Pragmatic and Observational Research最新文献

{"title":"Characterisation of the Australian Adult Population Living with Asthma: Severe - Exacerbation Frequency, Long-Term OCS Use and Adverse Effects.","authors":"Kerry L Hancock,&nbsp;Sinthia Bosnic-Anticevich,&nbsp;John D Blakey,&nbsp;Mark Hew,&nbsp;Li Ping Chung,&nbsp;Biljana Cvetkovski,&nbsp;Scott Claxton,&nbsp;Peter Del Fante,&nbsp;Eve Denton,&nbsp;Joe Doan,&nbsp;Kanchanamala Ranasinghe,&nbsp;Lucy Morgan,&nbsp;Anita Sharma,&nbsp;Peter K Smith,&nbsp;Deb Stewart,&nbsp;Philip J Thompson,&nbsp;Russell Wiseman,&nbsp;John W Upham,&nbsp;Kwok Y Yan,&nbsp;Victoria Carter,&nbsp;Kiranjeet Dhillon,&nbsp;Florian Heraud,&nbsp;Thao Le,&nbsp;Rebecca Vella,&nbsp;David Price","doi":"10.2147/POR.S360044","DOIUrl":"https://doi.org/10.2147/POR.S360044","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma poses a significant burden for the Australian population. Understanding severe exacerbation rates, and steroid-related burden for adults diagnosed with asthma stands to offer insights into how this could be reduced.</p><p><strong>Methods: </strong>Electronic medical records (EMR) and questionnaires from the Optimum Patient Care Research Database Australia (OPCRDA) were utilised retrospectively. OPCRDA is a real-world database with >800,000 medical records from Australian primary care practices. Outcomes were severe asthma exacerbations in Australian adults, over a 12-month period, stratified by Global Initiative for Asthma (GINA) treatment intensity steps, and steroid associated comorbidities.</p><p><strong>Results: </strong>Of the 7868 adults treated for asthma, 19% experienced at least one severe exacerbation in the last 12-months. Severe exacerbation frequency increased with treatment intensity (≥1 severe exacerbation GINA 1 13%; GINA 4 23%; GINA 5a 33% and GINA 5b 28%). Questionnaire participants reported higher rates of severe exacerbations than suggested from their EMR (32% vs 23%) especially in steps 1, 4 and 5. Patients repeatedly exposed to steroids had an increased risk of osteoporosis (OR 1.95, 95% CI 1.43-2.66) and sleep apnoea (OR 1.78, 95% CI 1.30-2.46).</p><p><strong>Conclusion: </strong>The Australian population living with GINA 1, 4, 5a and 5b asthma have high severe exacerbation rates and steroid-related burden, especially when compared to other first world countries, with these patients needing alternative strategies or possibly specialist assessment to better manage their condition.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"43-58"},"PeriodicalIF":8.9,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/c4/por-13-43.PMC9270906.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Experience with Favipiravir for the Treatment of Mild-to-Moderate COVID-19 in India.","authors":"Shashank Joshi,&nbsp;Agam Vora,&nbsp;K Venugopal,&nbsp;Pramod Dadhich,&nbsp;Anil Daxini,&nbsp;Sagar Bhagat,&nbsp;Saiprasad Patil,&nbsp;Hanmant Barkate","doi":"10.2147/POR.S364066","DOIUrl":"10.2147/POR.S364066","url":null,"abstract":"<p><strong>Background: </strong>Favipiravir, an RNA-dependent RNA polymerase inhibitor (RdRp), is a broad-spectrum oral antiviral agent approved in India under emergency use authorization, for the treatment of mild-to-moderate coronavirus disease (COVID-19). The present study was planned to evaluate the effectiveness and safety of favipiravir in real-world clinical practice.</p><p><strong>Materials and methods: </strong>This was a multicentric, retrospective, single-arm study conducted across four centres in India, after obtaining permission from the independent ethics committee. Medical records were analysed to evaluate effectiveness and safety of patients who were prescribed favipiravir.</p><p><strong>Results: </strong>The medical records of a total of 360 patients met the inclusion criteria, with 358 of them available for the final analysis. Males made up 58.46% of the study population. The average age of enrolled patients was 51.80 ± 16.45 years. The most common symptoms were fever, cough, and myalgia-fatigue. The median time to clinical cure and fever relief was five and four days, respectively. The average length of stay in the hospital was six days. In total, 8% of the patients experienced adverse events. Hepatic enzyme elevation, diarrhoea, decreased appetite, headache, fatigue, and giddiness were the common symptoms.