scholarly journals Does drug compliance change in asthmatic patients during pregnancy?

2013 ◽  
Vol 8 ◽  
Author(s):  
Insu Yilmaz ◽  
Ferda Oner Erkekol ◽  
Sevki Celen ◽  
Mujdegul Zayifoglu Karaca ◽  
Omur Aydin ◽  
...  
Keyword(s):  
Emergency Room ◽  
Pregnant Women ◽  
Systemic Steroid ◽  
Emergency Room Visits ◽  
Behavioral Differences ◽  
Drug Compliance ◽  
Face To Face ◽  
Asthmatic Patients ◽  
Significant Difference ◽  
Symptomatic Asthma

Background: Pregnant women with asthma are recommended to maintain optimal therapeutic management during pregnancy. Uncontrolled, symptomatic asthma may increase the risk of adverse peri-natal outcomes; thus adequate regular anti-asthmatic treatment must be given to provide optimal asthma control during pregnancy. However, doubts about the safety of asthmatic drugs can affect pregnant asthmatic patients’ drug compliance. The aim of this study was to assess behavioral differences in drug compliance among pregnant asthmatic patients. Methods: Thirty two asthmatic and 121 healthy pregnant women were enrolled in the study. Structured face-to-face interviews were conducted after delivery. The interviews included disease characteristics, drug compliance and patients’ own perspective for asthma status prior to and during pregnancy. In addition, medical and pregnancy history, pregnancy complications and outcomes, and newborn characteristics were recorded. Results: In our study group the rates of hospitalization, emergency room visits and systemic steroid use in the year before pregnancy were 13%, 46.9% and 18.8%, respectively. The rate of regular asthma medication use was only 32% at that period and increased to 44% during pregnancy. However, hospitalization, emergency room visits, systemic steroid usage rates remained unchanged and according to patients’ own evaluations, 44% of asthmatics pointed out that their asthma had worsened during pregnancy. No statistically significant difference was detected in terms of pregnancy/labour complication between asthmatic and non-asthmatics. Conclusions: Contrary to some previous studies, in our study regular use of asthma drugs increased during pregnancy. The uncontrolled condition of their asthma before and during pregnancy and the idea that their asthma worsened during pregnancy might force the patients to use medication more regularly.

The impact of pharmacist telephone calls after discharge on satisfaction of oncology patients: A randomized controlled study

2017 ◽  
Vol 24 (5) ◽  
pp. 359-364 ◽  
Author(s):  
Sewar S Salmany ◽  
Lujeen Ratrout ◽  
Abdallah Amireh ◽  
Randa Agha ◽  
Noor Nassar ◽  
...  
Keyword(s):  
Emergency Room ◽  
Hospital Readmissions ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Emergency Room Visits ◽  
Oncology Patients ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Impact

Purpose The aim of the study was to determine the impact of telephone follow-up calls on satisfaction in oncology patients after hospital discharge. Method A randomized controlled study, in which patients were randomized into two groups: The experimental group with the telephone follow-up (TFU) calls (intervention) and the control group (no intervention). The telephone follow-up call was conducted within 72 h after discharge. During the call, patients were asked about their medications, namely, whether they received them, understood how to take them, and whether they developed any medication-related adverse effect. Both groups were contacted by phone two weeks later to assess their satisfaction with the discharge medication instructions and the provided pharmaceutical services, using the 5-point Likert scale. In addition, hospital records were reviewed for emergency room visits and hospital readmissions within 30 days after discharge. Results There was no difference in the percentage of patients who reported being very satisfied between both the intervention and the control groups (45% intervention vs. 48% control, P = 0.68). The mean time of the intervention phone call was 3 ± 1.7 (SD) min. During the telephone follow-up call, medication-related problems were identified in 20% of the patients. There was no significant difference in emergency room visits and hospital readmissions in the intervention group vs. control (44% vs. 53%, P = 0.123) and (37% vs. 43%, P = 0.317), respectively. Conclusion Telephone follow-up calls conducted by a pharmacist to discharged oncology patients did not improve patients' satisfaction, emergency room visits or hospital readmissions; however, they helped to identify medication-related adverse effects in the oncology patients.

