Characteristics of patients in platform C19, a COVID-19 research database combining primary care electronic health record and patient reported information

Background Data to better understand and manage the COVID-19 pandemic is urgently needed. However, there are gaps in information stored within even the best routinely-collected electronic health records (EHR) including test results, remote consultations for suspected COVID-19, shielding, physical activity, mental health, and undiagnosed or untested COVID-19 patients. Observational and Pragmatic Research Institute (OPRI) Singapore and Optimum Patient Care (OPC) UK established Platform C19, a research database combining EHR data and bespoke patient questionnaire. We describe the demographics, clinical characteristics, patient behavior, and impact of the COVID-19 pandemic using data within Platform C19. Methods EHR data from Platform C19 were extracted from 14 practices across UK participating in the OPC COVID-19 Quality Improvement program on a continuous, monthly basis. Starting 7th August 2020, consenting patients aged 18–85 years were invited in waves to fill an online questionnaire. Descriptive statistics were summarized using all data available up to 22nd January 2021. Findings From 129,978 invitees, 31,033 responded. Respondents were predominantly female (59.6%), white (93.5%), and current or ex-smokers (52.6%). Testing for COVID-19 was received by 23.8% of respondents, of which 7.9% received positive results. COVID-19 symptoms lasted ≥4 weeks in 19.5% of COVID-19 positive respondents. Up to 39% respondents reported a negative impact on questions regarding their mental health. Most (67%-76%) respondents with asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, heart, or kidney disease reported no change in the condition of their diseases. Interpretation Platform C19 will enable research on key questions relating to COVID-19 pandemic not possible using EHR data alone.

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Relationships between Physical and Social Behavioural Changes and the Mental Status of Homebound Residents in Hong Kong during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186653 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6653

Author(s):

Ben Y. F. Fong ◽

Martin C. S. Wong ◽

Vincent T. S. Law ◽

Man Fung Lo ◽

Tommy K. C. Ng ◽

...

Keyword(s):

Mental Health ◽

Hong Kong ◽

Physical Health ◽

Negative Impact ◽

Severe Depression ◽

Social Contact ◽

Well Being ◽

Full Time ◽

Online Questionnaire ◽

Physical Strain

In Hong Kong, social distancing has been adopted in order to minimise the spread of COVID-19. This study aims to examine the changes in physical health, mental health, and social well-being experienced by local residents who were homebound during the pandemic. An online questionnaire in both Chinese and English versions was completed by 590 eligible participants from 24 April to 13 May 2020. The questionnaire found that individuals aged 18 to 25 years spent more time resting and relaxing but experienced more physical strain. Working status was associated with social contact, with participants working full-time jobs scoring higher in “maintaining social communication via electronic means” and “avoiding social activities outside the home”. Additionally, approximately one third of the participants (29.7%) had moderate to severe depression, and participants aged 18 to 25 were found to have higher scores in PHQ-9. Changes in physical health and social contact were significantly associated with developing depressive symptoms. From the results, it is clear that the COVID-19 pandemic has the potential to exert a negative impact on the mental health status of individuals.

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The Impact of Study Mode (Online vs. Hybrid) on Early Symptoms of Depression and Coping Strategies among University Students in Poland in Time of COVID-19 Pandemic—Preliminary Study

Brain Sciences ◽

10.3390/brainsci11121578 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1578

Author(s):

Anna Drelich-Zbroja ◽

Anna Jamroz-Wiśniewska ◽

Maryla Kuczyńska ◽

Monika Zbroja ◽

Weronika Cyranka ◽

...