</p><p><strong>Conclusion: </strong>In our real-world study, favipiravir was found to have a clinical cure rate of more than 90% in mild-to-moderate COVID-19 patients. This supports the use of favipiravir in the treatment of COVID-19. Favipiravir was well tolerated, with only minimal side effects, which were transient in nature.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":"13 1","pages":"33-41"},"PeriodicalIF":8.9,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9154000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43204616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in Demographic and Clinical Characteristics of Patients with COPD Receiving Care in US Primary Care: Data from the Advancing the Patient EXperience (APEX) in COPD Registry","authors":"C. Fox, W. Pace, E. Brandt, V. Carter, Ku-Lang Chang, C. Edwards, Alexander Evans, Gabriela Gaona, M. Han, A. Kaplan, R. Kent, J. Kocks, Maja Kruszyk, Ledoux Chantal, Tessa LiVoti, Cathy Mahle, B. Make, A. Ratigan, A. Shaikh, N. Skolnik, Brooklyn Stanley, B. Yawn, D. Price","doi":"10.2147/POR.S342736","DOIUrl":"https://doi.org/10.2147/POR.S342736","url":null,"abstract":"Introduction Little is known about the variability in chronic obstructive pulmonary disease (COPD) management and how it may be affected by patient characteristics across different healthcare systems in the US. This study aims to describe demographic and clinical characteristics of people with COPD and compare management across five primary care medical groups in the US. Methods This is a retrospective observational registry study utilizing electronic health records stored in the Advancing the Patient Experience (APEX) COPD registry. The APEX registry contains data from five US healthcare organizations located in Texas, Ohio, Colorado, New York, and North Carolina. Data on demographic and clinical characteristics of primary care patients with COPD between December 2019 and January 2020 were extracted and compared. Results A total of 17,192 patients with COPD were included in analysis: Texas (n = 811), Ohio (n = 8722), Colorado (n = 472), New York (n = 1149) and North Carolina (n = 6038). The majority of patients at each location were female (>54%) and overweight/obese (>60%). Inter-location variabilities were noted in terms of age, race/ethnicity, exacerbation frequency, treatment pattern, and prevalence of comorbid conditions. Patients from the Colorado site experienced the lowest number of exacerbations per year while those from the New York site reported the highest number. Hypertension was the most common co-morbidity at 4 of 5 sites with the highest prevalence in New York. Depression was the most common co-morbidity in Ohio. Treatment patterns also varied by site; Colorado had the highest proportion of patients not on any treatment. ICS/LABA was the most commonly prescribed treatment except in Ohio, where ICS/LABA/LAMA was most common. Conclusions and Relevance Our data show heterogeneity in demographic, clinical, and treatment characteristics of patients diagnosed with COPD who are managed in primary care across different healthcare organizations in the US.","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":"13 1","pages":"17 - 31"},"PeriodicalIF":8.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44347565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Health-Related Quality of Life in Randomised Controlled Trials: Expected and Reported Results Do Not Match","authors":"F. Wiedemann, F. Porzsolt","doi":"10.2147/POR.S350165","DOIUrl":"https://doi.org/10.2147/POR.S350165","url":null,"abstract":"Purpose The assessment of health-related quality of life (hrQoL) may need to be reconsidered due to important differences between efficacy (the effect of a treatment under experimental study conditions) and effectiveness (the effect of a treatment under real-world conditions). We presume that most researchers intend to describe effects under real-world conditions when investigating hrQoL as an endpoint. Unfortunately, most studies are designed to confirm two theories: the efficacy of a new intervention under experimental study conditions and the real-world effectiveness of this intervention on hrQoL under non-experimental study conditions. Conflicting information emerges when the outcomes are supposed to describe effects under real-world conditions, but the assessment generates results obtained under experimental conditions. This paper examines the existing conflict between