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Total 555 results found since Jan 2013.

Atrial fibrillation (AF) pilot screening programme in primary care in Ireland: an implementation study protocol
This study aims to investigate the acceptability, feasibility and impact of AF screening in primary care using a handheld mobile ECG device. Methods and analysis General practitioners (GPs) and practice nurses in the South of Ireland will opportunistically screen patients aged ≥65 years for AF at routine consultation using a handheld one-lead ECG device, KardiaMobile. This study will screen up to 4000 patients. Blood pressure and smoking status will be checked concurrently. A mixed-method evaluation will be undertaken including a partial economic evaluation. Anonymised data will be collected from participating practice...
Source: BMJ Open - February 7, 2022 Category: General Medicine Authors: Callanan, A., Quinlan, D., O'Sullivan, S., Bradley, C. P., Kearney, P. M., Murphy, A., Buckley, C. M. Tags: Open access, Public health Source Type: research

Factors associated with the longer-term unmet supportive care needs of stroke survivors in Ethiopia: a multicentre cross-sectional study
Conclusions There are significant longer-term unmet supportive care needs among adult stroke survivors. The factors associated with longer-term unmet supportive care needs were; having comorbidities, moderate and above level of disability according to the modified Rankin Scale score and unable to use the physiotherapy service. The development of appropriate services to address the longer-term unmet supportive care needs of stroke survivors is warranted.
Source: BMJ Open - January 31, 2022 Category: General Medicine Authors: Tamrat, E. G., Gufue, Z. H., Getachew, S., Yifru, Y. M., Gizaw, M. Tags: Open access, Neurology Source Type: research

Supported self-management in community stroke rehabilitation: what is it and how does it work? A protocol for a realist evaluation study
Introduction A growing evidence base demonstrates the effectiveness of supported self-management in stroke for stroke survivors and their families. However, there is significant variation in its implementation in community stroke care and little understanding about how supported self-management works and is delivered across different settings, models used and contexts of community stroke rehabilitation. Methods and analysis Using a mixed method, realist approach across two phases, this protocol describes a study on community-based supported self-management. The aim is to identify the mechanisms and outcomes of supported s...
Source: BMJ Open - January 20, 2022 Category: General Medicine Authors: Kidd, L., Millar, J. D., Mason, H., Quinn, T., Gallacher, K. I., Jones, F., Fisher, R. J., Lebedis, T., Barber, M., Brennan, K., Smith, M. Tags: Open access, Rehabilitation medicine Source Type: research

Hyperacute stroke thrombolysis via telemedicine: a multicentre study of performance, safety and clinical efficacy
Conclusions The results from this large hyperacute telestroke cohort indicate two important points for clinical practice. First, telemedicine via a hubless horizontal model provides a clinically effective and safe method for delivering hyperacute stroke thrombolysis. Second, improved door-to-needle times were offset by a concerning rise in prehospital timings. These findings indicate that although telemedicine may benefit in-hospital hyperacute stroke care, improvements across the whole stroke pathway are essential.
Source: BMJ Open - January 17, 2022 Category: General Medicine Authors: Evans, N. R., Sibson, L., Day, D. J., Agarwal, S., Shekhar, R., Warburton, E. A. Tags: Open access, Neurology Source Type: research

Healthcare resource utilisation for chronic kidney disease and other major non-communicable chronic diseases in China: a cross-sectional study
Conclusions The presence of diagnosed CKD alongside each major NCD was associated with an additional burden on the healthcare system. Healthcare resource utilisation and prognosis of CKD were comparable with those of other major NCDs, which highlights the importance of CKD as a major public health burden.
Source: BMJ Open - January 13, 2022 Category: General Medicine Authors: Yang, C., Long, J., Shi, Y., Zhou, Z., Wang, J., Zhao, M.-H., Wang, H., Zhang, L., Coresh, J. Tags: Open access, Epidemiology Source Type: research

