bluuebunny/crossref_metadata_2025_split huggingface dataset:
P472 Payer addressable burden of Crohn’s disease in patients treated with ustekinumab and vedolizumab in the United States
Authors: Ghosh T , Smith I , Fehr J , Davidson J , Fan T , Candela N , Tsang C , Koch T 
Published: May 2021

Abstract

Background
Vedolizumab (VDZ) and ustekinumab (UST) are treatments for moderate-to-severe Crohn’s disease (CD). The payer addressable burden (PAB) is the total allowed cost of care of a national health plan based on an actuarial analysis of all members total cost burden, for a given disease, regardless of any other underlying conditions. We used an actuarial retrospective claims analysis of direct and indirect costs associated with payer allowed resource utilizations to understand the US payer cost burden of the biologic-treated CD population.

Methods
Mean annual allowed cost per member with CD in the commercial health plan population was examined from a health plan actuarial and financial perspective. Data were obtained from medical and prescription claims of commercial and Medicare health plan members from Optum’s proprietary de-identified Normative Health Information database. Administrative claims data for all commercial members with pharmacy and medical coverage were used to determine medical utilization and medication unit cost patterns for CD treatment for 2017–2019. PAB analysis includes resource utilizations and associated costs among CD patients (pts) whose last biologic agent received in a year was UST subcutaneous (SC) or VDZ intravenous (IV). Costs captured were the total paid by plan and pts for medical or pharmacy claims. ICD-10 diagnosis codes were used to identify prescriptions to be included based on CD diagnosis. Members with diagnostic codes for concomitant ulcerative colitis (UC) were included only if they had more claims for CD than UC. Allowed claims costs, the sum of all medical and pharmacy costs, were categorized as CD-specific PAB and all-cause PAB. Cost per member per month was estimated by dividing total costs by total member enrolled months.

Results
In this retrospective claims analysis, more members with CD were treated with VDZ IV than UST SC in 2017 and 2018. Total and CD-related costs were lower with VDZ IV than with UST SC in overall members with CD and biologic-naïve members with CD (Figure 1). Both CD-related and all-cause PAB were markedly lower for VDZ IV than UST SC (Figure 2).

Conclusion
PAB can help payers identify opportunities for cost-saving. For patients with CD, the payer cost burden was lower with VDZ IV than with UST SC. This analysis provides a cross-sectional view of financial burden for US payers in managing members with CD. The analysis did not include longitudinal follow-up of pts for cost difference or adjustment of confounders in biologic-treated pts. The results capture the real-world burden of all forms of clinical practice and resource utilization in treating pts with CD enrolled in a commercial national plan.
P503 Inflammatory bowel disease video-consulting: a satisfaction survey during the second wave of Covid-19 pandemics
Authors: Todeschini A 
Published: May 2021

Abstract

Background
During the SARS-CoV-2 pandemic there was a substantial change in providing medical care. National and international statements recommended avoiding face-to-face visit for treatment of patients especially for chronic disease. Also lockdown and social distancing cause a lot of concern among patients, which prefer avoid hospital facilities due to fear of contracting COVID-19. For these reason there was a reorganization of inflammatory bowel disease follow-up visit shifting from traditional visit to telemedicine whereas it’ was possible. Our survey aimed to evaluated satisfaction about follow up video-consulting in IBD patients.

Methods
From September to December 2020, 75 video-consults were made as follow up in patients with IBD. Video-consult wasn’t performed as first visit nor in patients with new clinical issue. Every consult lasted about 15 minutes. At the end of the visit, a questionnaire of satisfaction was e-mailed to each patient. This questionnaire evaluated several items: satisfaction, difficulty of connection, opportunity to repeat the video-consult even in post-Covid-19 era, safety compared to face-to-face visit, level of concern about Covid-19 disease and fear of in-hospital transmission

Results
70% of the patients indicated an high video-consult rating and in most of cases (88%) there were no connection problems. The majority (88%) would like to repeat the tele-visit even in the post-Covid 19 era (77%). Video-consult seemed to be perceived as safer than face-to-face visit even if, in case of urgent consultation, it was preferred a traditional visit. Moreover, Covid-19 infection and fear of in-hospital trasmission was a great concern in the 73% and 58% of the patients respectively.

