scholarly journals Persistent frequent attenders in primary care: case-control study comparing chronic diseases of five-year and one-year frequent attenders and features of the typical five-year frequent attenders

2019 ◽  
Author(s):  
Anne Santalahti ◽  
Sinikka H. Luutonen ◽  
Tero J. Vahlberg ◽  
Päivi T. Rautava
Keyword(s):  
Heart Failure ◽  
Back Pain ◽  
Treatment Plan ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Chronic Obstructive ◽  
Study Group ◽  
Frequent Attenders ◽  
One Year

Abstract Background Persistent frequent attenders have 10 or more face-to-face visits to a general practitioner (GP) within one year and they continue frequent visits for two years or more. It seems that GPs don´t recognize their persistent frequent attenders. These patients can cause frustration for GPs and furthermore patients don`t seem to get the needed help from GPs. We wanted to find out typical features of persistent frequent attenders and thus help GPs to recognize these patients and even to foresee which patients will most probably become persistent attenders in the future. Methods We used the data of 4,392 frequent attenders (FAs) from the primary healthcare centers of the study city in 2001-2006. The five-year FAs formed the study group. Patient record entries of them were scrutinized and the background variables recorded. The background variables were described in terms of means and standard deviations or frequencies and percentages. Chronic diagnoses in the study group were compared to those of the control group. The control group was randomly selected from the group of the one-year frequent attenders in 2001–2006. Conditional logistic regression was used to compare chronic diagnoses between groups. Results Out of 4,392 FAs in 2001- 2006 19.4% were FAs during two years and 1.1% during five years. In the study group, there were 65% women and 35% men and the gender distribution remained equal throughout the whole follow-up period. Their average age was 51.7 year. The study group had 15.3 self-initiated visits to a GP annually and had significantly more depression (p=0.004), epilepsy (p=0.035), heart failure (p=0.019), asthma (p=0.032), chronic obstructive pulmonary disease (COPD, p=0.036) and back pain/lumbago (p=0.046) compared to the control group. Patients in the study group were referred to secondary care, on average, 20.1 times per person. Conclusion We found out that a typical persistent frequent attender was a woman at the age of 55 who had depression, low back pain, heart failure, asthma or COPD. When a GP notices this kind of a patient it might be wisdom to have extra effort with the patient and make a follow-up and treatment plan together.

scholarly journals Depression risk in patients with heart failure in primary care practices in Germany

2016 ◽  
Vol 28 (11) ◽  
pp. 1889-1894
Author(s):  
Marcel Konrad ◽  
Jens Bohlken ◽  
Michael A Rapp ◽  
Karel Kostev
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Health Insurance ◽  
Control Group ◽  
Patients With Heart Failure ◽  
Study Population ◽  
Care Practices ◽  
One Year ◽  
Primary Care Practices

ABSTRACTBackground:The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices.Methods:This study was a retrospective database analysis in Germany utilizing the Disease Analyzer® Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices. The observation period was between 2004 and 2013. Follow-up lasted up to five years and ended in April 2015. A total of 66,497 HF patients were selected after applying exclusion criteria. The same number of 66,497 controls were chosen and were matched (1:1) to HF patients on the basis of age, sex, health insurance, depression diagnosis in the past, and follow-up duration after index date.Results:HF was a strong risk factor for diagnosed depression (p < 0.0001). A total of 10.5% of HF patients and 6.3% of matched controls developed depression after one year of follow-up (p < 0.001). Depression was documented in 28.9% of the HF group and 18.2% of the control group after the five-year follow-up (p < 0.001). Cancer, dementia, osteoporosis, stroke, and osteoarthritis were associated with a higher risk of developing depression. Male gender and private health insurance were associated with lower risk of depression.Conclusions:The risk of diagnosed depression is significantly increased in patients with HF compared to patients without HF in primary care practices in Germany.

HOW “MILD” IS MILD TRAUMATIC BRAIN INJURY (MTBI)? A PROSPECTIVE STUDY WITH ONE-YEAR FOLLOW-UP ON SYMPTOMATOLOGY, COGNITION, DISABILITY AND LIFE SATISFACTION AFTER HEAD INJURY.

2021 ◽  
pp. 1-5
Author(s):  
Abhishek Chaturbedi
Keyword(s):  
Life Satisfaction ◽  
Healthy Control Group ◽  
Acute Injury ◽  
Control Group ◽  
Study Group ◽  
Post Injury ◽  
Healthy Control ◽  
One Year ◽  
A Prospective Study