Psychological Factors Associated with Emergency Room Visits among Asthmatic Patients

1999 ◽  
Vol 23 (2) ◽  
pp. 217-233 ◽  
Author(s):  
Arie Nouwen ◽  
Mark H. Freeston ◽  
RÉJean LabbÉ ◽  
Louis-Philippe Boulet
Keyword(s):  
Emergency Room ◽  
Psychological Factors ◽  
Emergency Room Visits ◽  
Factors Associated ◽  
Asthmatic Patients

scholarly journals 112 Impact of the COVID-19 pandemic on emergency department visits at a university medical centre

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e81-e82
Author(s):  
Viviane Mallette ◽  
Claude Cyr
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
Emergency Department Visits ◽  
Medical Centre ◽  
Pediatric Care ◽  
Emergency Room Visits ◽  
Traumatic Injuries ◽  
Health Measures ◽  
Significant Difference ◽  
The Impact

Abstract Primary Subject area Emergency Medicine - Paediatric Background The new coronavirus, SARS-Cov-2, responsible for a global pandemic, led to the declaration of a health emergency and the implementation of large-scale public health measures by governments in 2020. Those measures, combined with the overlapping symptoms of COVID-19 disease and common viral infections in children, have led hospitals to prepare for possible changes in volume of emergency room visits by children. Objectives This study aims to determine the effect of the pandemic and governmental restrictions on the use of the emergency department by pediatric patients at a university medical centre, as well as to assess the impact on the severity of initial presentations. Design/Methods A single-centre study was conducted at a university hospital among children aged 0 to 17 who visited the emergency room. We used interrupted time series analysis to compare the average of pre-COVID-19 data (from January 1 2017, to December 31 2019) with data from the first wave of the COVID-19 pandemic (from January 1 to September 2020). Emergency room visits, initial triage codes, and admission and pediatric consultation rates were analyzed to assess whether there was a significant difference between periods. Results An important increase in total daily visits (+11.18, 95% CI [6.23-16.14]) was first observed with the emergence of COVID-19 cases in Canada. Then, during the strict confinement, which corresponds to an active period of COVID-19, we detected a significant drop in daily visits (-25.64, 95% CI [-30.4 to -20.66]), which continued while progressively loosening restrictions. The proportion of admissions and pediatric consultations rose slightly only throughout the time of intensive health measures (respectively +4.07% and +3.32%), but no changes in the severity of the triage codes at the emergency department were observed for all periods. Traumatic injuries also saw a significant decrease (p=0.018) when comparing data by groups of diagnosis. Conclusion These results show a significantly lower number of children’s visits to the emergency room of a university medical centre, and a transient increase in pediatric care with little impact on the immediate severity of the initial presentations during strict government health measures in the first wave of COVID-19. These measures also had a beneficial effect in reducing the number of traumatic injuries.

scholarly journals Patient Complications After Interscalene Block: A Retrospective Comparison of Liposomal Bupivacaine to Non-Liposomal Bupivacaine.

2019 ◽  
Author(s):  
jacob hutchins ◽  
Jason Habeck ◽  
Zac Novaczyk ◽  
Richard Campbell ◽  
Christopher Creedon ◽  
...  
Keyword(s):  
Emergency Room ◽  
Surgical Procedure ◽  
Interscalene Block ◽  
Emergency Room Visits ◽  
Liposomal Bupivacaine ◽  
Phone Calls ◽  
Number Of Patients ◽  
Significant Difference ◽  
Liposome Bupivacaine ◽  
Anesthetic Complications

Abstract Background The purpose of this study was to investigate if the addition of liposome bupivacaine (LB) to an interscalene block (ISB) had an effect on the number of patients with surgical or block related complications.Methods This was a single-center retrospective chart view was performed identifying patients who received an ISB from January 1, 2014 through April 26, 2018 at the University of Minnestoa. 1,518 patients were identified who received an ISB (LB =784, non-liposomal bupivacaine =734). Patients were divided into two groups those who did receive liposome bupivacaine in their ISB and those who did not receive liposome bupivacaine in their ISB. Medical records were individually reviewed for surgical procedure, block medications, complications related to the block or surgical procedure, phone calls to the healthcare system for issues related to opioids or pain within 3 and within 30 days, readmissions within 30 days, and emergency room visits for complications within 3 and 30 days.Results There was no significant difference in the number of patients with surgical or anesthetic complications. Only phone calls for pain within 3 days was significantly different. The LB group had 3.2% of patients call compared to 5.6% in the non-liposomal bupivacaine group (aOR=1.71 [95% CI: 1.04-2.87], p=0.036). We found no significant difference in any of the other secondary outcomes.Conclusions The use of LB in an ISB demonstrated no significant difference compared to non-liposomal bupivacaine in numbers of complications, emergency room visits, and readmissions.

