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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321099

ABSTRACT

Background: Whilst an effective vaccine may present the safest way to achieve adequate population immunity from the COVID-19 pandemic, a key challenge towards successful uptake is vaccine hesitancy. We examine and provide novel insights on the key drivers and barriers towards COVID-19 vaccine uptake.Methods: This study involved an anonymous cross-sectional online survey circulated across the UK. Multi-nominal logistic models examined demographic factors that may impact vaccine uptake. We used principle component analysis and text mining to explore perception related to vaccine uptake.Findings: The survey had 4884 respondents of which 9·44% were BAME (Black Asian Minority Ethnic). Overall 3873 (79·3%) respondents were interested in taking approved vaccines while 677 (13·9%) respondents were unsure, and 334 (6·8%) respondents would not take a vaccine. Participants aged over 70 years (Odds Ratio (OR) = 4·63) and the BAME community (OR = 5·48) were more likely to accept approved vaccines. Smokers (OR=0·45) and respondents with no known illness (OR = 0·70) were less likely to accept approved vaccines. The study identified 16 key reasons for not accepting approved vaccines - the most common (60%) being the possibility of the COVID-19 vaccine having side effects.Interpretation: This study provides an insight into potential governmental policy recommendations essential in designing strategies to reduce vaccine hesitancy. These strategies could increase engagement and encourage participation from BAME groups, smokers and those with no diagnosed health conditions, ensuring adequate immunity. This proves crucial in managing the COVID-19 pandemic.Funding: This study was independently funded and there was no funding source associated with this study.Declaration of Interests: This research has been supported by NIHR CRN West Midlands. MJB has received grants and travel expenses from Vifor International and Tillots Pharma, outside of the submitted work. All other authors report no competing interests.Ethics Approval Statement: The interview questions were collated, reviewed and refined internally by a group of researchers. This was followed by an external review and further refinement by a group of volunteers made up of patients, public and user groups, the CRN West Midlands Equality, Diversity and Inclusion Research Champions Group. Feedback from this group was used to modify questions prior to the survey going live. The study was approved by local approval processes and by theClinical Research Network, West Midlands. From ethics discussions, no ethical-related issues were identified. Consent was obtained from participants prior to completion of the form. Participants were provided with information about the study, and how the data was going to be disseminated in the initial page of the survey.

2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321098

ABSTRACT

Background: Developing a safe and effective vaccine will be the principal way of controlling the COVID-19 pandemic. However, current COVID-19 vaccination trials are not adequately representing a diverse participant population in terms of age, ethnicity and comorbidities. Achieving the representative recruitment targets that are adequately powered to the study remains one of the greatest challenges in clinical trial management. To ensure accuracy and generalizability of the safety and efficacy conclusions generated by clinical trials, it is crucial to recruit patient cohorts as representative as possible of the future target population. Missing these targets can lead to reduced validity of the study results, and can often slow down drug development leading to costly delays. This study explores the key factors related to perceptions and participation in vaccination trials. Methods: This study involved an anonymous cross-sectional online survey circulated across the UK. Statistical analysis was done in six phases. Multi-nominal logistic models examined demographic and geographic factors that may impact vaccine uptake. Results: The survey had 4884 participants of which 9·44% were BAME (Black Asian Minority Ethnic). Overall 2020 (41.4%) respondents were interested in participating in vaccine trials;27.6% of the respondents were not interested and 31.1.% were unsure. The most interested groups were male (OR=1.290), graduates (OR=1.277), the 40-49 and 50-59 age group (OR=1.880 and OR=1.460 respectively) and those with no health issues (OR=1.064). The least interested groups were BAME (OR=0.427), those from villages and small towns (OR=0.66 and 0.54 respectively), and those aged 70 and above (OR=1.11). Conclusions: : In order to have a vaccination that is generalizable to the entire population, greater work needs to be done in engaging a diverse cohort of participants. Public health campaigns need to be targeted in improving trial recruitment rates for the elderly, BAME community and the less educated rural population.

