Patient Sociodemographic Characteristics Research Articles

Sociodemographic and Clinical Characteristics of Adult Asthma Patients: A Cross-sectional Study

Sociodemographic and Clinical Characteristics of Adult Asthma Patients: A Cross-sectional Study

Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil

BackgroundA full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil.MethodsThis study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups.ResultsAnalysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE.ConclusionThis study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC.

Effects of the COVID-19 Pandemic on Primary Health Care for Chronic Conditions in Canada: Protocol for a Retrospective Pre-Post Study Using National Practice-Based Research Network Data.

Since the COVID-19 pandemic began, there have been concerns that interruptions to the health care system may have led to changes in primary care, especially for care of chronic conditions such as diabetes and heart failure. Such changes may have longer term implications for population health. This study aims to describe the impacts of the COVID-19 pandemic on indicators of primary care access, comprehensiveness, and appropriateness among adult patients, as well as on specific indictors of chronic conditions. Additionally, this study aims to determine whether any identified changes were associated with patient sociodemographic characteristics and multimorbidity. This is a retrospective, single-arm, pre-post study using Canadian Primary Care Sentinel Surveillance Network (CPCSSN) data. CPCSSN is a research network supported by a primary care electronic medical record database, comprising over 1500 physicians and nearly 2 million patients. We are examining changes in care (eg, frequency of contacts, laboratory tests and investigations, referrals, medications prescribed, etc) among adults. We will also examine indicators specific to evidence-based recommendations for care in patients with diabetes and those with heart failure. We will compare rates of outcomes during key periods of the pandemic between March 13, 2020, and December 31, 2022, with equal time periods before the pandemic. Differences will be examined among specific subgroups of adults, including by decade of age, number of comorbidities, and socioeconomic status. Regression models appropriate to outcome distributions will be used to estimate changes, adjusting for potential confounders. This analysis is part of a mixed-methods study with a qualitative component investigating how patients with diabetes with or without concurrent heart failure perceived the impact of the pandemic on access to primary care and health care-related decisions. This study was approved by the Hamilton Integrated Research Ethics Board (14782-C). The start date of this study was October 5, 2022, and the prospective end date is January 31, 2024. As of May 2023, the study cohort (n=875,934) is defined, data cleaning is complete, and exploratory analyses have begun. Extended analyses using 2022 data are planned once the new data becomes available. We will disseminate results through peer-reviewed publications and academic conference, as well as creating evidence briefs, infographics, and a video for policy maker and patient audiences. This study will investigate whether the COVID-19 pandemic has resulted in changes in the provision of primary care in Canada and whether these potential changes have led to gaps in care. This study will also identify patient-level characteristics associated with changes in care patterns across the COVID-19 pandemic. Indicators specific to chronic conditions, namely diabetes and heart failure, will also be explored to determine whether there were changes in care of these conditions. ClinicalTrials.gov NCT05813652; https://clinicaltrials.gov/ct2/show/NCT05813652. RR1-10.2196/49131.

Maxillofacial infections in lithuanian hospitalised children and adolescents: a 17-years retrospective study.

To analyse the epidemiology, treatment, and microbiological findings of hospitalised Lithuanian children and adolescents admitted due to maxillofacial infections over a 17-years period. 428 medical records of paediatric (under the age of 18) patients hospitalised at Vilnius University Hospital from 2003 to 2019 due to a maxillofacial infection were reviewed. The data concerning patient sociodemographic characteristics, aspects related to a hospital stay, treatment modalities, microbiological findings, and sensitivity to antibiotics, were collected and analysed. The most prevalent condition was odontogenic maxillofacial space infection (28.7%), followed by lymphadenitis (21.7%). The mean (sd) age was 10.86 (4.8) years and the male-to-female ratio was 1.37:1. The majority of patients (83.4%) underwent surgical treatment. The mean (sd) hospital stay was 5.49 (2.9) days. The longest hospital stay was observed in the case of odontogenic maxillofacial space infections. A longer period of hospitalisation was generally associated with the presence of anaerobes and their resistance to antibiotics as well as multiple space involvement in deep neck space infections and a permanent causative tooth in odontogenic cases. The most commonly isolated microbiological species was Staphylococcus aureus spp. The most common origin of maxillofacial infection was odontogenic among investigated Lithuanian children and adolescents. In the majority of cases, a penicillin group antibiotic was prescribed. Streptococci were the predominant bacteria in the cases of odontogenic infection, while Staphylococci were the most prevalent among non-odontogenic cases. Nearly 40.0% of isolated microorganisms were resistant to penicillin. High resistance to metronidazole was identified among anaerobic bacteria.