Objective: To determine cognitive functions, symptoms, disabilities and life satisfaction of patients with rst time concussed patients during acute injury and subsequent follow-up visits (3, 6 and 12 months). Materials and Methods: One hundred patients with single mTBI answered questionnaires about symptoms, disabilities (RHFUQ) and life satisfaction (LiSat-11) apart from neuropsychological evaluation at each subsequent follow-up (F/U) visits. Fifty healthy control subjects also underwent same tests for comparison with study group (mTBI patients). Results: At1year post-injury: 21% had persistent post-concussion symptoms (PCS), with statistically signicant difference between the number of symptoms at 1 year F/U visit for study group (4.8 ± 1.8) and the healthy control group (1.3 ± 0.8), (p= 0.03). The total RHFUQ score (13.0 ± 8.8) was statistically signicant compared to the control group (3.2 ± 2.3), (p <0.001). The number of disability items in the study group (5.4 ± 2.8) was also signicant compared with the healthy control group (1.1± 0.6) with p <0.001. The study group exhibited statistically signicant (p=0.01) lower level of life satisfaction (40.8 ± 9.5) compared with the control group (56.7 ± 11.5). In the study group, the number of cognitive tests with outcomes below cut-off limits (± 2SD) was statistically signicant compared with control group. Conclusion: The high frequency of persistent PCS, disabilities along with lower level of life satisfaction and decline in cognitive function appears to characterize single mTBI patients in our study at 1 year post-injury. This highlights the need to carefully evaluate a single mTBI for long-term implications.

Abstract WP258: Effectiveness of Detection Asymptomatic Episodes of Atrial Fibrillation in Heart Failure Patients With Cardioverter Defibrillator

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Barbara Dominik ◽  
Wojciech Zorawski ◽  
Ilona Kowalik ◽  
Adam Ciesielski ◽  
Przemyslaw Mitkowski
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiac Resynchronisation Therapy ◽  
Study Group ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillator ◽  
Intracardiac Electrogram ◽  
Significant Difference ◽  
One Year

Introduction: Implantable cardioverter defibrillators due to the possibility of continuous recording of intracardiac electrograms can detect episodes of atrial fibrillation. In practice, this allows better identification of patients with asymptomatic AF episodes, thus increasing the proportion of patients who may benefit from pharmacological prophylaxis of thromboembolic events, particularly stroke. Hypothesis: If intracardiac electrogram analysis should be part of each visit carried out in patients with implantable cardioverter defibrillator, how much of detected episodes of atrial fibrillation is asymptomatic. Methods: The study included 174 consecutive outpatient cases with heart failure, sinus rhythm and implanted Cardioverter Defibrillator and Cardiac Resynchronisation Therapy with Defibrillator. Control visits with analysis intracardiac electrograms records occurred every three months. Each AF episode stored in the device’s memory lasting at least 30 seconds was considered an episode of atrial fibrillation. A symptomatic episode was considered when arrhythmia led to ICD shock, heart deterioration, collapse or fainting, palpitations, weakness, chest pain or shortness of breath accompanied by a feeling of irregular heartbeat. During mean follow-up of 20 months, 901 visits were carried out. 147 patients had at least one year of follow-up. Results: Atrial fibrillation (AF) episodes in the study occurred in 54 (31.0%) patients. Of the 241 atrial fibrillation episodes recorded in the device’s memory, 71.4% were asymptomatic. There was no statistically significant difference in the incidence of new episodes of atrial fibrillation (P = 0.384) in the study group with a history of stroke or transient ischemic episodes during follow-up. However, asymptomatic AF episodes were more common in stroke patients (P = 0.0074). In the time of observation in the whole group of patients there were no new strokes and transient ischemic attack. Conclusion: In conclusion, detection of asymptomatic atrial fibrillation episodes based on intracardiac electrocardiogram records is effective method. In the study group, such episodes were up 71.4% of all newly detected AF episodes.

RELATED FACTORS TO RELAPSE IN DEPRESSED PATIENTS AFTER COGNITIVE BEHAVIOURAL THERAPY DURING ONE YEAR PROSPECTIVE FOLLOW-UP

2011 ◽  
pp. 13-19
Author(s):  
Nhu Minh Hang Tran ◽  
Huu Cat Nguyen ◽  
Dang Doanh Nguyen ◽  
Van Luong Ngo ◽  
Vu Hoang Nguyen ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Relapse Rate ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Related Factors ◽  
Depressed Patients ◽  
One Year

Objectives: To determine factors impact on the relapse in depressed patients treated with Cognitive Behavioral Therapy (CBT) during one year follow-up. Materials and Methods: 80 depressed patients divided into two groups, group 1: included 40 patients treated with CBT; group 2: 40 patients on amitriptyline. Non-randomized controlled clinical trial, opened, longiditual and prospective research. Results and Conclusions: relapse rate after CBT during 1 year follow-up is 10% (compared to 25% in control group), related factors to relapse rate in depression after CBT are age and education. Shared predictors between 2 groups are severity and recurrence of depression. Key words: Depression, relapse, Cognitive Behavioral Therapy (CBT)

scholarly journals Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska
Keyword(s):  
Systemic Sclerosis ◽  
Hand Function ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Home Exercise ◽  
Control Group ◽  
Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

scholarly journals THU0254 Risk factors for back pain in a cross sectional and in a one-year follow up study in nurses

2001 ◽  
Author(s):  
M Brzosko ◽  
I Fiedorowicz-Fabrycy ◽  
J Fliciñski ◽  
H Przepiera-Bêdzak ◽  
K Prajs
Keyword(s):  
Risk Factors ◽  
Back Pain ◽  
Cross Sectional ◽  
Follow Up Study ◽  
One Year
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