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The 2000 Canadian recommendations for the management of hypertension: part two--diagnosis and assessment of people with high blood pressure.

https://arctichealth.org/en/permalink/ahliterature192030
Source
Can J Cardiol. 2001 Dec;17(12):1249-63
Publication Type
Conference/Meeting Material
Article
Date
Dec-2001
Author
K B Zarnke
M. Levine
F A McAlister
N R Campbell
M G Myers
D W McKay
P. Bolli
G. Honos
M. Lebel
K. Mann
T W Wilson
C. Abbott
S. Tobe
E. Burgess
S. Rabkin
Author Affiliation
Department of Medicine, London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, Ontario N6A 5A5, Canada. Kelly.Zarnke@lhsc.on.ca
Source
Can J Cardiol. 2001 Dec;17(12):1249-63
Date
Dec-2001
Language
English
French
Publication Type
Conference/Meeting Material
Article
Keywords
Adrenal Gland Neoplasms - complications
Adult
Blood Pressure Determination - methods - psychology - standards
Blood Pressure Monitoring, Ambulatory - methods - standards
Canada
Cardiovascular Diseases - etiology - prevention & control
Clinical Laboratory Techniques - standards
Diabetes Complications
Diabetic Nephropathies - complications - diagnosis
Echocardiography - standards
Electrocardiography
Evidence-Based Medicine - methods
Humans
Hypertension - complications - diagnosis - etiology - psychology
Hypertension, Renovascular - diagnosis
Hypertrophy, Left Ventricular - complications - ultrasonography
Office Visits
Patient compliance
Pheochromocytoma - complications - diagnosis
Risk factors
Self Care - methods - standards
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of high blood pressure in adults.
For people with high blood pressure, the assignment of a diagnosis of hypertension depends on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the duration of follow-up and the presence of concomitant vascular risk factors, target organ damage and established atherosclerotic diseases. For people diagnosed with hypertension, defining the overall risk of adverse cardiovascular outcomes requires laboratory testing, a search for target organ damage and an assessment of the modifiable causes of hypertension. Out-of-clinic blood pressure assessment and echocardiography are options for selected patients.
People at increased risk of adverse cardiovascular outcomes and were identified and quantified.
Medline searches were conducted from the period of the last revision of the Canadian recommendations for the management of hypertension (May 1998 to October 2000). Reference lists were scanned, experts were polled, and the personal files of the subgroup members and authors were used to identify other studies. All relevant articles were reviewed and appraised, using prespecified levels of evidence, by content experts and methodological experts.
A high value was placed on the identification of people at increased risk of cardiovascular morbidity and mortality.
The identification of people at higher risk of cardiovascular disease will permit counselling for lifestyle manoeuvres and the introduction of antihypertensive drugs to reduce blood pressure for patients with sustained hypertension. In certain settings, and for specific classes of drugs, blood pressure lowering has been associated with reduced cardiovascular morbidity and/or mortality.
The present document contains detailed recommendations pertaining to aspects of the diagnosis and assessment of patients with hypertension, including the accurate measurement of blood pressure, criteria for the diagnosis of hypertension and recommendations for follow-up, routine and optional laboratory testing, assessment for renovascular hypertension, home and ambulatory blood pressure monitoring, and the role of echocardiography in hypertension.
All recommendations were graded according to strength of the evidence and voted on by the Canadian Hypertension Recommendations Working Group. Only the recommendations achieving high levels of consensus are reported here. These guidelines will be updated annually.
These recommendations are endorsed by the Canadian Hypertension Society, The Canadian Coalition for High Blood Pressure Prevention and Control, The College of Family Physicians of Canada, The Heart and Stroke Foundation of Canada, The Adult Disease Division and Bureau of Cardio-Respiratory Diseases and Diabetes at the Centre for Chronic Disease Prevention and Control of Health Canada.
PubMed ID
11773936 View in PubMed
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Abdominal symptoms, visits to the doctor, and medicine consumption among the elderly. A population based study.

