scholarly journals Nationwide surveillance for Telmisartan alone or with combination at real world therapy in Indian patients with hypertension (START)

2021 ◽  
Vol 9 (10) ◽  
pp. 3091
Author(s):  
Manoj B. Chopda ◽  
Sunil G. Gadkar ◽  
Yashwanth A. L. ◽  
Ravi Kumar L. ◽  
Dhammadeep C. Dabhade ◽  
...  
Keyword(s):  
Categorical Data ◽  
Angiotensin Receptor Blockers ◽  
Real Life ◽  
Clinical Settings ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Prescribing Behaviour ◽  
Receptor Blockers ◽  
Nationwide Surveillance

Background: Angiotensin receptor blockers (ARBs) are amongst the most preferred class of antihypertensive as reported at various evidences or guidelines. However, choice amongst ARBs differs between practicing physicians in real-life scenario. This survey aimed to understand the usage preferences of telmisartan therapy alone and in combination for treating hypertension (HT) among practitioners at various clinical settings in real-life scenario in India.Methods: A cross‑sectional survey was conducted with a pre-validated survey questionnaire consisting of 15 questions pertaining to the telmisartan and its combination usage in HT management. Total 498 registered medical practitioners (mostly physicians and cardiologists) had participated in survey. They were approached for seeking their perception, opinions, and prescribing behaviour. Categorical data was summarized by number (n) and percentage (%) in each category. Data were summarised in frequency tables.Results: Key findings from the data analysed were as follows: Around 20-40% of patients been reported to have co-morbid hypertension and diabetes as reported by the majority of the physicians. Preferred class of drug in patients with hypertension with diabetes reported to be ARB. Around 90.36% of doctors reported that telmisartan was the most preferred ARB in patients with hypertension associated with high cardiovascular risk. Around 90.76% of doctors reported for their preference for telmisartan in patients with hypertension for 24-hr BP control. Around 82.93% of doctors preferred telmisartan in patients with hypertension and stroke/post-MI status.Conclusions: Indian healthcare practitioners prefer telmisartan as the most preferred ARB either alone or in a combination in patients with hypertension, including those with comorbidities.

scholarly journals POS0733 REAL-LIFE PHYSICAL ACTIVITY IN SLE PATIENTS: ASSOCIATIONS WITH FATIGUE AND QUALITY OF SLEEP

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 617.1-617
Author(s):  
H. Wohland ◽  
N. Leuchten ◽  
M. Aringer
Keyword(s):  
Physical Activity ◽  
Sleep Quality ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Real Life ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Fatigue Score ◽  
The Mean

