The journal of medicine access最新文献

{"title":"Pre-pandemic factors associated with delayed health care among US older adults during the COVID-19 pandemic.","authors":"Alyssa N Jones, Melinda C Power","doi":"10.1177/27550834231202860","DOIUrl":"10.1177/27550834231202860","url":null,"abstract":"<p><strong>Background: </strong>During the first year of the COVID-19 pandemic, more than one-third of US older adults (aged 65 years and older) reported delaying medical care. Delayed health care may exacerbate short- and long-term health changes in older adults. Older adults more likely to delay health care may benefit from targeted follow-up to return these individuals to the health care system.</p><p><strong>Objective: </strong>The aim of this study was to describe pre-pandemic sociodemographic, psychological, cognitive, and medical factors associated with delayed health care among US older adults during the COVID-19 pandemic.</p><p><strong>Design: </strong>We conducted a secondary analysis of 2905 participants from the National Health and Aging Trends Study (NHATS), a nationally representative, prospective cohort of US older adult Medicare beneficiaries.</p><p><strong>Methods: </strong>Pre-pandemic factors were reported at the Round 9 interview (2019). Delayed health care, including medical (e.g. usual doctor) and supplementary (e.g. dental) care, was reported on the COVID-19 questionnaire (2020). We calculated adjusted odds ratios using weighted logistic regression, accounting for the NHATS sampling design.</p><p><strong>Results: </strong>Overall, 40% of participants reported delayed care. After adjustment, female participants and those reporting fair (vs good) health were consistently more likely to delay health care while persons with lower income or excellent health were less likely to delay care. Other associations varied by care type.</p><p><strong>Conclusion: </strong>Women and those with higher income or fair health before the COVID-19 pandemic were more likely to delay care during the pandemic. Our results may inform targeted outreach to older adults who delayed care during the COVID-19 pandemic, or other disruptions to the health care system, to return these individuals to care and promote better management of their health needs.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231202860"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/9c/10.1177_27550834231202860.PMC10590541.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694927","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":"Access and use of immunoglobulins in secondary supportive cancer care: A systematic literature review.","authors":"Muireann Counihan,&nbsp;Larisa Cervenakova,&nbsp;Dominika Misztela,&nbsp;Maarten Van Baelen,&nbsp;Bernard D Naughton","doi":"10.1177/27550834231197315","DOIUrl":"10.1177/27550834231197315","url":null,"abstract":"Background: Immunoglobulin replacement therapy (IgRT) benefits patients with primary immuno deficiency (PID) originating from the innate or polygenic defects in the immune system. However, evidence supporting their therapeutic role is not as explicit in secondary immuno deficiency (SID) resulting from the treatment of haematological malignancies. Objectives: This study aimed to (1) create a dataset of relevant research papers, which explore the use of IgRT in SID for analysis, (2) assess the risk of bias within this dataset and (3) study the characteristics of these papers. Design: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. In addition to the risk of bias, the study characteristics explored in this article included study design, study geographical location and year of publication. Data Sources and Methods: To identify studies relevant to the research question, EMBASE and PubMed databases were searched. The Population, Intervention, Comparison and Outcome (PICO) framework was used to assess study quality. Risk of bias and quality of studies were assessed in accordance with the study design. As one model was not appropriate to assess bias in all articles, several tools were used. Results: A total of 43 studies were identified from the literature search as relevant to the research objective. The most common study design was a retrospective case–control cohort study (n = 16/43), and randomised trials were among the least commonly used approaches (n = 1). Research in this area is occurring around the globe including the United States (n = 7), Italy (n = 7), China, India, Japan and throughout Europe. The annual number of papers in this area has varied from 2012 (n = 1) to 2021 (n = 7). The studies in this article demonstrated a varied risk of bias, with 9 of the 20 cohort studies scoring less than 5 out of 9 stars. Conclusions: Randomised controlled trials are less frequently used to assess access and use of immunoglobulins. More commonly, a retrospective case–control cohort study was used which correlates with the higher risk of bias seen in the studies in this article. Most of the research concerning immunoglobulin use and access occurs in higher-income countries.","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231197315"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/87/10.1177_27550834231197315.PMC10576927.