Prevalence of atrial fibrillation, oral anticoagulation prescription and associated factors in Brazilian older adults

INTRODUCTION: Atrial fibrillation increases five times the risk of stroke. Anticoagulation reduces the incidence of cerebrovascular events. However, many patients do not receive thromboprophylaxis. OBJECTIVES: To estimate the prevalence of atrial fibrillation in the elderly at a Brazilian university hospital and the proportion of anticoagulation prescription. Secondary objectives were to identify the therapeutic options, the main reasons for non-prescription and the factors associated with ineffectiveness or lack of treatment. METHOD: cross-sectional study with a consecutive sample of 1,630 outpatients selected at Hospital de Clínicas de Porto Alegre between April and June of 2017. Atrial fibrillation was identified in 220 (13.50%) individuals. Medical records from 145 patients were accessed, followed by a telephone interview. The association between variables and outcomes was checked using the Mann-Whitney’s U Test and the binary logistic regression. RESULTS: The prevalence of atrial fibrillation was 13.50%. Anticoagulation therapy was prescribed in 77.93% of cases. In 76.11% of patients, warfarin was the chosen drug. There was a tendency towards no prescription in patients with previous bleeding (RR = 2.32; 95%CI 0.95 – 5.64; p = 0.06) and falls (RR = 2.02; 95%CI 0.82 – 5.03; p = 0.08). We found an association between reduced functional capacity (Barthel’s Activities of Daily Living Score < 80) and higher rate of anticoagulation in therapeutic aim (RR = 0.22; 95%CI 0.06 – 0.87; p = 0.04). CONCLUSION: The prevalence of atrial fibrillation in this population was 13.50% and in 77.93% of cases anticoagulant were prescribed. Functional impairment was associated with a higher rate of anticoagulation in therapeutic aim.

Download Full-text

Anticoagulation adherence and its associated factors in patients with atrial fibrillation: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029974 ◽

2019 ◽

Vol 9 (9) ◽

pp. e029974

Author(s):

Pei-Ti Chen ◽

Tsae-Jyy Wang ◽

Ming-Hsiung Hsieh ◽

Ju-Chi Liu ◽

Chieh-Yu Liu ◽

...

Keyword(s):

Atrial Fibrillation ◽

Self Efficacy ◽

Associated Factors ◽

Anticoagulation Therapy ◽

Cross Sectional Study ◽

The Self ◽

Perceived Barriers ◽

Sectional Study ◽

Cross Sectional ◽

Unit Increase

ObjectiveTo investigate anticoagulant adherence and its associated factors, including demographics, clinical variables, atrial fibrillation (AF) severity, knowledge, satisfaction with services, perceived barriers, perceived benefits, symptom severity and self-efficacy in patients with AF.DesignThis is a cross-sectional study.Participants and settingA convenient sample of patients with AF were recruited from cardiology clinics of two teaching hospitals in Taiwan.MeasuresData were collected using the study questionnaires, including the AF-related symptom subscale of the AF Severity Scale, the Knowledge of Warfarin Anticoagulation Treatment Scale, the Satisfaction Scale about Service and Warfarin Treatment, the perceived benefits subscale of the Beliefs about Anticoagulation Survey, the Concerns about Anticoagulation Therapy Scale, The Self-efficacy for Appropriate Medication Use Scale and the short-form Adherence to Reﬁlls and Medications Scale.ResultsA total of 151 patients with AF participated in the study; 53 treated with warfarin and 98 treated with novel oral anticoagulants (NOACs). The difference in adherence to warfarin (mean=8.6; SD=1.6) and NOACs (mean=8.9; SD=2.0) was statistically insignificant. Multiple linear regression analysis showed that perceived barriers (β=0.18, p=0.017) and self-efficacy (β=−0.48, p<0.001) were significant predictors of anticoagulation adherence. For every 1-unit increase in the perceived barriers, there will be a 0.18-unit increase in the adherence to anticoagulation therapy. For every 1-unit increase in the self-efficacy, there will be a 0.48-unit decrease in the adherence to anticoagulation therapy. Perceived barriers and self-efficacy collectively explained 34.0% of the variance in adherence to anticoagulation therapy (F(2,149)=38.11, p<0.001).ConclusionWe found no better adherence to NOACs compared with warfarin. Patients with greater self-efficacy and perceived fewer barriers showed better adherence to anticoagulation therapy.

