Design and rationale of NATURE-HTN: the NAtional Tunisian REgistry of HyperTensioN (Preprint)

2020 ◽  
Author(s):  
Leila Abid ◽  
Salem Abdesselem ◽  
Rania Hammami ◽  
Hedi Ben Slima ◽  
Khaled Sayahi ◽  
...  

BACKGROUND The present study was designed to evaluate the care of hypertensive patients in daily clinical practice in public and private centers in all Tunisian regions. It will allow us to have an overview of the Tunisian hypertensive patient in order to optimize treatment and to know the degree of adherence of practitioners to international recommendations in the care of the hypertension in Tunisia. OBJECTIVE he present study was designed to evaluate the care of hypertensive patients in daily clinical practice in public and private centers in all Tunisian regions. METHODS National, observational, cross-sectional, and multicenter study that will include patients older than 18 years with hypertension for duration of 4 weeks, following up in public and private centers and after signing a consent form. The study will exclude patients undergoing dialysis. The parameters that will be evaluated include demographic and anthropometric data, lifestyle habits, BP levels, lipid profile, treatment and adherence to treatment. The data are collected via the DACIMA Clinical Suite® web interface. RESULTS At the end of the study, we will find the demographic and anthropometric characteristics of the patients, their past medical history, clinical features and their paraclinical exploratory characteristics (biology, EKG and / or holter blood pressure, transthoracic echocardiography (TTE),). We will provide a description of the therapeutic environment and of adverse events occurring during medical treatment and recommendations. CONCLUSIONS We will provide a description of the therapeutic environment and of adverse events occurring during medical treatment and recommendations. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT04013503.

2021 ◽  
Vol 31 (5) ◽  
pp. 613-626
Author(s):  
Vladimir V. Arkhipov ◽  
Zaurbek R. Aisanov ◽  
Sergey N. Avdeev

Asthma management approaches are improving yearly, but the problem of asthma control is still acute. Combinations of inhaled glucocorticosteroids (ICS) and long-acting β2-agonists (LABA) play a crucial role in asthma therapy, but their effectiveness in real practice can be insufficient, and asthma control level in the population remains low. Optimizing the use of these drugs, changing the usual therapy regimens, and implementing upgraded inhalers can improve adherence to treatment and inhalation technique, which affects the effectiveness of the therapy.The study aimed to describe the key characteristics of the patient population getting asthma treatment in real clinical practice and assess factors influencing asthma control, including adherence to therapy.Methods. A single-stage cross-sectional observational study in 124 primary health care centers in 22 cities of the Russian Federation included 3,214 patients > 18 years old, with a clinical diagnosis of asthma for at least 1 year, who were able to perform a spirometry test and fill out the ACQ-5 and TAI-12 questionnaires.Results. Assessment of asthma control with the ACQ-5 questionnaire showed that most patients had uncontrolled asthma (56%). Controlled and partially controlled asthma was diagnosed in 21 and 19% of patients, respectively. 4% of patients had severe uncontrolled asthma. The TAI questionnaire revealed low adherence to therapy in more than half of the patients (53.6%). The rate of patients with controlled asthma and the average annual frequency of exacerbations were significantly lower in subgroups of patients who received therapy with extrafine ICS/LABA and ICS/formoterol in single inhaler regimen, compared with controller therapy using fixed and free combinations of ICS and LABA.Conclusion. The main causes of insufficient asthma control are low adherence to treatment, inhalation errors, monotherapy with ICS, asthma with small airways dysfunction, and adverse events associated with ICS. Prescribing the combinations of ICS/LABA in the form of extra-fine aerosol and using it in the Maintenance and Reliever Therapy (MART) regimen can significantly increase asthma control, reduce the risk of adverse events, and increase patient adherence to treatment. A potential alternative to improve asthma control is administering ICS-LABA combinations once daily.


1970 ◽  
Vol 1 ◽  
pp. 19-26
Author(s):  
D Sarkar ◽  
SA Latif ◽  
J Aich ◽  
MM Uddin

Objectives: To assess the serum creatinine and creatinine clearance values in hypertensive patients for providing information to the health-policy planners, clinical practitioners about the importance of routine monitoring of serum creatinine and creatinine clearance in hypertensive patients for prevention of ESRD and other consequences to combat morbidity and mortality and to reinforce the need to consider these parameters in daily clinical practice. Study design: It was a cross-sectional study. Setting: The study was conducted at Department of Physiology and Biochemistry of Mymensingh Medical College, Medicine Unit of Mymensingh Medical College Hospital. Study period: The period of the study was January 2005 to December 2005. Participants: A total number of seventy subjects were included in this study. Out of 70 subjects, 40 (forty) were hypertensive patients and 30 (thirty) were normotensive & healthy controls. Intervention: The subjects were selected on the basis of history and clinical examination. Convenient sampling technique was applied. During visit the available hypertensive patients and controls (normotensive & healthy) those who were present were selected. Having received their written consent they were interviewed & examined by prepared personal data sheet and sample of blood (after overnight fasting) was drawn for biochemical examination. Main outcome measure: Mean values of serum creatinine and creatinine clearance. Result: Serum creatinine was greater in hypertensive than those of normotensive. Creatinine clearance was less in hypertensive than those of normotensive. Serum creatinine & creatinine clearance in between males hypertensive & control shows that CrCl were statistically significant but not the serum creatinine. In females of hypertensive & control shows no differences in case of SCr & CrCl. Among 40 hypertensive the number of “Getting treatment - regular” & “ Getting treatment-irregular” was 14 (35%) & 26 (65%) respectively. Similarly in patients “suffering less than 5 yrs” and “suffering 5 yrs & above” the differences are also not statistically significant. Conclusion: The observations of this study revealed that most of the hypertensive patients were taking treatment irregularly and there was significant alteration of biochemical parameters in hypertensive patients. Therefore, for routine monitoring of hypertensive patients to prevent the end stage renal disease (ESRD) and other consequences, the reinforcement of the investigations of these parameters may be recommended in daily clinical practice. Key Words: Hypertension, creatinine, creatinine clearance, Cockcroft-Gault formula J Bangladesh Soc Physiol. 2006 Dec;(1):19-26.