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241918","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":"Accessing and re-accessing mental health walk-in clinics for children and families.","authors":"Catalina Sarmiento,&nbsp;Graham J Reid","doi":"10.1177/27550834231200617","DOIUrl":"https://doi.org/10.1177/27550834231200617","url":null,"abstract":"<p><strong>Background: </strong>Many child and youth mental health (CYMH) agencies across Canada and in Ontario are using mental health walk-in clinics (MHWCs).</p><p><strong>Objectives: </strong>(1) Explore how MHWCs are used by families (e.g. mean, mode, and median number of visits), and (2) document how often and how soon families returned for a second MHWC visit and identify correlates of time to a second MHWC visit.</p><p><strong>Design: </strong>Administrative data from two CYMH agencies in Ontario were extracted, including demographics, visit data, and presenting concerns.</p><p><strong>Methods: </strong>In this exploratory, descriptive study, analyses of administrative data were conducted to identify patterns and correlates of MHWC use before other agency services, compared to MHWC use exclusively.</p><p><strong>Results: </strong>About a third of children and families using MHWCs had two or more visits. Child age, guardianship, and disposition at discharge emerged as correlates of time to a second MHWC visit.</p><p><strong>Conclusion: </strong>MHWCs can save families' time, and both agencies' time and money by eliminating the need to complete a detailed assessment prior to treatment for cases that would go on to have a single visit within this service.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231200617"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167757","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":"Analysis of the effectiveness of remote intervention of patients affected by chronic diseases: A systematic review and meta-analysis.","authors":"Demetrius Ruben Borges de Rezende,&nbsp;Isadora Andrade Neto,&nbsp;Denise Hollanda Iunes,&nbsp;Leonardo César Carvalho","doi":"10.1177/27550834231197316","DOIUrl":"https://doi.org/10.1177/27550834231197316","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to verify the effectiveness of telemedicine in randomized controlled trials (RCTs) in terms of its influence on physical conditioning, quality of life, and health conditions in adults/elderly people affected by chronic diseases.</p><p><strong>Design: </strong>This was a systematic review and meta-analysis.</p><p><strong>Methods: </strong>The search covered RCTs published from 2011 to 2021 and was conducted using the PubMed, Embase, PEDro, Lilacs, and Cochrane Library databases, on volunteers of both sexes, that were rehabilitated, and/or monitored, and/or evaluated, specifically, via remote care. The extraction, quality of studies, and risk of bias were assessed using the RoB2 (risk of bias) tool, for analysis of the strength of evidence, the GRADE (Grading of Recommendations Assessment, Developing, and Evaluation) method was used, and for the preparation of meta-analysis was used at RevMan 5.4 (Review Manager) was used.</p><p><strong>Results: </strong>The database search identified 3949 potential articles for screening, 13 of which were eligible for the present systematic review, involving 1469 participants with chronic diseases (chronic obstructive pulmonary disease (COPD), asthma, heart failure, diabetes mellitus, and fibromyalgia). Through the meta-analysis, an advantage was identified for the remote intervention on physical conditioning (<i>p</i> = 0.001), with an estimated effect of 0.29 (0.11, 0.46) and on health conditions (<i>p</i> = 0.0004), -0.30 (-0.47, -0.14), while for quality of life, no significant difference was identified (<i>p</i> = 0.90), 0.01 (-0.13, 0.14).</p><p><strong>Conclusion: </strong>Telemedicine has clinical effectiveness for the outcome of physical conditioning and general health conditions in adults with chronic diseases when compared to usual care without face-to-face intervention.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231197316"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/05/10.1177_27550834231197316.PMC10540568.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41123905","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":"Insomnia in primary care: Considerations for screening, assessment, and management.","authors":"Mari Yamamoto, Christopher T Lim, Heather Huang, Margaret Spottswood, Hsiang Huang","doi":"10.1177/27550834231156727","DOIUrl":"10.1177/27550834231156727","url":null,"abstract":"<p><p>Insomnia, including insomnia disorder, is a common but often overlooked complaint in primary care settings. It is a risk factor for various medical and psychiatric diagnoses and is associated with substantial health care costs. While cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia disorder, access to CBT-I is limited. This article provides a pragmatic approach to screening, assessment, and treatment of insomnia in the primary care setting, promoting a population health approach. The authors review the role of CBT-I, treatment of comorbid conditions, and pharmacologic recommendations in working with primary care patients with insomnia. In addition, the authors highlight the potential utility of technology in improving access to insomnia care.