Keyword(s):

Mental Health ◽

University Students ◽

Coping Strategies ◽

Negative Impact ◽

Mental States ◽

Online Questionnaire ◽

Early Symptoms ◽

Study Mode ◽

And Coping ◽

The Impact

Introduction: mental health has been one of the most important issues surrounding the COVID-19 pandemic; mental disorders can be exacerbated by isolation during lockdowns or online learning. The aim of this study was to analyze the relationship between non-clinical (early) symptoms of depressed moods, personality traits, and coping strategies, as well as whether the learning mode (online versus hybrid) differentiates the experiences of these early symptoms and coping strategies. Methods: 114 university students aged 19 to 34, whose education model was changed from stationary to hybrid or online due to COVID-19 restrictions, participated in the study. The participants completed the online questionnaire, which consisted of two sections: (1) demographic questions to characterize the subjects and 44 questions based on the literature review. (2) Mini-COPE Inventory. Results: the study showed that the fully online study mode has a negative impact on the mental health of students; hybrid students are more likely to use active and positive coping strategies, which effectively help to control negative thoughts and/or reduce negative mental states. Conclusions: the COVID-19 pandemic has had significant psychological effects that will extend to coming years; therefore, implementing systemic psychological care is of utmost importance.

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Physical Activity Protects Against the Negative Impact of Coronavirus Fear on Adolescent Mental Health and Well-Being During the COVID-19 Pandemic

Frontiers in Psychology ◽

10.3389/fpsyg.2021.580511 ◽

2021 ◽

Vol 12 ◽

Author(s):

Laura J. Wright ◽

Sarah E. Williams ◽

Jet J. C. S. Veldhuijzen van Zanten

Keyword(s):

Mental Health ◽

Physical Activity ◽

Protective Factor ◽

Negative Impact ◽

Well Being ◽

Adolescent Mental Health ◽

Regression Analyses ◽

Negative Effects ◽

Online Questionnaire ◽

Health And Well Being

Background: The severity of the Coronavirus pandemic has led to lockdowns in different countries to reduce the spread of the infection. These lockdown restrictions are likely to be detrimental to mental health and well-being in adolescents. Physical activity can be beneficial for mental health and well-being; however, research has yet to examine associations between adolescent physical activity and mental health and well-being during lockdown.Purpose: Examine the effects of adolescent perceived Coronavirus prevalence and fear on mental health and well-being and investigate the extent to which physical activity can be a protective factor against these concerns.Methods: During United Kingdom lockdown restrictions, 165 participants (100 female, aged 13–19) completed an online questionnaire assessing perceived Coronavirus prevalence and fear, physical activity, and indicators of mental health and well-being (stress, anxiety, depression, fatigue, vitality, and perceived health). Separate hierarchical multiple linear regression analyses (with age, gender, perceived Coronavirus prevalence, and fear entered in step 1, and physical activity in step 2) were run to predict each well-being outcome.Results: Regression analyses indicated that in general, while Coronavirus fear was a negative predictor, physical activity was a positive and stronger predictor of enhanced mental health and well-being outcomes.Conclusion: Findings suggest that physical activity during the Coronavirus pandemic can counteract the negative effects of Coronavirus fear on adolescent mental health and well-being. Therefore, physical activity should be promoted during lockdown to support good mental health and well-being.

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The Impact of COVID-19 Pandemic Restrictions on Physical Activity and Psychological Characteristics of the Iranian People

10.21203/rs.3.rs-1192981/v1 ◽

2022 ◽

Author(s):

Esmaeel Saemi ◽

Hadi Nobari ◽

Georgian Badicu ◽

Habibollah Ghazizadeh ◽

Ali Pashabadi ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Negative Impact ◽

Short Form ◽

Health Indicators ◽

Self Esteem ◽

Wilcoxon Test ◽

Online Questionnaire ◽

Cross Sectional ◽

The Impact

Abstract BackgroundThe aim of this study was to investigate the impact of the COVID-19 pandemic restrictions on physical activity behaviours, as well as on mental health indicators among Iranian residents. MethodsIn this cross-sectional study, 335 participants were included (155 males, mean age = 30.06 ± 14.58 years). The eligibility criteria for this study were as follows; 1- Having at least 10 years of age. 2- Having a minimum literacy rate 3- Ability to work with networks of smart communication devices such as smartphones and computers 4- Living in Iran for the past 5 years. Participants were selected through the convenience sampling and filled out an online questionnaire measuring physical activity behaviours (The International Physical Activity Questionnaire; IPAQ; Short Form) and two mental health indicators – self-esteem (Rosenberg self-esteem scale) and social physical anxiety (7-items social physique anxiety scale). ResultsThe results of Wilcoxon test showed that participants reported significant differences from before to during the pandemic in all three variables of physical activity (significant decreases), self-esteem (significant decreases), and social physical anxiety (significant increases). This difference was found, regardless of participants’ gender. The results of Spearman correlation test between changes in physical activity and changes in mental health indicators showed that COVID-19 pandemic negatively impacted self-esteem and social physical anxiety. However, we have not found any significant association of physical activity’s change with social physical anxiety or self-esteem’s changes before and during the pandemic. ConclusionsIn sum, the findings of the present study indicate a detrimental effect of the COVID-19 pandemic on the physical activity and mental health among Iranian’s residents. Public policies aiming to buffer the negative impact on COVID-19 Iranians’ health are urgently needed.