Conclusion
In our survey, outpatients reported a very high degree of satisfaction with video consultations. It was an easy and safe tool that may become an integral part of clinical practice in the future.
P601 Are Inflammatory Bowel Disease patients’ expectations met by dietetic services?
Authors: McCarthy N , Schultz M , Wall C 
Published: May 2021

Abstract

Background
Guidelines recommend that Inflammatory Bowel Disease (IBD) patients should have access to specialised dietitian support. Literature suggests that patients are often dissatisfied with their access to reliable nutrition information and dietitian services. Our aim was to assess whether New Zealand (NZ) dietetic services were meeting the expectations of patients.

Methods
In early 2020 an electronic survey to explore experience of dietetic services was disseminated to approximately 2000 patients (and parents) by Crohn’s and Colitis NZ and IBD health professionals. Quantitative responses were analysed via non-parametric methods and qualitative responses were analysed via inductive analysis.

Results
Responses were received from 407 IBD patients. Participants were asked if it ‘is useful for patients diagnosed with IBD to have access to a dietitian for nutrition advice?’ with 86% responding ‘Yes’ and 12% ‘Maybe’. Almost all (95%) patients had nutrition topics that they would like to discuss with a dietitian but only 52% had seen a dietitian and 45% had never been referred. Patients were interested in various nutrition topics (Table 1). Most (65%) would like access to a dietitian whenever a new nutrition issue arises.
The most frequent nutrition advice received was to follow a specific diet, most commonly a low fermentable carbohydrate diet followed by a low residue diet, or general nutrition advice. Two-thirds (66%) of respondents found the dietitian advice at least moderately useful while 18% reported it was not at all useful. Patients who saw a dietitian in a private clinic were more likely to find the advice useful (p=0.0001), as were those who had received written advice (p&lt;0.0001).
Common themes in response to open-ended questions included: frustration at difficulty accessing dietetic services; desire for routine dietitian referral at diagnosis and ongoing access; the need for dietitians to have specialist knowledge of IBD; a perception that some medical staff believe nutrition is not relevant in IBD management.

Conclusion
Many patients have never been referred to a dietitian and a proportion of patients did not find dietitian advice useful. Dietitian advice appears to be on the topics most commonly of interest to patients. Access to dietetic services needs to improve and exploration is needed to elucidate why some aspects of services are not meeting patient expectations.
An unusual case report of stress-induced cardiomyopathy presenting as ventricular fibrillation cardiopulmonary arrest and third-degree atrioventricular block
Authors: Parekh Akarsh , Sengupta Vivek , Zainea Mark 
Published: May 2021

Abstract

Background
Takotsubo cardiomyopathy (TCM) can clinically present as an acute coronary syndrome; however, the former has regional wall motion abnormalities that extend beyond a single coronary vascular territory without any plaque rupture. Takotsubo cardiomyopathy classically involves apical ballooning of left ventricle (LV). It is uncommon for TCM to present as cardiopulmonary arrest (CPA) along with third-degree atrioventricular (AV) block.

Case summary
A 63-year-old female, underwent a ventricular fibrillation (VF) CPA. She was defibrillated three times and return of spontaneous circulation (ROSC) was achieved after 37 min. Her post-ROSC electrocardiogram showed non-specific ST-segment changes and T-wave inversions and soon progressed to third-degree AV block. Patient had a transvenous pacemaker placed to pace her heart. Echocardiogram showed an LV ejection fraction of 15–20% with akinesis of the apex and anteroseptum. An echocardiogram repeated 4 days after the cardiopulmonary arrests showed an ejection fraction of 60–65% with hypokinesis of mid anterior and antero-apical hypokinesis. However, the patient still continued to require a pacemaker and hence eventually received a dual-chamber pacemaker/implantable cardioverter-defibrillator for her AV block and ventricular arrhythmia.