The effect of preoperative anemia on perioperative outcomes among patients undergoing emergency surgery: A multicenter prospective cohort study

IntroductionPreoperative anemia is a common finding among surgical patients. It is associated with an increased risk of perioperative morbidity and mortality. Outcomes among emergency surgical patients are not established. This study aimed to assess the effect of preoperative anemia on perioperative outcomes among patients undergoing emergency surgery in selected Southern Ethiopia governmental teaching hospitals, Southern Ethiopia, 2022. MethodA multicenter prospective cohort study was conducted. Data were collected at selected hospitals, after obtaining ethical approval from the institutional review board. Descriptive statistics, cross-tabulation, and multivariable binary logistic regression analysis were performed. A P-value less than 0.05 were taken as statistically significant. ResultA total of 200 patients who underwent emergency surgery were grouped into the anemia group (100 patients) while the rest were in the non-anemia group. There was no statistically significant difference between the groups regarding socio-demographic and intraoperative patient characteristics. Based on multivariate logistic regression, anemia group had a significant risk of perioperative transfusion requirement (Relative Risk (RR) = 4.030, p < 0.001), developing postoperative complications (RR = 1.868, p = 0.017), occurring in-hospital mortality (RR = 5.763, p = 0.045), prolong the length of hospital stay (RR = 4.028, p < 0.001), and requiring postoperative intensive care unit admission (RR = 6.332, p = 0.003) compared with non-anemia groups. ConclusionPreoperative anemia was associated with a higher rate of perioperative transfusion requirements, along with increased postoperative complication, increased in-hospital mortality, increased Intensive Critical Care Unit admission rate, and prolonged length of hospital stay. We recommend adequate preoperative assessment and correction of hemoglobin concentrations to normal values to improve surgical outcomes and reduce complications.

Instruction Program for Patient with Peptic Ulcer about Nutritional Habits: case-control study

Objectives: The purpose of the study is to ascertain the relationship between the training program and the socio-demographic features of patients with peptic ulcers in order to assess the efficiency of the program on patients' nutritional habits. Methodology: Between January 17 and October 30 of 2022, The Center of Gastrointestinal Medicine and Surgery at Al-Diwanyiah Teaching Hospital conducted "a quasi-experimental study". A non-probability sample of 30 patients for the case group and 30 patients for the control group was selected based on the study's criteria. The study instrument was divided into 4 sections: the first portion contained 7 questions about demographic information, the second section 6 questions about the patient's medical history, the third section 2 questions concerning harmful behaviors, and the fourth section 9 questions about eating habits. The data were analyzed using Statistical Package for Social Sciences Version 26. Statistical analysis methods for both descriptive and inferential analysis were used to examine the study's findings. Results: The study's finding showed that the training program had a favorable impact on patients' understanding of good nutritional practices (the case group), as evidenced by a shift in the total mean from 1.40 at the pre-test to 2.39 at the post-test, while there was no difference for the control group. Conclusion: The instruction program have positive effect on the knowledge of patients with peptic ulcer then change their nutritional habits among case group. Recommendations: The study recommends to increasing the patient’s health awareness regarding nutritional habits and explained dietary , advice, guidelines by dietitian should be undertaken for peptic ulcer patients.

