{"title":"Guest Editors’ Memo","authors":"Marc A. Simon, Richard A. Krasuski","doi":"10.21693/1933-088x-22.3.121","DOIUrl":"https://doi.org/10.21693/1933-088x-22.3.121","url":null,"abstract":"","PeriodicalId":92747,"journal":{"name":"Advances in pulmonary hypertension","volume":"27 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135614565","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":"Effects of Face-to-Face Nursing Support on Optimal Adherence to Oral Titratable PAH Therapies","authors":"Evangelia Sourounis, Pavlo Kyrychenko, Elisea Avalos-Reyes, Denise Bagford, Rashmi Grover, Lucia Feczko, Kjel Johnson","doi":"10.21693/1933-088x-22.3.144","DOIUrl":"https://doi.org/10.21693/1933-088x-22.3.144","url":null,"abstract":"Background Therapies currently available to pulmonary arterial hypertension (PAH) patients do not reverse the disease; however, they improve pulmonary hemodynamics, offer symptomatic relief, and lengthen the time to clinical worsening. These therapies do not come without their challenges, which include side effects and compliance with challenging titration regimens. Health care providers, particularly nurses, play a significant role in improving patient medication adherence. In-home nurse visits offer disease state education, set medication expectations, and provide support tools for patients when experiencing adverse events that may lead to therapy discontinuation. The purpose of this study is to determine the impact that in-home, face-to-face nursing visits have on optimal adherence to oral PAH therapies. Methods We identified patients who received an oral PAH drug (riociguat, selexipag, or treprostinil) supported by a nursing program (study group) and patients who received an oral PAH drug (bosentan, ambrisentan, or macitentan) not supported by a nursing program (control group) using CVS Health pharmacy data from January 1, 2018, to June 30, 2019. A logistic regression model examined demographic and medication factors associated with adherence. Results From January 2018 to June 2019, we identified 107 patients in the study group and 213 patients in the control group. After 6 months, patients in the study group reported 0.6 more fill counts (5.1 vs 4.5; P = .002) and an 11% higher medication possession ratio (MPR) than those in the control group (86.4% vs 75.0%; P = .001). After adjusting for patient characteristics, control patients tended to be more likely to drop therapy in the first 6 months after the index fill (hazard ratio = 1.52; P = .064). After 6 months, the study group reported higher rates of therapy persistence than the control group (72.0% vs 60.6%; P < .05). Conclusions Patients receiving oral PAH therapies (riociguat, selexipag, or treprostinil) supported through a visiting nurse program had significantly higher rates of optimal adherence as demonstrated by a statistically significant improvement in the MPR and a higher prescription fill count than a control group. Ultimately, a multidisciplinary approach supporting the patient and providing patient education, proper motivation, and face-to-face nursing may support improved patient outcomes.","PeriodicalId":92747,"journal":{"name":"Advances in pulmonary hypertension","volume":"26 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135614567","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":"PH Roundtable: The Role of Caregivers in Pulmonary Hypertension Care","authors":"","doi":"10.21693/1933-088x-22.2.98","DOIUrl":"https://doi.org/10.21693/1933-088x-22.2.98","url":null,"abstract":"","PeriodicalId":92747,"journal":{"name":"Advances in pulmonary hypertension","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42197956","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":"Diet and Exercise Intervention in Pulmonary Hypertension","authors":"Natalie M. Taylor, G. Heresi","doi":"10.21693/1933-088x-22.2.106","DOIUrl":"https://doi.org/10.21693/1933-088x-22.2.106","url":null,"abstract":"Current pharmacologic treatments for pulmonary arterial hypertension lead to vasodilation of the pulmonary arteries, increasing cardiac output and reducing pulmonary vascular resistance in patients with pulmonary arterial hypertension. Right ventricular failure is a leading cause of death in patients with pulmonary arterial hypertension, but there remain no promising leads in the treatment of right ventricular failure. Current research demonstrates that metabolic abnormalities, particularly regarding insulin resistance and glucose intolerance, may be pathologic in the development of right ventricular failure in patients with pulmonary arterial hypertension. In this review, we will address the potential role diet and exercise may play in improving right ventricular failure in patients with pulmonary arterial hypertension.","PeriodicalId":92747,"journal":{"name":"Advances in pulmonary hypertension","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41858163","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":"Wearable Devices in Pulmonary Arterial Hypertension: What Are We Trying to Learn?","authors":"D. Lachant, R. White","doi":"10.21693/1933-088x-22.2.92","DOIUrl":"https://doi.org/10.21693/1933-088x-22.2.92","url":null,"abstract":"\u0000 \u0000 Wearable technologies (accelerometers) are currently being evaluated as an alternative to the 6-minute walk test as an objective measure of functional status in pulmonary arterial hypertension (PAH). Multiple observational studies incorporating accelerometers have shown patients with PAH have low physical activity (PA) time.\u0000 \u0000 \u0000 \u0000 Despite widespread use of accelerometers, PA has not been shown to increase after adding vasodilator therapy, which suggests a behavioral component influencing activity. A decrease in PA from baseline may identify clinical worsening and someone at risk for future hospitalization. Cardiac Effort, the number of heart beats used during the 6-minute walk test/6-minute walk distance (beats per meter), has less variability than 6-minute walk distance and provides a comparable clinic measurement in the home setting. Cardiac Effort may provide a better remote measurement than changes in total daily activity when evaluating for clinical improvement.\u0000 \u0000 \u0000 \u0000 The amount and duration of PA achieved in patients with PAH is likely related to a combination of right ventricular (RV) function, deconditioning, and environmental factors. Strategies to target all aspects are needed to improve PA. Further studies are needed to determine the optimal remote measure and monitoring period.\u0000","PeriodicalId":92747,"journal":{"name":"Advances in pulmonary hypertension","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46020837","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":"Socioeconomic and Social Determinants of Health: Effects on Pulmonary Arterial Hypertension Care","authors":"R. Bernardo, A. Jose, J. Elwing","doi":"10.21693/1933-088x-22.2.111","DOIUrl":"https://doi.org/10.21693/1933-088x-22.2.111","url":null,"abstract":"There is increasing awareness on the significance of socioeconomic status, social determinants of health, and the role of ethnicity and race in clinical outcomes of patients with pulmonary arterial hypertension. However, to date, underrepresentation of minorities in pulmonary hypertension clinical trials and registries remains. In the present review, we summarize the current knowledge on race, ethnicity, traditional and novel socioeconomics and social determinants of health, and its association with clinical outcomes in patients with pulmonary arterial hypertension. We present case examples on the interplay of these factors for specific disease phenotypes and discuss strategies for addressing these variables at the patient care level.","PeriodicalId":92747,"journal":{"name":"Advances in pulmonary hypertension","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43637666","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":"PH Professional Network: Mental Health and PH: APRNs and RNs Having a Positive Effect","authors":"Lillian Hansen, J. Brewer","doi":"10.21693/1933-088x-22.2.87","DOIUrl":"https://doi.org/10.21693/1933-088x-22.2.87","url":null,"abstract":"Pulmonary hypertension is a complex and progressive disease. Patients suffering from pulmonary hypertension may also experience mental health issues. Screening and treatment for mental health issues in the pulmonary hypertension population is imperative but remains a challenge. Advanced practice registered nurses and registered nurses are key to overcoming these challenges.","PeriodicalId":92747,"journal":{"name":"Advances in pulmonary hypertension","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41823592","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}