scholarly journals Patient Complications after Interscalene Block: A Retrospective Comparison of Liposomal Bupivacaine to Nonliposomal Bupivacaine

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jacob L. Hutchins ◽  
Jason Habeck ◽  
Zac Novaczyk ◽  
Richard Campbell ◽  
Christopher Creedon ◽  
...  
Keyword(s):  
Emergency Room ◽  
Surgical Procedure ◽  
Interscalene Block ◽  
Emergency Room Visits ◽  
University Of Minnesota ◽  
Phone Calls ◽  
Number Of Patients ◽  
Significant Difference ◽  
Liposome Bupivacaine ◽  
Anesthetic Complications

Background. The purpose of this study was to investigate if the addition of liposome bupivacaine (LB) to an interscalene block (ISB) had an effect on the number of patients with surgical- or block-related complications. Methods. This was a single-center retrospective chart view performed by identifying patients who received an ISB from January 1, 2014, through April 26, 2018, at the University of Minnesota. 1,518 patients were identified who received an ISB (LB = 784, nonliposomal bupivacaine = 734). Patients were divided into two groups those who did receive liposome bupivacaine in their ISB and those who did not receive liposome bupivacaine in their ISB. Medical records were individually reviewed for surgical procedure, block medications, complications related to the block or surgical procedure, phone calls to the healthcare system for issues related to opioids or pain within 3 and within 30 days, readmissions within 30 days, and emergency room visits for complications within 3 and 30 days. Results. There was no significant difference in the number of patients with surgical or anesthetic complications. Only phone calls for pain within 3 days were significantly different. The LB group had 3.2% of patients call compared to 5.6% in the nonliposomal bupivacaine group (aOR = 1.71 (95% CI: 1.04–2.87), p=0.036). We found no significant difference in any of the other secondary outcomes. Conclusions. The use of LB in an ISB demonstrated no significant difference compared to nonliposomal bupivacaine in numbers of complications, emergency room visits, and readmissions.

scholarly journals The Changes in Fear of Childbirth in Pregnancy During and Before the COVID-19 Pandemic

2021 ◽  
Author(s):  
Cenk Soysal ◽  
Özlem Erten ◽  
Mehmet Murat Işıkalan ◽  
İsmail Bıyık ◽  
Yasemin Taşçı ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Study Data ◽  
Education Level ◽  
Fear Of Childbirth ◽  
Cross Sectional ◽  
Face To Face ◽  
Significant Difference ◽  
Education Levels ◽  
Training And Research

Abstract Background: We aimed to compare the changes experienced by pregnant women before and during the pandemic regarding fear of childbirth andhow much they were affected by factors such as age, education level, and planned delivery type.Materials and Methods: This cross-sectional study comparedthe pre-pandemic pregnant group (July 2019 and December 2019) and the pandemic group (November 2020 and May 2021) of patients atKütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant womenin their second trimesterwere included in the study. All of them were literate andvoluntarily agreed to participate in the study. Data were collected with the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face.Results: The mean age of the pregnant women participating in the study was 31.6±6.8 years. While the total Wijma score was 62.1±25.1 in the pre-pandemic group, it was 61.3±26.4 in the pandemic group, and there was no significant difference between the two groups (p=0.738).While 25.7% (n=179) of all participants had a normal fear of childbirth, 22% (n=153) had a mild fear of childbirth, 27% (n=188) had a moderate fear of childbirth, and 25.3% (n=176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth wasunchanged in pregnant women at all education levels (p=0.079, p=0.957, p=0.626, p=0.539, p=0.202).Conclusion: When the pre-pandemic and pandemic periods are compared, it is seen that the fear of childbirth didnot change within each education level. Informing pregnant women about the effects of COVID-19 during the pandemic period may be effective in reducing fear of childbirth and reducing the numberof cesarean sections due to fear of birth.

