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  • Ovid Technologies (Wolters Kluwer Health)  (7)
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  • Ovid Technologies (Wolters Kluwer Health)  (7)
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  • 1
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 13 ( 2019-07-02)
    Abstract: The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke ( AIS ) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or “defect‐free” care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18–1.65) and better survival (odds ratio, 2.23; 95% CI , 1.62–3.09). Defect‐free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0–1) (odds ratio, 1.22; 95% CI , 1.04–1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions Use of evidence‐based care is associated with improved clinical outcome in AIS . Strategies are required to address regional variation in the use of proven AIS treatments. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique Identifier: NCT 02162017.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
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  • 2
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 95, No. 6 ( 2016-02), p. e2554-
    Type of Medium: Online Resource
    ISSN: 0025-7974
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2049818-4
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  • 3
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Nervous & Mental Disease Vol. 205, No. 7 ( 2017-7), p. 550-557
    In: Journal of Nervous & Mental Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 205, No. 7 ( 2017-7), p. 550-557
    Type of Medium: Online Resource
    ISSN: 1539-736X , 0022-3018
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2071032-X
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  • 4
    In: Circulation: Cardiovascular Quality and Outcomes, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. Suppl_1 ( 2019-04)
    Abstract: Background: Mobile health technologies are low-cost, scalable interventions with the potential to promote patient engagement and behavior change. We designed and tested a tailored culturally-sensitive text messaging intervention to support secondary prevention in patients with coronary heart disease. Methods: In this multi-center, single-blinded randomized controlled trial, we enrolled 822 patients (mean age, 56.4 [SD, 9.5] years; 16.1% [132 of 822] women) with a history of AMI or PCI and without diabetes from 37 hospitals in China from August 2016 to March 2017. In addition to usual care, the control group (n=411) received 2 thank-you messages/month; the intervention group (n=411) received 6 text messages/week for 6 months delivered by an automated computerized system. The messages provided educational and motivational information related to disease-specific knowledge, risk factor control, physical activity and medication adherence. The primary endpoint was change in systolic blood pressure (SBP) from baseline to 6 months. Secondary end points included the proportion with SBP 〈 140mmHg, smoking status, and change in BMI, LDL-C, and physical activity. The endpoints were assessed using analyses of covariance. Results: Follow up was 99.6% (819 of 822). The mean baseline SBP (SD) for the intervention and control groups were 130.9 (15.1) mmHg and 131.4 (17.5) mmHg, respectively. At 6 months, SBP was not significantly lower in the intervention group compared to the control group (mean SBP 127.8 vs. 129.4mmHg, p=0.089), with a mean change (SD) of 3.2 (14.3) mmHg and 2.0 (15.0) mmHg from baseline, respectively (mean net change -1.3mmHg [95%CI -3.3 to 0.8]; P=0.221). There were no significant differences in the change in LDL-C level, physical activity, BMI or smoking status between two groups. Nearly all patients in the intervention group reported the text messages to be useful (96.1%[389 of 405] ), easy to understand (98.8%[400 of 405]), appropriate in frequency (93.8%[380 of 405] ), and reported being willing to receive future text messages (94.8%[384 of 405]). Conclusions: Text messages supporting secondary prevention among patients with CHD did not lead to a greater reduction in blood pressure at 6 months. However, it was feasible and highly acceptable to patients.
