. Method. A hospital-based prospective cohort study was conducted. A total of 110 elective patients with controlled hypertension (55) and normotensive (55) patients who underwent surgery with spinal anesthesia at black lion hospital during the study period were included. The sample was selected using a systematic random sampling technique. Continuous data of independent and dependent variables were analyzed using an independent sample t-test for normally distributed and Mann–Whitney U-test for nonnormally distributed between the study groups. Categorical variables between the study groups were analyzed using the chi-square test. Descriptive data were displayed using tables and figures. For continuous and categorical variables, a p value <0.05 was considered statistically significant. Results. The incidence of hypotension in the controlled hypertension group (23.6%) was higher than the normotensive group (7.3%) with p value of 0.018. The occurrence of bradycardia was seen to be 12.7% in each group with a p value >0.05. There was a statistically significant difference in the mean systolic blood pressure, mean arterial pressure, mean heart rate, and vasopressor consumption at the measurement time interval between controlled hypertension and normotensive groups. Conclusion. Under spinal anesthesia, patients with controlled hypertension are more likely to develop hypotension than normotensive patients, but on the occurrence of bradycardia, there was no statistically significant difference between the two groups.

scholarly journals Are self-reported telemonitored blood pressure readings affected by end-digit preference: a prospective cohort study in Scotland

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019431 ◽  
Author(s):  
Richard A Parker ◽  
Mary Paterson ◽  
Paul Padfield ◽  
Hilary Pinnock ◽  
Janet Hanley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Automatic Transmission ◽  
Transmission System ◽  
Text Messages ◽  
Uncontrolled Hypertension ◽  
Digit Preference

ObjectiveSimple forms of blood pressure (BP) telemonitoring require patients to text readings to central servers creating an opportunity for both entry error and manipulation. We wished to determine if there was an apparent preference for particular end digits and entries which were just below target BPs which might suggest evidence of data manipulation.DesignProspective cohort studySetting37 socioeconomically diverse primary care practices from South East Scotland.ParticipantsPatients were recruited with hypertension to a telemonitoring service in which patients submitted home BP readings by manually transcribing the measurements into text messages for transmission (‘patient-texted system’). These readings were compared with those from primary care patients with uncontrolled hypertension using a system in which readings were automatically transmitted, eliminating the possibility of manipulation of values (‘automatic-transmission system’).MethodsA generalised estimating equations method was used to compare BP readings between the patient-texted and automatic-transmission systems, while taking into account clustering of readings within patients.ResultsA total of 44 150 BP readings were analysed on 1068 patients using the patient-texted system compared with 20 705 readings on 199 patients using the automatic-transmission system. Compared with the automatic-transmission data, the patient-texted data showed a significantly higher proportion of occurrences of both systolic and diastolic BP having a zero end digit (OR 2.1, 95% CI 1.7 to 2.6) although incidence was <2% of readings. Similarly, there was a preference for systolic 134 and diastolic 84 (the threshold for alerts was 135/85) (134 systolic BP OR 1.5, 95% CI 1.3 to 1.8; 84 diastolic BP OR 1.5, 95% CI 1.3 to 1.9).ConclusionEnd-digit preference for zero numbers and specific-value preference for readings just below the alert threshold exist among patients in self-reporting their BP using telemonitoring. However, the proportion of readings affected is small and unlikely to be clinically important.Trial registration numberISRCTN72614272; Post-results.

scholarly journals Health literacy, health status and health behaviors of German students– study protocol for the “Healthy Habits” cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Martin Lange ◽  
Alexandra Löwe ◽  
Gerrit Stassen ◽  
Andrea Schaller
Keyword(s):  
Cohort Study ◽  
Health Status ◽  
Health Literacy ◽  
Health Behavior ◽  
Health Behaviors ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
The State ◽  
The Impact ◽  
Study Format

Abstract Background The emerging adulthood is traditionally viewed as a time of optimal health, but also as a critical life span, characterized by changing life circumstances and the establishment of an individual lifestyle. Especially university life seems to hold several challenges impeding the manifestation of a health supporting manner, as many students tend to show a poorer health behavior and a higher amount of health-related problems than comparable age groups. This, along with a steady growth of the higher education sector, brings increased attention to the university setting in the context of prevention. To date, there are few empirical longitudinal and coherent cross-sectional data on the status of students’ health literacy, health status, and health behaviors, and on the impact of the study format on students’ health. The aim of this prospective cohort study is to reduce this research gap. Methods Starting during winter semester 2020/21, the prospective cohort study collects data on health literacy, health status and health behavior on a semester-by-semester basis. All enrolled students of the IST University of Applied Sciences, regardless of study format and discipline, can participate in the study at the beginning of their first semester. The data are collected digitally via a specifically programmed app. A total of 103 items assess the subjectively perceived health status, life and study satisfaction, sleep quality, perceived stress, physical activity, diet, smoking, alcohol consumption, drug addiction and health literacy. Statistical analysis uses (1) multivariate methods to look at changes within the three health dimensions over time and (2) the association between the three health dimensions using multiple regression methods and correlations. Discussion This cohort study collects comprehensive health data from students on the course of study. It is assumed that gathered data will provide information on how the state of health develops over the study period. Also, different degrees of correlations of health behavior and health literacy will reveal different impacts on the state of students’ health. Furthermore, this study will contribute to empirically justified development of target group-specific interventions. Trial registration German Clinical Trials Register: DRKS00023397 (registered on October 26, 2020).

scholarly journals Depression, non-fatal stroke and all-cause mortality in old age: A prospective cohort study of primary care patients

2013 ◽  
Vol 150 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Sebastian Köhler ◽  
Frans Verhey ◽  
Siegfried Weyerer ◽  
Birgitt Wiese ◽  
Kathrin Heser ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Old Age ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Fatal Stroke ◽  
All Cause Mortality ◽  
Primary Care Patients

scholarly journals Incidence of Neuralgic Amyotrophy (Parsonage Turner Syndrome) in a Primary Care Setting - A Prospective Cohort Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0128361 ◽  
Author(s):  
Nens van Alfen ◽  
Jeroen J. J. van Eijk ◽  
Tessa Ennik ◽  
Sean O. Flynn ◽  
Inge E. G. Nobacht ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Turner Syndrome ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Care Setting ◽  
Primary Care Setting ◽  
Neuralgic Amyotrophy
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