Author(s):  
Morgane Guillou-Landreat ◽  
Antoine Dany ◽  
Gaëlle Challet-Bouju ◽  
Edouard Laforgue ◽  
Juliette Leboucher ◽  
...  

(1) Background: Opioid use disorder (OUD) is a complex condition that can require long-term treatment. Pharmacological therapy for OUD involves treatment with opioid agonists (OMT) tailored to individual profiles. The aim of our study in daily clinical practice was to compare the profiles of patients treated with methadone (MTD) and those using buprenorphine (BHD or BHD-naloxone-NX). (2) Methods: A cross-sectional multicentre study explored the psychological, somatic and social profiles of patients with Opioid Use Disorder (OUD) following Opioid Maintenance Treatment (BHD, BHD/NX, or MTD). Descriptive and comparative analyses were performed (3) Results: 257 patients were included, a majority were men using heroin. 68% (178) were on MTD, 32% (79) were on BHD. Patients with MTD were significantly more likely to report socio-affective damage, and more likely to be younger and not to report oral or sublingual use as the main route for heroin or non-medical opioids (4) Conclusions: In daily clinical practice, regarding OUD damage, only socio-affective damage was significantly more prevalent among patients on MTD than among those on BHD in the multivariate model. Age and route of administration also differed, and our results could raise the issue of the type of OMT prescribed in case of non-medical use of prescribed opioids. These hypothesis should be confirmed in larger studies.


2021 ◽  
Vol 15 (8) ◽  
pp. 1858-1860
Author(s):  
Junaid Mushtaq ◽  
Israr-Ul- Haq ◽  
Waqas Mahmood ◽  
Mujtaba H. Siddiqui ◽  
Atiq Ahmad ◽  
...  

Aim: To determine the factors that affect compliance and adherence to medications of hypertensive patients visiting OPD clinics. Study design: Descriptive-cross sectional study. Place and duration of study: Department of Medicine, Unit 1, Lahore General Hospital, Doctors Hospital & Medical Center and Farooq Hospital Lahore from 1st January 2019 to 31st December 2019. Methodology: One hundred and sixty five patients with hypertension were handed over questionnaire socio-demographic, compliance and adherence were recorded. Results: Patients who maintained BP charting were only 13(7.9%) and those without BP charting were 152(92.1%). Patients taking regular medications were only 20(12.1%). Forgetfulness in taking medications was found in 47.3% of patients. 20.6% of patients were unable to purchase medicines because of financial reasons. Thirty two patients (19.4%) thought that they should not take medicines as they were not having any symptoms. Conclusion: Major causes of non-adherence were expense of medications, lack of symptoms, lack of money, forgetfulness, lack of awareness due to poor educational status and nature of job. Keywords: Compliance, Adherence, Medications, Hypertension, Forgetfulness


2019 ◽  
Vol 10 (5) ◽  
pp. 1
Author(s):  
Connie Berthelsen ◽  
Bente Martinsen ◽  
Marianne Vamosi

Objective: To describe Master of Science in Nursing students’ expectations to participate in nursing research-related tasks in daily clinical practice after completing their education.Methods: To support this assumption a descriptive cross-sectional study was conducted to describe Master of Science in nursing students’ expectations to participate in nursing research-related tasks in daily clinical practice after completing their education. Data were collected using a 41-item structured questionnaire.Results: A convenience sample of Master of Science in Nursing students (n = 116) was recruited during their third semester and 92 (79.3%) students replied the questionnaire. The results showed how 91.3% of the students expressed high expectations regarding their possibilities for participation in nursing research-related tasks in clinical practice. However, 64.1% doubted that time and resources would be allocated to nursing research.Conclusions: The key motivator for the students was to improve patient care, further develop clinical practice, and strengthen the nursing profession. However, the literature suggests that colleagues and the nursing management in clinical practice impose certain barriers that prevent nurses from participating in research.


2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Perez-Sosa Abigail M ◽  

Background: Diabetes mellitus 2 (T2D) is the leading cause of morbidity and mortality in northern Mexico. Various treatments are used to control the disease; however, the cost of these and the difficulty of dietary management have as a consequence that the patient abandons them and looks for cheaper and easier-to-use alternatives. Aim: The purpose of this study is to determine the relationship between the use of alternative medicine and adherence to medical treatment in patients with T2D. Design and Setting: Analytic cross-sectional study. Methods: An analytical cross-sectional study was designed between March and July 2019 including 464 patients with T2D from the family medicine unit #48 Ciudad Juarez, Mexico. We used the Morisky-Green scale for adherence to treatment and the use of Alternative Medicine (CAM) was evaluated with a holistic complementary and alternative medicine questionnaire. The Chi-Square test was used for comparison of proportions and risk factors were calculated using odds ratio with 95% confidence intervals. Results: 53% of patients use CAM; biological therapy (herbs and supplements) is the most frequent (94%). The association between CAM use and adherence to medical treatment was 2.1 (95% CI 1.4-3.1, p= 0.001). The risk factors for the use of CAM were female sex, basic level education, uncontrolled disease and a time of evolution greater than 10 years. Conclusion: CAM users are 2.1 times more at risk of having a regular or bad adherence to medical treatment.


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