efficacy and effectiveness in a sample of 100 studies investigating hrQoL. Methods We analysed a sample of freely available publications of clinical studies listed in PubMed between April 2015 and August 2016 which assessed quality of life as an outcome. We assessed the following four characteristics that should differ in studies measuring either efficacy or effectiveness: 1) specification of the study as a randomised controlled trial or not, 2) description of the study design as pragmatic or not, 3) classification of the study as an efficacy or an effectiveness study and 4) number of selected inclusion and exclusion criteria. Results 91% of the studies assessed hrQoL under experimental conditions (in a randomised controlled trial), but not under real-world conditions. The important difference between efficacy and effectiveness was not described in 60% of the studies. Only 6% of studies classified the study as a pragmatic trial. The difference between inclusion and exclusion criteria was not addressed in any of the investigated studies. Conclusion The results of the four criteria confirmed our hypothesis that hrQoL studies are conducted mainly as experimental, but not pragmatic, trials indicating that the meaningfulness of the important difference between efficacy and effectiveness requires further discussion. Keywords pragmatic trial, experimental study conditions, real-world conditions, efficacy, effectiveness, pragmatic.","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":"13 1","pages":"9 - 16"},"PeriodicalIF":8.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41695296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deriving a Standardised Recommended Respiratory Disease Codelist Repository for Future Research.","authors":"Clare MacRae, Hannah Whittaker, Mome Mukherjee, Luke Daines, Ann Morgan, Chukwuma Iwundu, Mohammed Alsallakh, Eleftheria Vasileiou, Eimear O'Rourke, Alexander T Williams, Philip W Stone, Aziz Sheikh, Jennifer K Quint","doi":"10.2147/POR.S353400","DOIUrl":"10.2147/POR.S353400","url":null,"abstract":"<p><strong>Background: </strong>Electronic health record (EHR) databases provide rich, longitudinal data on interactions with healthcare providers and can be used to advance research into respiratory conditions. However, since these data are primarily collected to support health care delivery, clinical coding can be inconsistent, resulting in inherent challenges in using these data for research purposes.</p><p><strong>Methods: </strong>We systematically searched existing international literature and UK code repositories to find respiratory disease codelists for asthma from January 2018, and chronic obstructive pulmonary disease and respiratory tract infections from January 2020, based on prior searches. Medline searches using key terms provided in article lists. Full-text articles, supplementary files, and reference lists were examined for codelists, and codelists repositories were searched. A reproducible methodology for codelists creation was developed with recommended lists for each disease created based on multidisciplinary expert opinion and previously published literature.</p><p><strong>Results: </strong>Medline searches returned 1126 asthma articles, 70 COPD articles, and 90 respiratory infection articles, with 3%, 22% and 5% including codelists, respectively. Repository searching returned 12 asthma, 23 COPD, and 64 respiratory infection codelists. We have systematically compiled respiratory disease codelists and from these derived recommended lists for use by researchers to find the most up-to-date and relevant respiratory disease codelists that can be tailored to individual research questions.</p><p><strong>Conclusion: </strong>Few published papers include codelists, and where published diverse codelists were used, even when answering similar research questions. Whilst some advances have been made, greater consistency and transparency across studies using routine data to study respiratory diseases are needed.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":"13 ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/03/por-13-1.PMC8859726.