Download Full-text

Determinants of occupational multisite musculoskeletal disorders: a cross sectional study among 254 patients

Reumatismo ◽

10.4081/reumatismo.2018.1047 ◽

2018 ◽

Vol 70 (2) ◽

pp. 92 ◽

Cited By ~ 1

Author(s):

A. Mahfoudh ◽

K. Fennani ◽

M. Akrout ◽

K. Taoufik

Keyword(s):

Social Support ◽

Musculoskeletal Disorders ◽

Rest Period ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

University Hospital ◽

Individual Risk ◽

Sectional Study ◽

Cross Sectional ◽

Dependent Children

The aim was to describe the profile of workers with occupational multi-site musculoskeletal disorders (MSMSD) and study the relationship between these lesions and socio-professional factors. This is a cross-sectional study involving 254 subjects with occupational musculoskeletal disorders (MSD), identified in the Department of Occupational Medicine at the University Hospital of Mahdia, in Tunisia, over a period of 10 years from 2005 to 2014. The study population was subdivided into two groups; mono-site MSD and multi-site (≥2 sites) groups. Data collection was based on a questionnaire prepared beforehand and covered the description of sociodemographic and professional characteristics. To study psychosocial constraints at work, we have used the Karasek questionnaire. MS-MSD was correlated to the number of dependent children (p=0.02), job/place of work (p=0.00), qualification (p=0.02), taking a rest period (p=0.03), decision latitude (p=0.00), mental demands (p=0.002), social support (p=0.00) and job stress (p=0.04). After binary logistic regression, MS-MSD depended significantly on the number of dependent children (p=0.013; OR=0,33; IC=0,17-0,83), working spouse (p=0.05; OR=0.35; IC=0.12-0.99), job/place of work (p=0.00; OR=4.16; IC=1.95-8.88), qualification (p=0.008; OR=0.28; IC=0.11-0.72), taking a break during work (p=0.04; OR=3.10; IC=1.04-9.22) and social support (p=0.00; OR=7,1; IC=1,9-25,3). When individual risk factors are fixed, the prevention of MS-MSD must target modifiable levers, related to the professional environment of the employees.

Download Full-text

Profile of the cases of violence reported in university hospital

Revista de Enfermagem UFPE on line ◽

10.5205/reuol.1025-8513-1-le.0403201016 ◽

2010 ◽

Vol 4 (3) ◽

pp. 1457

Author(s):

Aline Do Nascimento Silva ◽

Eduardo Tavares Gomes ◽

Renata Livia Alves de Souza Melo ◽

Rutheanne Melo de Siqueira ◽

Lucileide Silva Fonteles

Keyword(s):

