Pragmatic and Observational Research最新文献

{"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}

{"title":"Assessment of Ethical Compliance of Handling and Usage of the Human Body in Anatomical Facilities of Ethiopian Medical Schools.","authors":"Solomon Tesfaye,&nbsp;Niguse Hamba,&nbsp;Wakjira Kebede,&nbsp;Mitiku Bajiro,&nbsp;Lemessa Debela,&nbsp;Tihahun Alemayehu Nigatu,&nbsp;Asfaw Gerbi","doi":"10.2147/POR.S321646","DOIUrl":"https://doi.org/10.2147/POR.S321646","url":null,"abstract":"<p><strong>Background: </strong>Human anatomy has historically been a cornerstone in medical education and is special in that it uses human remains kept in various anatomical facilities like a morgue, gross anatomy laboratory, or museums for instruction and research. While serving knowledge advancement facilitating clinical practice and research, human cadaver handling, and usage at all levels, such as cadaver sourcing, transportation, storage, preservation, dissection, and final disposal deserves in return the utmost respect. In Ethiopia, even though there is not enough information on when, where, and by whom the first cadaver dissection was conducted, dissection is being conducted in many of its medical schools. Despite ethical necessity surrounding human body usage in every anatomical setting, there is still ethical and legal uncertainty due to several challenging barriers which is severe in developing nations including Ethiopia. The aim of this study is, therefore, to assess ethical practices of handling and usage of the human body to promote, in the near future, formulation and implementation of acceptable, respectful, and ethical guidelines for the anatomy dissection laboratories and related settings in Ethiopia.</p><p><strong>Methods: </strong>A multicentered cross-sectional study was used at selected anatomy facilities of eight Ethiopian medical schools. The collected data through structured questionnaires and checklists were cleaned, preset and entered in to SPSS version 20 for analysis. Internal consistency and reliability were measured by using Cronbach's alpha.</p><p><strong>Results: </strong>The study result showed vivid human body ethical breaches that ranged from lack of power by anatomy unit to oversee the process during sourcing, transportation, embalming, caring, and dissection of cadavers in the anatomy laboratories to student's mistreatment of cadavers.</p><p><strong>Conclusion: </strong>In addition to lack of compliance due to lack of standard ethical guidelines or policies regarding human body usage, the compliance-based professional development is also nonexistent. The ethical way of body sourcing is through body donation; however, in Ethiopia, anatomy teaching exclusively depends on unclaimed bodies. Using a body for dissection that is solely sourced unethically may generate a negative emotional sense of life for anatomy instructors, technical assistants, morticians, and medical students. We inspire better provision of moral and ethical exercise with the good practice concerning the human body through recognizing the humanity and uniqueness of the deceased person. The results of this study serve as a serious condemnation of practices in Ethiopian anatomy facilities and we urge the Anatomical Society of Ethiopia to play its part in changing the present practices related to ethical and legal uncertainty of the human body usage.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"65-80"},"PeriodicalIF":8.9,"publicationDate":"2021-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/8c/por-12-65.PMC8285299.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203618","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":"Treatment Compliance Communications Between Patients with Severe Mental Illness and Treating Healthcare Providers: A Retrospective Study of Documentation Using Healthcare Reimbursement Claims and Medical Chart Abstraction.","authors":"Carolyn Martin,&nbsp;Eleena Koep,&nbsp;John White,&nbsp;Angela Belland,&nbsp;Heidi Waters,&nbsp;Felicia Forma","doi":"10.2147/POR.S303453","DOIUrl":"https://doi.org/10.2147/POR.S303453","url":null,"abstract":"<p><strong>Introduction: </strong>Successful treatment for serious mental illnesses (SMIs) requires a good therapeutic alliance with healthcare providers and compliance with prescribed therapies such as antipsychotic medications. This retrospective study, which utilized administrative claims linked with abstracted medical chart data, addressed a data gap regarding compliance-related discussions between providers and patients.</p><p><strong>Methods: </strong>Commercially insured patients in ambulatory care post-acute (emergency or inpatient) event were eligible. Criteria included age 18-65 years; schizophrenia, bipolar disorder, or major depressive disorder diagnoses; continuous enrollment 6 months before to 12 months after the first acute event claim dated 01/01/2014 to 12/31/2015; and antipsychotic medication prescription. Demographic and clinical data, and patient-provider discussions about treatment compliance were characterized from claims and abstracted medical charts.</p><p><strong>Results: </strong>Ninety patients (62% female, mean age 41 years) were included and 680 visits were abstracted; only 58% had first-visit antipsychotic compliance discussions. Notably, 18% of patients had discussions using the specific terms \"compliance,\" \"persistence,\" or \"adherence,\" whereas half were identified by more general terms. Compliance discussions were observed least often among the patients with schizophrenia, as compared with bipolar or major depressive disorders-a counterintuitive finding.</p><p><strong>Discussion: </strong>Compliance discussions may represent intervention opportunities to optimize treatment, yet their study is a complex endeavor. The results of this study show an opportunity to improve this valuable treatment step.