https://arctichealth.org/en/permalink/ahliterature73151
Source
Dan Med Bull. 1994 Sep;41(4):466-9
Publication Type
Article
Date
Sep-1994
Author
L. Kay
Author Affiliation
Medical Department C, Glostrup County Hospital.
Source
Dan Med Bull. 1994 Sep;41(4):466-9
Date
Sep-1994
Language
English
Publication Type
Article
Keywords
Abdominal Pain - drug therapy - epidemiology - therapy
Aged
Aged, 80 and over
Aging - physiology - psychology
Cohort Studies
Denmark - epidemiology
Drug Therapy - utilization
Female
Gastrointestinal Diseases - complications - epidemiology - therapy
Health services needs and demand
Health Services for the Aged - utilization
Humans
Male
Office Visits - utilization
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Abstract
Abdominal symptoms are frequent in the normal elderly population, but only a minority contact doctors. The present study was performed to assess the impact of abdominal symptoms on primary health care and medicine consumption and, in addition, to describe factors that relate to resource consumption. A postal questionnaire was mailed to a random cohort of 859 Danish people at the age of 75. Seventy-nine percent returned the questionnaire. A total of 31% of the men and 42% of the women had experienced at least one abdominal symptom within the past year. Among these 25% had visited a doctor and a little less had taken medicine. The total expenses used on primary health care and medicine were 22,000 U.S. Dollars per 1000 persons. Factors related to visiting a doctor were not only the presence of symptoms but also the subject's concept of the symptom as a health problem. As a consequence, efforts to control expenses should also focus on why some subjects consider their symptoms a health-problem while others do not.
PubMed ID
7813253 View in PubMed
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[A casual link between shaking hands and risk of infection].

https://arctichealth.org/en/permalink/ahliterature180803
Source
Duodecim. 2004;120(3):305-10
Publication Type
Article
Date
2004
Author
Annakaisa Suominen
Pentti Huovinen
Author Affiliation
Mikrobiekologian ja tulehdustautien osasto PL 57, 20521 Turku. annakaisa.suominen@ktl.fi
Source
Duodecim. 2004;120(3):305-10
Date
2004
Language
Finnish
Publication Type
Article
Keywords
Bacterial Infections - epidemiology - transmission
Female
Finland - epidemiology
Hand Disinfection
Humans
Infectious Disease Transmission, Patient-to-Professional
Male
Office Visits
Physician-Patient Relations
Risk assessment
PubMed ID
15061008 View in PubMed
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Access to health care among status Aboriginal people with chronic kidney disease.

https://arctichealth.org/en/permalink/ahliterature154422
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Publication Type
Article
Date
Nov-4-2008
Author
Song Gao
Braden J Manns
Bruce F Culleton
Marcello Tonelli
Hude Quan
Lynden Crowshoe
William A Ghali
Lawrence W Svenson
Sofia Ahmed
Brenda R Hemmelgarn
Author Affiliation
Department of Medicine, Division of Nephrology, University of Calgary, Calgary, AB.
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Date
Nov-4-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alberta - epidemiology
Chronic Disease
Creatinine - blood
Delphi Technique
Female
Glomerular Filtration Rate
Health Services Accessibility
Healthcare Disparities
Humans
Indians, North American - statistics & numerical data
Kidney Diseases - epidemiology
Male
Middle Aged
Nephrology
Office visits - statistics & numerical data
Patient Admission - statistics & numerical data
Registries
Severity of Illness Index
Abstract
Ethnic disparities in access to health care and health outcomes are well documented. It is unclear whether similar differences exist between Aboriginal and non-Aboriginal people with chronic kidney disease in Canada. We determined whether access to care differed between status Aboriginal people (Aboriginal people registered under the federal Indian Act) and non-Aboriginal people with chronic kidney disease.
We identified 106 511 non-Aboriginal and 1182 Aboriginal patients with chronic kidney disease (estimated glomerular filtration rate less than 60 mL/min/1.73 m(2)). We compared outcomes, including hospital admissions, that may have been preventable with appropriate outpatient care (ambulatory-care-sensitive conditions) as well as use of specialist services, including visits to nephrologists and general internists.
Aboriginal people were almost twice as likely as non-Aboriginal people to be admitted to hospital for an ambulatory-care-sensitive condition (rate ratio 1.77, 95% confidence interval [CI] 1.46-2.13). Aboriginal people with severe chronic kidney disease (estimated glomerular filtration rate
Notes
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Comment In: CMAJ. 2008 Nov 4;179(10):985-618981431
PubMed ID
18981441 View in PubMed
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Access to heart failure care post emergency department visit: do we meet established benchmarks and does it matter?