Corticocortical paired associative stimulation for treating motor dysfunction after stroke: study protocol for a randomised sham-controlled double-blind clinical trial
This study protocol aims to examine the corticocortical paired associative stimulation (ccPAS) for inducing synaptic plasticity to rescue the paralysed after stroke. Methods and analysis The current study is designed as a 14-week double-blind randomised sham-controlled clinical trial, composed of 2-week intervention and 12-week follow-up. For the study, 42 patients who had a stroke aged 40–70 will be recruited, who are randomly assigned either to the ccPAS intervention group, or to the control group at a 1:1 ratio, hence an equal number each. In the intervention group, ccPAS is practised in conjunction with the conv...
Source: BMJ Open - January 13, 2022 Category: General Medicine Authors: Duan, Y.-J., Hua, X.-Y., Zheng, M.-X., Wu, J.-J., Xing, X.-X., Li, Y.-L., Xu, J.-G. Tags: Open access, Rehabilitation medicine Source Type: research

Do baseline characteristics and treatments account for geographical disparities in the outcomes of patients with newly diagnosed atrial fibrillation? The prospective GARFIELD-AF registry
Conclusion The variability in outcomes across countries for patients with newly diagnosed AF is not accounted for by baseline characteristics and antithrombotic treatments. Residual mortality rates were correlated with Healthcare Access and Quality indices. The findings suggest the management of patients with AF needs to not only address guideline indicated and sustained anticoagulation, but also the treatment of comorbidities and lifestyle factors. Trial registration number NCT01090362.
Source: BMJ Open - January 7, 2022 Category: General Medicine Authors: Fox, K. A. A., Virdone, S., Bassand, J.-P., Camm, A. J., Goto, S., Goldhaber, S. Z., Haas, S., Kayani, G., Koretsune, Y., Misselwitz, F., Oh, S., Piccini, J. P., Parkhomenko, A., Sawhney, J. P. S., Stepinska, J., Turpie, A. G. G., Verheugt, F. W. A., Kakk Tags: Open access, Cardiovascular medicine Source Type: research

Development of strategies to support home-based exercise adherence after stroke: a Delphi consensus
Conclusion We developed a framework of comprehensive strategies to assist clinicians in supporting exercise adherence among stroke survivors. It provides practical methods that can be deployed in both research and clinical practices. Future studies should explore stakeholders’ experiences and the cost-effectiveness of implementing these strategies.
Source: BMJ Open - January 6, 2022 Category: General Medicine Authors: Mahmood, A., Deshmukh, A., Natarajan, M., Marsden, D., Vyslysel, G., Padickaparambil, S., TS, S., Direito, A., Kumaran, S., N, G., Sachdev, H., Kumar Veluswamy, S., Karthikbabu, S., Unnikrishnan, B., English, C., Solomon, J. M. Tags: Open access, Neurology Source Type: research

Feasibility of an individualised, task-oriented, video-supported home exercise programme for arm function in patients in the subacute phase after stroke: protocol of a randomised controlled pilot study
This study follows the Standard Protocol Items: Recommendations for Interventional Trials-Patient-Reported Outcome (PRO) Extension guideline. Ethical approval was received from the Ethics Committee of the Medical University of Innsbruck, Austria (1304/2020). Written informed consent will be obtained from all participants prior to data collection. Study results will be disseminated to participating patients, patient organisations, via the clinic’s homepage, relevant conferences and peer-reviewed journals. Trial registration number DRKS-ID: DRKS00023395. Study protocol, second revision, 5 December 2021.
Source: BMJ Open - January 4, 2022 Category: General Medicine Authors: Wanner, M., Schönherr, G., Kiechl, S., Knoflach, M., Müller, C., Seebacher, B. Tags: Open access, Neurology Source Type: research

Danish validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ) and findings from a population health survey: a mixed-methods study
Conclusion The Danish MTBQ is a valid measure of treatment burden with good construct validity and high internal reliability. This is the first study to explore treatment burden at a population level and provides important evidence to policy makers and clinicians about sociodemographic groups at risk of higher treatment burden.
Source: BMJ Open - January 3, 2022 Category: General Medicine Authors: Pedersen, M. H., Duncan, P., Lasgaard, M., Friis, K., Salisbury, C., Breinholt Larsen, F. Tags: Open access, Research methods Source Type: research

