3 results
Search Results
2. Challenges in heart failure care in four European countries: a comparative study.
- Author
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Steiner, Bianca, Neumann, Anne, Pelz, Yannick, Ski, Chantal F, Hill, Loreena, Thompson, David R, Fitzsimons, Donna, Dixon, Lana J, Brandts, Julia, Verket, Marlo, Schütt, Katharina, Eurlings, Casper G M J, Boyne, Josiane J J, Gingele, Arno J, Maesschalck, Lieven De, Murphy, Marguerite, Luz, Ermelinda Furtado da, Barrett, Matthew, Windle, Karen, and Hoedemakers, Thom
- Subjects
HEART failure treatment ,HEALTH services accessibility ,RESEARCH methodology ,SELF-management (Psychology) ,MEDICAL care ,POPULATION geography ,INTERVIEWING ,ACQUISITION of data ,COMPARATIVE studies ,MEDICAL care research ,QUESTIONNAIRES ,MEDICAL records ,MEDICAL informatics ,HEART failure - Abstract
Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
3. Burden of comorbid conditions in children and young people with juvenile idiopathic arthritis: a collaborative analysis of 3 JIA registries.
- Author
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Kearsley-Fleet, Lianne, Klotsche, Jens, Straalen, Joeri W van, Costello, Wendy, D'Angelo, Gianfranco, Giancane, Gabriella, Horneff, Gerd, Klein, Ariane, Láday, Matilda, Lunt, Mark, Roock, Sytze de, Ruperto, Nicolino, Schoemaker, Casper, Vijatov-Djuric, Gordana, Vojinovic, Jelena, Vougiouka, Olga, Wulffraat, Nico M, (PRINTO), UK JIA Biologics Registers Investigators Group; Paediatric Rheumatology International Trials Organisation, Hyrich, Kimme L, and Minden, Kirsten
- Subjects
REPORTING of diseases ,JUVENILE idiopathic arthritis ,POPULATION geography ,BIOTHERAPY ,CHICKENPOX vaccines ,ANTIRHEUMATIC agents ,COMORBIDITY - Abstract
Objectives Burden of comorbidities are largely unknown in JIA. From 2000, national and international patient registries were established to monitor biologic treatment, disease activity and adverse events in patients with JIA. The aim of this analysis was to investigate in parallel, for the first time, three of the largest JIA registries in Europe/internationally—UK JIA Biologic Registers (BCRD/BSPAR-ETN), German biologic registers (BiKeR/JuMBO), multinational Pharmachild—to quantify the occurrence of selected comorbidities in patients with JIA. Methods Information on which data the registers collect were compared. Patient characteristics and levels of comorbidity were presented, focussing on four key conditions: uveitis, MAS, varicella, and history of tuberculosis. Incidence rates of these on MTX/biologic therapy were determined. Results 8066 patients were registered into the three JIA registers with similar history of the four comorbidities across the studies; however, varicella vaccination coverage was higher in Germany (56%) vs UK/Pharmachild (16%/13%). At final follow-up, prevalence of varicella infection was lower in Germany (15%) vs UK/Pharmachild (37%/50%). Prevalence of TB (0.1–1.8%) and uveitis (15–19%) was similar across all registers. The proportion of systemic-JIA patients who ever had MAS was lower in Germany (6%) vs UK (15%) and Pharmachild (17%). Conclusion This analysis is the first and largest to investigate the occurrence of four important comorbidities in three JIA registries in Europe and the role of anti-rheumatic drugs. Combined, these three registries represent one of the biggest collection of cases of JIA worldwide and offer a unique setting for future JIA outcome studies. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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