https://arctichealth.org/en/permalink/ahliterature114344
Source
Am Heart J. 2013 May;165(5):725-32
Publication Type
Article
Date
May-2013
Author
Debbie Ehrmann Feldman
Thao Huynh
Julie Des Lauriers
Nadia Giannetti
Marc Frenette
François Grondin
Caroline Michel
Richard Sheppard
Martine Montigny
Serge Lepage
Viviane Nguyen
Hassan Behlouli
Louise Pilote
Author Affiliation
Université de Montréal, Montreal, Quebec, Canada. debbie.feldman@umontreal.ca
Source
Am Heart J. 2013 May;165(5):725-32
Date
May-2013
Language
English
Publication Type
Article
Keywords
Aged
Benchmarking
Continuity of Patient Care - standards
Emergencies
Emergency Service, Hospital - organization & administration
Female
Heart Failure - therapy
Humans
Male
Office Visits - utilization
Quebec
Abstract
The Canadian Cardiology Society recommends that patients should be seen within 2 weeks after an emergency department (ED) visit for heart failure (HF). We sought to investigate whether patients who had an ED visit for HF subsequently consult a physician within the current established benchmark, to explore factors related to physician consultation, and to examine whether delay in consultation is associated with adverse events (AEs) (death, hospitalization, or repeat ED visit).
Patients were recruited by nurses at 8 hospital EDs in Québec, Canada, and interviewed by telephone within 6 weeks of discharge and subsequently at 3 and 6 months. Clinical variables were extracted from medical charts by nurses. We used Cox regression in the analysis.
We enrolled 410 patients (mean age 74.9 ± 11.1 years, 53% males) with a confirmed primary diagnosis of HF. Only 30% consulted with a physician within 2 weeks post-ED visit. By 4 weeks, 51% consulted a physician. Over the 6-month follow-up, 26% returned to the ED, 25% were hospitalized, and 9% died. Patients who were followed up within 4 weeks were more likely to be older and have higher education and a worse quality of life. Patients who consulted a physician within 4 weeks of ED discharge had a lower risk of AEs (hazard ratio 0.59, 95% CI 0.35-0.99).
Prompt follow-up post-ED visit for HF is associated with lower risk for major AEs. Therefore, adherence to current HF guideline benchmarks for timely follow-up post-ED visit is crucial.
PubMed ID
23622909 View in PubMed
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Accuracy and consistency of quadratic odds estimates.

https://arctichealth.org/en/permalink/ahliterature225712
Source
Fam Pract. 1991 Sep;8(3):269-75
Publication Type
Article
Date
Sep-1991
Author
B W Smith
Author Affiliation
Department of Family Practice, College of Human Medicine, Michigan State University, East Lansing 48824.
Source
Fam Pract. 1991 Sep;8(3):269-75
Date
Sep-1991
Language
English
Publication Type
Article
Keywords
Family Practice
Female
Health Services Research - methods
Humans
Hypertension - epidemiology
Male
Michigan - epidemiology
Models, Statistical
Odds Ratio
Office Visits
Ontario
Probability
Regression Analysis
Risk factors
Abstract
In medical practices that do not have rosters, only the number of patients who come to the practice can be enumerated: the number who might have visited if they had had a reason to do so remains unknown. The Quadratic Odds Estimator is a technique for estimating the total number of patients cared for by a primary care medical practice, including the non-visitors. A revised version of the model is shown to have an error of less than 1% in predicting the number of patients at risk of visiting a primary care medical practice. Aggregate and sex-specific estimates of total practice size are shown to be comparable to within 2%. The model estimates the prevalence of hypertension among the patients of two family practice resdencies as 18 and 11%. The rationale for employing unconventional regression weights and dual regressions is explained.
PubMed ID
1959728 View in PubMed
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Accuracy of syndrome definitions based on diagnoses in physician claims.