Epidemiological characteristics of the Covid-19 epidemic between 2020 and 2022 in Kongo central, DRC

The Democratic Republic of Congo (DRC) has experienced widespread community transmission of SARS-CoV-2 and has recorded four successive waves from March 2020 to March 2022. The objective of this study is to determine the socio-demographic characteristics of Covid-19 patients during these epidemic waves in the province of Kongo central and to identify factors associated with deaths. This is a cross-sectional study of Covid-19 data from the provincial surveillance system. The data consisted of epidemiological surveillance data, laboratory data (tests), hospital data and patient follow-up data. We determined the characteristics of positive cases throughout the period and implemented logistic regression of factors associated with death. During the successive waves, 9, 573 positive cases were reported in the province, 546 cases in the first wave and 6, 346 in the fourth wave. Seven positive cases out of 10 concerned people aged 25 to 64. The districts of Matadi, Moanda and Mbanza-Ngungu were the most affected. Age above 64 [OR: 7.2 CI:5.1-10.3] and wave 2 [OR: 4.4 CI:1.6-12.4] were the factors statistically associated with death. As in other African settings, age, comorbidities, higher socio-professional level and living in urban areas were the major risk factors for severe forms of the disease and death. Our analysis underlines the importance of collecting and analysing several epidemiological variables down to the provincial level over time for a better continuous knowledge of the situation.

Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic

The COVID-19 pandemic accelerated adoption of telemedicine in cardiology clinics. Early in the pandemic, there were sociodemographic disparities in telemedicine use. It is unknown if these disparities persisted and whether they were associated with changes in the population of patients accessing care. We examined all adult cardiology visits at an academic and an affiliated community practice in Northern California from March 2019 to February 2020 (pre-COVID) and March 2020 to February 2021 (COVID). We compared patient sociodemographic characteristics between these periods. We used logistic regression to assess the association of patient/visit characteristics with visit modality (in-person vs telemedicine and video- vs phone-based telemedicine) during the COVID period. There were 54,948 pre-COVID and 58,940 COVID visits. Telemedicine use increased from <1% to 70.7% of visits (49.7% video, 21.0% phone) during the COVID period. Patient sociodemographic characteristics were similar during both periods. In adjusted analyses, visits for patients from some sociodemographic groups were less likely to be delivered by telemedicine, and when delivered by telemedicine, were less likely to be delivered by video versus phone. The observed disparities in the use of video-based telemedicine were greatest for patients aged ≥80 years (vs age <60, OR 0.24, 95% CI 0.21, 0.28), Black patients (vs non-Hispanic White, OR 0.64, 95% CI 0.56, 0.74), patients with limited English proficiency (vs English proficient, OR 0.52, 95% CI 0.46-0.59), and those on Medicaid (vs privately insured, OR 0.47, 95% CI 0.41-0.54). During the first year of the pandemic, the sociodemographic characteristics of patients receiving cardiovascular care remained stable, but the modality of care diverged across groups. There were differences in the use of telemedicine vs in-person care and most notably in the use of video- vs phone-based telemedicine. Future studies should examine barriers and outcomes in digital healthcare access across diverse patient groups.

Association between non-pharmacological therapy and healthcare use and expenditure of patients with diabetes mellitus

This study explored the sociodemographic and clinical characteristics of patients with diabetes who incorporated two non-pharmacological therapies into their lifestyle and the association between non-pharmacological therapy and healthcare utilization and expenditure. In the USA, 26.4 million people were reportedly diagnosed with diabetes and treated with diet modification or physical activity in the 2019 Medical Expenditure Panel Survey. Physical activity was defined as moderate-to-vigorous physical exercise five times per week, whereas dietary modification involved healthy eating that reduced glucose levels. Only 4.8 million patients with diabetes did not integrate any non-pharmacological intervention into their therapy regimen. Those who did not include non-pharmacological interventions had higher annual total healthcare expenditures (M = $18,428) than those who incorporated either single (M = $17,058) or dual intervention (M = $15,134). A significant difference was observed in prescribed medicine utilization per year for those who did not include lifestyle modifications or non-pharmacological interventions. Propensity score-matched participants revealed significant differences in hospital stays, outpatient visits, and emergency department expenditures. Patients with diabetes who adhered to two non-pharmacological interventions showed significantly lower healthcare utilization. Being active and following a healthy diet can help prevent the progression of diabetes mellituscomplications and reduce the cost associated with diabetes.

Maximizing Equity in Acute Coronary Syndrome Screening across Sociodemographic Characteristics of Patients.