Abstract 103: Obesity Paradox in Heart failure- Are African Americans Affected?

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Minaba A Wariboko ◽  
Kimberli Taylor ◽  
Chimalum Okafor ◽  
Taopheeq Mustapha ◽  
Victor Nwazue ◽  
...  
Keyword(s):  
Heart Failure ◽  
African Americans ◽  
Ejection Fraction ◽  
Emergency Room ◽  
Left Ventricular Systolic Dysfunction ◽  
The United States ◽  
Left Ventricular ◽  
Small Sample ◽  
Emergency Room Visits ◽  
Significant Difference

Background - Obesity is a major risk factor for heart failure. However, many studies have shown that obesity is paradoxically associated with better outcomes in those with chronic heart failure (HF). Initially thought to occur only in those with left ventricular systolic dysfunction (LVSD), recent studies such as CHARM and I-PRESERVE have described the same phenomenon in those with HF with preserved ejection fraction (HFpEF). It is also known that minorities have the highest rates of obesity in the United States, yet no major studies have included a large enough sample (>10% minority representation) to study this relationship. Thus we propose to examine the relationship of different weight categories to HF outcomes in patients with LVSD (45%) utilizing a minority cohort. Methods - Outcomes (HF admissions & cardiac admissions, non-cardiac admissions, and emergency room visits) were assessed for162 HF patients with documentation of body mass index (BMI) and ejection fraction from the Meharry Heart Failure Registry (a registry composed of 80% African Americans and Hispanics). The cohort was evenly divided by EF into HFpEF versus LVSD. Utilizing the Center for Disease Control definitions, 5 categories for BMI were defined: 40.0. ANOVA was applied to test for possible differences among BMI groups and outcomes. Results - There was a trend towards a paradoxical relationship noted between BMI and outcome in males with HFpEF when looking at all-cause readmissions (p<0.0606). This same relationship was noted between BMI and outcome in women with HFpEF when looking at the all-cause emergency room visits (p<0.0677). However, we failed to find a significant difference across BMI categories and outcome for those with LVSD. Conclusion - Our study suggests that irrespective of race, there is a paradoxical relationship noted between BMI and outcome for both men and women with HFpEF. However, contrary to current literature, we failed to find the same relationship in minority patients with LVSD. This may be due to the small sample size hence a larger prospective study of this group is warranted.

ALLERGIST INFLUENCE IN ASTHMA CARE

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 256-256
Author(s):  
Stanley P. Galant
Keyword(s):  
Intensive Care ◽  
Emergency Room ◽  
Peak Flow ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Emergency Room Visits ◽  
Inhaled Steroids ◽  
Flow Monitoring ◽  
Significant Difference ◽  
Metered Dose

Purpose of the Study. To determine whether care by an allergist reduces the morbidity for asthma specifically by decreasing the need for hospitalizations and emergency room visits. Methods. This was a retrospective chart review of patients first seen between June 1985 and June 1986 and followed the second year either in an allergy clinic or in a general pediatric clinic. Charts were analyzed for demographic information; information regarding hospitalizalions, emergency room visits, and intensive care unit admissions; medications, including bronchodilators, systemic steroids and inhaled steroids, and home nebulizer; and home peak flow meters. There were 209 charts reviewed initially. Of these, 83 patients were then followed by allergists, 40 by non-allergists, and 86 were lost to followup. Findings. There was no statistically significant difference in patient characteristics of asthma at baseline, except that those followed by allergists had a significant increase in the use of oral steroids. There was a significant difference in favor of the allergy followup group for decrease in hospitalization rate and emergency room visits. In terms of medication, there was no significant difference in the use of theophylline, beta2-agonists, or home nebulizers, but there was a statistically significant increase in the use of cromolyn sodium and inhaled steroids, the use of spacers for the metered-dose inhalers, use of home peak flow monitoring, and a decreased incidence of intensive care admissions. Interestingly, there was no change in pets or smoking in the children's environment. Reviewer's Comments. This study suggests that the followup of asthmatics by an allergist is superior to the non-allergist.

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