The Elderly ◽

Cross Sectional Study ◽

University Hospital ◽

Sectional Study ◽

Specific Training ◽

Recording Instrument ◽

Cross Sectional ◽

Ethics Research ◽

The Social ◽

Lack Of Commitment

ABSTRACTObjective: to elucidate the situation of the notification of cases of violence in a university in a university hospital in Recife at the beginning of training actions and professional awareness of this issue. Method: an observational cross-sectional study as conducted. Data collection was done through referrals made to the Social Service of Clinics Hospital of the Federal University of Pernambuco (HC/UFPE), by reports of professional by itself, a recording instrument from the hospital and copies of the notification form of cases. The project was approved by the Ethics Research Center of Health Sciences of the Federal University of Pernambuco/UFPE with protocol number 13/10. All cases were considered of September 2006, when began using the Notification Form from the Ministry of Health until December 2008. Results: the most notification was cases against the child (n=20, 46,51%), while there isn’t registration of cases against the elderly. Professionals who often made the notification were doctors (n=22, 51.16%) and psychologists (n=12, 27,91%). The Notification Form was used in only 41,86% of cases. Conclusion: the data underscore the under-reporting. Further research should verify the cause of poor service (lack of commitment, lack of specific training, among others) so that they can perform actions to make better situation. Descriptors: violence; epidemiology; public health; mandatory reporting.RESUMOObjetivo: elucidar a situação da notificação dos casos de violência em um hospital universitário do Recife no inicio das ações de capacitação e sensibilização dos profissionais para essa questão. Método: foi realizado um estudo observacional do tipo corte transversal. A coleta de dados foi realizada a partir dos encaminhamentos realizados para o Serviço Social do Hospital das Clínicas da Universidade Federal de Pernambuco/HC/UFPE por meio de relatórios dos profissionais, instrumento de registro próprio do hospital e cópias das Fichas de Notificação dos casos. O projeto foi aprovado pelo Comitê de Ética em Pesquisa do Centro de Ciências da Saúde/UFPE com número de protocolo 13/10. Foram considerados todos os casos de setembro de 2006, quando iniciou o uso da Ficha de Notificação do Ministério da Saúde até dezembro 2008. Resultados: a maior notificação foi de casos contra à criança (n=20, 46,51%), ao passo que não consta registro de casos contra idosos. Os profissionais que mais notificaram foram os médicos (n=22, 51,16%) e os psicólogos (n=12, 27,91%). A Ficha de Notificação foi usada em apenas 41,86% dos casos. Conclusão: os dados ressaltam a sub-notificação. Pesquisas posteriores devem verificar a causa da pouca notificação (falta de compromisso, falta de formação específica, entre outras), para que se possam realizar medidas para melhorar o quadro. Descritores: violência; epidemiologia; saúde pública; notificação de abuso.RESUMENObjetivo: conocer la situación de la notificación de casos de violencia en un hospital universitario en Recife al inicio de las acciones de formación y sensibilización del profesional de esta cuestión. Método: se realizó un estudio observacional, transversal. Recolección de datos se realiza através de consultas que el Servicio Social del Hospital de Clínicas, Universidad Federal de Pernambuco/HC/UFPE por los informes de profesionales de por sí, un instrumento de registro del hospital y copia del Formulario de Notificación de los casos. El proyecto fue aprobado por el Centro de Ética de la Investigación de las Ciencias de la Salud/UFPE com el número de protocolo 13/10. Se consideraron todos los casos de septiembre de 2006, cuando comenzó a usar el Formulario de Notificación del Ministerio de Salud hasta diciembre de 2008. Resultados: la mayoría de los casos de notificación fue contra el niño (n=20, 46,51%), mientras que no hay registro de casos en contra de los ancianos. Los profesionales que a menudo hace la notificación eran médicos (n=22, 51,16%) y los psicólogos (n=12, 27,91%). El Formulario de Notificación se utilizó en sólo 41,86% de los casos. Conclusión: los datos ponen de relieve la subnotificación. Las investigations futuras deberían verificar la causa de la notificación de baja (falta de compromiso, la falta de formación específica, entre otros) de modo que puedan llevar a cabo acciones para mejorar la situación. Descriptores: violencia; epidemiología; salud pública; notificatión obligatoria.

Download Full-text

Prevalence of diabetes, hypertension, and the socio-demographic predictors of the type of facility utilized for related services in rural Telangana

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204751 ◽

2020 ◽

Vol 7 (11) ◽

pp. 4499

Author(s):

M. Abdul Wassey ◽

Ashish Giri ◽

Aakash Raikwar ◽

Vishal Dogra

Keyword(s):

Secondary Data ◽

Binary Logistic Regression ◽

The Elderly ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Cross Sectional ◽

