scholarly journals Racial, Ethnic, and Socioeconomic Disparities in Web-Based Patient Portal Usage Among Kidney and Liver Transplant Recipients: Cross-Sectional Study

10.2196/11864 ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. e11864 ◽  
Author(s):  
Joel Wedd ◽  
Mohua Basu ◽  
Laura M Curtis ◽  
Kayla Smith ◽  
Denise J Lo ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Cross Sectional Study ◽  
Socioeconomic Disparities ◽  
Patient Portal ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Web Based ◽  
Liver Transplant Recipients ◽  
Racial Ethnic

scholarly journals Racial, Ethnic, and Socioeconomic Disparities in Web-Based Patient Portal Usage Among Kidney and Liver Transplant Recipients: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Joel Wedd ◽  
Mohua Basu ◽  
Laura M Curtis ◽  
Kayla Smith ◽  
Denise J Lo ◽  
...  
Keyword(s):  
Higher Education ◽  
Liver Transplant ◽  
Kidney Transplant ◽  
Socioeconomic Disparities ◽  
Patient Portal ◽  
Transplant Recipients ◽  
Patient Portals ◽  
Web Based ◽  
Liver Transplant Recipients ◽  
Racial Ethnic

BACKGROUND Kidney and liver transplant recipients must manage a complex care regimen after kidney transplant. Although the use of Web-based patient portals is known to improve patient-provider communication and health outcomes in chronic disease populations by helping patients manage posttransplant care, disparities in access to and use of portals have been reported. Little is known about portal usage and disparities among kidney and liver transplant recipients. OBJECTIVE The aim of this study was to examine patient racial/ethnic, socioeconomic, and clinical characteristics associated with portal usage among kidney and liver transplant recipients. METHODS The study included all adult kidney and liver transplant recipients (n=710) at a large academic transplant center in the Southeastern United States between March 2014 and November 2016. Electronic medical record data were linked with Cerner portal usage data. Patient portal use was defined as any portal activity (vs no activity) recorded in the Cerner Web-based portal, including viewing of health records, lab results, medication lists, and the use of secure messaging. Multivariable log-binomial regression was used to determine the patient demographic, clinical, and socioeconomic characteristics associated with portal usage, stratified by organ. RESULTS Among 710 transplant recipients (n=455 kidney, n=255 liver), 55.4% (252/455) of kidney recipients and 48.2% (123/255) of liver recipients used the patient portal. Black patients were less likely to use the portal versus white patients among both kidney (57% black vs 74% white) and liver (28% black vs 55% white) transplant recipients. In adjusted multivariable analyses, kidney transplant recipients were more likely to use the portal if they had higher education; among liver recipients, patients who were white versus black and had higher education were more likely to use the portal. CONCLUSIONS Despite studies showing that patient portals have the potential to benefit transplant recipients as a tool for health management, racial and socioeconomic disparities should be considered before widespread implementation. Transplant centers should include portal training and support to all patients to encourage use, given its potential to improve outcomes.

scholarly journals Variations in TM6SF2, PCSK9 and PCSK7 genes and risk of hepatic steatosis after liver transplantation: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahad Eshraghian ◽  
Elham Moasser ◽  
Negar Azarpira ◽  
Mohammad Reza Fattahi ◽  
Saman Nikeghbalian ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Hepatic Steatosis ◽  
Cross Sectional Study ◽  
Genetic Variations ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Proprotein Convertase ◽  
Cross Sectional ◽  
Liver Transplant Recipients