https://arctichealth.org/en/permalink/ahliterature138094
Source
BMC Public Health. 2011;11:17
Publication Type
Article
Date
2011
Author
Geneviève Cadieux
David L Buckeridge
André Jacques
Michael Libman
Nandini Dendukuri
Robyn Tamblyn
Author Affiliation
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. genevieve.cadieux@mail.mcgill.ca
Source
BMC Public Health. 2011;11:17
Date
2011
Language
English
Publication Type
Article
Keywords
Clinical Coding - methods
Community Health Services - utilization
Data Collection
Diagnostic Techniques and Procedures - standards
Exanthema - classification - diagnosis
Female
Fever - classification - diagnosis
Humans
International Classification of Diseases
Male
Nervous System Diseases - classification - diagnosis
Office Visits - utilization
Population Surveillance - methods
Quebec
Registries
Respiratory Tract Infections - classification - diagnosis
Sensitivity and specificity
Abstract
Community clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study's objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics.
We selected a random sample of 3,600 community-based primary care physicians who practiced in the fee-for-service system in the province of Quebec, Canada in 2005-2007. We randomly selected 10 visits per physician from their claims, stratifying on syndrome type and presence, diagnosis, and month. Double-blinded chart reviews were conducted by telephone with consenting physicians to obtain information on patient diagnoses for each sampled visit. The sensitivity, specificity, and positive predictive value (PPV) of physician claims were estimated by comparison to chart review.
1,098 (30.5%) physicians completed the chart review. A chart entry on the date of the corresponding claim was found for 10,529 (95.9%) visits. The sensitivity of syndrome definitions based on diagnostic codes in physician claims was low, ranging from 0.11 (fever) to 0.44 (respiratory), the specificity was high, and the PPV was moderate to high, ranging from 0.59 (fever) to 0.85 (respiratory). We found that rarely used diagnostic codes had a higher probability of being false-positives, and that more commonly used diagnostic codes had a higher PPV.
Future research should identify physician, patient, and encounter characteristics associated with the accuracy of diagnostic codes in physician claims. This would enable public health to improve syndromic surveillance, either by focusing on physician claims whose diagnostic code is more likely to be accurate, or by using all physician claims and weighing each according to the likelihood that its diagnostic code is accurate.
Notes
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PubMed ID
21211054 View in PubMed
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Adherence of Finnish people with glaucoma to treatment plans and connected factors.

https://arctichealth.org/en/permalink/ahliterature139427
Source
Int J Circumpolar Health. 2011 Feb;70(1):79-89
Publication Type
Article
Date
Feb-2011
Author
Jaana Lunnela
Maria Kääriäinen
Helvi Kyngäs
Author Affiliation
Department of Ophthalmology, Hospital District of Helsinki and Uusimaa, Helsinki, Finland. jaana.lunnela@netti.fi
Source
Int J Circumpolar Health. 2011 Feb;70(1):79-89
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Cross-Sectional Studies
Drug Utilization
Female
Finland
Glaucoma - drug therapy
Humans
Male
Middle Aged
Office Visits
Patient compliance
Patient Education as Topic
Questionnaires
Self Care
Young Adult
Abstract
The aim of the study was to describe the adherence of Finnish people with glaucoma to prescribed treatment plans, the factors connected to adherence and to produce knowledge for developing effective interventions to improve adherence to treatment plans.
This was a cross-sectional study.
The data (n = 249) were collected at one point in time from Finnish adults diagnosed with glaucoma with a questionnaire covering adherence to treatment. These patients used glaucoma medication and had follow-up appointments with ophthalmologists.
Sixty-seven percent (n = 166) of the patients with glaucoma were very adherent to the prescribed treatment plan in terms of self-care, treatment and follow-up visits. Almost all were very adherent to medical care (97%, n = 242). More than half of those who had received information from physicians and nurses were very adherent to treatment (66%, n = 163). Two factors, support from physicians and nurses (p
PubMed ID
21062571 View in PubMed
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Adherence to health regimens among frequent attenders of Finnish healthcare.

https://arctichealth.org/en/permalink/ahliterature280267
Source
Int J Circumpolar Health. 2016;75:30726
Publication Type
Article
Date
2016
Author
Sari Hirsikangas
Outi Kanste
Juha Korpelainen
Helvi Kyngäs
Source
Int J Circumpolar Health. 2016;75:30726
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Cross-Sectional Studies
Female
Finland
Health Services Misuse - statistics & numerical data
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Office visits - statistics & numerical data
Outcome Assessment (Health Care)
Patient Compliance - statistics & numerical data
Primary Health Care - statistics & numerical data
Risk assessment
Self Care - statistics & numerical data
Sex Factors
Abstract
The aim of the study was to describe adherence to health regimens and the factors associated with it among adult frequent attenders (FAs).
This was a cross-sectional study. The study sample consisted of 462 healthcare FAs in 7 municipal health centres in northern Finland. An FA is a person who has had 8 or more outpatient visits to a GP (in a health centre) or 4 or more outpatient visits to a university hospital during 1 year. The main outcome was self-reported adherence to health regimens.
Of the FAs, 82% adhered well to their health regimens. Carrying out self-care, medical care and feeling responsible for self-care were the most significant predictors to good adherence in all models. No significant differences in adherence were found in male and female subjects, age groups or educational levels. Support from healthcare providers and support from relatives were not significant predictors of good adherence.
FAs in Finland adhere well to health regimens and exceptionally well to medication. Variables that predict the best adherence of FAs to health regimens are carrying out self-care, receiving medical care and feeling responsible for self-care.
Notes
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PubMed ID
26996780 View in PubMed
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395 records – page 1 of 40.