Discussion
Most commonly TCM presents with chest pain and symptoms of acute myocardial infarction. We present a very rare presentation of TCM associated with VF and CPA along with third-degree AV block. There have handful of case reports documenting TCM causing CPA in some patients and other case reports showing TCM causing high degree AV block. In our patient, TCM was associated with both VF and CPA along with third-degree AV block.
May Measurement Month 2019: blood pressure screening results from Chile
Authors: Lanas Fernando , Garcia María Soledad , Paccot Melanie , Beaney Thomas , Xia Xin , Poulter Neil R 
Published: May 2021

Abstract
Hypertension is a major preventable cause of death worldwide. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high blood pressure (BP) and identifying individuals with increased BP. A cross-sectional survey of volunteers aged ≥18 years old was carried out in May 2019 in Chile. Participating sites were distributed across the country, most of them from the Public Health System outpatient clinics. In addition, clinical research sites, universities, and private clinics participated. Blood pressure measurement protocol, hypertension categories, and statistical analysis followed the MMM protocol. Hypertension was diagnosed as mean systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or receiving antihypertensive medication. Overall, 6876 individuals were screened. After multiple imputations, hypertension prevalence was 35.4%, of which 65.9% were aware of their condition. While 60.1% were on antihypertensive medication and 34.4% of the total number of hypertensives had their BP controlled. Of participants not receiving antihypertensive treatment, 17.9% were identified as hypertensive. The MMM 2019 survey demonstrated a high proportion of participants with hypertension, with only one-third of these individuals having controlled BP (systolic BP &lt;140 mmHg and diastolic BP &lt;90 mmHg). The high percentage of participants with hypertension who were either untreated (39.9%) or were treated but uncontrolled (57.2%) suggesting that such opportunistic screening programmes may be a useful tool to improve hypertension control in Chile.
May Measurement Month 2019: an analysis of blood pressure screening results from Ghana-Sub-Saharan Africa
Authors: Twumasi-Ankrah Betty , Poulter Neil R , Tannor Elliot K , Adu-Boakye Yaw , Nyarko Obed O , Opoku Gilder , Konadu Saabea O , Aniagyei Marian , Ogah Anita , Baidoo Timothy E , Mensah Clarence , Clarke Jonathan , Beaney Thomas , Myers-Hansen Gustavus A 
Published: May 2021

Abstract
Raised blood pressure (BP) remains the biggest single risk factor contributing to the global burden of disease and to global mortality. Although a substantial number of people who have hypertension are either oblivious of it, not treated, or being managed but remain uncontrolled. May Measurement Month (MMM) is a global initiative led by the International Society of Hypertension (ISH) with the goal of increasing awareness of high BP and serving as a spur to establish screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2019. Measurement of BP and collection of relevant health information were performed according to a standardized protocol for MMM. Screening sites were set up in churches, mosques, health facilities, pharmacies, recreational parks, sports facilities, shopping centres, marketplaces, universities, workplaces, and community centres across four regions of Ghana. A total of 7102 participants gave their consent and were screened during MMM 2019. After multiple imputation, of all 7102 participants 1836 (25.9%) had hypertension. Of all 1836 participants with hypertension, 36.5% were aware of their status and 30.0% were on anti-hypertensive medication. Of 550 participants on antihypertensive medications, 46.1% had controlled BP (systolic BP &lt;140 mmHg and diastolic BP &lt;90 mmHg). Also, of all 1836 participants with hypertension, 13.8% had their BP controlled. Again, the proportion of participants with hypertension of those not receiving anti-hypertensive treatment was 1286 (19.6%). Data obtained from this project demonstrates that there is still a significant number of people with hypertension who are unaware of having it, are untreated, or are on treatment but remain uncontrolled. It also highlights the significance of BP screening campaigns as a tool to identify persons with elevated BP.
May Measurement Month 2019: an analysis of blood pressure screening results from Jamaica
Authors: Nwokocha Magdalene , Beaney Thomas , Holder Cheryl , Thaxter Nesbeth Karen , Whylie Natalie , Leitch Joan , Ferguson Trevor , Hosang Mark , Riley Vincent , Soyibo Adedamola , Oshi Daniel , Brown Paul , Paul Tomlin , Wilks Rainford , Poulter Neil R , Nwokocha Chukwuemeka 
Published: May 2021

