Dataset Information

Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study.

ABSTRACT: OBJECTIVES:To describe all iron deficiency anaemia (IDA)-related causes during follow-up of patients newly diagnosed with IDA and to assess whether a delayed colorectal cancer (CRC) diagnosis influences survival. DESIGN AND SETTING:Retrospective cohort study of patients from general practices in the Dordrecht area, the Netherlands. PARTICIPANTS:Men and women aged ?50 years with a new diagnosis of IDA (ie, no anaemia 2?years previously). METHOD:From February 2007 to February 2018, all relevant data were collected from the files of the referral hospital. Early IDA-related cause was defined as established within 18 weeks after IDA diagnosis. Cox proportional-hazards regression was used to analyse survival of patients with CRC diagnosis. RESULTS:587 patients with IDA were included with a median follow-up of 4.6 years. Early and late IDA-related causes could be established in 32% and 8% of patients, respectively. Early and late CRC was found in 8% and 2% of patients, respectively, and were located mainly right sided. After adjustment for age, gender and TNM classification, mortality risk was lower in patients with IDA with early CRC diagnosis, but not significantly (HR 0.30, 95%?CI 0.09 to 1.02). CONCLUSION:Even with extended follow-up, the cause of IDA remains elusive in the majority of patients with IDA in general practice. However, patients with IDA are at increased risk for in particular right-sided CRC and a late diagnosis of CRC appears to have a detrimental effect on survival in patients with IDA.

SUBMITTER: Schop A

PROVIDER: S-EPMC6924716 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study.

Schop Annemarie A Stouten Karlijn K Riedl Jurgen J van Houten Ron R van Rosmalen Joost J Wolfhagen Frank F Bindels Patrick J E PJE Levin Mark-David MD

BMJ open 20191128 11

<h4>Objectives</h4>To describe all iron deficiency anaemia (IDA)-related causes during follow-up of patients newly diagnosed with IDA and to assess whether a delayed colorectal cancer (CRC) diagnosis influences survival.<h4>Design and setting</h4>Retrospective cohort study of patients from general practices in the Dordrecht area, the Netherlands.<h4>Participants</h4>Men and women aged ≥50 years with a new diagnosis of IDA (ie, no anaemia 2 years previously).<h4>Method</h4>From February 2007 to F ...[more]

PMID: 31784447

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Project description:ObjectivesHypotension is of particular relevance for patients with heart failure (HF), since almost all HF drugs cause lowering of blood pressure (BP) and it is associated with a poor prognosis. We aimed to investigate hypotension incidence and risk factors in patients with incident HF in the UK.DesignRetrospective cohort study including nested case-control analyses.SettingThe Health Improvement Network UK primary care database.Participants18 677 adult patients with incident HF during 2000-2005 were followed and cases of hypotension (systolic BP ≤90 mm Hg) were identified. Controls were age-matched, sex-matched and date-matched to cases (1:2).Primary and secondary outcome measuresWe estimated hypotension incidence in the full study population and relevant subgroups (eg, sex and age). Potential risk factors for hypotension overall and for multiple versus single hypotensive episodes were evaluated using conditional logistic regression and unconditional regression models, respectively.ResultsDuring a mean follow-up of 3.31 years, 2565 patients (13.7%) developed hypotension. The incidence of hypotension was 3.17 cases per 100 patient years (95% confidence interval (CI): 3.05-3.30), and was markedly increased in women aged 18-39 years (n=32; 17.72 cases per 100 patient-years; 95% CI: 9.69-29.73). Hypotension risk factors included high healthcare utilisation (proxy measure for HF severity and general comorbidity; eg, ≥10 primary care physician visits versus none, odds ratio (OR): 2.29; 95% CI: 1.34-3.90), previous hypotensive episodes (OR: 2.32; 95% CI: 1.84-2.92), renal failure and use of aldosterone antagonists, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Risk factors identified for hypotension generally overlapped with those for multiple versus single hypotensive episodes.ConclusionsHypotension occurs frequently in patients with incident HF. Our findings may help identify patients most likely to benefit from close BP monitoring. The increased incidence of hypotension in young women with HF requires investigation.

Project description:BackgroundType 2 diabetes mellitus (T2D) is predominantly managed in primary care, and patients need to be provided with appropriate knowledge and education to understand how to best self-manage their condition. For optimal T2D self-management, primary care teams should share this information from the time of diagnosis. Little is currently known about how and when these resources are being provided to patients with T2D in New Zealand.MethodsAn online survey was carried out between Oct 2022 and Feb 2023. Patients diagnosed with T2D after Jan 2020 were invited to participate, with recruitment occurring via primary care and social media. Questions included information about demographics, diagnosis, provision of education resources and/or referral services as well as about current diabetes management. All responses were analysed with chi square tests. Free-text comments were summarised only.ResultsA total of 203 participants from across New Zealand completed the survey, but 18 were excluded due to being diagnosed more than 3 years ago, or self-reporting with type 1 diabetes rather than T2D. Nearly three quarters (70.7%) of participants reported that they were given appropriate resources to understand and manage their T2D, though half of these would have like more information. Overall, family and friends, self-led research and healthcare-provided education were equally useful, though this differed by ethnic groups. Similarly, approx. 70% of patients thought that medications had been well explained. Free text comments suggested a need for more targeted information around food choice and insulin use as well as a need for empathy and appropriate language from healthcare providers.ConclusionsPrimary care appears to be providing most newly diagnosed patients with appropriate resources to understand and manage their T2D, but there is room for improvement with up to a third of participants not understanding how to manage foods, medication and lifestyle choices to optimise health outcomes. Further work is required to address this gap and should include the use of culturally-appropriate materials to meet the multi-ethnic population needs.

Dataset Information

Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study.

Publications

Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study.

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