Background:Fatigue is among the top complaints of patients with systemic lupus erythematosus (SLE), but only in part associated with SLE disease activity. Physical activity can help to reduce fatigue and should therefore be recommended to SLE patients. Vice versa, fatigue may arguably lead to reduced physical activity.Objectives:To investigate the extent of physical activity and the perception of fatigue and sleep quality in patients with SLE.Methods:Starting in February 2019, SLE patients were invited to participate in a cross-sectional survey study of fatigue and physical exercise during their routine outpatient clinic visits. Participants filled out a ten-page paper questionnaire focused on physical activity. To evaluate fatigue, we primarily used a 10 cm visual analogue scale (0-100 mm, with 100 meaning most fatigued), but also the FACIT fatigue score (range 0-52). Sleep quality was estimated using grades from 1 (excellent) to 6 (extremely poor).Results:93 SLE patients took part in the study. All patients fulfilled the European League Against Rheumatism/ American College of Rheumatology (EULAR/ACR) 2019 classification criteria for SLE. 91% of the patients were female. Their mean (SD) age was 45.5 (14.3) years and their mean disease duration 12.1 (9.4) years. The mean BMI was 25.2 (5.6). Of all patients, 7.5% had a diagnosis of (secondary) fibromyalgia. The mean fatigue VAS was 32 (27) mm and the mean FACIT fatigue score 35.7 (10.3). As expected, fatigue by VAS and FACIT was correlated (Spearman r=-0.61, p<0.0001). The mean SLEDAI was 1 (1) with a range of 0 to 6. Median glucocorticoid doses were 2 mg prednisolone equivalent, with a range from 0 to 10 mg.Out of 66 patients in payed jobs, 64 (97%) reported details on their working space. One person (2%) worked in a predominanty standing position, 37 (58%) worked in essentially sedentary jobs and 26 (40%) were in positions where they were mildly physically active in part. The mean fatigue VAS was 31 (24) mm for patients with partly active jobs and 27 (30) mm for those in sedentary jobs. Sleep was graded 2.9 (0.9) by those with active and 3.1 (1.3) by those with sedentary jobs.Half of the patients (51%) reported more than one physical recreational activity. 44 (47%) were walking and for five persons (5%) this was the only form of activity. Cycling was reported by 19 patients (20%), 18 of whom also practiced other activities. For transport, 52 (56%) in part chose active modes, such as walking and cycling. Patients who reported any of the above activities showed a mean fatigue VAS of 28 (25) mm, compared to 36 (28) mm in the patient group without a reported activity. Sleep quality was very similar: 3.1 (1.2) and 3.2 (1.1) for more active and more passive patients, respectively.65 (70%) patients regularly practiced sports. Of these, 39 (60%) practiced one kind of sport, 15 (23%) two, 7 (11%) three, and 2 (3%) each four and five kinds of sports. Fatigue VAS of patients practicing sports was 27 (25) mm versus 43 (28) in those who did not (p=0.0075). Sleep quality was 2.9 (1.1) in the sports cohort and 3.5 (1.1) in the no-sports cohort (p=0.0244).Conclusion:A majority of SLE patients in remission or low to moderate disease activity regularly practiced sports, and those doing so reported lesser fatigue and better sleep quality. The absolute values on the fatigue VAS were in a moderate range that made fatigue as the main cause of not performing sports rather unlikely for most patients.Disclosure of Interests:Helena Wohland: None declared, Nicolai Leuchten Speakers bureau: AbbVie, Janssen, Novartis, Roche, UCB, Consultant of: AbbVie, Janssen, Novartis, Roche, Martin Aringer Speakers bureau: AbbVie, Astra Zeneca, BMS, Boehringer Ingelheim, Chugai, Gilead, GSK, HEXAL, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Astra Zeneca, BMS, Boehringer Ingelheim, GSK, Lilly, MSD, Roche, Sanofi, UCB

The mental health of Australian medical practitioners during Covid-19

2021 ◽  
pp. 103985622110108
Author(s):  
Michelle Anne Adams ◽  
Matthew Brazel ◽  
Richard Thomson ◽  
Hannah Lake
Keyword(s):  
Mental Health ◽  
Junior Doctor ◽  
Demographic Factors ◽  
Cross Sectional Survey ◽  
Mental Health Diagnosis ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Psychological Distress Scale ◽  
Distress Scale ◽  
Health Diagnosis

Objectives: To ascertain whether doctors were experiencing higher rates of distress during Covid-19 and whether this was impacted by demographic factors. Our hypotheses were that being a junior doctor, having a previous mental health diagnosis and treating Covid-19 positive patients would predict higher rates of distress. Methods: Cross-sectional survey conducted via Survey Monkey. Voluntary participants were recruited from the mailing list of a national-based referral service for doctors to psychiatrists. Distress was measured using the Kessler Psychological Distress Scale (K10). Demographic factors were analysed for predictive value of a higher rating on the K10. Areas of concern in relation to Covid-19 and preference for support services were measured on a Likert scale and compared to levels of distress. Results: The rate of very high distress was 15%. Being a junior doctor and having a previous mental health diagnosis were predictive factors of a higher K10 score. K10 was not affected by likelihood of contact with Covid-19-positive patients. Social isolation had a larger impact on mental health in the context of a previous psychiatric diagnosis. Face-to-face assessments were preferred. Conclusions: Rates of distress in doctors have been higher than baseline during Covid-19. Some groups have been particularly vulnerable.

