Patients’ perspectives about their treatment in cardiovascular diseases and mental disorders (Preprint)

2021 ◽  
Author(s):  
Philippe Courtet ◽  
Catherine Pecout ◽  
Anne-Félice Lainé-Pellet ◽  
Michael Chekroun ◽  
Charlotte Avril ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Disease Management ◽  
Mental Disorders ◽  
Mental Disorder ◽  
World Health ◽  
Inclusion Criteria ◽  
Therapeutic Adherence ◽  
Number Of Patients ◽  
The Impact

BACKGROUND Non-communicable diseases (NCDs) account for 71% of deaths worldwide. The World Health Organization has recently developed a global action plan to address the impact of NCDs, with a goal of reducing the number of premature NCD-related deaths to 25% by the year 2025. Appropriate therapeutic adherence is critical for effective disease management; however, approximately 30-50% of patients with an NCD do not comply with disease management activities as prescribed. Online patient communities can represent a platform from which to gather specific information outside of a clinical trial setting on patient perception of treatment adherence. OBJECTIVE This study aimed to better understand patient perspectives regarding therapeutic adherence and iatrogenic risk in two major groups of NCDs for which poor disease management can have fatal consequences: cardiovascular diseases and mental disorders. Therapeutic adherence, motivational factors, patient awareness and perception of iatrogenesis, and treatment tools used by patients were assessed. METHODS An online survey was performed among patients with cardiovascular diseases and/or mental disorders who were registered on the French Carenity platform, an online community in which patients with an NCD can share experiences and receive support and information. The study inclusion criteria were defined as follows: adults with a diagnosis of cardiovascular disease and/or mental disorder, ≥18 years of age, residing in France, registered on the French Carenity platform and undergoing pharmaceutical treatment for their illness. The patients that met the inclusion criteria were then invited to complete a self-administered online questionnaire, which included questions addressing therapeutic adherence and iatrogenic risk. RESULTS A total of 820 patients were enrolled in the study which included patients with cardiovascular diseases (403/820, 49.2%), mental disorders (292/820, 35.6%), and both (125/820, 15.2%). The mean age of the participants was 55.2±12.7 years. It was found that 82.8% (679/820) of patients experienced medication side effects. Patients tended to perceive themselves as more adherent than they actually were, as a significant number of patients disregarded their prescription and stopped or interrupted a medication without consulting with a doctor. Patients with cardiovascular disease were nearly twice as adherent as patients with a mental disorder (P≤.001). Gender, age, and treatment complexity were significantly associated with adherence. Finally, for each disease type, three patient profiles were identified that provide significant insight to improve therapeutic adherence and adapt strategies specifically according to patient behavior. CONCLUSIONS This study provides insight into the perspectives of patients undergoing therapy for cardiovascular disease and/or mental disorder, which could help to improve the management of NCDs and prevent premature death. Our study also shows that online patient platforms provide new opportunities to improve disease management based on patient experiences.

scholarly journals Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph K. Akyea ◽  
Nadeem Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
World Health ◽  
Obese Adults ◽  
Bmi Trajectories ◽  
The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

scholarly journals Clinicopathological features of Egyptian colorectal cancer patients regarding somatic genetic mutations especially in KRAS gene and microsatellite instability status: a pilot study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Neemat M. Kassem ◽  
Gamal Emera ◽  
Hebatallah A. Kassem ◽  
Nashwa Medhat ◽  
Basant Nagdy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Cpg Island ◽  
Human Cancer ◽  
Statistical Significance ◽  
Public Health Problem ◽  
World Health ◽  
Cpg Island Methylator Phenotype ◽  
Number Of Patients ◽  
The Impact

Abstract Background Colorectal cancer (CRC) is the third most common cause of cancer-related deaths which contributes to a significant public health problem worldwide with 1.8 million new cases and almost 861,000 deaths in 2018 according to the World Health Organization. It exhibits 7.4% of all diagnosed cancer cases in the region of the Middle East and North Africa. Molecular changes that happen in CRCs are chromosomal instability, microsatellite instability (MSI), and CpG island methylator phenotype. The human RAS family (KRAS, NRAS, and HRAS) is the most frequently mutated oncogenes in human cancer appearing in 45% of colon cancers. Determining MSI status across CRCs offers the opportunity to identify patients who are likely to respond to targeted therapies such as anti-PD-1. Therefore, a method to efficiently determine MSI status for every cancer patient is needed. Results KRAS mutations were detected in 31.6% of CRC patients, namely in older patients (p = 0.003). Codons 12 and 13 constituted 5/6 (83.3%) and 1/6 (16.7%) of all KRAS mutations, respectively. We found three mutations G12D, G12C, and G13D which occur as a result of substitution at c.35G>A, c.34G>T, and c.38G>A and have been detected in 4/6 (66.6%), 1/6 (16.7%), and 1/6 (16.7%) patients, respectively. Eleven (57.9%) patients had microsatellite instability-high (MSI-H) CRC. A higher percentage of MSI-H CRC was detected in female patients (p = 0.048). Eight patients had both MSI-H CRC and wild KRAS mutation with no statistical significance was found between MSI status and KRAS mutation in these studied patients. Conclusion In conclusion, considering that KRAS mutations confer resistance to EGFR inhibitors, patients who have CRC with KRAS mutation could receive more tailored management by defining MSI status. MSI-high patients have enhanced responsiveness to anti-PD-1 therapies. Thus, the question arises as to whether it is worth investigating this association in the routine clinical setting or not. Further studies with a larger number of patients are needed to assess the impact of MSI status on Egyptian CRC care.

