Sharing electronic health records with patients - Who is using the Care Information Exchange portal? A cross-sectional study. (Preprint)

2020 ◽  
Author(s):  
Ana Luisa Neves ◽  
Katelyn R Smalley ◽  
Lisa Freise ◽  
Paul Harrison ◽  
Ara Darzi ◽  
...  
Keyword(s):  
Health Status ◽  
Digital Literacy ◽  
Educational Level ◽  
Information Exchange ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Patient Portals ◽  
Cross Sectional ◽  
Health Records ◽  
Care Information

BACKGROUND Sharing electronic health records with patients has been shown to improve patient safety and quality of care, and patient portals represent a powerful and convenient tool to enhance patient access to their own healthcare data. However, adoption rates vary widely across countries and, within countries, across regions and health systems. A better understanding of the characteristics of users and non-users is critical to understand which groups remain underserved or excluded from using such tools. OBJECTIVE To identify the determinants of usage of the Care Information Exchange (CIE), a shared patient portal program in the United Kingdom. METHODS A cross-sectional study was conducted, using an online questionnaire. Individual-level data from patients registered in the CIE portal were collected, including age, gender, ethnicity, educational level, health status, postcode, and digital literacy (using the eHEALS tool). Registered individuals were defined as having an account created in the portal, independent of their actual use of the platform, and users were defined as having ever used the portal. Multivariate logistic regression was used to model the probability of being a user. Statistical analysis was performed in R, and Tableau ® was used to create maps of the proportion of CIE users by postcode area. RESULTS A total of 1,083 subjects replied to the survey (+186% of the estimated minimum target sample). The proportion of users was 61.6% (n=667), and within these, the majority (57.7%, n=385) used the portal at least once a month. To characterise the users and non-users of the system, we performed a sub-analysis of the sample, including only participants that have provided at least information regarding gender and age category. The sub-analysis included 650 individuals (59.8% women, 84.8% over 40 years). The majority of the subjects were white (76.6%, n=498), resident in London (64.7%, n=651), and lived in North West London (55.9%, n=363). Individuals with a higher educational degree (undergraduate/professional or postgraduate/higher) had higher odds of being a portal user (adjusted OR = 1.58 (95%CI [1.04 - 2.39]), and 2.38 (95%CI [1.42 - 4.02], respectively), compared to those with a secondary degree or below. Higher digital literacy scores (<30) were also associated with higher odds of being a user (adjusted OR = 2.96 (95%CI [2.02 - 4.35]). Those with a good overall health status had lower odds of being a user (adjusted OR = 0.58 (95%CI [0.37 - 0.91]). CONCLUSIONS This work adds to the growing body of evidence highlighting the importance of educational aspects (educational level and digital literacy) in the adoption of patient portals. It is critical that further research not only describes, but also systematically addresses these inequalities through patient-centred interventions aiming to reduce the digital divide. Healthcare providers and policymakers must partner in investing and delivering strategic programs that improve access to technology and digital literacy, in an effort to improve digital inclusion and reduce inequities in delivery of care. CLINICALTRIAL Not applicable.

scholarly journals Suicide attempt and its associated factors amongst women who were pregnant as adolescents in Bangladesh: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jie Li ◽  
Syeda Zerin Imam ◽  
Zhengyue Jing ◽  
Yi Wang ◽  
Chengchao Zhou
Keyword(s):  
Social Support ◽  
Health Status ◽  
Adolescent Pregnancy ◽  
Young Women ◽  
Associated Factors ◽  
Suicide Attempts ◽  
Perceived Social Support ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Adolescent pregnancy is a risk factor for suicide. We aimed to assess the prevalence of suicide attempts among young women with adolescent pregnancy in Bangladesh and to explore its associated factors. Methods In this cross-sectional study, we surveyed young women with adolescent pregnancy in urban and rural areas in Bangladesh to assess suicide attempts, socio-demographic and pregnancy-related characteristics, perceived health status, and perceived social support. Binary logistic regression analysis was conducted to explore the relationship between potentially related factors and suicide attempts. Results Of the participants, 6.5% (61/940) reported suicide attempts in the past 12 months, and the majority (88.5%) of the attempts happened within one year after the pregnancy. Participants with more years after first pregnancy (odds ratio (OR) = 0.47, 95% CI: 0.37–0.61) and more perceived social support from friends (OR = 0.69, 95% CI: 0.55–0.86) were less likely to have suicide attempts, and those perceived bad health status compared with good/fair health status (OR = 8.38, 95% CI: 3.08–22.76) were more likely to attempt suicide. Conclusions Women with adolescent pregnancy were at high risk of suicide attempts, especially those during the first postnatal year. The risk of suicide attempts attenuated with the time after pregnancy, and perceived social support from friends was a protective factor and perceived bad health status was a risk factor for suicide attempts among young women who have experienced adolescent pregnancy.