scholarly journals To study doctor’s beliefs, barriers, awareness, and actual practices regarding use of generic medicines

2017 ◽  
Vol 6 (8) ◽  
pp. 1871 ◽  
Author(s):  
Venkatesh V. Khadke ◽  
Shahbaz Yasin Khanda
Keyword(s):  
Response Rate ◽  
Tertiary Care ◽  
Generic Medicines ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Exact Test ◽  
Item Questionnaire ◽  
Kap Survey ◽  
Quality Aspects

Background: Government of India is trying to popularize generic medicines, still most Registered Medical Practitioners (RMPs) doubt its quality and efficacy. We conducted a cross sectional survey to study the barriers that hinders the practice of writing generic prescriptions. The aim was to study doctor’s knowledge, beliefs and actual practices regarding generic medicines. This study is a KAP survey model (Knowledge, attitude, practices) to study beliefs, barriers, awareness and actual practices regarding use of generic medicines amongst private practioners and RMPs of tertiary care Government hospital in Nanded city.Methods: A cross sectional survey was conducted on a sample of 300 randomly selected RMPs practicing in Nanded, Maharashtra. A 26-item questionnaire was designed, validated, and data collected through personal visits. Fisher’s exact test was applied to see associations between variables using Graphpad Prism 7.Results: 234 RMPs responded to the questionnaire i.e. a response rate of 78% was achieved. 107 (45.7%) participants claimed to be actively prescribing generic medicines. 122 (52.1%) of the participants were unaware of any generic medical shop in their locality. 83 (35.5%) participants believed generics to be duplicate/ substandard. However, 16 (19.3%) of them still prescribed generics. One-third of them actually preferred its use for family.Conclusions: RMPs do not accept the use of generic medicines for concerns about its quality and efficacy. Also, there was unawareness regarding availability of generic medicines in the locality. RMPs need to be educated about manufacture, sale and quality aspects of generic medicines in India.

scholarly journals An observational cross-sectional study to determine the effect of telmisartan on reducing microalbuminuria in diabetic hypertensive patients in tertiary care teaching hospital, Central India

2017 ◽  
Vol 6 (8) ◽  
pp. 2082
Author(s):  
Santenna Chenchula ◽  
Rupesh Gupta ◽  
Balakrishnan S. ◽  
Akash Vishwe ◽  
Pushparaj Gour ◽  
...  
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Angiotensin Receptor Blockers ◽  
Tertiary Care ◽  
Channel Blockers ◽  
Angiotensin Receptor ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Urine Albumin ◽  
Receptor Blockers

Background: There are many groups of drugs to decrease microalbuminuria like angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), calcium channel blockers and direct vasodilators. Among these, ACEI and ARBs are commonly used for this purpose. If side effects occur, ACEI are replaced with ARBs. Many ARBs have been studied for their effect on reducing microalbuminuria, but data on telmisartan with its additional unique properties are scarce in Indian population.Methods: This cross sectional observational study was carried out in a tertiary care centre. We first measured base line urine albumin levels in included patients, 3 months after treatment with telmisartan using ‘hemocue urine albumin analyser’. We collected and compared both baseline and after treatment data of microalbuminuria and analysed in descriptive statistics.Results: A total of 110 patients participated in this study; out of which 10 patients were excluded from the study because they were not available for follow up. As compared to baseline, urine albumin level decreased by 30.42% after 12 weeks treatment with telmisartan (P <0.001).Conclusions: Microalbuminuria is one of the leading cause of end stage renal disease and coronary heart diseases in diabetic hypertensive patients. Drugs like ACE inhibitors, Angiotensin receptor blockers, Calcium channel blockers and direct vasodilators are used to prevent these complications. In this present study, we concluded that telmisartan decreases urine albumin excretion around 30.42% from baseline after 12 weeks of treatment.

