La qualité de la communication des malades cardiaques avec leurs médecins améliore leur adhésion aux changements alimentaires

Conference given outside the academic context (2016)

Quality of doctor-patient communication in cardiovascular diseases and secondary preventive adherence. The role of gender

in Innovative ideas in Health Psychology (2017)

The doctor-patient communication intervenes on the preventive behaviours of chronic patients by reducing their risk factors – in cardiovascular diseases: hypertension, overweight, obesity ... [more ▼]

The doctor-patient communication intervenes on the preventive behaviours of chronic patients by reducing their risk factors – in cardiovascular diseases: hypertension, overweight, obesity, hypercholesterolemia, diabetes. What are the associations between the quality of communication and the improvement of secondary preventive behaviours? How does gender influence these relationships? Methods: 1,289 patients who underwent a coronary angiography in 2008/09 in Luxembourg completed a self-administered questionnaire at the time of the visit, and at a five-year follow-up. The probability of improving each preventive eating behaviour (decrease of salt, sugar, fat consumption and increase of fruits/vegetables), and the quality of doctor-patient communication (5-item scale) were evaluated using logistic regression models. Sex was introduced in interaction with the communication score. Findings: Among hypertensive respondents, a higher quality of communication was associated with a higher probability of decreasing the salt intake in women (OR [95% CI]: 1.139 [1.060; 1.223]) whereas in men, the OR was only 1.086 [1.017; 1.159]. ORs were also higher in women among patients with hypertension, overweight and hypercholesterolemia regarding the increase of fruits/vegetables consumption; among patients with diabetes and hypercholesterolemia regarding sugar decrease or cessation; and among patients with overweight and hypercholesterolemia regarding fat reduction or stop. ORs were slightly higher among men only among diabetic and obese patients, regarding the increase of fruits/vegetables consumption. Discussion: The quality of the communication showed an effect on the adoption of secondary preventive eating behaviours, especially in women patients. Motivational interviews could encourage, especially men patients, to adhere to the recommendations about lifestyle change. [less ▲]

Quality of life and attitudes towards psychotropics and dependency: consumers versus non-consumers aged 50 and over

in Journal of Clinical Pharmacy & Therapeutics (2004), 29

Aim: To assess the relationships between sociodemographic factors, quality of life and attitudes towards psychotropic drugs and dependency and to compare those relationships in continuous consumers (CC ... [more ▼]

Aim: To assess the relationships between sociodemographic factors, quality of life and attitudes towards psychotropic drugs and dependency and to compare those relationships in continuous consumers (CC), occasional consumers (OC) and non-consumers (NC) of those drugs. Methods: Quality of life (SF36) and attitudes (14 statements) were measured in 601 subjects (45–60 years old) from the SUVIMAX cohort (SUpple´mentation en VItamines et en sels Mine ´raux AntioXydants). Data were obtained on 334 NC, 142 CC, 125 OC from the inclusion questionnaire and the monthly consumption report notebooks kept by subjects between 1994 and 1998. Dichotomous and polychotomous logistic regressions were used for the analysis. Results: The lower the quality of life score the more frequent was consumption. NC tended to be men, with high quality of life scores. They entertained negative attitudes towards psychotropics and dependency. OC tended to be women reporting a chronic pathology, with fairly high social status. They had intermediate quality of life and denied dependency. CC tended to be men with no professional activity and low quality of life scores in particular for mental health and perceived health. They had positive attitudes towards psychotropics and accept dependency. Discussion: Assessment of patients’ quality of life and understanding of their attitudes towards psychotropics can provide essential information for those in charge of health promotionprogrammes and may help in identifying new intervention strategies. Preventive education and follow-up of therapy may be better suited to the needs of patients [less ▲]

Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

in Neurology (2019)

Objective Toinvestigatepredictorsforimprovementofdisease-specificqualityoflife(QOL)afterdeepbrainstimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications ... [more ▼]