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39958272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Experiences of COVID-19 Vaccine Side-Effects Among Healthcare Workers in Southern Ethiopia: A Cross-Sectional Study.","authors":"Bewunetu Zewude,&nbsp;Tewodros Habtegiorgis,&nbsp;Ashenafi Hizkeal,&nbsp;Tamirat Dela,&nbsp;Getahun Siraw","doi":"10.2147/POR.S344848","DOIUrl":"https://doi.org/10.2147/POR.S344848","url":null,"abstract":"<p><strong>Background: </strong>We examined the perceptions of healthcare workers about the side-effects of COVID-19 vaccine and the types of side-effects they experienced in the post-vaccination period.</p><p><strong>Methods: </strong>An institutional-based cross-sectional survey research design was used in which a semi-structured questionnaire was distributed to collect quantitative data from healthcare workers in Southern Ethiopia that were selected on the basis of a multi-stage cluster sampling technique. After inserting the completed cases into SPSS software, descriptive statistical techniques, such as frequencies, percentages, charts and inferential statistical tool, particularly binary logistic regression analysis, were used to analyze and present the data.</p><p><strong>Results: </strong>Majority (43.6%) of respondents perceive that COVID-19 vaccine will have muscle pain around the injection site, followed by fever (39.9%), problems of blood clots (37.8%), headache (35.6%), fatigue (33.5%), and aching limbs (16%). And 63.6%) of them reported that they have experienced muscle pain around the injection site after receiving the COVID-19 vaccine, followed by fatigue (42%), headache (37.2%), fever (34.2%), redness around the injection site (21.6%), and swelling around the injection site (17.8%). Moreover, 25% reported that the fear of potential side-effects of COVID-19 vaccine inhibited them from taking the vaccine. Above all, it is found that respondents' expectation of COVID-19 vaccine to have such serious side-effects is significantly associated to their educational status (OR = 0.229; P < 0.01; 95%C.I.: 0.080-0.651).</p><p><strong>Conclusion: </strong>While the expectations of most of the healthcare workers regarding the side-effects of the vaccine are parallel to the normal reactions of the vaccine, a significant proportion of the study participants have reported that they perceive COVID-19 vaccine will have life-threatening side-effects. Such fears have also played a role in affecting vaccine uptake. Therefore, the Ministry of Health, and other concerned government bodies should create further awareness on COVID-19 vaccine and related safety issues.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"131-145"},"PeriodicalIF":8.9,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/cb/por-12-131.PMC8687675.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39750050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Pitfalls of Using Repeat Spirometry Recordings in Routine Primary Care Data to Measure FEV₁ Decline in a COPD Population.","authors":"Hannah R Whittaker,&nbsp;Steven J Kiddle,&nbsp;Jennifer K Quint","doi":"10.2147/POR.S319965","DOIUrl":"https://doi.org/10.2147/POR.S319965","url":null,"abstract":"<p><strong>Background: </strong>Electronic healthcare records (EHR) are increasingly used in epidemiological studies but are often viewed as lacking quality compared to randomised control trials and prospective cohorts. Studies of patients with chronic obstructive pulmonary disease (COPD) often use the rate of forced expiratory volume in 1 second (FEV₁) decline as an outcome; however, its definition and robustness in EHR have not been investigated. We aimed to investigate how the rate of FEV₁ decline differs by the criteria used in an EHR database.</p><p><strong>Methods: </strong>Clinical Practice Research Datalink and Hospital Episode Statistics were used. Patient populations were defined using 8 sets of criteria around repeated FEV₁ measurements. At a minimum, patients had a diagnosis of COPD, were ≥35 years old, were current or ex-smokers, and had data recorded from 2004. FEV₁ measurements recorded during follow-up were identified. Thereafter, eight populations were defined based on criteria around: i) the exclusion of patients or individual measurements with potential measurement error; ii) minimum number of FEV₁ measurements; iii) minimum time interval between measurements; iv) specific timing of measurements; v) minimum follow-up time; and vi) the use of linked data. For each population, the rate of FEV₁ decline was estimated using mixed linear regression.