scholarly journals Physical Activity and Attitudes Toward Social Media Use of Active Individuals During the COVID-19 Pandemic in Saudi Arabia: Cross-Sectional Survey

2021 ◽  
Vol 12 ◽  
Author(s):  
Mezna A. AlMarzooqi
Keyword(s):  
Physical Activity ◽  
Social Media ◽  
Saudi Arabia ◽  
Media Use ◽  
Real Life ◽  
Cross Sectional Survey ◽  
Social Media Use ◽  
Cross Sectional ◽  
Physically Active ◽  
Social Media Platforms

Background: Social media became an integral part of the lives of people because it encourages social relations and shares interests, activities, and real-life connections. As quarantine and lockdown orders are prolonged, many people, as well as those physically active individuals, typically responded to this stressful condition by using social media platforms.Objective: This study aimed to examine the level of physical activity of physically active individuals and their attitudes toward social media use during the COVID-19 pandemic.Methods: A descriptive cross-sectional survey was conducted among physically active individuals in Saudi Arabia between June 2020 and July 2020. An online survey was employed among eligible participants who completed a self-administered questionnaire that covered reasons for physical activity and attitudes toward social media platforms during the COVID-19 pandemic.Results: Of these 323 participants, 29.1% were in the age group of 18–24 years, 66.6% were women, and 67.8% were single. The proportion of participants whose metabolic equivalent of tasks-min/week from vigorous activity &lt;1,680 was 31.9%, and all of the participants follow people or pages in social media related to sports teams and fitness models. The average number of hours spent on social media per day was 2.95 ± 0.90 h. The majority of the participants showed positive attitudes toward social media used for exercise and physical activity. Of the eight variables, age, level of physical activity, and the average of hours spent on social media emerged as significant predictors of attitudes toward the use of social media (P &lt; 0.05).Conclusions: The present survey results indicate adverse consequences of home quarantine as reflected by a small proportion of participants who had differences in levels of vigorous activities during the COVID-19 pandemic in Saudi Arabia. Social media appears to be a key avenue to promote and disseminate health interventions to promote physical activity during this COVID-19 pandemic.

scholarly journals Work of Health Educators in a Clinical Setting

2006 ◽  
Vol 4 (1) ◽  
pp. 58-63
Author(s):  
Lisa Smith ◽  
James F. McKenzie
Keyword(s):  
Health Education ◽  
Clinical Setting ◽  
Clinical Settings ◽  
Health Educators ◽  
Education Curriculum ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Content Areas ◽  
Survey Results

This study examined the task of health educators working in a clinical setting to better understand their roles. The study was designed as a descriptive, cross-sectional survey using a convenience sample of health educators who worked in clinical settings in Indiana and who had a college degree in health education. Forty health educators were contacted and 62% of the subjects participated in the survey. Results indicated most jobs were similar in nature and the health education curriculum studied helped them in the roles they were serving. However, many educators felt there were other content areas of study that would have been helpful to prepare them for working in the clinical setting. A majority of the respondents reported that having Certified Health Education Specialist (CHES) certification was helpful and necessary in their positions.

scholarly journals Increase in the proportion of Plasmodium falciparum with kelch13 C580Y mutation and decline in pfcrt and pfmdr1 mutant alleles in Papua New Guinea

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoko Yoshida ◽  
Masato Yamauchi ◽  
Ryosuke Morikawa ◽  
Francis Hombhanje ◽  
Toshihiro Mita
Keyword(s):  
Plasmodium Falciparum ◽  
Papua New Guinea ◽  
New Guinea ◽  
Therapeutic Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
In The Wild ◽  
Nationwide Surveillance ◽  
Greater Mekong Subregion ◽  
C580y Mutation

