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- Aad, G., et al.
(författare)
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- 2010
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swepub:Mat__t
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| 2. |
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| 3. |
- Metra, M., et al.
(författare)
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Should beta-blocker therapy be reduced or withdrawn after an episode of decompensated heart failure? Results from COMET
- 2007
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Ingår i: Eur J Heart Fail. - : Wiley. - 1388-9842. ; 9:9, s. 901-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is unclear whether beta-blocker therapy should be reduced or withdrawn in patients who develop acute decompensated heart failure (HF). We studied the relationship between changes in beta-blocker dose and outcome in patients surviving a HF hospitalisation in COMET. METHODS: Patients hospitalised for HF were subdivided on the basis of the beta-blocker dose administered at the visit following hospitalisation, compared to that administered before. RESULTS: In COMET, 752/3029 patients (25%, 361 carvedilol and 391 metoprolol) had a non-fatal HF hospitalisation while on study treatment. Of these, 61 patients (8%) had beta-blocker treatment withdrawn, 162 (22%) had a dose reduction and 529 (70%) were maintained on the same dose. One-and two-year cumulative mortality rates were 28.7% and 44.6% for patients withdrawn from study medication, 37.4% and 51.4% for those with a reduced dosage (n.s.) and 19.1% and 32.5% for those maintained on the same dose (HR,1.59; 95%CI, 1.28-1.98; p<0.001, compared to the others). The result remained significant in a multivariable model: (HR, 1.30; 95%CI, 1.02-1.66; p=0.0318). No interaction with the beneficial effects of carvedilol, compared to metoprolol, on outcome was observed (p=0.8436). CONCLUSIONS: HF hospitalisations are associated with a high subsequent mortality. The risk of death is higher in patients who discontinue beta-blocker therapy or have their dose reduced. The increase in mortality is only partially explained by the worse prognostic profile of these patients.
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| 4. |
- Schonborn, Danielle, et al.
(författare)
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Characteristics and Help-Seeking Behavior of People Failing a Smart Device Self-Test for Hearing
- 2020
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Ingår i: American Journal of Audiology. - : AMER SPEECH-LANGUAGE-HEARING ASSOC. - 1059-0889 .- 1558-9137. ; 29:3, s. 365-374
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study investigated user characteristics, help-seeking behavior, and follow-up actions of people who failed an app-based digits-in-noise hearing screening test, considering their stage of change. Method: Test and user characteristics of 3,092 listeners who failed the test were retrospectively analyzed. A posttest survey determining follow-up (verb) actions was sent to listeners who failed the test (n = 1,007), of which 59 responded. Results: The majority of listeners were in the precontemplation stage (75.5%). Age and stage of change were significant (p < .05) predictors of the digits-in-noise speech recognition threshold (DIN SRT). Listeners in the precontemplation stage were significantly younger than in other stages (p < .05). Posttest survey response rate was low (5.9%). Of those, most (82.4%) did not think they had a hearing loss. Only 13.6% followed up with an audiologist. Conclusion: Older people presented with poorer DIN SRTs and were typically in a more advanced stage of change. The majority of those who did not follow up after failing the screening test did not believe they had a hearing loss. A combination of factors, including poor DIN SRT, older age, and a more advanced stage of change inclined participants to follow up with audiological care.
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