We compared four methods to screen emergency department (ED) patients for an early electrocardiogram (ECG) to diagnose ST-elevation myocardial infarction (STEMI) in a 5-year retrospective cohort through observed practice, objective application of screening protocol criteria, a predictive model, and a model augmenting human practice. We measured screening performance by sensitivity, missed acute coronary syndrome (ACS) and STEMI, and the number of ECGs required. Our cohort of 279,132 ED visits included 1397 patients who had a diagnosis of ACS. We found that screening by observed practice augmented with the model delivered the highest sensitivity for detecting ACS (92.9%, 95%CI: 91.4-94.2%) and showed little variation across sex, race, ethnicity, language, and age, demonstrating equity. Although it missed a few cases of ACS (7.6%) and STEMI (4.4%), it did require ECGs on an additional 11.1% of patients compared to current practice. Screening by protocol performed the worst, underdiagnosing young, Black, Native American, Alaskan or Hawaiian/Pacific Islander, and Hispanic patients. Thus, adding a predictive model to augment human practice improved the detection of ACS and STEMI and did so most equitably across the groups. Hence, combining human and model screening--rather than relying on either alone--may maximize ACS screening performance and equity.

THE IMPACT OF ORAL AND OROPHARYNGEAL CANCER PATIENT'S MEDICAL PROFILE ON TREATMENT-RELATED TOXICITIES.

Objective To characterize oral and oropharyngeal squamous cell carcinoma (OOPSCC) patients with dental needs before cancer treatment. Patient's pre-oncological treatment data, including medical and sociodemographic characteristics, and laboratory tests results, were correlated with treatment-related head and neck toxicities. Study Design A prospective cohort study. Results 110 patients were included. The most common comorbidities were hypertension, dyslipidemia, and diabetes. C-reactive protein, hemoglobin, and hematocrit were the most altered tests results. Toxicities were progressive over time. There was a positive correlation (0.268) between the number of medications and oral mucositis (OM), and a negative correlation (-0.257) between medications and dysgeusia. For OM, altered exams showed significative P-values: thyroxine (T4) and free thyroxine (FT4) starting at D15; calcium at D5/10/30; urea at D25/30/33-35; creatinine at D15/30; alkaline phosphatase at D20/25; syphilis at D15/30. Family income and housing were OM predictors. Oral candidiasis (OC) was associated with syphilis and HIV at D20. Conclusion OOPSCC patients have several comorbidities and abnormal laboratory results. No dental treatment before cancer treatment resulted in adverse events. Laboratory findings of altered T4, FT4, urea, calcium, alkaline phosphatase, creatinine, and syphilis may be useful predictors of OM. Syphilis and HIV may also be predictors of OC secondary to OOPSCC treatment. To characterize oral and oropharyngeal squamous cell carcinoma (OOPSCC) patients with dental needs before cancer treatment. Patient's pre-oncological treatment data, including medical and sociodemographic characteristics, and laboratory tests results, were correlated with treatment-related head and neck toxicities. A prospective cohort study. 110 patients were included. The most common comorbidities were hypertension, dyslipidemia, and diabetes. C-reactive protein, hemoglobin, and hematocrit were the most altered tests results. Toxicities were progressive over time. There was a positive correlation (0.268) between the number of medications and oral mucositis (OM), and a negative correlation (-0.257) between medications and dysgeusia. For OM, altered exams showed significative P-values: thyroxine (T4) and free thyroxine (FT4) starting at D15; calcium at D5/10/30; urea at D25/30/33-35; creatinine at D15/30; alkaline phosphatase at D20/25; syphilis at D15/30. Family income and housing were OM predictors. Oral candidiasis (OC) was associated with syphilis and HIV at D20. OOPSCC patients have several comorbidities and abnormal laboratory results. No dental treatment before cancer treatment resulted in adverse events. Laboratory findings of altered T4, FT4, urea, calcium, alkaline phosphatase, creatinine, and syphilis may be useful predictors of OM. Syphilis and HIV may also be predictors of OC secondary to OOPSCC treatment.

Sociodemographic Characteristics of Patients Undergoing Surgery for Metastatic Disease of the Spine.

