Testosterone supplementation on sarcopenia components in chronic patients: a systematic review and meta-analysis

Background: Sarcopenia is a progressive and generalized skeletal muscle disorder with unfavorable muscle changes throughout life, which can be associated with chronic disease. Testosterone supplementation is emerging as a possible therapy; however, it is still necessary to explore its effectiveness Objectives: This systematic review and meta-analysis aimed to evaluate and summarize the evidence related to the effect of testosterone supplementation on sarcopenia components of chronic disease patients. Methods: We performed a systematic review and meta-analysis with studies that assessed the effect of testosterone supplementation on sarcopenia components of chronic disease patients. Papers were identified using Medical Subject Heading (MeSH) terms, combining “sarcopenia”, “muscular atrophy”, and “testosterone”, searching MEDLINE, EMBASE, and Cochrane Library databases, and also hand searching. Results: The database search resulted in 1602 applicable citations that could be included. Of those, 1560 were removed at the first phase, by reading the title and abstract, and a total of 17 studies were finally included after full-text assessment and manual searches of previous review references. With regard to the effects of testosterone supplementation on sarcopenia components, when taken together, the evaluated studies presented an increase in muscle mass and/or muscle strength, but results for muscle functional capacity were inconsistent. Conclusions: Testosterone supplementation increased the muscle mass and muscle strength in chronic disease patients. However, current evidence does not indicate that those patients could benefit from testosterone supplementation in order to improve their muscle function.

Depression, Anxiety and Stress Levels among Chronic Disease Patients During COVID-19 Pandemic in Dessie Town Hospitals, Ethiopia

Introduction: Coronavirus disease 2019 was first detected in China in December 2019. In Ethiopia, depression, anxiety, and stress levels of chronic disease patients were not known during COVID-19. Thus, this study aimed to assess depression, anxiety, and stress levels of chronic disease patients in government and private hospitals of Dessie town during COVID-19. Methods: Hospital-based cross-sectional study design was used. The Depression Anxiety and Stress Scale-21 was used to measure depression, anxiety, and stress of chronic disease patients during the current pandemic. Both binary and multivariate logistic regression analyses were performed to identify factors, and a significant association was declared at p-value < 0.05 in multivariate analysis. Results and Discussion: The overall anxiety, depression, and stress level were 19.9%, 21.5%, and 17.7%, respectively. In multivariate analysis, older age, female gender, urban residency, duration of living with chronic diseases, and presence of comorbidities were associated with depression of chronic disease patients during the pandemic at p-value <0.05. Age, female gender, presence of comorbidities, and no social support were associated with anxiety. Urban residency, use of hand sanitizer, those who had respiratory manifestations, and travel history in the last two weeks were significantly associated with stress levels. Conclusion: A significant number of chronic disease patients had depression, anxiety, and stress during the COVID-19 pandemic. Therefore, governmental and non-governmental organizations, health professionals, media, and hospital administrators should be involved to decrease the depression, anxiety, and stress of chronic disease patients during the pandemic. Moreover, we encourage researchers to conduct comparative longitudinal studies to assess depression, anxiety, and stress levels of chronic disease patients before and after the onset of the COVID-19 pandemic.

Fear of COVID-19 Among Elderly Patients with a Chronic Physical or Mental Disease

Older age renders individuals vulnerable during public emergency crises. Considering that older adults are a highly heterogeneous and continuously growing demographic subgroup, this study aimed to assess the mental health impact of COVID-19 on two groups of older patients: a group of chronic physical disease and a group of chronic mental disease. A total of 102 patients completed the Fear of COVID-19 Scale, the Generalized Anxiety Disorder scale, the Brief Patient Health Questionnaire (PHQ-9) and several questions regarding demographic characteristics. Suicidality was assessed by the 9th item of the PHQ-9.According to the results, older chronic disease patients showed higher levels of fear, whereas anxiety and depressive symptoms were present mainly in the group of older psychiatric patients. Suicidality was reported from a subtotal of 25.4% that was composed of 7.8% chronic disease patients and 17.6% psychiatric patients. Chronic physical disease and higher anxiety predicted more severe COVID-19-related fear.

Ways to Improve Medication Adherence in Chronic Disease Patients – A Review

Adherence has been defined as the “voluntary, active, and collaborative involvement of the patients in mutually acceptable courses of behaviour to produce desired therapeutic effects”. Medication adherence generally illustrates the term as to whether the patients take their medicines as per prescription instruction and either they keep on to take a prescribed medication. Medication adherence performance has thus been classified into two head conceptions, namely, adherence and persistence. Whilst theoretically similar, adherence refers to concentration of drug utilization for the duration of the ongoing treatment, whereas persistence refers to the general interval of drug therapy. Improving prescription adherence may impact the well-being of the populace than the revelation of any new treatment. Indian patients are not adherent to their medication half the time, mainly due to lack of proper education and patient counselling. Albeit most doctors do not accept adherence basically because of the absence of access or neglect, and no adherence can frequently be a purposeful decision made by the Indian patients. Persistent covering of their medicine taking conduct is regularly persuaded by feelings with respect to both supplier and the patient, prompting possible desperate outcomes. On time medicine taking behaviour of the patients have great impact on the health of people than the need for new treatment option. KEY WORDS Medication Adherence, Drug Therapy, Prescription, Wellbeing, Compliance, Chronic Disease

The role of innovative technology to improve patient centered care

Chronic disease is a long term disease. Treatment performed by patients is also routine and continuous to achieve therapeutic success as well as to avoid complications that can be occurred. Adherence is an important factor to reduce complications of chronic disease. There are some efforts that need to do to increase compliance, such as providing information about drug usage from health providers. The use of technology can also be an option as a facility to increase compliance, such as using audiovisual media as an additional means of providing information and short message services or a mobile application for medication reminders on smartphones. This article provides an overview of the role of technology in increasing adherence to patients especially those who are suffering from chronic disease. This article is based on a literature study from some literature or research results. The reviewed literature shows that the use of video in providing information about drugs, sending short messages, and the use of mobile medication reminders to take medication has an effect on increasing adherence significantly in chronic disease patients. The use of technology is effective and efficient in increasing adherence of chronic disease patients.

Optimizing Healthcare Through Digital Health and Wellness Solutions to Meet the Needs of Patients With Chronic Disease During the COVID-19 Era

The COVID-19 pandemic exposed and exacerbated longstanding inefficiencies and deficiencies in chronic disease management and treatment in the United States, such as a fragmented healthcare experience and system, narrowly focused services, limited resources beyond office visits, expensive yet low quality care, and poor access to comprehensive prevention and non-pharmacological resources. It is feared that the addition of COVID-19 survivors to the pool of chronic disease patients will burden an already precarious healthcare system struggling to meet the needs of chronic disease patients. Digital health and telemedicine solutions, which exploded during the pandemic, may address many inefficiencies and deficiencies in chronic disease management, such as increasing access to care. However, these solutions are not panaceas as they are replete with several limitations, such as low uptake, poor engagement, and low long-term use. To fully optimize digital health and telemedicine solutions, we argue for the gamification of digital health and telemedicine solutions through a pantheoretical framework—one that uses personalized, contextualized, and behavioral science algorithms, data, evidence, and theories to ground treatments.