Abstract Background Genetic abnormalities might have important role in pathogenesis of hepatic steatosis after liver transplantation. We aimed to investigate association between genetic variations in transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, proprotein convertase subtilisin/kexin type 9 (PCSK9) rs505151 and proprotein convertase subtilisin/kexin type 7 (PCSK7) rs2277287 with hepatic steatosis in liver transplant recipients. Methods In a cross-sectional study, adult (> 18 years) liver transplant recipients who were referred for their routine post-transplant follow-up between June 2018 and September 2018 were included in the study. Hepatic steatosis in transplant recipients was assessed by controlled attenuation parameter (CAP). Polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) was used to study TM6SF2 rs58542926, PCSK7 rs2277287 and PCSK9 rs505151 genotypes. Results 107 liver transplant recipients were included. There was no association between different genotypes of PCSK9 rs505151 and PCSK7 rs2277287 with hepatic steatosis in liver transplant recipients (P value > 0.05). The presence of TT genotype of TM6SF2 rs58542926 was higher in patients with hepatic steatosis measured by CAP after liver transplantation. In patients with moderate and severe hepatic steatosis (grade 2 and 3 steatosis), AG + GG genotypes of PCSK9 rs505151 were more prevalent than AA genotype (OR 8.667; 95% CI 1.841–40.879; P value = 0.004) compared to patients with mild steatosis (grade 1). In multivariate regression model, AG + GG genotypes of PCSK9 rs505151 were associated with moderate and severe steatosis in liver transplant recipients (OR 5.747; 95% CI 1.086–30.303; P value = 0.040). Conclusions Genetic variations in TM6SF2 rs58542926 and PCSK9 rs505151 might be associated with hepatic steatosis in liver transplant recipients.

scholarly journals Fatigue and its associated factors in liver transplant recipients in Beijing: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. e011840 ◽  
Author(s):  
Xiao-Hong Lin ◽  
Sha Teng ◽  
Lu Wang ◽  
Jing Zhang ◽  
Ya-Bin Shang ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Liver Transplant Recipients

eHealth literacy and web‐based patient portal usage among kidney and liver transplant recipients

2020 ◽  
Author(s):  
Kieran Maroney ◽  
Laura M. Curtis ◽  
Lauren Opsasnick ◽  
Kayla D. Smith ◽  
Morgan R. Eifler ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Patient Portal ◽  
Transplant Recipients ◽  
Web Based ◽  
Ehealth Literacy ◽  
Liver Transplant Recipients

scholarly journals Racial and Ethnic Differences in COVID-19 Outcomes, Stressors, Fear, and Prevention Behaviors Among US Women: Web-Based Cross-sectional Study (Preprint)

2020 ◽  
Author(s):  
Jamila K Stockman ◽  
Brittany A Wood ◽  
Katherine M Anderson
Keyword(s):  
United States ◽  
Ethnic Differences ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Web Based ◽  
Racial And Ethnic Differences ◽  
Race Ethnicity ◽  
Racial Ethnic

BACKGROUND In the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence. OBJECTIVE The purpose of this study is to examine racial and ethnic differences in the prevalence of COVID-19 outcomes, stressors, fear, and prevention behaviors among adult women residing in the United States. METHODS Between May and June 2020, women were recruited into the Capturing Women’s Experiences in Outbreak and Pandemic Environments (COPE) Study, a web-based cross-sectional study, using advertisements on Facebook; 491 eligible women completed a self-administered internet-based cross-sectional survey. Descriptive statistics were used to examine racial and ethnic differences (White; Asian; Native Hawaiian or other Pacific Islander; Black; Hispanic, Latina, or Spanish Origin; American Indian or Alaskan Native; multiracial or some other race, ethnicity, or origin) on COVID-19 outcomes, stressors, fear, and prevention behaviors. RESULTS Among our sample of women, 16% (73/470) reported COVID-19 symptoms, 22% (18/82) were concerned about possible exposure from the people they knew who tested positive for COVID-19, and 51.4% (227/442) knew where to get tested; yet, only 5.8% (27/469) had been tested. Racial/ethnic differences were observed, with racial/ethnic minority women being less likely to know where to get tested. Significant differences in race/ethnicity were observed for select stressors (food insecurity, not enough money, homeschooling children, unable to have a doctor or telemedicine appointment) and prevention behaviors (handwashing with soap, self-isolation if sick, public glove use, not leaving home for any activities). Although no racial/ethnic differences emerged from the Fear of COVID-19 Scale, significant racial/ethnic differences were observed for some of the individual scale items (eg, being afraid of getting COVID-19, sleep loss, and heart racing due to worrying about COVID-19). CONCLUSIONS The low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the United States, particularly among racial/ethnic minority women. Although the overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities are warranted in communities of color, particularly with consideration for stressors and adverse mental health.

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