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Identifying COPD in routinely collected electronic health records: a systematic scoping review

ERJ Open Research ◽

10.1183/23120541.00167-2021 ◽

2021 ◽

pp. 00167-2021

Author(s):

Shanya Sivakumaran ◽

Mohammad A. Alsallakh ◽

Ronan A. Lyons ◽

Jennifer K. Quint ◽

Gwyneth A. Davies

Keyword(s):

Electronic Health Records ◽

Smoking Status ◽

Case Definition ◽

Chronic Obstructive ◽

Health Records ◽

Obstructive Pulmonary Disease ◽

Electronic Healthcare Databases ◽

Patient Reported ◽

Icd 10 ◽

Electronic Health

Although routinely collected electronic health records (EHR) are widely used to examine outcomes related to chronic obstructive pulmonary disease (COPD), consensus regarding the identification of cases from electronic healthcare databases is lacking. We systematically examine and summarise approaches from the recent literature.MEDLINE via EBSCOhost was searched for COPD-related studies using EHR published from January 1, 2018 to November 30, 2019. Data were extracted relating to the case definition of COPD and determination of COPD severity and phenotypes.From 185 eligible studies, we found widespread variation in the definitions used to identify people with COPD in terms of code sets used (with 20 different code sets in use based on the ICD-10 classification alone) and requirement of additional criteria (relating to age (n=139), medication (n=31), multiplicity of events (n=21), spirometry (n=19) and smoking status (n=9)). Only 7 studies used a case definition which had been validated against a reference standard in the same dataset. Various proxies of disease severity were used since spirometry results and patient-reported outcomes were not often available.To enable the research community to draw reliable insights from electronic health records and aid comparability between studies, clear reporting and greater consistency of the definitions used to identify COPD and related outcome measures is key.

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Impact of COVID-19 on the mental health of optometry students at a higher education institution: A case study

African Vision and Eye Health ◽

10.4102/aveh.v80i1.652 ◽

2021 ◽

Vol 80 (1) ◽

Author(s):

Yusuf Simjee ◽

Zothile Mncwabe ◽

Keihara Sindhrajh ◽

Rabia Khan ◽

Maseeha Seedat ◽

...

Keyword(s):

Mental Health ◽

Higher Education ◽

Black People ◽

Negative Impact ◽

Physical And Mental Health ◽

Online Questionnaire ◽

The Impact ◽

Optometry Students

Background: The coronavirus disease 2019 (COVID-19) outbreak poses serious threats to the physical and mental health of individuals worldwide. The lockdown strategy and social distancing regulations adopted in South Africa have disrupted the day-to-day life activities of all people including students.Aim: To explore the impact of COVID-19 on the mental health of optometry students at a higher education institution.Setting: The study population included optometry students currently registered at the University of KwaZulu-Natal, in Durban, South Africa.Methods: The study adopted a case study research design and used an online questionnaire and follow-up interviews to collect data. The Depression Anxiety Stress Scale (DASS-21) questionnaire that assesses depression, anxiety and stress subscales was used. Data were analysed using descriptive and inferential statistics. The interview data were analysed using thematic content analysis.Results: A total of 147 participants responded to the online questionnaire and consisted of majority black people (n = 98), female (n = 114) and second year (n = 58) students. The majority of the participants had normal scores for depression (n = 97), anxiety (n = 79) and stress (n = 107). Only a few participants had scores indicating severe or extremely severe depression (n = 13), anxiety (n = 23) and stress (n = 5). Follow-up interviews were conducted with 10 participants and of these, seven reported that COVID-19 had a negative impact on their ability to concentrate and they felt anxious about examining patients. Factors such as stigma and judgment were perceived as hindrances to seeking mental health help.Conclusion: Most participants had normal scores for depression, anxiety and stress; however, some participants presented with abnormal scores. The impact of the COVID-19 pandemic on mental health should be highlighted and higher education authorities should plan and provide appropriate services to improve the quality of life of affected students.

