ABSTRACT
To evaluate the effectiveness of health belief model-based health education intervention in improving blood pressure control of patients with hypertension in community settings. From September 2016 to September 2017, 400 newly diagnosed patients with hypertension were recruited from 6 community healthcare centers with comparable population size and health services in the Shunyi District of Beijing. All community healthcare centers were randomly assigned to the intervention group (206 patients) and the control group (194 patients). Patients in the intervention group received 3 lectures (20-30 min for each) of health belief model-based health education. Patients in the control group received usual care. The basic characteristics, health beliefs, and health literacy were collected, and blood pressure was measured before and after the intervention, respectively. The difference-in-difference model was used to analyze the change of blood pressure and the influencing factors between two groups before and after the intervention. A total of 134 patients in the intervention group and 129 patients in the control group completed the study. After adjusting for the age, gender, family income, medical insurance, chronic diseases and family history, the score of perceived barriers was increased by 1.65 (0.016), and perceived seriousness was decreased by 0.73 (0.018). The systolic blood pressure of patients was decreased by 7.37 mmHg (1 mmHg=0.133 kPa, 0.001) and diastolic blood pressure was decreased by 4.07 mmHg (0.014), respectively. The β (95) values were -7.37 (-11.88,-2.86) and -4.07 (-7.30, -0.84). The perceived susceptibility and self-efficacy had a significant influence on the blood pressure of patients (0.05). Health belief model-based health education intervention could significantly improve the blood pressure control of patients with hypertension in the community settings.
ABSTRACT
Objective This study applied the theory of planned behavior to investigate the leisure exercise situation among patients with type 2 diabetes mellitus (T2DM) and its influencing factors. Methods The questionnaire was self-designed based on the theory of planned behavior, which had good reliability and validity. Structural equation modeling was used to estimate the determinants of leisure exercise and the potential intermediate effect. Results 774 patients with T2DM were enrolled in this study. 52.6% were over 60 years old. The median amount of leisure exercise was 0.0 thousand-step equivalent with quartile of (0.0, 2.0). Structural equation modeling showed that the effects of attitude (β=0.080) and intention (β=0.277) on leisure exercise were significant. Besides, perceived behavioral control (β=0.180) had an indirect effect on exercise through intention. Conclusions In general, most patients with type 2 diabetes have insufficient amount of exercise. Improving attitude, control and intention to exercise would be one crucial part of exercise health education among patients with T2DM.
ABSTRACT
OBJECTIVE: To explore the factors that association with voriconazole-related hepatotoxicity in patients with invasive fungal infections. METHODS: Voriconazole trough plasma concentrations(ρmin) were measured by high-performance liquid chromatography(HPLC). Voriconazole-related hepatotoxicity was defined according to Common Terminology Criteria for Adverse Events(CTCAE), and the multivariate linear regression and classification and regression tree(CART) were used to explore the factors that association with hepatotoxicity. RESULTS: A total of 328 samples from 144 patients were measured, and 18 patients with signs of hepatotoxicity. There was a significant difference between the voriconazole ρmin in patients with hepatotoxicity and those without hepatotoxicity [(3.49 ± 2.31) μg•mL-1 vs (1.96 ± 1.48 ) μg•mL-1, P 2.89 μg•mL-1; ③non-poor metabolizer with voriconazole ρmin > 2.89 μg•mL-1 who received CYP2C19 inhibitor. CONCLUSION: Monitoring voriconazole ρmin and liver function could benefit to the safety of voriconazole therapy in patients with invasive fungal infections.
ABSTRACT
OBJECTIVE: To characterize the pharmacokinetics of voriconazole, find the factors influencing pharmacokinetics and optimize dosing regimen in patients with invasive fungus infections(IFIs). METHODS: To prospectively quantitate the relationship between VRC parameters and covariates, a population pharmacokinetics analysis was conducted on pooled data from patients with invasive fungus infections. The list of covariates tested included demographic factors, biochemistry, concomitant medications and CYP2C19 genotype. The final model was internally evaluated using bootstrap method. Monte Carlo simulation was used to evaluate the effective of currently recommended dosing regimen and to design an optimized pharmacodynamics dosing strategy for VRC. RESULTS: Four hundred and six samples from 151 patients were collected for population pharmacokinetics analysis. A one-compartment model with first-order absorption and elimination as the basic structural model appropriately fitted the data. VRC clearance was 6.95 L·h-1, volume of distribution was 200 L. The clearance was significantly association with age, alkaline phosphatase and CYP2C19 genotype. Bootstrap method confirmed that the pharmacokinetics parameters was accurate and the final model was robust. Monte Carlo simulation suggests that recommended dosing regimen for treat Aspegllius infections and 300 mg q12 h po or 200 mg q12 h iv. drip for treat Candida infections are effective. CONCLUSION: This study is able to show that the optimal VRC dosage regimens are successfully determined using prospective population pharmacokinetics analysis and Monte Carlo simulation.