Abstract
There is evidence of an elevated risk of hypertension in populations that are primarily of African origin. Hypertension is predominantly asymptomatic, necessitating increased awareness. May Measurement Month was a descriptive, population-based, cross-sectional study of blood pressure (BP) screening and awareness campaign conducted in 2019 in a sample of 2550 participants (≥18 years) in Jamaica. In total, 1791 (70.2%) of the participants were female, 756 (29.6%) were male, with an average age of 49.3 years, and a body mass index (kg/m2) of 28.5 (6.2). Of all participants, 2289 (89.8%) were black and 154 (6.0%) were of mixed races. Twenty-two (0.9%) had never had their BP measured, whereas 354 (13.9%) had their measurements more than a year ago, and 2129 (83.5%) had measured within the year. Of all 2550 participants, 1055 (41.4%) had hypertension, 69.9% of our subjects with hypertension were aware, whereas only 62.5% were on antihypertensive medication and 27.8% had controlled BP (systolic &lt;140 mmHg and diastolic BP &lt;90 mmHg). Of 660 participants on antihypertensive medication, 44.4% had controlled BP. Two hundred and seventy-six (15.4%) of women reported hypertension in a previous pregnancy. Hypertension with previous pregnancy was positively correlated with current elevation. These results suggest a high rate of raised BP among community dwellers whose hypertension had not been previously diagnosed by a health professional and warrant proactive approaches that promote community-based awareness, and regular measurements.
May Measurement Month 2019: an analysis of blood pressure screening results from Angola
Authors: Victória Pereira Savarino , Neto Marisa , Feijão Ana , Lutucuta Eurico , Mbala Claudio , Muela Henrique , Soito Ermelinda , Matias Altino , Mundombe Leonardo , Beaney Thomas , Partington Giles , Poulter Neil R , Fernandes Mário 
Published: May 2021

Abstract
Raised blood pressure (BP) is the biggest risk factor that contributes to the global burden of disease and mortality. May Measurement Month (MMM) is a global initiative aimed to improved awareness of BP and has been a temporary solution to the lack of screening programmes. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2019. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. In total, 7112 individuals were screened (mean age 41.3 years; 50.4% female; 99.5% black) in 6 of the 18 Angolan provinces. In total, 99.6% of screenees provided three BP readings with an average BP of the 2nd and 3rd readings of 126/81 mmHg. After imputation, 2745 (38.6%) had hypertension of whom 1389 (59.8%) were aware of their diagnosis and 50.6% were on antihypertensive medication. Of those 1389 treated participants, 41.2% were controlled (&lt;140/90 mmHg) and of all hypertensive individuals, 20.8% were controlled. Also, 1356 individuals had untreated hypertension and 817 were inadequately treated. Angolan MMM19 follows on from the MMM17 (n = 17481) and MMM18 (n = 14433) studies, which were the largest BP screening campaigns undertaken in Angola. The 2019 results showed a high percentage of hypertensive individuals and almost 2200 adults had either untreated or inadequately treated hypertension, demonstrating that there is work to do but also that the Angolan MMM is being effective at raising awareness at least among these individuals.
May Measurement Month 2019: an analysis of blood pressure screening results from Malawi
Authors: Ndhlovu Henry L L , Chirwa Maureen L , Mbeba Mary K , Nyirenda Nancy M , Mbulaje Lucia D , Beaney Thomas , Xia Xin , Poulter Neil R 
Published: May 2021