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Understanding quality of life and treatment history of patients with Bertolotti syndrome compared with lumbosacral radiculopathy

Journal of Neurosurgery Spine ◽

10.3171/2019.2.spine1953 ◽

2019 ◽

Vol 31 (2) ◽

pp. 222-228 ◽

Cited By ~ 1

Author(s):

Joshua L. Golubovsky ◽

Arbaz Momin ◽

Nicolas R. Thompson ◽

Michael P. Steinmetz

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Propensity Score ◽

Disc Herniation ◽

Symptom Onset ◽

Patient Reported Outcomes ◽

Lumbosacral Radiculopathy ◽

Patient Reported ◽

Age And Sex

OBJECTIVEBertolotti syndrome is a rare spinal condition that causes low-back pain due to a lumbosacral transitional vertebra (LSTV), which is a pseudoarticulation between the fifth lumbar transverse process and the sacral ala. Bertolotti syndrome patients are rarely studied, particularly with regard to their quality of life. This study aimed to examine the quality of life and prior treatments in patients with Bertolotti syndrome at first presentation to the authors’ center in comparison with those with lumbosacral radiculopathy.METHODSThis study was a retrospective cohort analysis of patients with Bertolotti syndrome and lumbosacral radiculopathy due to disc herniation seen at the authors’ institution’s spine center from 2005 through 2018. Diagnoses were confirmed with provider notes and imaging. Variables collected included demographics, diagnostic history, prior treatment, patient-reported quality of life metrics, and whether or not they underwent surgery at the authors’ institution. Propensity score matching by age and sex was used to match lumbosacral radiculopathy patients to Bertolotti syndrome patients. Group comparisons were made using t-tests, Fisher’s exact test, Mann-Whitney U-tests, Cox proportional hazards models, and linear regression models where variables found to be different at the univariate level were included as covariates.RESULTSThe final cohort included 22 patients with Bertolotti syndrome who had patient-reported outcomes data available and 46 propensity score–matched patients who had confirmed radiculopathy due to disc herniation. The authors found that Bertolotti syndrome patients had significantly more prior epidural steroid injections (ESIs) and a longer time from symptom onset to their first visit. Univariate analysis showed that Bertolotti syndrome patients had significantly worse Patient-Reported Outcomes Measurement Information System (PROMIS) mental health T-scores. Adjustment for prior ESIs and time from symptom onset revealed that Bertolotti syndrome patients also had significantly worse PROMIS physical health T-scores. Time to surgery and other quality of life metrics did not differ between groups.CONCLUSIONSPatients with Bertolotti syndrome undergo significantly longer workup and more ESIs and have worse physical and mental health scores than age- and sex-matched patients with lumbosacral radiculopathy. However, both groups of patients had mild depression and clinically meaningful reduction in their quality of life according to all instruments. This study shows that Bertolotti syndrome patients have a condition that affects them potentially more significantly than those with lumbosacral radiculopathy, and increased attention should be paid to these patients to improve their workup, diagnosis, and treatment.

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Preliminary results from the COPE study using primary-care electronic health records and environmental modelling to examine COPD exacerbations

British Journal of General Practice ◽

10.3399/bjgp18x696749 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X696749 ◽

Cited By ~ 2

Author(s):

Maimoona Hashmi ◽

Mark Wright ◽

Kirin Sultana ◽

Benjamin Barratt ◽

Lia Chatzidiakou ◽

...