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231156727"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/2b/10.1177_27550834231156727.PMC10021100.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153491","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":"Educator's views on suicide prevention in high schools and what they need.","authors":"Miranda Lynne Bevilacqua","doi":"10.1177/27550834231158188","DOIUrl":"10.1177/27550834231158188","url":null,"abstract":"<p><strong>Background: </strong>Suicide is the leading cause of death among youth. Although school-aged youth are surrounded by educators and professionals, little is known about what educators want to know regarding suicide.</p><p><strong>Objective and design: </strong>The purpose of this qualitative study was to explore the perceived learning needs of high school educators in Northwestern Ontario (NWO) regarding suicide prevention using semi-structured interviews.</p><p><strong>Results: </strong>The results yielded educators prefer learning based on a mixture of styles that is relevant to their student needs; noting that time constraints are a barrier. Educators are interested in knowing what to say; however, limited by the unknown legalities involved. Educators expressed being comfortable talking about suicide and understood basic warning signs.</p><p><strong>Conclusions: </strong>The findings can assist mental health professionals and school board administration in supporting educators regarding suicide prevention. Future research can include the creation of a suicide prevention program that is targeted exclusively for high school educators.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231158188"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/b8/10.1177_27550834231158188.PMC9969467.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9385395","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":"Knowledge, perception and acceptance of generic drugs in the general Lebanese population: A cross-sectional survey among adults.","authors":"Georges Hatem, Rana Itani, Roula Ajrouche, Nour Abbas, Rita Farah, Mathijs Goossens, Sanaa Awada","doi":"10.1177/27550834221147789","DOIUrl":"10.1177/27550834221147789","url":null,"abstract":"<p><strong>Background: </strong>Many governments encouraged generic use to enhance health equality and minimise health expenditure. The lack of knowledge and acceptance of generic medicines are the main barriers to their use.</p><p><strong>Objectives: </strong>This study aimed to assess population knowledge and perception towards generic drugs, identify their primary sources of information and examine which variables are independently related to their acceptance.</p><p><strong>Design: </strong>An observational cross-sectional study was performed targeting the Lebanese adult population.</p><p><strong>Methods: </strong>Overall, 385 patients participated in the study. Data were collected using a uniform survey from six public healthcare centres.</p><p><strong>Results: </strong>The participants reported a distrust towards generic drugs; they either said that they were not as effective as the brand (36.9%), were of less quality than the brand (38.5%) or had more side effects than the brand (38.4%). Around 52% said they would never buy a generic drug, and two-thirds (68.6%) preferred using a brand drug over a generic one. After adjusting for socio-demographics, a high income (odds ratio (OR) = 3.7), knowing that brands and generics have the same active ingredients (OR = 2.28) and that brands and generics were equally effective (OR = 6.46) were the strongest independent predictors for the willingness to buy generic drugs.</p><p><strong>Conclusion: </strong>A lack of knowledge and misperceptions about generic drugs limited the use of generic drugs, and therefore must be addressed.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834221147789"},"PeriodicalIF":0.0,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/36/10.1177_27550834221147789.PMC9850132.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10582096","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":"Impact of the COVID-19 pandemic on the consumption patterns of psychotropic drugs and predictors of limited access to medication.","authors":"Maya Rachidi,&nbsp;Georges Hatem,&nbsp;Melissa Hatem,&nbsp;Salam Zein,&nbsp;Samar Rachidi,&nbsp;Sanaa Awada","doi":"10.1177/27550834231163706","DOIUrl":"https://doi.org/10.1177/27550834231163706","url":null,"abstract":"<p><strong>Background: </strong>Despite the efforts of the health system to improve access to medications during the coronavirus disease of 2019 (COVID-19) pandemic, such as online consultations, encouraging generic prescriptions, and other measures to limit the storage of medication, psychotropic patients faced significant challenges in accessing their medications.</p><p><strong>Objectives: </strong>This study aimed (1) to compare the consumption of psychotropics before and during the pandemic, (2) to assess the association between having difficulties finding the medications and the general characteristics of the patients, and (3) to assess the predictors of these difficulties.