Delivery Of Care ◽

Aggregated Data ◽

Medical Unit ◽

Demographic Predictors

Background: Diabetes mellitus and hypertension are chronic conditions that, on one hand demand early detection, screening, and treatment and on the other, require longitudinal follow-up for their successful management. Piramal Swasthya’s Arogyaseva program uses two contrasting methods (MMU and static clinic) to deliver diabetes and hypertension-related care. The MMU provides doorstep delivery of care, while the static clinic is located by the highway, is equipped with a telemedicine center, and has slightly higher diagnostic and therapeutic capabilities. The study aims to find the prevalence of diabetes and hypertension, and determine the association between the sociodemographic factors and the type of facility utilized for these conditions.Methods: This cross-sectional study is a secondary data analysis of the aggregated data of patients who availed health services at the Mobile Medical Unit and the static clinic. The data was analyzed to find out the prevalence of diabetes and hypertension, and Binary logistic regression was used to determine socio-demographic predictors of the type of health facility used for diabetes and hypertension-related care.Results: Overall hypertension and diabetes prevalence was 24% and 7%, respectively. Women (aOR 1.3; 95% CI 1.122–1.510), illiterate (aOR 2.61; 95% CI 2.021-3.392), hypertensives (aOR 3.28; 95% CI 2.807-3.846) and the elderly (aOR 1.43; 95% CI 1.204-1.721) were significantly more likely to utilize MMU based outreach facility compared to their respective baseline counterparts.Conclusions: The mobile medical unit can play a significant role in delivering hypertension and diabetes-related care, especially to women and the elderly.

Download Full-text

Risk factors for fear of falling in the elderly in Serbia

Vojnosanitetski pregled ◽

10.2298/vsp160620369i ◽

2018 ◽

Vol 75 (8) ◽

pp. 764-772

Author(s):

Suncica Ivanovic ◽

Sanja Trgovcevic

Keyword(s):

Risk Factors ◽

Fear Of Falling ◽

Binary Logistic Regression ◽

Female Gender ◽

The Elderly ◽

Cross Sectional Study ◽

Everyday Functioning ◽

Cross Sectional ◽

Demographic Questionnaire ◽

Study Results

Background/Aim. After a fall, the elderly can develop a fear of falling which can be more frequent and more serious problem than the fall itself because it represents the main factor limiting an older person in his/her everyday functioning. The aim of this study was to identify and examine, in a more detailed way, risk factors for developing fear of falling triggered by the history of their falls over the previous year in the elderly in Serbia who live in houses or apartments. Methods. The cross-sectional study was conducted on 400 people, mean age 75.04 years (min. 65, max. 94), randomly selected from the register of patients in the Primary Health Center of Nis (164 men and 236 women), in the period January- June 2014. Socio-demographic questionnaire ? Elderly Fall Screening Test (EFST), Multi-Factor Questionnaire Falls (MFQ) and Falls Efficacy Scale International (FESI) were used in this study. Results. After applying the multivariate binary logistic regression, it was found that significant predictors for developing fear of falling were as follows: female gender (OR = 2.599; p = 0.009), age 75?79 years (OR = 4.637; p = 0.009) and over 80 years (OR = 3.830; p = 0.001), increase in household members (OR = 1.206; p = 0.033), people who estimate their health as average (OR = 0.268; p < 0.001) and good (OR = 0.059; p < 0.001), number of falls higher than 2 (OR = 2.761; p = 0.003), presence of injuries during the fall (OR = 2.483; p = 0.028), periodical and repeating situations of ?near-fall? (OR = 3.830; p = 0.001), limited activity (OR = 2.124; p = 0.007) problems with sight (OR = 3.006; p < 0.001), cognitive problems (OR = 2.296; p = 0.005) and problems with balance (OR = 3.809; p < 0.001). Conclusion. The results of this study can be used for planning promotional programs for falls and a fear of falling prevention, as well as prevention of their consequences.