Keyword(s):

Primary Care ◽

Electronic Health Records ◽

Health Management ◽

Practice Research ◽

Chronic Obstructive ◽

Clinical Practice Research Datalink ◽

Health Records ◽

Preliminary Results ◽

Copd Exacerbations ◽

Electronic Health

BackgroundChronic Obstructive Airway Disease (COPD) is marked by often severely debilitating exacerbations. Efficient patient-centric research approaches are needed to better inform health management primary-care.AimThe ‘COPE study’ aims to develop a method of predicting COPD exacerbations utilising personal air quality sensors, environmental exposure modelling and electronic health records through the recruitment of patients from consenting GPs contributing to the Clinical Practice Research Datalink (CPRD).MethodThe study made use of Electronic Healthcare Records (EHR) from CPRD, an anonymised GP records database to screen and locate patients within GP practices in Central London. Personal air monitors were used to capture data on individual activities and environmental exposures. Output from the monitors were then linked with the EHR data to obtain information on COPD management, severity, comorbidities and exacerbations. Symptom changes not equating to full exacerbations were captured on diary cards. Linear regression was used to investigate the relationship between subject peak flow, symptoms, exacerbation events and exposure data.ResultsPreliminary results on the first 80 patients who have completed the study indicate variable susceptibility to environmental stressors in COPD patients. Some individuals appear highly susceptible to environmental stress and others appear to have unrelated triggers.ConclusionRecruiting patients through EHR for a study is feasible and allows easy collection of data for long term follow up. Portable environmental sensors could now be used to develop personalised models to predict risk of COPD exacerbations in susceptible individuals. Identification of direct links between participant health and activities would allow improved health management thus cost savings.

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Collecting patient reported outcomes to facilitate prescription opioid management: Development and testing of the Opioid Management App (OM-App) (Preprint)

10.2196/preprints.23633 ◽

2020 ◽

Author(s):

Jessica Robinson-Papp ◽

Gabriela Cedillo ◽

Richa Deshpande ◽

Mary Catherine George ◽

Qiuchen Yang ◽

...

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Risk Behaviors ◽

Digital Health ◽

Monitoring Program ◽

Prescription Opioid ◽

Research Database ◽

Cross Sectional ◽

Study Duration ◽

Patient Reported

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468

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Percutaneous Tibial Nerve Stimulation in Chronic Post-Surgical Anorectal Pain: A Case Report

GE Portuguese Journal of Gastroenterology ◽

10.1159/000515655 ◽

2021 ◽

pp. 1-6

Author(s):

Marta Pacheco ◽

João Xavier ◽

Olga Santos ◽

Carina Raposo ◽

Ana Margarida Regalado

Keyword(s):

Nerve Stimulation ◽

Negative Impact ◽

Tibial Nerve ◽

Pain Syndrome ◽

Brief Pain Inventory ◽

Lower Urinary Tract Dysfunction ◽

Percutaneous Tibial Nerve Stimulation ◽

Tibial Nerve Stimulation ◽

Anorectal Pain ◽

Patient Reported

Introduction: Anorectal pain is a symptom with a negative impact on quality of life and it can sometimes develop into a chronic pain syndrome. Structural anorectal pain is treated according to the underlying pathology. In situations of chronic post-surgical pain that is refractory to conventional therapeutic approaches, percutaneous tibial nerve stimulation (PTNS) is an option. PTNS is a neurostimulation technique used in the treatment of lower urinary tract dysfunction. There has been increasing evidence of its benefits for improving other conditions, such as chronic pelvic pain (CPP) and faecal incontinence (FI). Case Presentation: We report a case of a 45-year-old woman with chronic post-surgical anorectal pain (CPAP) treated with PTNS. The patient reported a consistent and dramatic decrease in both the frequency and intensity of pain, assessed by the Brief Pain Inventory (BPI). A decrease in the pain interference with mood, normal work, and walking/mobility was also noted, as evaluated by BPI and EQ-5D-3L questionnaires. Discussion: Neuromodulation treatments have been reported as effective for anorectal pain, but reports on the use of PTNS are rare. The tibial nerve is easily accessible and provides an optimal site for neurostimulation without the need of an operating room or anaesthesia. The overall improvement observed in this case of chronic anorectal pain suggests a potential new area of research for PTNS.

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