SGLT2 inhibitors: A revolution in therapeutics of a major Non-Communicable Disease

2021 ◽  
pp. 1-3
Author(s):  
Muhammad Sami Khan
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Communicable Disease ◽  
Health Care Expenditure ◽  
Health Care Expenditures ◽  
Sglt2 Inhibitors ◽  
Care Providers ◽  
Cardiovascular Outcome Trials ◽  
Non Communicable Disease

Pakistan is facing an exorbitant burden of Non-communicable diseases among which Cardiovascular diseases are the most prominent which has not only caused mortality but also posed a big threat on weakened economy and health care system of the country. Amidst of this growing crisis, Sodium glucose co-transporter 2 (SGLT2) inhibitors emerge as a ray of hope by reducing simultaneously the complication and health care expenditure associated with the management of this major mortality-bringing Non-communicable disease. SGLT2 inhibitors, including Dapagliflozin and Empagliflozin, are evidence-based standardized novel anti-diabetic agents tested in cardiovascular outcome trials namely DAPA-HF and EMPEROR-Reduced, when added to standard care in heart failure patients with reduced ejection fraction, provides breakthrough heart failure outcomes and also addresses massive health care expenditures. This novel finding provides an impetus to promote its beneficial effects among health care providers and early implementation. Continuous....

scholarly journals Prevalence and Patterns of Health Care Use Among Poor Older People Under the Livelihood Empowerment Against Poverty Program in the Atwima Nwabiagya District of Ghana

2019 ◽  
Vol 5 ◽  
pp. 233372141985545 ◽  
Author(s):  
Williams Agyemang-Duah ◽  
Charles Peprah ◽  
Francis Arthur-Holmes
Keyword(s):  
Health Care ◽  
Health Services ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Expenditure ◽  
Well Being ◽  
Health Care Use ◽  
Public Health Care ◽  
Care Providers ◽  
Health Lifestyle

In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations’ health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 ( N = 200). Chi-square and Fisher’s exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.

scholarly journals Naive Expectations to Resignation

2018 ◽  
Vol 5 (3) ◽  
pp. 219-224
Author(s):  
Michael M Evans ◽  
Judith E Hupcey ◽  
Lisa Kitko ◽  
Windy Alonso
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Longitudinal Study ◽  
Health Care Providers ◽  
Secondary Analysis ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Life Activity ◽  
Chronic Group ◽  
Stage D

Purpose: This study examined life descriptions of persons with stage D heart failure (HF) comparing those newly diagnosed to those with chronic HF. Methods: A secondary analysis of interviews from 75 participants followed in a longitudinal study of persons with stage D HF was thematically analyzed. There were 24 participants who were recently diagnosed with stage D HF (less than 2 years) and 51 participants with HF longer than 2 years. Results: Both groups shared life descriptions along a continuum, where recently diagnosed participants described naive expectations with hope for improvement, while the chronic group appeared resigned to their fate and the reality of the limitations of living with HF. Four themes illustrated differences between the groups: outlook on life, activity adjustments, understanding of HF, and mood. Conclusions: Although persons with stage D HF share the same life descriptions, they have differing perspectives of life with HF. Findings from this study can help health-care providers tailor interventions based on the length of time from diagnosis.

scholarly journals Usability and patients attitudes after implantation of an innovative intracardiac micro-computer system for web-based real-time monitoring of heart failure (Preprint)

2020 ◽  
Author(s):  
Giuseppe D´Ancona ◽  
Monica Murero ◽  
Sebastian Feickert ◽  
Hilmi Kaplan ◽  
Alper Oener ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Technology Use ◽  
Average Score ◽  
Care Providers ◽  
Cardiac Device ◽  
Good Communication ◽  
Empirical Survey