scholarly journals PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110304
Author(s):  
Ravindra Ganesh ◽  
Aditya K. Ghosh ◽  
Mark A. Nyman ◽  
Ivana T. Croghan ◽  
Stephanie L. Grach ◽  
...  
Keyword(s):  
Health Status ◽  
Social Roles ◽  
Disease Process ◽  
Cross Sectional Study ◽  
Large Sample Size ◽  
Sectional Study ◽  
Cross Sectional ◽  
Data Set ◽  
Patient Reported ◽  
The Impact

Objective Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. Methods A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. Results The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). Conclusion Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.

scholarly journals Oral Health Status of 12-Year-Old Hani Children in the Yunnan Province of China: A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5294
Author(s):  
Kitty Jieyi Chen ◽  
Ni Zhou ◽  
Biao Xu ◽  
Yuexiao Li ◽  
Shinan Zhang ◽  
...  
Keyword(s):  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Yunnan Province ◽  
Dental Fluorosis ◽  
Cross Sectional Study ◽  
Oral Health Status ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gingival Bleeding

Background: The aim of this cross-sectional study was to investigate the oral health status of Hani 12-year-old children in Yunnan, a province in Southwest China. Method: This study employed a multistage sampling method to recruit children from local primary schools. Two calibrated dentists examined the status of dental caries, gingival bleeding and dental fluorosis by adopting the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed. The chi-square test and multivariate logistic regression were conducted. Results: This study invited 480 Hani children, and recruited 413 children (52% boys) (response rate: 86%). The dental caries prevalence was 52%, and the caries experience associated with the mean (standard deviation) decayed, missing and filled teeth (DMFT) score was 1.10 (1.46). Gingival bleeding was diagnosed in 252 children (61%), and dental fluorosis was found in two children (0.5%). The results of the regression model indicated the prevalence of dental caries were associated with sugary snacking habits (p = 0.002). The prevalence of gingival bleeding was related to the mother’s education level as well as the child’s monthly pocket money (p < 0.05). Conclusion: Dental caries and gingival bleeding were prevalent among 12-year-old Hani children in the Yunnan province in China. Dental fluorosis was uncommon.

scholarly journals Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study

2020 ◽  
pp. 1-9
Author(s):  
Alessandro de Sire ◽  
Marco Invernizzi ◽  
Martina Ferrillo ◽  
Francesca Gimigliano ◽  
Alessio Baricich ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
Oral Health ◽  
Functional Status ◽  
Cross Sectional Study ◽  
Oral Health Status ◽  
Multidisciplinary Management ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lateral Sclerosis

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons. The current practice of caring for patients affected by ALS involves a multidisciplinary team without any indication about oral health care. OBJECTIVE: We sought to investigate the functional status and oral health in patients with ALS to define a specific multidisciplinary management. METHODS: In this cross-sectional study, we included patients affected by ALS, evaluating their functional status, using the Revised ALS Functional Rating Scale (ALSFRS-R) and their oral health status through specific parameters, including Brief Oral Health Status Examination (BOHSE), Winkel Tongue Coating Index (WTCI), and Oral Food Debris Index (OFDI). RESULTS: All 37 patients (mean age: 61.19±11.56 years) showed a poor oral status, independent from the functional status and strictly correlated to the severity of sialorrhea (p = 0.01). OFDI index was negatively correlated with the ALSFRS-R upper limb (p = 0.03). Patients with bulbar onset had significantly lower ability to perform adequate tongue movements in terms of protrusion (p = 0.006) and lateralization (p <  0.001). Significant negative correlations between survival rate and BOHSE (p = 0.03) was found. CONCLUSIONS: Taken together, our findings showed that a poor oral health status might be correlated to a worse functional status and survival time. Thus, an adequate oral health care and rehabilitation should be considered as crucial in the multidisciplinary management of patients with ALS.

scholarly journals Socioeconomic Factors and Health Status Disparities Associated with Difficulty in ADLs and IADLs among Long-Lived Populations in Brazil: A Cross-Sectional Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110072
Author(s):  
Júlia Cristina Leite Nóbrega ◽  
Juliana Barbosa Medeiros ◽  
Tácila Thamires de Melo Santos ◽  
Saionara Açucena Vieira Alves ◽  
Javanna Lacerda Gomes da Silva Freitas ◽  
...  
Keyword(s):  
Health Status ◽  
Activities Of Daily Living ◽  
Socioeconomic Factors ◽  
Chronic Diseases ◽  
Daily Living ◽  
Female Gender ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Objective: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. Method: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil’s Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using “R” statistical software. Results: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. Conclusion: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.

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