</p><p><strong>Results: </strong>For 7/8 patient populations, rates of FEV₁ decline (age and sex adjusted) were similar and ranged from -18.7mL/year (95% CI -19.2 to -18.2) to -16.5mL/year (95% CI -17.3 to -15.7). Rates of FEV₁ decline in populations that excluded patients with potential measurement error ranged from -79.4mL/year (95% CI -80.7 to -78.2) to -46.8mL/year (95% CI -47.6 to -46.0).</p><p><strong>Conclusion: </strong>FEV₁ decline remained similar in a COPD population regardless of number of FEV₁ measurements, time intervals between measurements, follow-up period, exclusion of specific FEV₁ measurements, and linkage to HES. However, exclusion of individuals with questionable data led to selection bias and faster rates of decline.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"119-130"},"PeriodicalIF":8.9,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/11/por-12-119.PMC8420778.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39408289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Counseling Practices in Medicine Retail Outlets Found in Bench Sheko Zone, Southern Nations, Nationalities, and Peoples' Region, South West Ethiopia.","authors":"Fikadu Ejeta,&nbsp;Diriba Feyisa,&nbsp;Oliyad Kebede,&nbsp;Temesgen Aferu,&nbsp;Jafer Siraj,&nbsp;Desalegn Feyissa,&nbsp;Emebet Wodajo,&nbsp;Alemu Tamiru","doi":"10.2147/POR.S322407","DOIUrl":"https://doi.org/10.2147/POR.S322407","url":null,"abstract":"<p><strong>Objective: </strong>The objectives of this research were to investigate pharmacy professionals' counseling practices as well as to evaluate pharmacy professionals' counseling skills and the content of counseling services provided to patients visiting medicine retail outlets.</p><p><strong>Methods: </strong>A facility-based observational cross-sectional study was used to assess medication counseling practice by pharmacy professionals. Data were gathered through an observation and a semi-structured questionnaire. Epi data version 4.0.2 was used to enter data, which was subsequently exported to SPSS version 21.0 for analysis. ANOVA and post hoc statistical analyses were used to investigate the association between independent and dependent variables; and a 0.05 p-value was considered.</p><p><strong>Results: </strong>This study has a total of 105 pharmacy professionals that were included in the analysis. The majority of those who responded were between the ages of 25 and 29. The most common drug information offered by pharmacy staff to patients was frequency of administration (90%), length of therapy (90%), and unit dose dispensed, according to the current study (86%). Pharmacy professionals' age was significant on components of counseling practice as on mentioning the name of drugs during dispensing the medication (p=0.000), the route of administration (p=0.000), a drug dose (p=0.003), frequency of drug administration (p=0.016), proper medicine storage (p=0.024), type of dosage form (p=0.025), and duration of treatment (p=0.012). In comparison with the other age groups, an age greater than 40 years was significant on components of counseling practice (p=0.001) as a factor associated with penurious counseling practice than the other groups.</p><p><strong>Conclusion: </strong>This study shows that counseling practice is still quite low in comparison to what is expected. Some of the issues that affect counseling include a high patient load, the lack of a private counseling room, a lack of updated drug knowledge, and a lack of experience were factors that influence counseling.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"105-117"},"PeriodicalIF":8.9,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/62/por-12-105.PMC8403070.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients.","authors":"Rupert Jones, Andrew Davis, Brooklyn Stanley, Steven Julious, Dermot Ryan, David J Jackson, David M G Halpin, Katherine Hickman, Hilary Pinnock, Jennifer K Quint, Kamlesh Khunti, Liam G Heaney, Phillip Oliver, Salman Siddiqui, Ian Pavord, David H M Jones, Michael Hyland, Lewis Ritchie, Pam Young, Tony Megaw, Steve Davis, Samantha Walker, Stephen Holgate, Sue Beecroft, Anu Kemppinen, Francis Appiagyei, Emma-Jane Roberts, Megan Preston, Antony Hardjojo, Victoria Carter, Marije van Melle, David Price","doi":"10.2147/POR.S316186","DOIUrl":"10.2147/POR.S316186","url":null,"abstract":"<p><strong>Introduction: </strong>Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and untested COVID-19 patients in primary care.