Objective Toinvestigatepredictorsforimprovementofdisease-specificqualityoflife(QOL)afterdeepbrainstimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications. Methods We performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective randomizedtrialcomparingSTN-DBS(n= 124)tobestmedicaltreatment(n= 127)after2yearsfollow-up with disease-specific QOL (39-item Parkinson ’s Disease Questionnaire summary index [PDQ-39-SI]) as the primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of motor complications, and disease severity measured at baseline with the Unified Parkinson’s Disease Rating Scale(UPDRS)(UPDRS-III“off”and“on”medications,UPDRS-IV)wereconductedtodeterminepredictors of change in PDQ-39-SI. Results PDQ-39-SIatbaselinewascorrelatedtothechangeinPDQ-39-SIafter24monthsinbothtreatmentgroups (p<0.05).Thehigherthebaselinescore(worseQOL)thelargertheimprovementinQOLafter24months. No correlation was found for any of the other baseline characteristics analyzed in either treatment group. Conclusion Impaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when selecting patients with PD for STN-DBS. [less ▲]

A quantitative approach to study indirect effects among disease proteins in the human protein interaction network

in BMC Systems Biology (2010), 4(1), 103

Quantitative sensory examination in diabetic children: Assessment of thermal discrimination

in Diabetic Medicine : A Journal of the British Diabetic Association (1987), 4(3), 251-253

Vibration perception thresholds (VPTs) and thermal discrimination thresholds (TDTs) were investigated in 55 insulin-dependent diabetic children aged 11.3 ± 3.9 years (mean ± SD) and in 81 controls. There ... [more ▼]

Vibration perception thresholds (VPTs) and thermal discrimination thresholds (TDTs) were investigated in 55 insulin-dependent diabetic children aged 11.3 ± 3.9 years (mean ± SD) and in 81 controls. There was no significant difference in VPTs between the two groups. TDTs were significantly higher in the group of diabetic children (p < 0.03). Eight diabetic children had abnormal thermal sensation and one child had abnormal vibratory sensation. TDT correlated positively with duration of diabetes mellitus (r = 0.25; p < 0.05). Both investigations can be carried out easily and are unobtrusive, which is an important advantage in the examination of children. [less ▲]

Randomised controlled non-inferiority trial of primary care based facilitated access to an alcohol reduction website (EFAR-FVG)

in Addiction Science & Clinical Practice (2013)

Introduction There is a strong body of evidence demonstrating effectiveness of brief interventions by primary care professionals for risky drinkers but implementation levels remain low. Facilitated access ... [more ▼]

Introduction There is a strong body of evidence demonstrating effectiveness of brief interventions by primary care professionals for risky drinkers but implementation levels remain low. Facilitated access to an alcohol reduction website constitutes an innovative approach to brief intervention, offering a time-saving alternative to face to face intervention, but it is not known whether it is as effective. Objective To determine whether facilitated access to an alcohol reduction website is equivalent to face to face intervention. Methods Randomised controlled non-inferiority trial for risky drinkers comparing facilitated access to a dedicated website with face to face brief intervention conducted in primary care settings in the Region of Friuli Venezia-Giulia, Italy. Adult patients are given a leaflet inviting them to log on to a website to complete the AUDIT-C alcohol screening questionnaire. Screen positives are requested to complete an online trial module including consent, baseline assessment and randomisation to either standard intervention by the practitioner or facilitated access to an alcohol reduction website. Follow up assessment of risky drinking is undertaken online at 1 month, 3 months and 1 year using the full AUDIT questionnaire. Proportions of risky drinkers in each group will be calculated and non-inferiority assessed against a specified margin of 10%. The trial is being undertaken as an initial pilot and a subsequent main trial. Results 12 practices have participated in the pilot, and more than 1300 leaflets have been distributed. 89 patients have been recruited to the trial with a one month follow-up rate of 79%. Discussion The findings of the pilot study suggest that the trial design is feasible, though modifications will be made to optimize performance in the main trial which will commence in January 2014. Plans are concurrently underway to replicate the trial in Australia, and potentially in the UK and Spain. [less ▲]

A randomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website (EFAR-FVG): the study protocol.

in BMJ open (2013), 3(2),

INTRODUCTION: There is a strong body of evidence demonstrating the effectiveness of brief interventions by primary care professionals for risky drinkers. However, implementation levels remain low because ... [more ▼]

INTRODUCTION: There is a strong body of evidence demonstrating the effectiveness of brief interventions by primary care professionals for risky drinkers. However, implementation levels remain low because of time constraints and other factors. Facilitated access to an alcohol reduction website offers primary care professionals a time-saving alternative to standard face-to-face intervention, but it is not known whether it is as effective. METHODS AND ANALYSIS: A randomised controlled non-inferiority trial for risky drinkers comparing facilitated access to a dedicated website with standard face-to-face brief intervention to be conducted in primary care settings in the Region of Friuli Giulia Venezia, Italy. Adult patients will be given a leaflet inviting them to log on to a website to complete the Alcohol Use Disorders Identification Test (AUDIT-C) alcohol screening questionnaire. Screen positives will be requested to complete an online trial module including consent, baseline assessment and randomisation to either standard intervention by the practitioner or facilitated access to an alcohol reduction website. Follow-up assessment of risky drinking will be undertaken online at 1 month, 3 months and 1 year using the full AUDIT questionnaire. Proportions of risky drinkers in each group will be calculated and non-inferiority assessed against a specified margin of 10%. Assuming a reduction of 30% of risky drinkers receiving standard intervention, 1000 patients will be required to give 90% power to reject the null hypothesis. ETHICS AND DISSEMINATION: The protocol was approved by the Isontina Independent Local Ethics Committee on 14 June 2012. The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations and public events involving the local administrations of the towns where the trial participants are resident. REGISTRATION DETAILS: Trial registration number NCT: 01638338. [less ▲]

A randomized controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website (EFAR-FVG): preliminary results

in Addiction Science & Clinical Practice (2015), 10(Suppl 2), 29

Background The effectiveness of brief interventions for risky drinkers by GPs is well documented.[1] However, implementation levels remain low. Facilitated access to an alcohol reduction website offers an ... [more ▼]

Background The effectiveness of brief interventions for risky drinkers by GPs is well documented.[1] However, implementation levels remain low. Facilitated access to an alcohol reduction website offers an alternative to standard face-to-face intervention, but it is unclear whether it is as effective.[2] This study evaluates whether online brief intervention, through GP facilitated access to an alcohol reduction website for risky drinkers, is not inferior to the face-to-face brief intervention conducted by GPs. Material and methods In a northern Italy region participating GPs actively encouraged all patients age 18 attending their practice, to access an online screening website based on AUDIT-C.[3] Those screening positive underwent a baseline assessment with the AUDIT-10[4] and EQ-5D[5] questionnaires and subsequently, were randomly assigned to receive either online counselling on the alcohol reduction website (intervention) or face-to-face intervention based on the brief motivational interview[6] by their GP (control). Follow-up took place at 3 and 12 months and the outcome was calculated on the basis of the proportion of risky drinkers in each group according to the AUDIT-10. Results More than 50% (n= 3974) of the patients who received facilitated access logged-on to the website and completed the AUDIT-C. Just under 20% (n = 718) screened positive and 94% (n= 674) of them completed the baseline questionnaires and were randomized. Of the 310 patients randomized to the experimental Internet intervention, 90% (n = 278) logged-on to the site. Of the 364 patients of the control group, 72% (263) were seen by their GP. A follow-up rate of 94% was achieved at 3 months. Conclusions The offer of GP facilitated access to an alcohol reduction website appears to be an effective way of identifying risky drinkers and enabling them to receive brief intervention. [less ▲]

Rapport intermédiaire de la première phase de la recherche PSE/VE. Santé, absentéisme et travail

Report (2011)