</p><p><strong>Design: </strong>A case-control study was performed in which 128 patients (cases) were recruited during the pandemic (July-October 2021), and 256 patients (controls) using psychotropics before the pandemic were matched for age and sex.</p><p><strong>Methods: </strong>Data were collected using a uniform survey given to patients using psychotropics and filled out at their time and place preferences.</p><p><strong>Results: </strong>More patients used antipsychotics and anti-anxiety medications before the pandemic, while antidepressants were used more during the pandemic. Almost half of the patients reported facing difficulties finding their medications in both time frames. Before the pandemic, these difficulties were noted per increase in age and being employed and were less faced if patients had medical assistance or lived in the north of Lebanon. However, more patients reported having difficulties accessing their medication during the pandemic, with no significant differences.</p><p><strong>Conclusion: </strong>The consumption of psychotropic drugs was higher among cases. All patients faced challenges in accessing their medication throughout the pandemic, while older and employed patients had more limitations before the pandemic. Further investigations exploring viable solutions are recommended in order to maintain sustainable access to treatment.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231163706"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/0d/10.1177_27550834231163706.PMC10086612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9303863","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":"Ethical challenges and opportunities in the development and approval of novel therapeutics for rare diseases.","authors":"Djurdja Djordjevic,&nbsp;Andrew McFadyen,&nbsp;James A Anderson","doi":"10.1177/27550834231177507","DOIUrl":"https://doi.org/10.1177/27550834231177507","url":null,"abstract":"<p><p>The development of novel therapeutics for rare \"orphan\" diseases has brought a growing tension between the desire to accelerate access to these breakthrough therapies and the need to generate quality evidence regarding their safety and efficacy. Accelerating the pace of drug development and approval may facilitate the rapid delivery of benefits to patients and cost savings for research and development, which theoretically improves affordability of drugs for the health system. However, several ethical challenges arise with expedited approval, compassionate release of drugs, and subsequent study of drugs in \"real-world\" settings. In this article, we explore the changing landscape of drug approval and the ethical challenges expedited approval creates for patients, caregivers, clinicians, and institutions, and propose tangible strategies to maximize the benefits of \"real-world\" data acquisition while mitigating risks to patients, clinicians, and institutions.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231177507"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9647112","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":"Co-created decision-making: From co-production to value co-creation in health care.","authors":"Jason Amorim,&nbsp;Andréa Cardoso Ventura","doi":"10.1177/27550834231177503","DOIUrl":"https://doi.org/10.1177/27550834231177503","url":null,"abstract":"<p><p>Rare diseases are characterized by a wide diversity of signs and symptoms and vary not only from disease to disease but also from person to person, and living with a disease leads patients to peculiar experiences, without limits of time and space, as they extend to various environments and relationships of their lives. Therefore, the objective of this study is the theoretical interaction between value co-creation (VC) and the stakeholder theory (ST) with the shared decision-making (SDM) health care theory, to enable the analysis of the relationships between patients and their stakeholders in the co-creation of value for decision-making focused on the patient's quality of life. It is configured as a multi-paradigmatic proposal by enabling the analysis of multiple perspectives of different stakeholders in health care. Thus, co-created decision-making (CDM) emerges with emphasis on interactivity of the relationships. As previous studies have already highlighted the importance of holistic care, seeing the patient as a whole and not just the body, studies with CDM will be beneficial for analyses that go beyond the clinical office and doctor-patient relationships, extending to all environments and interactions that add value to the patient's treatment. It was concluded that the essence of this new theory proposed here is neither in patient-centered care nor in patient self-care, but in co-created relationships with and between stakeholders, including non-health care environments that are important to the patient, such as relationships with friends, family, other patients with the same disease, social media, public policies, and the practice of pleasurable activities.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"7 ","pages":"27550834231177503"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/e7/10.1177_27550834231177503.PMC10262615.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299385","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}