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- Pettersen, T., et al.
(author)
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Sex differences in incidence of self-reported adverse drug reactions after percutaneous coronary intervention
- 2023
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In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 44:Supplement_2
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Journal article (peer-reviewed)abstract
- BackgroundDespite experiencing adverse drug reactions (ADRs) more often than men, the proportion of women participating in clinical drug trials is low. Thus, evidence for sex differences in the incidence of ADRs is limited.AimTo determine sex differences in incidence of self-reported ADRs after percutaneous coronary intervention (PCI). Further, to determine whether receiving information about ADRs is associated with sex.MethodsCONCARDPCI is a prospective multicentre cohort study (N=3417) conducted at seven referral PCI centres in two Nordic countries. Clinical data were collected from patients’ medical records. Socio-demographic characteristics were obtained by self-report after PCI. Two questions from the Heart Continuity of Care Questionnaire (HCCQ) were used to determine if information about potential ADRs was received before hospital discharge. De novo created questions were used to determine if patients reported ADRs from prescribed therapy. Questionnaires were distributed two- (T1), six- (T2), and twelve months (T3) after hospital discharge to assess the incidence of self-reported ADRs in a longitudinal perspective. Logistic regression was utilised to scrutinize the aims, reported as odds ratios (ORs) with 95% confidence intervals (CIs).ResultsPatients were predominantly male (78%), with a mean age of 65 years (SD 11). Female patients were older (68, SD 10). Acute coronary syndrome was the most frequent cause of admission for PCI (62%). At T1, 2656 of the included patients responded to the questions from the HCCQ. Of these, 1019 patients (39%) reported being informed of potential ADRs from prescribed therapy, 1075 patients (42%) reported not having been informed, 511 patients (20%) reported ‘Hard to decide’, and 51 (2%) reported ‘Not applicable’. Patients reporting ‘Hard to decide’ or ‘Not applicable’ were excluded from further analysis. Women were less likely to receive information than men (OR 0.58, CI 0.45 – 0.75, p<0.001). For the total study population, 42%, 49% and 40% reported ADRs at T1-T3 respectively. After adjusting for sociodemographic and clinical variables, the incidence of self-reported ADRs were significantly higher in women compared to men at T1 (OR 1.71, CI 1.36 – 2.15, p<0.001), T2 (OR 1.89, CI 1.49 – 2.38, p<0.001), and T3 (OR 1.79, CI 1.40 – 2.28, p<0.001).ConclusionWomen report significantly more ADRs from prescribed therapy than men after PCI. However, they are less likely to receive information about potential ADRs compared to men. Efforts to improve communication on ADRs and gender equity should be a priority.
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4. |
- Valaker, I., et al.
(author)
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Relational continuity with healthcare providers after percutaneous coronary interventions : the patient perspective
- 2017
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S89-S89
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Journal article (peer-reviewed)abstract
- Background: Relational continuity plays an important role when organizing the health care services for patients after early discharge. However, little is known about how patients experience relational continuity after percutaneous coronary interventions (PCI). Relational continuity has been defined as an ongoing therapeutic relationship between a patient and one or more healthcare providers.Purpose: To explore how patients undergoing PCI experience relational continuity after early discharge.Methods: Patients undergoing PCI hospitalized 6-8 weeks earlier, ⩾ 18 years and living at home at the time of inclusion were eligible for the study. Patients were purposively recruited from the Norwegian Registry for Invasive Cardiology. The study used an explorative design, and semistructured interviews were conducted with nine women and 13 men. The majority were older than 67 years, suffered an ST-elevation infarction and did not participate in cardiac rehabilitation. Interviews were analyzed using qualitative content analysis according to Graneheim and Lundman.Results: Important dimensions inherent in relational continuity found in this study were: (1) genuine interest in the patient as a person, (2) fostering a trusting relationship,(3) knowledge about the patient’s current health status (4) the importance of a motivated and supportive healthcare provider, and (5) being in competent and safe hands.Conclusions: Establishing trusting relationships with multiple healthcare providers and especially with the GP provide patients with a sense of security and predictability. At present, GPs are joined by numerous of other healthcare providers offering supplemental services. Developing clinical pathways, interdisciplinary teams, and adding more nursing personnel on advanced level in primary careseems to be important. Furthermore, collaboration with user organizations could be an arena for better communication between healthcare providers and patients undergoing PCI. There is a need for new knowledge about relational continuity through research and education within this field.
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