3.
Gut ; 70(Suppl 4):A187, 2021.
Article in English | ProQuest Central | ID: covidwho-1506684

ABSTRACT

IntroductionIn the wake of the COVID-19 pandemic in March 2020, NHS services were advised to restructure the delivery of outpatient clinic appointments. The emphasis being on reducing the number of hospital visits for stable patients and triage those who would benefit from a face-to-face (F2F) review which had constituted the vast majority of clinic appointment formats. We surveyed our patient cohort to assess the impact this had on their management, as well as evaluating their concerns and expectations.MethodsAn electronic questionnaire was sent out as a text, for patients to complete on their mobile phones, who underwent a telephone consultation in the hepatology clinic (April to July 2020). Questions included a mixture of multiple-choice questions, ranking questions and space for comments. Anonymised data was analysed using Microsoft Excel.ResultsThere were 268 respondents out of 1200 sent surveys, giving a response rate of 22.3%. The mean age was 56 years, with majority being females (52%) and from white ethnic background (80%). 119 patients (44%) identified themselves as high-risk group with 45 (17%) key workers and 170 (63%) adhering to strict self-isolation during the lockdown period. Alcoholic liver disease (27%) and non-alcoholic liver disease (21%) made half of the patient cohort with 15% unsure about their underlying liver condition. The majority (85%) of consultations were follow up appointments mainly conducted by consultants (79%) followed by middle grades (7%), specialist nurses (3%) whilst 11% patients unsure of the clinician’s grade. Patients answered, ‘strongly agree’ or ‘agree’ to;being assessed thoroughly (81%), their concerns addressed (84%) and opportunity to ask questions (90%). Overall patients rated their consultation as;excellent or good (85%), just as good or better than a F2F consultation (77%) and 85% would be happy to have telephone consultations in the future. Positive comments with telephone consultation included;no travelling involved or needing to take time off work, saving money on transport and parking, ease of convenience and feeling more relaxed. Limitations mentioned by patients were;lack of physical examination, issues with phone connectivity leading to interrupted consultation and a general preference for direct interaction with clinicians. Feedback to improve services was;incorporation of video consultation and alternating telephone with F2F appointments.ConclusionOur survey suggests that telephone consultation for patients with liver disease is a suitable modality for conducting outpatient clinics. It may be that those surveyed were more accepting of the new format due to the COVID pandemic, but our findings support implementing this as a future model for delivery of care, especially for stable patients on long term follow up.

4.
J Clin Med ; 10(19)2021 Sep 23.
Article in English | MEDLINE | ID: covidwho-1438637

ABSTRACT

During the COVID-19 pandemic many IBD units chose Budesonide MMX (Cortiment) as the first-line treatment for flares of ulcerative colitis (UC) in outpatients for its favourable side effect profile. This retrospective study of all UC patients treated with oral steroids between 1 March 2019-30 June 2019 and 1 March 2020-30 June 2020 aimed to compare Cortiment with Prednisolone in routine clinical practice. Outcomes included the need for hospitalisation for acute severe ulcerative colitis, symptoms at four weeks and end of treatment, and the need for rescue Prednisolone. The 2019 and 2020 cohorts did not differ at the baseline. Cortiment prescriptions rose from 24.5% in 2019 to 70.1% in 2020 (p < 0.001). At week four there were significant differences between 2019 and 2020 in mean bowel frequency (3.49 vs. 5.85, p = 0.001), rectal bleeding <50% (89.7% vs. 73.1% of patients, p = 0.039), and physician global assessment (PGA) (39.2% vs. 19.8% in remission, p = 0.045). There was no significant difference in hospital admissions, rectal bleeding, and PGA at week eight. Rescue Prednisolone was required in 10% of Cortiment patients in 2019 vs. 31.3% in 2020 (p = 0.058). Active IBD is associated with worse COVID-19 outcomes prompting the careful evaluation of the choice of first-line steroid for UC, as Cortiment was associated with worse outcomes at four weeks.

5.
BMJ Open ; 11(6): e048856, 2021 06 15.
Article in English | MEDLINE | ID: covidwho-1270894

ABSTRACT

OBJECTIVE: A key challenge towards a successful COVID-19 vaccine uptake is vaccine hesitancy. We examine and provide novel insights on the key drivers and barriers towards COVID-19 vaccine uptake. DESIGN: This study involved an anonymous cross-sectional online survey circulated across the UK in September 2020. The survey was designed to include several sections to collect demographic data and responses on (1) extent of agreement regarding various statements about COVID-19 and vaccinations, (2) previous vaccination habits (eg, if they had previously declined vaccination) and (3) interest in participation in vaccine trials. Multinominal logistic models examined demographic factors that may impact vaccine uptake. We used principle component analysis and text mining to explore perception related to vaccine uptake. SETTING: The survey was circulated through various media, including posts on social media networks (Facebook, Twitter, LinkedIn and Instagram), national radio, news articles, Clinical Research Network website and newsletter, and through 150 West Midlands general practices via a text messaging service. PARTICIPANTS: There were a total of 4884 respondents of which 9.44% were black, Asian and minority ethnic (BAME) group. The majority were women (n=3416, 69.9%) and of white ethnicity (n=4127, 84.5%). RESULTS: Regarding respondents, overall, 3873 (79.3%) were interested in taking approved COVID-19 vaccines, while 677 (13.9%) were unsure, and 334 (6.8%) would not take a vaccine. Participants aged over 70 years old (OR=4.63) and the BAME community (OR=5.48) were more likely to take an approved vaccine. Smokers (OR=0.45) and respondents with no known illness (OR=0.70) were less likely to accept approved vaccines. The study identified 16 key reasons for not accepting approved vaccines, the most common (60%) being the possibility of the COVID-19 vaccine having side effects. CONCLUSIONS: This study provides an insight into focusing on specific populations to reduce vaccine hesitancy. This proves crucial in managing the COVID-19 pandemic.