BACKGROUND Heart failure (HF) management guided by the measurement of intracardiac and pulmonary pressure values, obtained through innovative permanent intra-cardiac micro-sensors ("embodied"), has been recently proposed as a valid strategy to individualize treatment and anticipate hemodynamic destabilization, hoping to reduce patients´ hospitalization rate and optimize their quality of life. OBJECTIVE The present manuscript has focused on the analysis and interpretation of an empirical survey evaluating usability and patients’ attitudes towards a new permanent intra-cardiac device implanted to remotely monitor left intra-atrial pressures (V-LAP™, Vectorious Medical Technologies, Tel Aviv, Israel) of chronic HF patients. METHODS The V-LAP system is a miniaturized sensor implanted totally percutaneously across the inter-atrial septum. It communicates wirelessly with a "companion device" (a wearable belt) that is placed on the patient's chest at the time of acquisition /transmission of left heart pressure measurements. At first follow-up after implantation the patients and the health care providers were asked to fill out a questionnaire on the usability of the system, the ease in performing the various required tasks (data acquisition and transmission), and overall satisfaction. Replies to the questions were mainly given using a 5-point Likert scale (1: very poor, 2: poor, 3: average, 4: good, 5: excellent). RESULTS Use and acceptance of in-body technology from the first 8 patients implanted with the V-LAP technology worldwide have been analysed. No peri-procedural morbidity/mortality was observed. Before discharge, a tailored educational session was performed after the device implantation with the participation of patients and health care providers. A pre-determined appropriate measurement position for the external measuring unit (thoracic belt) was identified before discharge to guarantee, for each patient, good communication with the internal cardiac sensor and via wireless/RF communication. At the first follow-up, the overall comfort in technology use was 3.7±1.3 with 87.5 % (7/8) of patients succeeding in applying and operating the system independently. An average score of 3.5±1.4 points was given to the ease in positioning the external measuring belt in the pre-determined measurement position. All health care providers (8/8) were able to support patients with the technology. Health care providers’ average overall ease and comfort in operating the system was 3.8± 0.8 points with 4.1±0.8 points for the ease in positioning the thoracic belt in the appropriate measuring position. CONCLUSIONS Despite the gravity of their HF pathology and the complexity of their comorbid profile, patients are comfortable in using the V-LAP technology and, in the majority of cases they can correctly and consistently acquire and transmit hemodynamic data. The overall patient/care provider satisfaction with the V-LAP system seems to be high. Patients and respective health care providers have reported a score between average to good when assessing the ease in performing simple but crucial tasks such as wearing and fastening the thoracic belt and more specifically in consistently finding its appropriate position for ideal measurements. Improvements in the external thoracic belt design have been very recently introduced and will hopefully further optimize patients´ and health care providers´ acceptance and adoption of this technology. CLINICALTRIAL NCT03775161

The Role of the Biotechnology Industry in Addressing Health Inequities in Africa: Strengthening the Entire Health Care Value Chain

2021 ◽  
Vol 26 (4) ◽  
Author(s):  
Stephen M. Sammut
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Value Chain ◽  
Communicable Disease ◽  
Diagnostic Tools ◽  
Health Coverage ◽  
Care Providers ◽  
African Countries ◽  
Patient Journey ◽  
Health Care Value

There are many misconceptions surrounding health care in Africa, a continent of 54 sovereign countries and a population exceeding 1.2 billion souls which is growing at the fastest rate in the world. Enormous diversity has direct impact on the notion, practices, and availability of health care on the continent. There are no satisfactory generalizations about the state of health and the strength of health care systems for the continent as a whole. Indeed, differences between neighboring countries are enormous, as well as among population groups within countries. There is a significant mix of public, private, and faith-based health care providers. In most African countries, 60 percent of health providers fall into the latter two categories (IFC, 2008). Moreover, movements towards national and private risk pooling for payment of health care are underway in only a few countries, but virtually all modern African constitutions declare health care as a human right and aspire to some form of Universal Health Coverage (UHC). Despite these principles, Africans endure a dual burden of communicable and non-communicable disease. In the face of these challenges, Africans are confronted with out-of-pocket payment for health services – when it is available at all – and challenging logistics for accessing and maintaining consistency of care. The patient journey for Africans is a winding path, often exacerbated by an additional reliance on the importation of talent, pharmaceuticals and vaccines, medical and diagnostic tools, and digital support of the health systems. The health care value chain in Africa is incomplete. Each of Providers, Payers and Producers need further development. When any of these is weak or missing, there cannot be a sustainable health system. The issue, therefore, is not scientific or clinical competence; it is capacity and the necessity to promote a comprehensive and integrated health care ecosystem – including the Producer segment. To address the Producer link, more direct engagement by the global biopharmaceutical industry in assisting and investing in the advancement of indigenous laboratory and clinical development, product production and distribution, and the advancement of human capital necessary to achieve health care sovereignty for the continent is necessary. There is all the more reason to do so as humanity enters the age of genomic and precision medicine. There is a pathway for African health care to leapfrog as it has done in telecommunications.