    Type of Medium: Online Resource
    ISSN: 1941-7713 , 1941-7705
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2453882-6
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  NeuroReport Vol. 16, No. 12 ( 2005-08-22), p. 1297-1301
    In: NeuroReport, Ovid Technologies (Wolters Kluwer Health), Vol. 16, No. 12 ( 2005-08-22), p. 1297-1301
    Type of Medium: Online Resource
    ISSN: 0959-4965
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2005
    detail.hit.zdb_id: 2031485-1
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  • 6
    In: Circulation: Cardiovascular Quality and Outcomes, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 9 ( 2019-09)
    Abstract: Mobile health interventions may support risk factor management and are readily scalable in healthcare systems. We aim to evaluate the efficacy of a text messaging–based intervention to improve glycemic control in patients with coronary heart disease and diabetes mellitus in China. Methods and Results: The CHAT-DM study (Cardiovascular Health and Texting-Diabetes Mellitus) was a parallel-group, single-blind, randomized clinical trial that included 502 patients with both coronary heart disease and diabetes mellitus from 34 hospitals in China. The intervention group (n=251) received 6 text messages per week for 6 months in addition to usual care. Messages were theory driven and culturally tailored to provide educational and motivational information on glucose monitoring, blood pressure control, medication adherence, physical activity, and lifestyle. The control group (n=251) received usual care and 2 thank you messages per month. The primary outcome was change in glycated hemoglobin (HbA 1C [hemoglobin A 1C ]) from baseline to 6 months. Secondary outcomes were change in proportion of patients achieving HbA 1C 〈 7%, fasting blood glucose, systolic blood pressure, LDL (low-density lipoprotein) cholesterol, body mass index, and physical activity from baseline to 6 months. The end points were assessed using analyses of covariance. The follow-up rate was 99%. When compared with control group at 6 months, the intervention group had a greater reduction in HbA 1C (−0.2% versus 0.1%; P =0.003) and a greater proportion of participants who achieved HbA 1C 〈 7% (69.3% versus 52.6%; P =0.004). Change in fasting blood glucose was larger in the intervention group (between-group difference: −0.6 mmol/L; 95% CI, −1.1 to −0.2; P =0.011), but no other outcome differences were observed. Nearly all participants reported that messages were easy to understand (97.1%) and useful (94.1%). Conclusions: A text message intervention resulted in better glycemic control in patients with diabetes mellitus and coronary heart disease. While the mechanism of this benefit remains to be determined, the results suggest that a simple, culturally sensitive mobile text messaging program may provide an effective and feasible way to improve disease self-management. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT02883842.
    Type of Medium: Online Resource
    ISSN: 1941-7713 , 1941-7705
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2453882-6
    Location Call Number Limitation Availability
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  • 7
    In: Circulation: Cardiovascular Quality and Outcomes, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 4 ( 2019-04)
    Abstract: Mobile health technologies are low cost, scalable interventions with the potential to promote patient engagement and behavior change. We aimed to test whether a culturally sensitive text messaging intervention supporting secondary prevention improves the control of risk factors in patients with coronary heart disease in China. Methods and Results: In this multicenter, single-blinded randomized controlled trial, 822 patients (mean age, 56.4 [SD, 9.5] years; 14.1% women) with coronary heart disease and without diabetes mellitus from 37 hospitals in China were enrolled between August 2016 and March 2017. In addition to usual care, the control group (n=411) received 2 thank you messages/month; the intervention group (n=411) received 6 text messages/week for 6 months delivered by an automated computerized system. The messages provided educational and motivational information related to disease-specific knowledge, risk factor control, physical activity, and medication adherence. The primary end point was change in systolic blood pressure from baseline to 6 months. Secondary end points included the proportion with systolic blood pressure 〈 140 mm Hg, smoking status, and change in body mass index, LDL-C (low-density lipoprotein cholesterol), and physical activity (assessed using the International Physical Activity Questionnaire). The end points were assessed using analyses of covariance. Follow-up was 99.6%. At 6 months, systolic blood pressure was not significantly lower in the intervention group compared with the control group, with a mean change (SD) of 3.2 (14.3) mm Hg and 2.0 (15.0) mm Hg ( P 〉 0.05) from baseline, respectively (mean net change, −1.3 mm Hg [95% CI, −3.3 to 0.8]; P =0.221). There were no significant differences in the change in LDL-C level, physical activity, body mass index, or smoking status between the 2 groups. Nearly all patients in the intervention group reported the text messages to be useful (96.1%), easy to understand (98.8%), appropriate in frequency (93.8%), and reported being willing to receive future text messages (94.8%). Conclusions: Text messages supporting secondary prevention among patients with coronary heart disease did not lead to a greater reduction in blood pressure at 6 months. Mobile phone text messaging for secondary prevention was feasible and highly acceptable to patients. Clinical Trial Registration: URL: https://clinicaltrials.gov . Unique identifier: NCT02888769.
    Type of Medium: Online Resource
    ISSN: 1941-7713 , 1941-7705
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2453882-6
    Location Call Number Limitation Availability
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