Subject(s)
COVID-19 , Vaccines , Aged , COVID-19 Vaccines , Cross-Sectional Studies , Female , Humans , Male , Pandemics , SARS-CoV-2 , United Kingdom , Vaccination
7.
Trials ; 22(1): 296, 2021 Apr 20.
Article in English | MEDLINE | ID: covidwho-1195925

ABSTRACT

BACKGROUND: Developing a safe and effective vaccine will be the principal way of controlling the COVID-19 pandemic. However, current COVID-19 vaccination trials are not adequately representing a diverse participant population in terms of age, ethnicity and comorbidities. Achieving the representative recruitment targets that are adequately powered to the study remains one of the greatest challenges in clinical trial management. To ensure accuracy and generalisability of the safety and efficacy conclusions generated by clinical trials, it is crucial to recruit patient cohorts as representative as possible of the future target population. Missing these targets can lead to reduced validity of the study results and can often slow down drug development leading to costly delays. OBJECTIVE: This study explores the key factors related to perceptions and participation in vaccination trials. METHODS: This study involved an anonymous cross-sectional online survey circulated across the UK. Statistical analysis was done in six phases. Multi-nominal logistic models examined demographic and geographic factors that may impact vaccine uptake. RESULTS: The survey had 4884 participants of which 9.44% were Black Asian Minority Ethnic (BAME). Overall, 2020 (41.4%) respondents were interested in participating in vaccine trials; 27.6% of the respondents were not interested and 31.1% were unsure. The most interested groups were male (OR = 1.29), graduates (OR = 1.28), the 40-49 and 50-59 age groups (OR = 1.88 and OR = 1.46 respectively) and those with no health issues (OR = 1.06). The least interested groups were BAME (OR = 0.43), those from villages and small towns (OR = 0.66 and 0.54 respectively) and those aged 70 and above (OR = 1.11). CONCLUSIONS: In order to have a vaccination that is generalisable to the entire population, greater work needs to be done in engaging a diverse cohort of participants. Public health campaigns need to be targeted in improving trial recruitment rates for the elderly, BAME community and the less educated rural population.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Clinical Trials as Topic , Patient Selection , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , Surveys and Questionnaires , United Kingdom , Vaccination , Young Adult
8.
Frontline Gastroenterol ; 13(2): 104-110, 2022.
Article in English | MEDLINE | ID: covidwho-1133278

ABSTRACT

Introduction: During COVID-19, the management of outpatient inflammatory bowel disease (IBD) changed from face-to-face (F2F) to telephone and video consultations across the UK. We surveyed patients with IBD and IBD healthcare professionals (HCPs) to evaluate the impact of this abrupt transition on patient and HCP satisfaction outcomes, including the barriers and enablers of this service. Methods: Patient satisfaction surveys were sent to patients who had a telephone consultation from May to July 2020. A second survey was sent to IBD HCPs across the UK. Questions from both surveys consisted of a mixture of multiple-choice options, ranking answers as well as short-answer questions. Results: 210 patients and 114 HCPs completed the survey. During COVID-19, there was a significantly greater use of telephone, video or a mixture of consultation. F2F consultations were consistently preferred by patients, with 50% of patients indicating they did not want the option of for video consultations. Patients were more likely to prefer a telephone consultation if they were stable and needed routine review. Significantly fewer HCPs (5.3%) intend to use F2F consultations alone, preferring the use of telephone (20.2%) or combinations of telephone/F2F (22.8%), telephone/video (4.4%) or combination of all three consultation types (34.2%). 63% indicated they intend to incorporate video consultations in the future. Conclusion: Telephone and video consultations need to be balanced proportionately with F2F clinics to achieve both patient and HCP satisfaction. Further research needs to be done to explore the use of video medicine in patients with IBD.

9.
Diagnostics (Basel) ; 10(6)2020 Jun 16.
Article in English | MEDLINE | ID: covidwho-854078

ABSTRACT

The Coronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), outbreak from Wuhan City, Hubei province, China in 2019 has become an ongoing global health emergency. The emerging virus, SARS-CoV-2, causes coughing, fever, muscle ache, and shortness of breath or dyspnea in symptomatic patients. The pathogenic particles that are generated by coughing and sneezing remain suspended in the air or attach to a surface to facilitate transmission in an aerosol form. This review focuses on the recent trends in pandemic biology, diagnostics methods, prevention tools, and policies for COVID-19 management. To meet the growing demand for medical supplies during the COVID-19 era, a variety of personal protective equipment (PPE) and ventilators have been developed using do-it-yourself (DIY) manufacturing. COVID-19 diagnosis and the prediction of virus transmission are analyzed by machine learning algorithms, simulations, and digital monitoring. Until the discovery of a clinically approved vaccine for COVID-19, pandemics remain a public concern. Therefore, technological developments, biomedical research, and policy development are needed to decipher the coronavirus mechanism and epidemiological characteristics, prevent transmission, and develop therapeutic drugs.

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