The impact of stigma and discrimination on the quality of life and social disability in persons with a diagnosis of mental disorder. A pilot study

2017 ◽  
Vol 41 (S1) ◽  
pp. S571-S571
Author(s):  
T.M. Gondek ◽  
K. Kotowicz ◽  
A. Kiejna
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Public Information ◽  
Scientific Data ◽  
Social Disability ◽  
Stigma And Discrimination ◽  
The Impact

Stigma and discrimination of persons diagnosed with mental disorder is a common issue. In many European countries, research studies on the prevalence and implications of this problem are conducted in order to better understand how to overcome it. In Poland, there is a scarcity of such studies, what results in neglecting this issue by the policy makers. The objective of the study is to assess the prevalence of stigma and discrimination affecting the patients hospitalized in psychiatric day units and in-patient wards between 2016–2017 as well as to analyze the relationship between the stigma and the quality of life and social disability in persons with a mental disorder diagnosis of F20–F48 according to ICD-10, aged 18–65, in a day ward and an in-patient ward settings. The pilot study presents the data gathered from a preliminary sample of 20 patients of both genders diagnosed with the aforementioned mental disorders, equaling 10 per cent of the targeted total study sample. The quality of life is assessed with WHOQOL-Bref, WHO-5 questionnaire and Rosenberg self-esteem scale, while social disability is measured with the second version of the Groningen Social Disabilities Schedule. The assessment of the impact of stigma on the social disability of persons with mental disorders and their quality of life can be useful in the context of developing evidence-based interventions for these persons, while it could also provide the scientific data to support public information campaigns aiming at tackling the stigma against persons with mental disorders in Poland.Disclosure of InterestThe authors have not supplied their declaration of competing interest.

A systematic review of adverse childhood experiences (ACEs) with people with intellectual disabilities: an unsafe gap in the literature

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chloe Crompton ◽  
Bethany Duncan ◽  
Graham Simpson-Adkins
Keyword(s):  
Systematic Review ◽  
Intellectual Disabilities ◽  
Adverse Childhood Experiences ◽  
World Health ◽  
Inclusion Criteria ◽  
Childhood Experiences ◽  
Content Type ◽  
Adverse Childhood ◽  
People With Intellectual Disabilities ◽  
The Impact

Purpose This paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority. Design/methodology/approach Published studies were identified from electronic database searches. Key journals and reference lists were also hand searched. Findings Two studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions. Originality/value This appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.

scholarly journals Cardiovascular Disease Prediction using Data Mining Techniques

2017 ◽  
Vol 10 (2) ◽  
pp. 520-528 ◽  
Author(s):  
Mudasir Kirmani
Keyword(s):  
Data Mining ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Learning Algorithm ◽  
Heart Diseases ◽  
Circulatory System ◽  
World Health ◽  
Support Vector ◽  
Predictive Tool

Cardiovascular disease represents various diseases associated with heart, lymphatic system and circulatory system of human body. World Health Organisation (WHO) has reported that cardiovascular diseases have high mortality rate and high risk to cause various disabilities. Most prevalent causes for cardiovascular diseases are behavioural and food habits like tobacco intake, unhealthy diet and obesity, physical inactivity, ageing and addiction to drugs and alcohol are to name few. Factors such as hypertension, diabetes, hyperlipidemia, Stress and other ailments are at high risk to cardiovascular diseases. There have been different techniques to predict the prevalence of cardiovascular diseases in general and heart disease in particular from time to time by implementing variety of algorithms. Detection and management of cardiovascular diseases can be achieved by using computer based predictive tool in data mining. By implementing data mining based techniques there is scope for better and reliable prediction and diagnosis of heart diseases. In this study we studied various available techniques like decision Tree and its variants, Naive Bayes, Neural Networks, Support Vector Machine, Fuzzy Rules, Genetic Algorithms, and Ant Colony Optimization to name few. The observations illustrated that it is difficult to name a single machine learning algorithm for the diagnosis and prognosis of CVD. The study further contemplates on the behaviour, selection and number of factors required for efficient prediction.