Some patients, particularly those who are socioeconomically deprived, are diagnosed with primary and/or metastatic cancer only after presenting to the emergency department. Our objective was to determine sociodemographic characteristics of patients undergoing surgery for metastatic spine disease at our institution. This retrospective case series included patients 18 years and older who presented to the emergency department with metastatic spine disease requiring surgery. Demographics and survival data were collected. Sociodemographic characteristics were estimated using the Social Deprivation Index (SDI) and Area Deprivation Index (ADI) for the state of California. Univariate log-rank tests and Kaplan-Meier curves were used to assess differences in survival for predictors of interest. Between 2015 and 2021, 64 patients underwent surgery for metastatic disease of the spine. The mean age was 61.0 ± 12.5 years, with 60.9% being male (n = 39). In this cohort, 89.1% of patients were non-Hispanic (n = 57), 71.9% were White (n = 46), and 62.5% were insured by Medicare/Medicaid (n = 40). The mean SDI and ADI were 61.5 ± 28.0 and 7.7 ± 2.2, respectively. 28.1% of patients (n = 18) were diagnosed with primary cancer for the first time while 39.1% of patients (n = 25) were diagnosed with metastatic cancer for the first time. During index hospitalization, 37.5% of patients (n = 24) received palliative care consult. The 3-month, 6-month, and all-time mortality rates were 26.7% (n = 17), 39.5% (n = 23), and 50% (n = 32), respectively, with 10.9% of patients (n = 7) dying during their admission. Payor plan was significant at 3 months ( P = 0.02), and palliative consultation was significant at 3 months ( P = 0.007) and 6 months ( P = 0.03). No notable association was observed with SDI and ADI in quantiles or as continuous variables. In this study, 28.1% of patients were diagnosed with cancer for the first time. Three-month and 6-month mortality rates for patients undergoing surgery were 26.7% and 39.5%, respectively. Furthermore, mortality was markedly associated with palliative care consultation and insurance status, but not with SDI and ADI. Retrospective case series, Level III evidence.

Epidemiological and Clinical Profile of COVID-19 Patients Hospitalized in University Hospitals in Mali

Introduction: The COVID-19 pandemic has caused a significant number of patients worldwide, associating mortality and sequelae. Its clinical presentation is very polymorphic and its tropism largely explains the different manifestations encountered. In order to determine the sociodemographic characteristics of patients hospitalized in the University Hospitals of Mali (CHU) for COVID-19, we conducted a study in the first year of the COVID-19 pandemic. Methods: This was a retrospective, descriptive, multicenter study over 12 months from March 2020 to February 2021 at the level of the various university hospitals in Mali, namely: Gabriel Touré University Hospital, Point-G University Hospital, Kati, Mali Hospital and Bamako Dermatology Hospital. Results: We collected 1349 patients out of 8376 cases during the period, i.e. 16.10%. Point G University Hospital accounted for 51.2% of admissions. The average age of the patients was 30 years old. The male sex was predominant with a sex ratio of 2.20. The median length of hospitalization was 8 days. The general signs were fatigue (11.6%) and asthenia (5.8%). The symptomatology was dominated by cough (23.1%), dyspnea (11.9%), headache (8.4%), anosmia (4.6%) and vomiting (2.1%). Biological abnormalities were dominated by anemia (13.9%), leucopenia (11.7%), hyperleukocytosis (4.8%), hypercreatinineemia (44.9%), hyperglycemia (9.8 %) and hypertransaminasemia (25.4%). Chest CT was performed in 10 patients, i.e. 0.7%; the most common radiological sign was multifocal ground glass opacities (100%). The evolution was favorable (88.2%), with 7.8% of cases of death. Conclusion: COVID-19 remains a polymorphic condition both in terms of symptoms, biology and imaging, further questioning the systemic nature of the disease.

Translated article] Aetiopathogenic factors and treatment of Müller-Weiss disease

Background and aimMüller-Weiss disease (MWD) is a rare anomaly of the tarsal scaphoid. Maceira and Rochera proposed the most commonly accepted etiopathogenic theory, in which dysplastic, mechanical, and socioeconomic environmental factors would be involved. The aim is to describe the clinical and sociodemographic characteristics of patients with MWD in our setting, corroborate their association with the socioeconomic factors previously described, estimate the influence of other factors involved in the development of MWD, and describe the treatment carried out. Materials and methodsRetrospective study of 60 patients diagnosed with MWD in 2 tertiary hospitals of Valencia (Spain) between 2010 and 2021. ResultsSixty patients were included, 21 (35.0%) men and 39 (65.0%) women. In 29 (47.5%) cases, the disease was bilateral. The mean age of onset of symptomatology was 41.9±20.3 years. During childhood, 36 (60.0%) patients suffered migratory movements, and 26 (43.3%) had dental problems. The mean age of onset was 14.6±4.5 years. Thirty-five (58.3%) cases were treated orthopedically versus 25 (41.7%) treated surgically, 11 (18.3%) by calcaneal osteotomy, and 14 (23.3%) with arthrodesis. ConclusionsAs in the series of Maceira and Rochera, we found a higher prevalence of MWD among those born around the Spanish Civil War and the period of massive migratory movements that occurred in the fifth decade of the 20th century. Treatment is still not well established.

