Strategies for improving influenza vaccination rates in patients with chronic renal disease—results from two randomized controlled trials and a prospective interventional study

BACKGROUND: Chronic kidney disease (CKD) is a global health burden in the world. One of the complications of CKD is proteinuria. Candesartan is a drug that is often used in CKD patients to improve proteinuria. There are several studies that suggest that using a higher dose of candesartan can further improve its effectiveness in reducing proteinuria in CKD patient AIM: This paper is aimed to review the effectiveness and safety at a supramaximal dose of 64 mg to a dose of 16 mg of candesartan. METHODS: We performed a literature search using PubMed, SCOPUS, EuropePMC, ProQuest, and Cochrane Central Databases using these keywords: “candesartan” and “16 mg” and “64 mg” or “proteinuria renal disease” or “albuminuria” and “blood pressure” that were published within the year of 1980–2021. Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) protocol were used to conduct this meta-analysis. We included randomized controlled trials, prospective cohort, retrospective or clinical observational evaluating the effect of candesartan in 16 mg or 64 mg in proteinuria renal disease patients regardless of clinical status. Non-randomized, controlled trials reporting efficacy were included if these trials were in the scope of our topic. Duplicate studies were excluded. Dichotomous variables were analyzed with the Mantel-Haenszel statistical method using risk ratio as the summary statistic and reported with 95% confidence intervals (CIs). RESULTS: Forty-six studies were initially generated using our search keyword. After applying inclusion and exclusion criteria, we included two studies in our analysis. Our pooled analysis found that candesartan 16mg dosage administration, compared to 64mg, was not associated with proteinuria reduction (std mean diff: −10.92 [95% CI: −40.09–18.26], p = 0.46). CONCLUSION: Candesartan supramaximal dosage 64 mg did not differ significantly in proteinuria reduction and blood pressure reduction against candesartan 16 mg. More studies are needed to determine this efficacy and safety.

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Behavioral nudges increase COVID-19 vaccinations: Two randomized controlled trials

10.1101/2021.04.12.21254876 ◽

2021 ◽

Author(s):

Hengchen Dai ◽

Silvia Saccardo ◽

Maria A Han ◽

Lily Roh ◽

Naveen Raja ◽

...

Keyword(s):

Randomized Controlled Trials ◽

Behavioral Science ◽

Age Groups ◽

Text Messages ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Controlled Trials ◽

Vaccination Rates ◽

Effective Strategies ◽

Randomized Controlled

AbstractFighting the COVID-19 pandemic requires quick and effective strategies to maximize vaccine uptake. We present two sequential randomized controlled trials (RCTs) that tackle this challenge with behavioral science insights. We deliver text-based nudges to UCLA Health patients one day (first RCT; N=113,229) and eight days (second RCT; N=90,662) after they receive notifications of vaccine eligibility. In the first RCT, text messages designed to make vaccination salient and easy to schedule boost appointment and vaccination rates by 86% and 26%, respectively. Nudges that make patients feel endowed with the vaccine heighten these effects, but addressing vaccine hesitancy via a video-based information intervention does not yield benefits beyond simple text. These results hold across ethnicity and age groups. By contrast, online experiments (N=2,003) soliciting hypothetical responses to the same messages reveal the opposite patterns, underscoring the importance of pilot-testing behavioral nudges in the real world before scaling them up. In the second RCT, we further find that receiving a second reminder boosts appointment and vaccination rates by 52% and 16%, respectively. Our findings suggest that text-based nudges can substantially increase and accelerate COVID-19 vaccinations at almost zero marginal cost, highlighting the promising role of behavioral science in addressing a critical component of the COVID-19 pandemic response.

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