scholarly journals The Impact of Debt Burden on the Number of Suicides in the Russian Regions

2021 ◽  
Vol 17 (4) ◽  
pp. 97-117
Author(s):  
Svetlana Doroshenko ◽  
◽  
Olga Sanaeva ◽  
◽  
Keyword(s):  
Mental Disorders ◽  
Unemployment Rate ◽  
Rural Areas ◽  
Negative Impact ◽  
Generalized Method Of Moments ◽  
Russian Regions ◽  
Debt Burden ◽  
Suicide Rates ◽  
Number Of Patients ◽  
The Impact

Population size is one of the most important parameters of national social and economic systems. This parameter is controlled by a variety of factors (components) that form ambiguous and complex feedback circuits. The most important issue is the study of the behavioral reactions of the population, which form certain parameters of the dynamics of the population. The authors consider only one behavioral reaction that seems to them to be important – the propensity for suicide, which ultimately leads to the formation of the suicide dynamics and which entails serious socio-economic and demographic losses. We put an emphasis on assessing the impact of financial parameters, namely households’ debt burden, on the suicide rates in the Russian regions. An econometric assessment of the influence of individual debt on the number of suicides among other socio-economic factors (unemployment rate, logarithm of GRP per capita, divorce rate, number of patients with mental disorders, average actual working week, number of alcoholics) was carried out for the regions among rural, urban populations and total. We use panel data for 80 Russian regions covering the period from 2005 to 2018. We apply the generalized method of moments (GMM) using Stata 14 statistical package. The empirical analysis demonstrates negative impact of the amount of individual debt on the number of suicides in the regions of Russia, which contradicts the results of similar studies conducted for developed economies. At the same time, some results obtained earlier in domestic and foreign studies have been confirmed, including an existence of a parabolic (U-shaped) dependence between the length of working hours and the suicide rates in the regions of the Russian Federation. In addition, there is a direct connection between an increase in the committed suicides and an increase in divorce rates and the number of patients with mental disorders. Moreover, we find out that the rise in unemployment rate and alcohol consumption leads to an increase in the number of committed suicides. This effect is especially perceptible among the people living in rural areas

scholarly journals Economic burden of silent mental disorders: a case study of agnosia in schizophrenia

2017 ◽  
Vol 5 (1) ◽  
pp. 401
Author(s):  
Vijay Kumar Chattu ◽  
Paula Mahon
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mental Health Problems ◽  
Action Plan ◽  
Developed Countries ◽  
World Health ◽  
Economic Output ◽  
The World

Mental health problems affect society as a whole, and not just a small, isolated segment. In developed countries with well-organized healthcare systems, between 44% and 70% of patients with mental disorders do not receive treatment whereas in developing countries the treatment gap being close to 90%. Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. People with schizophrenia are 2-2.5 times more likely to die early than the general population. The case study highlights about agnosia in a schizophrenic patient in a primary care setting and how to address the management at a broader perspective using the appropriate antipsychotic medication and ensuring the support from a family without violating the human rights of the patient. The World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16 trillion over the next 20 years, equivalent to more than 1% of the global gross domestic product. Mental health should be a concern for all of us, rather than only for those who suffer from a mental disorder. The mental health action plan 2013-2020, endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the action plan is to shift services from institutions to the community. Mental health must be considered a focus of renewed investment not just in terms of human development and dignity but also in terms of social and economic development.

scholarly journals Associations between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample

2010 ◽  
Vol 55 (4) ◽  
pp. 239-247 ◽  
Author(s):  
Natalie P Mota ◽  
Margaret Burnett ◽  
Jitender Sareen
Keyword(s):  
Substance Use ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Representative Sample ◽  
Suicide Attempts ◽  
World Health ◽  
Population Attributable Fractions ◽  
Attributable Fractions ◽  
Nationally Representative

Objective: Most previous studies that have investigated the relation between abortion and mental illness have presented mixed findings. We examined the relation between abortion, mental disorders, and suicidality using a US nationally representative sample. Methods: Data came from the National Comorbidity Survey Replication ( n = 3310 women, aged 18 years and older). The World Health Organization-Composite International Diagnostic Interview was used to assess mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and lifetime abortion in women. Multiple logistic regression analyses were employed to examine associations between abortion and lifetime mood, anxiety, substance use, eating, and disruptive behaviour disorders, as well as suicidal ideation and suicide attempts. We calculated the percentage of respondents whose mental disorder came after the first abortion. The role of violence was also explored. Population attributable fractions were calculated for significant associations between abortion and mental disorders. Results: After adjusting for sociodemographics, abortion was associated with an increased likelihood of several mental disorders—mood disorders (adjusted odds ratio [AOR] ranging from 1.75 to 1.91), anxiety disorders (AOR ranging from 1.87 to 1.91), substance use disorders (AOR ranging from 3.14 to 4.99), as well as suicidal ideation and suicide attempts (AOR ranging from 1.97 to 2.18). Adjusting for violence weakened some of these associations. Forall disorders examined, less than one-half of women reported that their mental disorder had begun after the first abortion. Population attributable fractions ranged from 5.8% (suicidal ideation) to 24.7% (drug abuse). Conclusions: Our study confirms a strong association between abortion and mental disorders. Possible mechanisms of this relation are discussed.