Non-odontogenic maxillofacial infections - a 17-years retrospective cohort study.

A retrospective 17-year review of the epidemiology, microbiological aspects, and treatment of patients hospitalized for non-odontogenic maxillofacial infections. A retrospective study reviewed 4040 medical records of patients hospitalized at Vilnius University Hospital Zalgiris Clinic during the period of 2003 to 2019. The following data were collected: patient sociodemographic characteristics, length of hospitalization, sources of infection, affected anatomical regions, treatment modalities, microbiological findings, and sensitivity to antibiotics. The mean (sd) annual incidence of non-odontogenic maxillofacial infections over the past 17years was 237 (49) cases, and the mean (sd) hospital stay was 7.3 (4.5) days. The male-to-female ratio was 1.9:1, while the mean (sd) patient age was 42.1 (19.0) years. The need for an additional incision and the involvement of multiple anatomical regions were the strongest predictors of longer hospitalization. A total of 139 microorganism species were identified, with Bacteroides, Prevotella, and Staphylococcus showing the highest resistance to penicillin. Longer hospital stays were associated with older age (≥ 65years), smoking, systemic diseases, type of treatment, involvement of multiple anatomical regions, and the need for additional surgery. Most of the cultured microorganisms were Staphylococcus species.

Changes in the clinico-functional characteristics of stroke patients in the acute phase during the COVID-19 pandemic.

To compare the sociodemographic and clinico-functional characteristics of patients admitted to a stroke unit immediately before and during two different COVID-19 pandemic phases. This exploratory study was conducted in the stroke unit of a public hospital in Brazil. Patients consecutively admitted to a stroke unit for 18 months with primary stroke aged ≥20 years were included and divided into three groups: G1: Pre-pandemic; G2: Early pandemic; and G3: Late pandemic. The sociodemographic and clinico-functional characteristics of the groups were compared (α=0.05). The study included 383 individuals (G1=124; G2=151; G3=108). The number of risk factors (higher in G2; p≤0.001), smoking (more common in G2; p≤0.01), type of stroke (ischemic more common in G3; p=0.002), stroke severity (more severe in G2; p=0.02), and level of disability (more severe in G2: p≤0.01) were significantly different among the groups. A greater number of serious events and risk factors including smoking and higher level of disability was observed in patients in the beginning of the pandemic than in the late phases. Only the occurrence of ischemic stroke increased in the late phase. Therefore, these individuals may have an increased need for rehabilitation services monitoring and care during their lifespan. Additionally, these results indicate that health promotion and prevention services should be strengthened for future health emergencies.

The Effects of Online Access to General Practice Medical Records Perceived by Patients: Longitudinal Survey Study.

Patient online access to medical records is assumed to facilitate patient empowerment and advance patient-centered health care. However, to date, the actual effects of online access to medical records perceived by patients and other outcomes are insufficiently empirically tested. This study aimed to investigate the effects of online access to medical records on patient empowerment, informed decision-making, and the patient-provider relationship perceived by patients. A nationwide, 2-wave, longitudinal survey study was conducted among Dutch adults (N=2402). Linear regression analyses were performed. In model 1, the perceived effects of online access to medical records (measured at T1 [first measurement; July 2021]) on 16 outcomes (measured at T2 [second measurement; January 2022]), which were associated with the use of online access to general practice medical records in previous research, were investigated. Model 2 included sociodemographic factors and patient characteristics as confounders. Users indicated more strongly than nonusers that online access to medical records would increase their participation in health care, improve the relationship with their general practitioner, and support informed decision-making. These results were robust when adjusted for the influence of confounders. Effect sizes were very small, with unstandardized regression coefficients (B) ranging between -0.39 and 0.28. Higher digital and health literacy were associated with higher ratings of almost all effects. Online access to medical records has the potential to empower patients and foster informed decision-making among patients. The effects in this study were small but might grow over time. Other factors, such as the attitude of general practitioners toward online access to medical records, might moderate these effects. The results indicate that the potential benefits of online access to medical records might be unevenly distributed. We suggest future exploration of the conditions under which online access to medical records can improve health care system functioning and efficiency without increasing health inequality.