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"49-63"},"PeriodicalIF":8.9,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/28/por-12-49.PMC8214573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39100556","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":"Willingness to Take COVID-19 Vaccine Among People Most at Risk of Exposure in Southern Ethiopia.","authors":"Bewunetu Zewude,&nbsp;Tewodros Habtegiorgis","doi":"10.2147/POR.S313991","DOIUrl":"https://doi.org/10.2147/POR.S313991","url":null,"abstract":"<p><strong>Background: </strong>Acceptance of a vaccine or hesitancy towards it have great public health implications as they partly determine the extent to which people are exposed to infections that could have otherwise been prevented. The present study examined the willingness of primary and secondary school teachers, bank employees, and university instructors in southern Ethiopia to take a Covid-19 vaccine and the factors associated with their willingness.</p><p><strong>Methods: </strong>An institutional-based cross-sectional study design was used with a quantitative research approach. Primary data were gathered mainly through the use of a survey research method in which a self-administered questionnaire was distributed to randomly selected research participants in Wolaita Sodo town. Data analysis was conducted using statistical techniques, including percentages, frequency distributions, and logistic regression analysis.</p><p><strong>Results: </strong>Research participants generally had a low (46.1%) willingness to take a COVID-19 vaccine. The main reason for most (37%) respondents' hesitancy to take the vaccine is found to be the concern over the safety and/or the side effects of the vaccine (37%), followed by doubt about the vaccine's effectiveness (20.7%), and lack of adequate information (12.7%). Moreover, 38.9% of survey participants revealed that they would like to take a COVID-19 vaccine other than AstraZeneca whereas 61.1% of respondents replied that they do not want to take any kind of COVID-19 vaccine. Furthermore, respondents' willingness to take a COVID-19 vaccine is significantly associated with attitude towards the vaccine (OR = 2.830; 95% CI = 1.834-4.368), belief that Covid-19 exists in the study area (OR = 0.221; 95% CI = 0.083-0.589), the perception that prevalence and death rate reports of the government are real (OR = 0.365; 95% CI = 0.197-0.676), status of chronic diseases (OR = 2.883; 95%CI = 1.039-7.999), and having a close relative/friend ever infected by COVID-19 (OR = 2.602; 95% CI = 1.117-6.063).</p><p><strong>Conclusion: </strong>The findings of the research demonstrated that there is generally low willingness to take a COVID-19 vaccine among university instructors, bank employees, and primary and secondary school teachers in southern Ethiopia. Therefore, the federal ministry of health, Ethiopian food and drug controlling agency, the media, and all other concerned organizations should create increased awareness about the safety/side effects issues and the need to take the vaccine.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"37-47"},"PeriodicalIF":8.9,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/a8/por-12-37.PMC8166351.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39055361","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":"Maximizing Adherence and Gaining New Information For Your Chronic Obstructive Pulmonary Disease (MAGNIFY COPD): Study Protocol for the Pragmatic, Cluster Randomized Trial Evaluating the Impact of Dual Bronchodilator with Add-On Sensor and Electronic Monitoring on Clinical Outcomes.","authors":"David Price,&nbsp;Rupert Jones,&nbsp;Pascal Pfister,&nbsp;Hui Cao,&nbsp;Victoria Carter,&nbsp;Anu Kemppinen,&nbsp;Björn Holzhauer,&nbsp;Alan Kaplan,&nbsp;Allan Clark,&nbsp;David M G Halpin,&nbsp;Hilary Pinnock,&nbsp;James D Chalmers,&nbsp;Job F M van Boven,&nbsp;Kai M Beeh,&nbsp;Konstantinos Kostikas,&nbsp;Nicolas Roche,&nbsp;Omar Usmani,&nbsp;Paul Mastoridis","doi":"10.2147/POR.S302809","DOIUrl":"https://doi.org/10.2147/POR.S302809","url":null,"abstract":"<p><strong>Background: </strong>Poor treatment adherence in COPD patients is associated with poor clinical outcomes and increased healthcare burden. Personalized approaches for adherence management, supported with technology-based interventions, may offer benefits to patients and providers but are currently unproven in terms of clinical outcomes as opposed to adherence outcomes.</p><p><strong>Methods: </strong>Maximizing Adherence and Gaining New Information For Your COPD (MAGNIFY COPD study), a pragmatic cluster randomized trial, aims to evaluate the impact of an adherence technology package (interventional package), comprising an adherence review, ongoing provision of a dual bronchodilator but with an add-on inhaler sensor device and a connected mobile application. This will compare time to treatment failure and other clinical outcomes in patients identified at high risk of exacerbations with historic poor treatment adherence as measured by prescription collection to mono/dual therapy over one year (1312 patients) versus usual care. Treatment failure is defined as the first occurrence of one of the following: (1) moderate/severe COPD exacerbation, (2) prescription of triple therapy (inhaled corticosteroid/long-acting β₂-agonist/long-acting muscarinic antagonist [ICS/LABA/LAMA]), (3) prescription of additional chronic therapy for COPD, or (4) respiratory-related death. Adherence, moderate/severe exacerbations, respiratory-related healthcare resource utilization and costs, and intervention package acceptance rate will also be assessed. Eligible primary care practices (N=176) participating in the Optimum Patient Care Quality Improvement Program will be randomized (1:1) to either adherence support cluster arm (suitable patients already receiving or initiated Ultibro^® Breezhaler^® [indacaterol/glycopyrronium] will be offered interventional package) or the control cluster arm (suitable patients continue to receive usual clinical care). Patients will be identified and outcomes collected from anonymized electronic medical records within the Optimum Patient Care Research Database. On study completion, electronic medical record data will be re-extracted to analyze outcomes in both study groups.