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Your search keyword '"Harrison, Stephanie L."' showing total 6 results
Start Over Author "Harrison, Stephanie L." Publisher biomed central
6 results on '"Harrison, Stephanie L."'

5. Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry.

Author

Proietti, Marco, Vitolo, Marco, Harrison, Stephanie L., Lane, Deirdre A., Fauchier, Laurent, Marin, Francisco, Nabauer, Michael, Potpara, Tatjana S., Dan, Gheorghe-Andrei, Boriani, Giuseppe, Lip, Gregory Y. H., on behalf of the ESC-EHRA EORP-AF Long-Term General Registry Investigators, Boriani, G., Lip, G. Y. H., Tavazzi, L., Maggioni, A. P., Dan, G.-A., Potpara, T., Nabauer, M., and Marin, F.

Subjects
ATRIAL fibrillation, PHENOTYPES, OLDER patients, CARDIOVASCULAR diseases risk factors, ATRIAL flutter, COMORBIDITY
Abstract

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients' clinical phenotypes and analyse the differential clinical course.Methods: We performed a hierarchical cluster analysis based on Ward's Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry.Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients' prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P < .001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27-3.62; HR 3.42, 95%CI 2.72-4.31; HR 2.79, 95%CI 2.32-3.35), and Cluster 1 (HR 1.88, 95%CI 1.48-2.38; HR 2.50, 95%CI 1.98-3.15; HR 2.09, 95%CI 1.74-2.51) reported a higher risk for the three outcomes respectively.Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes. [ABSTRACT FROM AUTHOR]

Published
2021
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6. Psychotropic medications in older people in residential care facilities and associations with quality of life: a cross-sectional study

Author

Lisa Kouladjian O'Donnell, Rachel Milte, Enwu Liu, Maria Crotty, Sarah N. Hilmer, Stephanie L Harrison, Clare Eileen Bradley, Harrison, Stephanie L, Bradley, Clare, Milte, Rachel, Liu, Enwu, Kouladjian O'Donnell, Lisa, Hilmer, Sarah N, and Crotty, Maria

Subjects
Gerontology, Male, Cross-sectional study, medicine.medical_treatment, Population, residential care, lcsh:Geriatrics, Proxy (climate), 03 medical and health sciences, 0302 clinical medicine, Residential care, Assisted Living Facilities, Surveys and Questionnaires, psychotropic medicatios, Medicine, Dementia, Homes for the Aged, Humans, 030212 general & internal medicine, Adverse effect, education, Aged, Aged, 80 and over, education.field_of_study, Psychotropic Drugs, Rehabilitation, business.industry, psychotropic medications, medicine.disease, 3. Good health, Nursing Homes, lcsh:RC952-954.6, antipsychotics, Cross-Sectional Studies, quality of life, antidepressants, Female, Geriatrics and Gerontology, business, Older people, 030217 neurology & neurosurgery, Research Article, dementia
Abstract

Background Psychotropic medications have been associated with many adverse outcomes in older people living in residential care. Home-like models of residential care may be preferable to traditional models of care and we hypothesized that this model may impact on the prevalence of psychotropic medications. The objectives were to: 1) examine associations between psychotropic medications and quality of life in older adults living in residential care facilities with a high prevalence of cognitive impairment and dementia and 2) determine if there was a difference in prevalence of psychotropic medications in facilities which provide a small group home-like model of residential care compared to a ‘standard model’ of care. Methods Participants included 541 residents from 17 residential aged care facilities in the Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study. Cross-sectional analyses were completed to examine the above objectives. Quality of life was measured with the dementia quality of life questionnaire (DEMQOL) and the EQ-5D-5L completed by the resident or a proxy. Results Overall, 70.8% (n = 380) of the population had been prescribed/dispensed at least one psychotropic medication in the 100 days prior to recruitment. An increased number of psychotropic medications was associated with lower quality of life according to DEMQOL-Proxy-Utility scores (β (SE): − 0.012 (0.006), p = 0.04) and EQ-5D-5L scores (− 0.024 (0.011), p = 0.03) after adjustment for resident-level and facility-level characteristics. Analysis of the individual classes of psychotropic medications showed antipsychotics were associated with lower DEMQOL-Proxy-Utility scores (− 0.030 (0.014), p = 0.03) and benzodiazepines were associated with lower EQ-5D-5L scores (− 0.059 (0.024), p = 0.01). Participants residing in facilities which had a home-like model of residential care were less likely to be prescribed psychotropic medications (OR (95% CI): 0.24 (0.12, 0.46), p

Published
2018

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