Exploring the experiences of stroke survivors, informal caregivers and healthcare providers in Sierra Leone: a qualitative study protocol
This study has received ethical approval from the Sierra Leone Ethics and Scientific Review Committee (8 December 2020) and the KCL Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference: HR-20/21-21050). The findings of the study and learning in terms of the process of coproduction and involvement of stroke survivors will be disseminated via peer-reviewed publications, conferences, media and lay reports.
Source: BMJ Open - December 30, 2021 Category: General Medicine Authors: O'Hara, J., Thompson, M., Deen, G., Leather, A. J. M., Youkee, D., Wall, J., Sackley, C., Parmar, D., McKevitt, C., NIHR Global Health Research Group at Kings College London, Wolfe, Langhorne, Lisk, Deen, McKevitt, Watkins, Leather, Prince, Youkee, Wang, Tags: Open access, Qualitative research Source Type: research

Self-care interventions in stroke survivor-caregiver dyads: a protocol for systematic review and meta-analysis
Introduction Stroke is known as one of the leading causes of mortality and disability worldwide. Self-care plays a significant role in improving the quality of life, self-efficacy and many other outcomes of stroke survivors. However, it is a dyadic phenomenon where patient self-care and the caregiver contribution to self-care are inter-related in terms of predictors and outcomes. Currently, there is still no systematic assessment conducted to examine the overall effectiveness of self-care interventions carried out in stroke survivor–caregiver dyads and explore the effect on stroke survivor and/or caregiver outcomes. ...
Source: BMJ Open - December 30, 2021 Category: General Medicine Authors: Wang, W., Lin, B., Mei, Y., Zhang, Z., Zhou, B. Tags: Open access, Nursing Source Type: research

Assessment of the effects of methodological choice in continuity of care research: a real-world example with dyslipidaemia cohort
Conclusions The study design in continuity of care studies should be planned carefully because the results are sensitive to the temporal relationship between continuity and outcome and the population selection criteria.
Source: BMJ Open - December 30, 2021 Category: General Medicine Authors: Choo, E., Choi, E., Lee, J., Siachalinga, L., Jang, E. J., Lee, I.-H. Tags: Open access, Health services research Source Type: research

Person-centred care transitions for people with stroke: study protocol for a feasibility evaluation of codesigned care transition support
This study protocol describes the evaluation of a feasibility study using a non-randomised controlled design. The codesigned care transition support includes patient information using videos, leaflets and teach back; what-matters-to me dialogue; a coordinated rehabilitation plan; bridged e-meeting; and a message system for cross-organisational collaboration. Patients with stroke, first time or recurrent, who are to be discharged home from hospital and referred to a rehabilitation team in primary healthcare for continued rehabilitation in the home will be included. One week after stroke, data will be collected on the primar...
Source: BMJ Open - December 23, 2021 Category: General Medicine Authors: Flink, M., Lindblom, S., Tistad, M., Laska, A. C., Bertilsson, B. C., Wärlinge, C., Hasselström, J., Elf, M., von Koch, L., Ytterberg, C. Tags: Open access, Neurology Source Type: research

What do people with lung cancer and stroke expect from patient navigation? A qualitative study in Germany
Conclusion For chronic and complex diseases—as is the case with lung cancer and stroke—it appears less important for navigators to fulfil disease-specific tasks. Rather, they should ensure that patients’ more general needs, in relation to social, practical and emotional support, are met in a way that suits their individual wishes. Following these results, patient navigation programmes might be designed to include generic elements, which should then be adapted to the infrastructure in a particular healthcare region and to the particularities of a specific healthcare system.
Source: BMJ Open - December 23, 2021 Category: General Medicine Authors: Fügemann, H., Goerling, U., Gödde, K., Desch, A. K., Müller-Nordhorn, J., Mauckisch, V., Siegerink, B., Rieckmann, N., Holmberg, C. Tags: Open access, Qualitative research Source Type: research