The scale of the problem

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mental Health Problems ◽  
Clinical Medicine ◽  
Well Being ◽  
World Health ◽  
The Social ◽  
Definition Of ◽  
Health Organization

One in four individuals suffer from a psychiatric disorder at some point in their life, with 15– 20 per cent fitting cri­teria for a mental disorder at any given time. The latter corresponds to around 450 million people worldwide, placing mental disorders as one of the leading causes of global morbidity. Mental health problems represent five of the ten leading causes of disability worldwide. The World Health Organization (WHO) reported in mid 2016 that ‘the global cost of mental illness is £651 billion per year’, stating that the equivalent of 50 million working years was being lost annually due to mental disorders. The financial global impact is clearly vast, but on a smaller scale, the social and psychological impacts of having a mental dis­order on yourself or your family are greater still. It is often difficult for the general public and clin­icians outside psychiatry to think of mental health dis­orders as ‘diseases’ because it is harder to pinpoint a specific pathological cause for them. When confronted with this view, it is helpful to consider that most of medicine was actually founded on this basis. For ex­ample, although medicine has been a profession for the past 2500 years, it was only in the late 1980s that Helicobacter pylori was linked to gastric/ duodenal ul­cers and gastric carcinoma, or more recently still that the BRCA genes were found to be a cause of breast cancer. Still much of clinical medicine treats a patient’s symptoms rather than objective abnormalities. The WHO has given the following definition of mental health:… Mental health is defined as a state of well- being in which every individual realizes his or her own po­tential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.… This is a helpful definition, because it clearly defines a mental disorder as a condition that disrupts this state in any way, and sets clear goals of treatment for the clinician. It identifies the fact that a disruption of an individual’s mental health impacts negatively not only upon their enjoyment and ability to cope with life, but also upon that of the wider community.

scholarly journals The impact of lower urinary tract symptomatology on urine volumes in stone formers

2018 ◽  
Vol 13 (8) ◽  
Author(s):  
Nathan Y. Hoy ◽  
Nick S. Dean ◽  
Jeremy Wu ◽  
Timothy A. Wollin ◽  
Shubha K. De
Keyword(s):  
Urinary Tract ◽  
Urine Output ◽  
Lower Urinary Tract ◽  
Urine Volume ◽  
Urine Collection ◽  
Inclusion Criteria ◽  
Stone Formers ◽  
Number Of Patients ◽  
The Impact ◽  
Lower Urinary

Introduction: We aimed to determine if there is a correlation between International Prostate Symptom scores (IPSS) and 24-hour urine collection volumes, as patients experiencing lower urinary tract symptoms (LUTS) may have impaired ability to increase fluid intake for stone prevention.Methods: We conducted a single-centre, retrospective review was performed of stone-formers presenting from 2014‒2016. Inclusion criteria were completion of an IPSS questionnaire and a 24-hour urine collection. Exclusion criteria included symptomatic stone or urinary tract infection at time of IPSS completion, inadequate 24-hour collection, or incomplete IPSS questionnaire.Results: A total of 131 patients met inclusion criteria. Stratification by IPSS severity into mild (0‒7), moderate (8‒19), and severe (20‒35) yielded groups of n=96, 28, and 7, respectively. Linear regression modelling did not reveal a correlation between IPSS score and volume (p=0.10). When compared to those with adequate urine volumes (>2 L/day, n=65), low-volume patients (<1 L/day, n=10) had a significantly higher total IPSS (11.7 vs. 6.1; p=0.036). These groups showed significant differences in their responses to questions about incomplete emptying (p=0.031), intermittency (p=0.011), and stranguria (p=0.0020), with higher scores noted in the low urine output group.Conclusions: This study is the first to examine the correlation between IPSS and 24-hour urine volume. Though our data does not show a linear relationship between urine output and IPSS, those with lower urine volumes appear to have worse self-reported voiding symptoms when compared to those with adequate volumes (>2 L/day) for stone prevention. The overall number of patients in our study is relatively small, which may account for the lack of a relationship between IPSS and 24-hour urine volumes.

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