Browsing by Subject "ADULTS"

Now showing 1 - 3 of 3
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    Depression, quality of life, and medical resource utilization in sickle cell disease.
    (Blood advances, 2017-10-12) Adam, Soheir S; Flahiff, Charlene M; Kamble, Shital; Telen, Marilyn J; Reed, Shelby D; De Castro, Laura M
    Sickle cell disease (SCD) is a chronic, debilitating disorder. Chronically ill patients are at risk for depression, which can affect health-related quality of life (HRQoL), health care utilization, and cost. We performed an analytic epidemiologic prospective study to determine the prevalence of depression in adult patients with SCD and its association with HRQoL and medical resource utilization. Depression was measured by the Beck Depression Inventory and clinical history in adult SCD outpatients at a comprehensive SCD center. HRQoL was assessed using the SF36 form, and data were collected on medical resource utilization and corresponding cost. Neurocognitive functions were assessed using the CNS Vital Signs tool. Pain diaries were used to record daily pain. Out of 142 enrolled patients, 42 (35.2%) had depression. Depression was associated with worse physical and mental HRQoL scores (P < .0001 and P < .0001, respectively). Mean total inpatient costs ($25 000 vs $7487, P = .02) and total health care costs ($30 665 vs $13 016, P = .01) were significantly higher in patients with depression during the 12 months preceding diagnosis. Similarly, during the 6 months following diagnosis, mean total health care costs were significantly higher in depressed patients than in nondepressed patients ($13 766 vs $8670, P = .04). Depression is prevalent in adult patients with SCD and is associated with worse HRQoL and higher total health care costs. Efforts should focus on prevention, early diagnosis, and therapy for depression in SCD.
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    Effects of cotrimoxazole prophylaxis on Talaromyces marneffei infection in HIV/AIDS patients receiving antiretroviral therapy: a retrospective cohort study
    (Emerging Microbes & Infections, 2019-01) Jiang, Junjun; Qin, Fengxiang; Meng, Sirun; Nehl, Eric J; Huang, Jinping; Liu, Yanfen; Zou, Jun; Dong, Wenyi; Huang, Jiegang; Chen, Hui; Zang, Ning; Liang, Bingyu; Ning, Chuanyi; Liao, Yanyan; Luo, Chaolian; Liu, Huifang; Liu, Xin; Wang, Jian; Zhou, Oulu; Le, Thuy; Ye, Li; Wu, Fengyao; Liang, Hao
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    Lessons learned when innovations go awry: a baseline description of a behavioral trial-the Enhancing Fitness in Older Overweight Veterans with Impaired Fasting Glucose study.
    (Translational behavioral medicine, 2011-11) Hall, KS; Pieper, CF; Edelman, DE; Yancy Jr, WS; Green, JB; Lum, H; Peterson, MJ; Sloane, R; Cowper, PA; Bosworth, HB; Huffman, KM; Cavanaugh, JT; Chapman, JG; Pearson, MP; Howard, TA; Ekelund, CC; McCraw, BL; Burrell, JB; Taylor, GA; Morey, MC
    Individuals diagnosed with impaired glucose tolerance (i.e., prediabetes) are at increased risk for developing diabetes. We proposed a clinical trial with a novel adaptive randomization designed to examine the impact of a home-based physical activity (PA) counseling intervention on metabolic risk in prediabetic elders. This manuscript details the lessons learned relative to recruitment, study design, and implementation of a 12-month randomized controlled PA counseling trial. A detailed discussion on how we responded to unforeseen challenges is provided. A total of 302 older patients with prediabetes were randomly assigned to either PA counseling or usual care. A novel adaptive design that reallocated counseling intensity based on self-report of adherence to PA was initiated but revised when rates of non-response were lower than projected. This study presents baseline participant characteristics and discusses unwelcome adaptations to a highly innovative study design to increase PA and enhance glucose metabolism when the best-laid plans went awry.