Download Full-text

ELDERLY RECEIVING OUTPATIENT CARE: REASONS FOR ADHERENCE/NONADHERENCE TO MEDICATION

Texto & Contexto - Enfermagem ◽

10.1590/0104-0707201500002230014 ◽

2015 ◽

Vol 24 (4) ◽

pp. 1094-1103

Author(s):

Daiane Porto Gautério-Abreu ◽

Silvana Sidney Costa Santos ◽

Bárbara Tarouco Silva ◽

Silomar Ilha ◽

Giovana Calcagno Gomes

Keyword(s):

Outpatient Care ◽

Rio Grande ◽

The Elderly ◽

Cross Sectional Study ◽

Health Condition ◽

University Hospital ◽

Rio Grande Do Sul ◽

Cross Sectional ◽

Adherence To Medication ◽

Outpatient Unit

ABSTRACT This study aimed to characterize the elderly receiving outpatient care in Rio Grande, Rio Grande do Sul state, Brazil, concerning their demographic and socioeconomic characteristics, health condition, medication usage and adherence to medication; to identify their self-reported reasons for adherence/nonadherence to the prescribed medication. A descriptive, cross-sectional study, with a quantitative approach, performed in the outpatient unit of a university hospital in Rio Grande do Sul, Brazil. One hundred seven elderly were interviewed in November of 2013. Data were collected with three instruments. The statistical analysis was descriptive. Among the elderly, 86.9% were adherent to medication. Wanting to feel good was the reason most often reported for adherence to the prescribed medication, and the occurrence of adverse reactions was the most often cited reason for nonadherence. The results of this study can support the development of actions that promote adherence to medication by the elderly.

Download Full-text

Telecare for the elderly: coercion, confidence and satisfaction associated with its use

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562018021.170200 ◽

2018 ◽

Vol 21 (4) ◽

pp. 464-471

Author(s):

Bruna Borba Neves ◽

José Roberto Goldim

Keyword(s):

The Elderly ◽

Cross Sectional Study ◽

Decision Making Process ◽

Porto Alegre ◽

High Confidence ◽

Cross Sectional ◽

Significance Level ◽

Statistical Measures ◽

Quantitative Data Analysis ◽

The City

Abstract Objective: to evaluate the expression of coercion, confidence and satisfaction with the use of telecare. Method: a cross-sectional study was carried out of prevalent cases with elderly residents in the city of Porto Alegre, Rio Grande do Sul, Brazil, who had already used telecare services. The sociodemographic variables used were: gender, age, schooling and marital status. In order to evaluate the perception of coercion, the Perceived Coercion Scale was applied in relation to the use of telecare and those responsible for deciding to use the technology. Confidence in the use of telecare technology and the satisfaction associated with its use were evaluated. Quantitative data analysis was performed using descriptive and inferential statistical measures. Means and standard deviations were used. Differences were assessed by analysis of variance, with a significance level of 5% (p<0.05). Results: the sample consisted of 25 elderly people who used telecare. When evaluating the distribution of the answers obtained, it was found that 11 (44%) of those interviewed did not perceive any coercion associated with their decision. The others had varying perceptions, with an average of 23%. Respondents expressed high confidence and satisfaction with telecare. Conclusion: the decision-making process associated with the use of telecare had a low perception of coercion, combined with high confidence and satisfaction with the use of the technology.

Download Full-text

Patterns of alcohol use in an elderly sample enrolled in the Family Health Strategy program in the city of Porto Alegre, Brazil

Ciência & Saúde Coletiva ◽

10.1590/1413-81232015211.10032015 ◽

2016 ◽

Vol 21 (1) ◽

pp. 27-35 ◽

Cited By ~ 3

Author(s):

Bruno Luiz Guidolin ◽

Irênio Gomes da Silva Filho ◽

Eduardo Lopes Nogueira ◽

Francisco Pascoal Ribeiro Junior ◽

Alfredo Cataldo Neto

Keyword(s):