Abstract Background The C580Y mutation in the Plasmodium falciparum kelch13 gene is the most commonly observed variant in artemisinin-resistant isolates in the Greater Mekong Subregion (GMS). Until 2017, it had not been identified outside the GMS, except for Guyana/Amazonia. In 2017, three parasites carrying the C580Y mutation were identified in Papua New Guinea (PNG). As the C580Y allele rapidly spread in the GMS, there is concern that this mutant is now spreading in PNG. Methods In 2020, a cross-sectional survey was conducted at two clinics in Wewak, PNG. Symptomatic patients infected with P. falciparum were treated with artemether plus lumefantrine following a national treatment policy. Blood samples were obtained before treatment, and polymorphisms in kelch13, pfcrt, and pfmdr1 were determined. Parasite positivity was examined on day 3. The results were compared with those of previous studies conducted in 2002, 2003, and 2016–2018. Results A total of 94 patients were included in this analysis. The proportion of C580Y was significantly increased (2.2% in 2017, 5.7% in 2018, and 6.4% in 2020; p = 4.2 × 10–3). A significant upward trend was observed in the wild-type proportion for pfcrt (1.9% in 2016 to 46.7% in 2020; p = 8.9 × 10–16) and pfmdr1 (59.5% in 2016 to 91.4% in 2020; p = 2.3 × 10–6). Among 27 patients successfully followed on day 3, including three with C580Y infections, none showed positive parasitaemia. Conclusions Under the conditions of significant increases in pfcrt K76 and pfmdr1 N86 alleles in PNG, the increase in kelch13 C580Y mutants may be a warning indicator of the emergence of parasites resistant to the currently used first-line treatment regimen of artemether plus lumefantrine. Therefore, nationwide surveillance of molecular markers for drug resistance and assessment of its therapeutic effects are important.

scholarly journals General practitioner attitudes and confidence to deprescribing for elderly patients

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Pier Riccardo Rossi ◽  
Sarah E. Hegarty ◽  
Vittorio Maio ◽  
Marco Lombardi ◽  
Andrea Pizzini ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Real Life ◽  
Care Physician ◽  
Local Health Authority ◽  
Local Health ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Factors Affecting

Deprescribing is a patient-centered process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required. The objective of this study was to assess the perceptions of primary care physicians on deprescribing and potential barriers to deprescribing in the Local Health Authority (LHA) of Turin, Piedmont, Italy. Secondary objective was to evaluate educational needs of primary care physician. Cross sectional survey of primary care physicians working in the LHA of Turin, Piedmont, Italy. 439 GPs (71.3% of the total number of primary care physicians) attended an educational session related to deprescribing and were asked to anonymously answer a paper survey. Participants were asked to complete a previously published questionnaire about deprescribing and potential factors affecting the deprescribing process. A correlation coefficient was calculated to assess the association between physicians’ confidence in deprescribing and attitudes or barriers associated with deprescribing. Many GPs (71%) reported general confidence in their ability to deprescribe. Most respondents (83%) reported they were comfortable deprescribing preventive medications, however almost half expressed doubts regarding deprescribing when medication was initially prescribed by a colleague (45%) or when patient and/or caregiver supported the opportunity to continue the assumption (49%). Around a third of doctors maintain that the absence of strong evidence supporting deprescribing prevents them from considering it (38%), that they do not have the necessary time to effectively go through the process of deprescribing (29%), and that fear of possible effects due on withdrawal prevents them from deprescribing (31%). There was no strong correlation between physicians’ confidence and attitudes or barriers associated with deprescribing. The present study confirms that general practitioners sense the importance of deprescribing and feel prepared to face it managing communication with patients and caregivers, but find barriers when enacting the practice in a real-life context.

scholarly journals Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jiayao Xu ◽  
Xiaomin Wang ◽  
Kai Sing Sun ◽  
Leesa Lin ◽  
Xudong Zhou
Keyword(s):  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Clinical Settings ◽  
Cross Sectional Survey ◽  
Self Medication ◽  
Cross Sectional ◽  
Prescribing Behavior ◽  
The Past ◽  
Outpatient Settings ◽  
The Impact

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

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