Browsing by Author "Khan, Nadia"

Now showing 1 - 5 of 5
  • Thumbnail Image
    ItemOpen Access
    Home care utilization and outcomes among Asian and other Canadian patients with heart failure
    (BioMed Central, 2010-03-04) Chen, Guanmin; Khan, Nadia; King, Kathryn M.; Hemmelgarn, Brenda R.; Quan, Hude
  • Thumbnail Image
    ItemOpen Access
    Identifying personalized barriers for hypertension self-management from TASKS framework
    (2024-08-14) Yang, Jiami; Zeng, Yong; Yang, Lin; Khan, Nadia; Singh, Shaminder; Walker, Robin L.; Eastwood, Rachel; Quan, Hude
    Abstract Objective Effective management of hypertension requires not only medical intervention but also significant patient self-management. The challenge, however, lies in the diversity of patients' personal barriers to managing their condition. The objective of this research is to identify and categorize personalized barriers to hypertension self-management using the TASKS framework (Task, Affect, Skills, Knowledge, Stress). This study aims to enhance patient-centered strategies by aligning support with each patient's specific needs, recognizing the diversity in their unique circumstances, beliefs, emotional states, knowledge levels, and access to resources. This research is based on observations from a single study focused on eight patients, which may have been a part of a larger project. Results The analysis of transcripts from eight patients and the Global Hypertension Practice Guidelines revealed 69 personalized barriers. These barriers were distributed as follows: emotional barriers (49%), knowledge barriers (24%), logical barriers (17%), and resource barriers (10%). The findings highlight the significant impact of emotional and knowledge-related challenges on hypertension self-management, including difficulties in home blood pressure monitoring and the use of monitoring tools. This study emphasizes the need for tailored interventions to address these prevalent barriers and improve hypertension management outcomes.
  • Thumbnail Image
    ItemOpen Access
    Incident prescriptions for common cardiovascular medications: comparison of recent versus pre-2020 medication adherence and discontinuation in three universal health care systems
    (2025-02-05) McNaughton, Candace D.; Austin, Peter C.; Jackevicius, Cynthia A.; Chu, Anna; Holodinsky, Jessalyn K.; Hill, Michael D.; Norris, Colleen M.; Kumar, Mukesh; Kamal, Noreen; Lee, Douglas S.; Khan, Nadia; Vyas, Manav V.; Joundi, Raed A.; Kapral, Moira K.; Yu, Amy Y. X.
    Abstract Background Health system disruptions since onset of the COVID-19 pandemic may have adversely impacted adherence to medications for common cardiovascular risk factors. Methods We examined adherence to and discontinuation of incident prescriptions for medications treating hypertension, dyslipidemia, diabetes, and atrial fibrillation in Ontario, Alberta, and Nova Scotia, Canada. We compared the recent period (April 1, 2020 through most recently available follow-up: September 30, 2021 for Ontario; March 31, 2021 for Alberta; and March 31, 2022 for Nova Scotia) to the baseline, pre-pandemic period (April 1, 2014 through March 31, 2019). In each province, people aged ≥66 years with a valid health number and corresponding incident prescription were included. For each medication class, adherence in the recent period, defined as ≥ 0.80 proportion-of-days-covered (PDC), was compared to the pre-pandemic period using modified Poisson regression with robust error variance, adjusted for patient characteristics. Similarly adjusted Cox proportional hazards models compared hazard of discontinuation over one year of follow-up between the two time periods. Results In the recent period, PDC ranged from 48.9% for dyslipidemia medications in Alberta to 82.2% for anticoagulants in Nova Scotia. Adherence was not different between periods, with the following exceptions: higher adherence in the recent period for antihypertensives (adjusted risk ratios [aRR] 1.08, 95% CI 1.06–1.10) and dyslipidemics (aRR 1.07, 95% CI 1.04–1.09) in Nova Scotia, and for antihyperglycemics (aRR 1.10, 95% CI 1.08–1.14) and anticoagulants (1.15, 95% CI 1.12, 1.18) in Alberta. Adherence was lower in the recent period only for antihypertensives in Alberta (aRR 0.95, 95% CI 0.93, 0.97). One-year rates of discontinuation ranged from 20.9% for anticoagulants in the Alberta recent period to 56.7% for antihypertensives in the Ontario baseline period. The adjusted hazard of discontinuation was lower or unchanged in the recent period for all medication classes. Conclusions Despite significant health system disruptions since 2020, recent adherence to incident cardiovascular prescriptions was similar or better than before and rates of medication discontinuation were lower. However, interventions are still needed to improve existing, suboptimal adherence.
  • Thumbnail Image
    ItemOpen Access
    Integrative analysis of clinicopathological features defines novel prognostic models for mantle cell lymphoma in the immunochemotherapy era: a report from The North American Mantle Cell Lymphoma Consortium
    (2023-12-16) Vose, Julie M.; Fu, Kai; Wang, Lu; Mansoor, Adnan; Stewart, Douglas; Cheng, Hongxia; Smith, Lynette; Yuan, Ji; Qureishi, Hina N.; Link, Brian K.; Cessna, Melissa H.; Barr, Paul M.; Kahl, Brad S.; Mckinney, Matthew S.; Khan, Nadia; Advani, Ranjana H.; Martin, Peter; Goy, Andre H.; Phillips, Tycel J.; Mehta, Amitkumar; Kamdar, Manali; Crump, Michael; Pro, Barbara; Flowers, Christopher R.; Jacobson, Caron A.; Smith, Sonali M.; Stephens, Deborah M.; Bachanova, Veronika; Jin, Zhaohui; Wu, Shishou; Hernandez-Ilizaliturri, Francisco; Torka, Pallawi; Anampa-Guzmán, Andrea; Kashef, Farshid; Li, Xing; Sharma, Sunandini; Greiner, Timothy C.; Armitage, James O.; Lunning, Matthew; Weisenburger, Dennis D.; Bociek, Robert G.; Iqbal, Javeed; Yu, Guohua; Bi, Chengfeng
    Abstract Background Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes. Methods The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed between 2000 and 2012 are included in this study. A comprehensive retrospective analysis was performed on the clinicopathological features, treatment approaches, and outcomes of these cases. The establishment of novel prognostic models was based on in-depth examination of baseline parameters, and subsequent validation in an independent cohort of MCL cases. Results In front-line strategies, the use of hematopoietic stem cell transplantation was the most significant parameter affecting outcomes, for both overall survival (OS, p < 0.0001) and progression-free survival (PFS, p < 0.0001). P53 positive expression was the most significant pathological parameter correlating with inferior outcomes (p < 0.0001 for OS and p = 0.0021 for PFS). Based on the baseline risk factor profile, we developed a set of prognostic models incorporating clinical, laboratory, and pathological parameters that are specifically tailored for various applications. These models, when tested in the validation cohort, exhibited strong predictive power for survival and showed a stratification resembling the training cohort. Conclusions The outcome of patients with MCL has markedly improved over the past two decades, and further enhancement is anticipated with the evolution of clinical management. The innovative prognostic models developed in this study would serve as a valuable tool to guide the selection of more suitable treatment strategies for patients with MCL.
  • Thumbnail Image
    ItemOpen Access