Alcohol Use ◽

Family Health ◽

Prevalence Ratio ◽

The Elderly ◽

Cross Sectional Study ◽

Porto Alegre ◽

Cross Sectional ◽

Family Health Strategy ◽

History Of ◽

The City

Abstract This article aims to determine the pattern of alcohol use in the elderly and its associations with sociodemographic characteristics in an elderly sample of patients from the city of Porto Alegre, Rio Grande do Sul, Brazil. A cross-sectional study was conducted involving 557 seniors, aged 60 years or more, through application of the Mini International Neuropsychiatric Interview and a global assessment questionnaire for the elderly. The majority of the 557 senior citizens did not complete elementary school (58.3%), were white (65.1%), married (37.6%), had no caregiver (62.2%), were catholic (65.5%) and practicing their religion (68.6%), were retired (67.7%), and had a personal income of up to one minimum salary (56.1%). The study revealed 67 (12%) elderly people with a history of alcoholism, of which 17 (3.1%) had a diagnosis of current alcoholism, 50 (9%) had a history of alcohol dependence in the past and 16 (2.9%) had a current alcohol abuse problem. Men had a prevalence ratio of 11.6 times for a history of alcoholism in comparison to women. The results confirm that alcoholism is frequent in the population of Brazilian elderly, drawing attention to some socio-demographic characteristics that can make a difference in the early diagnosis of alcoholism.

Download Full-text

Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China

BMJ Open ◽

10.1136/bmjopen-2018-026443 ◽

2019 ◽

Vol 9 (4) ◽

pp. e026443 ◽

Cited By ~ 1

Author(s):

Xiaomei Hu ◽

Hongxia Gao ◽

Yan Zhang ◽

Haomiao Li ◽

Dai Su ◽

...

Keyword(s):

Elderly People ◽

Rural China ◽

Admission Rate ◽

Binary Logistic Regression ◽

The Elderly ◽

Cross Sectional Study ◽

Elderly Group ◽

Cross Sectional ◽

Specific Factors ◽

Inappropriate Admission

ObjectiveThe purpose of this paper is to investigate the characteristics and determinants of inappropriate admission to hospital of elderly people in rural China.DesignA cross-sectional study of a comparison between the elderly and non-elderly groups of people.SettingThe survey was conducted on the largest county-level general hospitals in four counties in central and western China.ParticipantsA total of 652 rural patients admitted in hospitals were surveyed, who were divided into two groups according to age: elderly group (n=230, age ≥60 years) and non-elderly group (n=422, age <60 years).Primary measuresThe Chinese version of the appropriateness evaluation protocol was used to evaluate the inappropriate admission rates. The interactive regression models based on the relationship of age (elderly and non-elderly) with other factors and binary logistic regression models were used in the analysis of the specific factors and determinants of the inappropriate admission of elderly people.ResultThe inappropriate admission rate for the rural elderly was 30%, which was lower than that of the non-elderly people (40.8%). Compared with the non-elderly group, women in the elderly group (OR=0.33, 95% CI 0.15 to 0.73) had a lower incidence of inappropriate admission, and elderly people with chronic diseases (OR=3.33, 95% CI 1.23 to 9.04) were more prone to being inappropriately admitted than non-elderly people with chronic diseases. The binary logistic regression analysis shows that county, age (OR=0.94. 95% CI 0.90 to 0.99), gender (OR=0.49, 95% CI 0.25 to 2.98), department and response to doctor’s admission request were the determinants of the inappropriate admission of elderly patients.ConclusionThe inappropriate admission rate of elderly people in rural China was high. We found that gender and chronic disease are the specific factors that were specific to non-elderly people. County, age, gender, department and response to a doctor’s admission request had substantial influence on the inappropriate admission of the elderly in rural China.

Download Full-text

Peripartum Hysterectomies over a Fifteen-year Period

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1721354 ◽

2021 ◽

Vol 43 (01) ◽

pp. 003-008

Author(s):

Alessandra Dorigon ◽

Sérgio Hofmeister Martins-Costa ◽

José Geraldo Lopes Ramos

Keyword(s):

Placenta Accreta ◽

Placenta Previa ◽

Cross Sectional Study ◽

University Hospital ◽

Southern Brazil ◽

Sectional Study ◽

Porto Alegre ◽

Cross Sectional ◽

The Past ◽

Previous Cesarean

Abstract Objective To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure. Methods A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019. Results The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age. Conclusion Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.

Download Full-text