Perspectives of health care providers on the role of culture in the self-care of patients with chronic heart failure: a qualitative interview study conducted in Israel

2020 ◽  
Author(s):  
Adam Joensson ◽  
Emilie Cewers ◽  
Jean Marc Weinstein ◽  
Tuvia Ben Gal ◽  
Anna Stromberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Self Care ◽  
Cultural Background ◽  
Care Providers ◽  
Qualitative Interview Study ◽  
Specific Barriers

Abstract Background: Self-care is recognized as important behaviour in chronic diseases such as heart failure (HF). The cultural background of patients with HF is one of the factors that can be considered to affect their adherence to self-care. The cultural background of the health care providers might also influence their view on self-care behaviour and the education they provide. The aim of this study was to describe health care providers' perceptions of the role of culture in self-care and how those perceptions shape their experiences and their practices.Methods: A qualitative study was performed in Israel, a country with a culturally diverse population. Data was collected using semi-structured interviews with 12 healthcare providers from different cultural backgrounds, selected by purposeful sampling, from two hospitals in Israel. Interviews were audio recorded and transcribed verbatim. Data was analysed using content analysis.Results: Healthcare providers experienced cultural background influenced their patients’ self-care behaviour. Perceived cultural-specific barriers to self-care such as: dietary traditions interfering with the recommended HF diet, willingness to undertake self-care and beliefs conflicting with medical treatment were identified. Healthcare providers described that they adapted their patient education and care based on the cultural background of the patients. Shared cultural background, awareness and knowledge of differences were described as positively influencing self-care education, while cultural differences could complicate this process. These findings are encapsulated within four categories regarding perceptions of health care providers: ‘Culture permeates self-care behaviours’, ‘Culture influence the way care is provided’, ‘Mutual cultural background impacts the mindset to address self-care’ and ‘Culture is only a small piece of the puzzle...’Conclusions: Cultural-specific barriers for self-care were perceived by health care providers and they identified that their own cultural background shapes their experiences and their practices.

COVID-19 Mental Health Stressors of Health Care Providers in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) Intervention (Preprint)

2021 ◽  
Author(s):  
Christa Sato ◽  
Anita Adumattah ◽  
Krisel Maria Abulencia ◽  
Peter Dennis Garcellano ◽  
Alan Tai-Wai Li ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Communicable Disease ◽  
Care Providers ◽  
Emotional Labour ◽  
Workplace Stressors ◽  
Social Ecological ◽  
Acceptance And Commitment ◽  
At Home

BACKGROUND Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing high level of stressors are health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs are negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs’ experiences of fatigue, insomnia, anxiety, depression, and post-traumatic stress symptoms. OBJECTIVE The aim of this study is to explore the pandemic stressors experienced by HCPs at work, at home and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention. METHODS Informed by a social ecological approach, we use a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first two waves of the COVID-19 pandemic (June 2020 to February 2021) in Canada. RESULTS Informed by a social ecological framework, five overarching themes were identified in our thematic analysis: 1) personal level stressors that highlight HCPs identities and responsibilities beyond the workplace; 2) interpersonal level stressors from disrupted social relationships; 3) organizational stressors that contributed to unsettled workplaces and moral distress; 4) community and societal stressors attributed to vicarious trauma and emotional labour; and 5) the multilevel and cumulative impacts of COVID-19 stressors on HCPs’ health. CONCLUSIONS COVID-19 is not merely a communicable disease but a social and political phenomenon that intensifies the effects of social inequities. Current understanding of pandemic stressors affecting HCPs is largely partial in nature. While workplace stressors of HCPs are real and intense, they need to be explored and understood in the context of stressors that exist in other domains of HCPs’ lives such as family and community to ensure these experiences are not being silenced by the ‘hero’ discourses or overshadowed by professional demands.

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