</p><p><strong>Methods: </strong>This is an observational study using data from Platform C19, a quality improvement program-derived research database linking primary care electronic health record data (EHR) with patient-reported questionnaire information. Participating general practices invited consenting patients aged 18-85 to complete an online questionnaire since 7th August 2020. COVID-19 self-diagnosis, clinician-diagnosis, testing, and the presence and duration of symptoms were assessed via the questionnaire. Patients were considered present with long COVID if they reported symptoms lasting ≥4 weeks. EHR and questionnaire data up till 22nd January 2021 were extracted for analysis. Multivariable regression analyses were conducted comparing demographics, clinical characteristics, and presence of symptoms between patients with long COVID and patients with shorter symptom duration.</p><p><strong>Results: </strong>Long COVID was present in 310/3151 (9.8%) patients with self-diagnosed, clinician-diagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had test-confirmed COVID-19. Risk predictors of long COVID were age ≥40 years (adjusted Odds Ratio [AdjOR]=1.49 [1.05-2.17]), female sex (adjOR=1.37 [1.02-1.85]), frailty (adjOR=2.39 [1.29-4.27]), visit to A&E (adjOR=4.28 [2.31-7.78]), and hospital admission for COVID-19 symptoms (adjOR=3.22 [1.77-5.79]). Aches and pain (adjOR=1.70 [1.21-2.39]), appetite loss (adjOR=3.15 [1.78-5.92]), confusion and disorientation (adjOR=2.17 [1.57-2.99]), diarrhea (adjOR=1.4 [1.03-1.89]), and persistent dry cough (adjOR=2.77 [1.94-3.98]) were symptom features statistically more common in long COVID.</p><p><strong>Conclusion: </strong>This study reports the factors and symptom features predicting long COVID in a broad primary care population, including both test-confirmed and the previously missed group of COVID-19 patients.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":"12 ","pages":"93-104"},"PeriodicalIF":2.3,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/c3/por-12-93.PMC8366779.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9397750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Significant Changes of Glycemic Control and Renal Function in Patients with Advanced-Stage Diabetic Kidney Disease by Switching from Linagliptin to Teneligliptin.","authors":"Keiji Hirai,&nbsp;Hiroaki Nonaka,&nbsp;Moeka Ueda,&nbsp;Junki Morino,&nbsp;Shohei Kaneko,&nbsp;Saori Minato,&nbsp;Yuko Mutsuyoshi,&nbsp;Katsunori Yanai,&nbsp;Hiroki Ishii,&nbsp;Momoko Matsuyama,&nbsp;Taisuke Kitano,&nbsp;Akinori Aomatsu,&nbsp;Haruhisa Miyazawa,&nbsp;Kiyonori Ito,&nbsp;Yuichiro Ueda,&nbsp;Susumu Ookawara,&nbsp;Yoshiyuki Morishita","doi":"10.2147/POR.S314409","DOIUrl":"https://doi.org/10.2147/POR.S314409","url":null,"abstract":"<p><strong>Purpose: </strong>We compared the efficacy of teneligliptin versus linagliptin for glycemic control and renoprotection in patients with advanced-stage diabetic kidney disease.</p><p><strong>Patients and methods: </strong>Changes in the glycated hemoglobin (HbA1c), fasting blood glucose concentration, urine albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) during a 12-month period were retrospectively analyzed after switching from linagliptin to teneligliptin in 13 patients with advanced-stage diabetic kidney disease (teneligliptin group). Thirteen propensity score-matched patients who were treated with linagliptin alone served as controls (linagliptin group).</p><p><strong>Results: </strong>The HbA1c, fasting blood glucose concentration, and UACR did not change during the 12-month study period in either group. The annual change rate in the eGFR did not differ between before and after baseline in either group.</p><p><strong>Conclusion: </strong>Switching from linagliptin to teneligliptin may not improve glycemic control, reduce urinary protein excretion, or ameliorate the rate of renal function decline in patients with advanced-stage diabetic kidney disease. These results suggest that teneligliptin may not be more advantageous for glycemic control and renoprotection compared with linagliptin in patients with advanced-stage diabetic kidney disease.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"81-91"},"PeriodicalIF":8.9,"publicationDate":"2021-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/2e/por-12-81.PMC8354772.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39323540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}