Prevalence and factors associated with suicide attempts among Moroccan patients with schizophrenia: cross-sectional study.

The purpose of this study is to investigate the prevalence of suicide attempts and their sociodemographic and clinical characteristics in Moroccan patients with schizophrenia. This is a cross-sectional study of patients admitted to our Hospital of Psychiatry in Morocco, between year and year, with adiagnosis f schizophrenia. In our sample (n=304), 65 (21.4%) had attempted suicide. Suicide attempts were significantly and positively associated with a family history of bipolar disorder, comorbidity with a substance use disorder, a relatively short duration of treatment, poor adherence to medication, and severe general, positive, and depressive symptoms. The prevention of suicide risk requires the effective management of depressive and addictive comorbidities, the reduction of schizophrenia symptoms through appropriate treatment and an effort to improve adherence.

Understanding disparities in who gets offered a virtual visit in oncology care.

e18608 Background: Multiple studies found virtual visits (real-time video or telephone calls with a medical provider) were not equitably accessible to all people during the COVID-19 pandemic. We explored structural barriers to virtual visit access by evaluating disparities in the socio-demographic characteristics of adult oncology patients who reported being offered a visit format choice during appointment scheduling. Methods: We used electronic health record data to identify adults aged ≥21 treated for cancer within the last three years at an academic medical center or affiliated community practice. Patients with a scheduled oncology-related appointment type that could be eligible for virtual format were recruited via a letter of study introduction followed by telephone call(s) to complete a brief survey prior to and following their scheduled appointment. We approached all patients scheduled for a virtual visit and weekly random samples of those scheduled for in-person visits, oversampling Black adults. Participants were recruited between 04/04/22 and 1/26/23. We used logistic regression to evaluate disparities in who on the pre-visit survey reported being offered a visit format choice. For each patient characteristic evaluated, we present unadjusted and adjusted estimates. Covariates in adjusted models were selected in consideration of causal pathways, including structural mechanisms (e.g., racism, sexism). Results: N = 412 patients completed the pre-visit survey (23% response rate), 16% prior to a scheduled virtual visit. 38% of respondents self-identified as Black, 67% as female, 42% as not married; 14% reported difficulty getting by with their current household income, and 51% as not having a college education. Respondents had a mean age of 63 years (SD = 13), and 31% rated their health as excellent/very good, 40% as good, and 29% as fair/poor. 18% reported being offered a visit format choice during appointment scheduling. In unadjusted analyses, we did not find statistically significant differences in patients who reported being offered a visit format choice by race (16% Black, 20% non-Black), education (19% no college degree, 18% college degree+), marital status (18% not married, 19% married), personal finances (19% difficulty, 19% no difficulty), and self-reported health status (15% poor/fair, 21% good, 19% very good/excellent). We found significant unadjusted differences by gender (15% female, 24% male) and age (younger patients more likely to report choice). Only male gender remained significant after covariate adjustment (OR = 1.76, 1.03-3.00). Conclusions: Almost a fifth of patients receiving cancer care were offered a visit format choice. Apart from gender, no socio-demographically defined categories of people reported being offered virtual visits less frequently than others. Other structural contributors to virtual visit accessibility, including reliable internet and device access, warrant study.

EPH200 Sociodemographic and Clinical Characteristics of Patients with Alopecia Areata in Colombia: Data from the First National Registry

Alopecia areata (AA) is an autoimmune disorder with high impact on mental health and health-related quality of life. This disease is poorly characterized in Latin America and research efforts to improve the knowledge of its epidemiology, risk factors and health-care practices are unmet needs. We sought to describe the sociodemographic and clinical characteristics and treatment patterns of patients with Alopecia Areata (AA) in Colombia