Abstract
May Measurement Month (MMM) is a global initiative that aims at raising awareness and screening people for high blood pressure (BP). Malawi has participated in MMM since 2017. A 2017 STEPwise Survey conducted in Malawi among 4187 participants found that 65.2% had never had their BP measured before, 26.8% had their BPs measured but not diagnosed, 3.9% were diagnosed but not within the last 12 months, and 4.1% were diagnosed within the last 12 months. An opportunistic cross-sectional survey of volunteers aged 18 and above was carried out in May and June 2019. All BP measurements, definition of hypertension and statistical analysis followed the standard MMM protocol. The screening took place in Nkhatabay, Lilongwe, and Blantyre. A total number of 9723 participants were screened with a mean age of 42.0 (SD 16.6) years. Of these 8444 (86.8%) had never had their BP measured within the last 12 months, 2559 (26.3%) had raised BP, 2169 (23.2%) of those with raised BP were not on treatment whereas 390 (4.0%) were on treatment. The results showed that many of the participants had not had their BP checked in the past year. There is a significant need to expand BP screening opportunities within Malawi for early detection of hypertension.
May Measurement Month 2019: an analysis of blood pressure screening results from Armenia
Authors: Zelveian Parounak , Hayrumyan Samvel , Gourgenyan Svetlana , Hakobyan Zoya , Kzhdryan Hovhannes , Avagyan Avag , Minasyan Arsen , Gharibyan Heghine , Ustyan Tsiala , Aroyan Siranush , Vatinyan Susanna , Beaney Thomas , Clarke Jonathan , Poulter Neil R 
Published: May 2021

Abstract
Elevated blood pressure (BP) is an enormous public health problem and a growing burden worldwide and the biggest single risk factor for cardiovascular death. May Measurement Month (MMM) is a global initiative aimed to raise awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May to July 2019. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. The study was conducted in public areas (23 sites in the capital city Yerevan and 13 in other regions), both indoor and outdoor, as well as in primary and secondary healthcare centres. In total, 9818 individuals (11.3% participated in either MMM2017/2018 or both) were screened of which 9786 had three BP measurements available, 1.6% of them reported never having had their BP measured. The mean age of screened participants was 47.6 (SD ± 16.5) years, 61.9% were female. After multiple imputation, 41.6% of participants had hypertension and 72.8% of them were aware of their high BP, 65.4% were on treatment, and of those treated, 46.5% had controlled BP (&lt;140/90 mmHg). Of 4088 participants with hypertension, 30.4% had controlled BP. Of all risk factors analysed, reported use of anti-hypertensive medication and a previous diagnosis of hypertension were the strongest predictors of higher levels of BP. We found that the prevalence of hypertension, untreated and treated, but uncontrolled hypertension is still substantial in Armenia, which maybe a vital contributor to the growing burden of non-communicable diseases.
Atrial edema in patients with atrial fibrillation with chronic heart failure
Authors: Kirillova VV , Mochula OV , Garganeeva AA , Usov VYU , Batalov RE , Meshchaninov VN , Popov SV 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
to investigate the intensity of the atrial septum by T2-weighted magnetic resonance imaging (MRI) in patients with chronic heart failure (CHF), with and without atrial fibrillation (AF). Materials and methods. In patients with CHF with atrial fibrillation (n = 23, including 11 patients with paroxysmal form, and 12 patients with constant forms) and without (n = 9) of arrhythmias in the control group – almost healthy (n = 6) we evaluated the signal intensity (SI) of the interatrial septum, the interventricular septum, and skeletal muscle at MRI T-2 weighted images. An increase in the value of SI in 2 times or more compared with the SI of skeletal muscle was regarded as an MRI signs of myocardial edema. Results. The SI of the atrial septum in patients with CHF who have constant forms of atrial fibrillation is higher than in the control (2775.58 ± 383.61 relative to the control - 1448.57 ± 291.30, p &lt; 0.05). The MPP gain index in patients with paroxysmal AF equal to 1.59 ± 0.10 did not differ in comparison with patients with CHF who do not have rhythm disorders - 1.53 ± 0.12. An index of atrial septal enhancement greater than 2, indicating the presence of MRI signs of atrial septal myocardial edema was detected only in patients with a constant form of AF (2.39 ± 0.18) than in patients with CHF with paroxysmal AF, in patients with CHF without rhythm disturbances and in the control group (1.59 ± 0.23; 1.53 ± 0.28 and 1.15 ± 0.16, respectively, p &lt; 0.05). Summary. In patients with CHF who have a constant form of atrial fibrillation, according to T2-weighted MRI images, signs of edema of the myocardium of the atrial septum were revealed in comparison with the control group and patients with CHF who have a paroxysmal form of atrial fibrillation and without rhythm disturbances.