</p><p><strong>Registration number: </strong>ISRCTN10567920.</p><p><strong>Conclusion: </strong>MAGNIFY will explore patient benefits of technology-based interventions for electronic adherence monitoring.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"25-35"},"PeriodicalIF":8.9,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/7a/por-12-25.PMC8163732.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39055360","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":"Identification and Comparison of Patient Characteristics for Those Hospitalized with COVID-19 versus Influenza Using Machine Learning in a Commercially Insured US Population.","authors":"Xiaoxue Chen,&nbsp;Zhi Wang,&nbsp;Samantha G Bromfield,&nbsp;Andrea DeVries,&nbsp;David Pryor,&nbsp;Vincent Willey","doi":"10.2147/POR.S304220","DOIUrl":"https://doi.org/10.2147/POR.S304220","url":null,"abstract":"Background The novel severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID–19), continues to spread in the US through the 2020–2021 influenza season and beyond. Approaches to identify those most at risk for poor outcomes for the two viral infections are needed for future planning. As influenza is a well-known respiratory disease sharing some similarities to COVID-19, such comparison will aid physicians and health systems to predict disease trajectory and allocate health resources most efficiently. A retrospective cohort study using a French national administrative database found that patients hospitalized with COVID-19 were more frequently obese or overweight, diabetic, and hypertensive. 1 Patients hospitalized with influenza more frequently had heart failure, chronic respiratory disease, and cirrhosis. 1 Similar observations were reported in an international network study that included US, South Korea, and Spain. 2 While this information provides useful context to the current understanding of characteristics of patients hospitalized with COVID-19 in several countries, understanding of the overall risk profile for the two viral infections is lacking in a broad US population. Advanced modelling, machine learning, and artificial intelligence (AI) techniques have been employed to detect, diagnose, evaluate, and prioritize for Examples include laboratory examination frameworks to prioritize patients with COVID-19, AI techniques in the detection and classification of COVID-19 medical images, and models to predict the spread of disease. An increasing number of severe COVID-19 outcome risk assessment studies found that demographic factors, comorbidities, radiographic findings, and laboratory markers may individually or collectively predict worse outcomes. 3 deepen the understanding of COVID-19,","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"9-13"},"PeriodicalIF":8.9,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/5d/por-12-9.PMC8080116.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38939538","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":"Clinicians' Attitude Toward Computer-Guided Implant Surgery Approach: Survey in Saudi Arabia.","authors":"Linah M Ashy","doi":"10.2147/POR.S243623","DOIUrl":"https://doi.org/10.2147/POR.S243623","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the attitude of clinicians in Saudi Arabia towards dental implant treatment using different implant surgery approaches.</p><p><strong>Materials and methods: </strong>This cross-sectional observational study was conducted using a web-based questionnaire wherein 56 clinicians ranked their attitude toward computer-guided implant surgery (CGIS) and conventional non-computer-guided surgery (non-CGIS) in terms of advantages, disadvantages and clinical indications. Statistical analysis was conducted by the Spearman correlation test, Kruskal-Wallis test, and Wilcoxon rank sum tests, at a significance level of <i>P</i><0.05.</p><p><strong>Results: </strong>The survey results indicated that the most significant advantages of CGIS from the participants' perspective were low levels of stress during surgery (<i>P</i> = 0.003) and minimal requirement of surgical skills (<i>P</i> = 0.04). Notably, the advantages of accurate outcome and predictable flapless surgery were not considered significantly higher for CGIS than for non-CGIS (<i>P</i> = 0.2 and 0.7, respectively). The high treatment cost was the most significant disadvantage of CGIS when compared to non-CGIS (<i>P</i> = 0.002), and complete edentulism was the most recommended clinical condition for CGIS.</p><p><strong>Conclusion: </strong>Clinicians acknowledged the advantages of CGIS over non-CGIS, especially in complete edentulism. The significant advantages of CGIS were the clinician's state of low stress and minimal skills required rather than the patient's interest in treatment predictability. CGIS is an attractive approach for most participants, in spite of the low rate of actual use.</p>","PeriodicalId":20399,"journal":{"name":"Pragmatic and Observational Research","volume":" ","pages":"1-8"},"PeriodicalIF":8.9,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/ba/por-12-1.PMC8021253.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25589672","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}