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Etemadi F, Bessonneau P, Yaya I, Dara A, Eriksson L, Rodriguez S, Lona Juraskova, Henrique M, Réjean T, Griffith W, Thonon F, Chassany O, Duracinsky M. Factors associated with sexual quality of life among men living with HIV. Int J STD AIDS 2024; 35:352-364. [PMID: 38146622 DOI: 10.1177/09564624231217324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
INTRODUCTION This study aims to assess the prevalence of sexual difficulties and identify factors associated with the Sexual Quality of Life (SQoL) among people living with HIV (PLWHA). METHODS The study included 107 heterosexual men and 474 men who have sex with men (MSM) from five countries. Participants self-reported variables related to physical and mental health, as well as HIV-related parameters. Erectile or ejaculation difficulty, as well as low sexual desire, were investigated. SQoL was measured using the PROQOL-SexLife questionnaire. RESULTS Most of participants reported low sexual desire, predominantly among MSM. Among MSM, living with a partner and healthcare satisfaction were associated with SQoL scores in POP dimension, while consistent condom use, cardiovascular complications, and being single were associated with SQoL scores in STI dimension. Viagra use, anti-cholesterol treatment, and living with a partner were associated with SQoL scores in DIS dimension. Among heterosexual men, employment and African origin were associated with SQoL scores in the POP dimension. Alcohol consumption was associated with SQoL scores in STI dimension. CONCLUSION This study underscores the importance of non-clinical determinants when assessing SQoL among PLWHA, emphasizing psychological factors and the perceived quality of healthcare. Tailored interventions should incorporate these findings to enhance overall SQoL outcomes.
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Affiliation(s)
- Fatima Etemadi
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Pascal Bessonneau
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Issifou Yaya
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Aichata Dara
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Lars Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
| | - Sarah Rodriguez
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Lona Juraskova
- School of Psychology, University of Sydney, Sydney, Australia
| | | | | | | | - Frédérique Thonon
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Olivier Chassany
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Martin Duracinsky
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
- Internal Medicine and Clinical Immunology Department, AP-HP, Bicetre Hospital, Kremlin-Bicêtre, France
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Roucoux G, Thonon F, Zucman D, Rey D, Abgrall S, Eriksson LE, Préau M, Michels D, Chéret A, Duracinsky M. Questioning the "Ease" in disease: Was living with HIV a burden or boost during the first wave of Covid-19 in France? A qualitative study (COVIDHIV). PLoS One 2024; 19:e0295223. [PMID: 38452028 PMCID: PMC10919596 DOI: 10.1371/journal.pone.0295223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/18/2023] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Clinical research has focused on risk factors and treatment for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), particularly in people with a comorbidity including the human immunodeficiency virus (HIV), but little attention has been paid to the care pathway. This article aims to show how living with HIV may have been a biopsychosocial burden or boost in care pathways for Covid-19. METHOD People living with HIV (PLHIV) from 9 clinical centers were invited to participate in this qualitative study. The sampling was purposive with a maximum variation in their sociodemographic profiles. Semi-structured interviews were conducted until data saturation, then coded for thematic analysis, using an inductive general approach. RESULTS We interviewed 34 PLHIV of which 20 had SARS-COV-2 once. They were 24 males, 26 born in France; median age: 55. Twenty had a CD4 number above 500, and all were on antiretroviral therapy (ART). HIV appeared as a burden when Covid-19 symptoms reminded HIV seroconversion, fear of contamination, and triggered questions about ART effectiveness. HIV was not considered relevant when diagnosing Covid-19, caused fear of disclosure when participants sought SARS-COV-2 testing, and its care in hospitals was disrupted by the pandemic. ART-pill fatigue caused avoidance for Covid-19 treatment. As a boost, living with HIV led participants to observe symptoms, to get advice from healthcare professionals, and screening access through them. Some participants could accept the result of screening or a clinical diagnosis out of resilience. Some could consider ART or another drug prescribed by their HIV specialist help them to recover from Covid-19. CONCLUSION Living with HIV could function as a burden and/or a boost in the care pathways for Covid-19, according to patients' relationship to their HIV history, comorbidities and representation of ART. Covid-19 in PLHIV needs further qualitative study to gain a more comprehensive assessment of the pandemic's consequences on their lives and coping strategies.
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Affiliation(s)
- Guillaume Roucoux
- ECEVE, UMR-S 1123, Inserm, Université Paris Cité, Paris, France
- Patient-Reported Outcomes Research (PROQOL), Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Frédérique Thonon
- ECEVE, UMR-S 1123, Inserm, Université Paris Cité, Paris, France
- Patient-Reported Outcomes Research (PROQOL), Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | | | - David Rey
- Trait d’Union–Strasbourg University Hospitals, Strasbourg, France
| | - Sophie Abgrall
- Hôpital Antoine Béclère, Service de Médecine Interne, Clamart, France
- UVSQ, INSERM U1018, CESP, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | | | - Marie Préau
- Inserm Unit 1296 « Radiations: Defense, Health, Environment », Lyon, France
- Lyon 2 Lumière University, Lyon, France
| | - David Michels
- AIDES (French HIV/AIds and Viral Hepatites Organization), Pantin, France
- Laboratoire de Recherche Communautaire, Coalition PLUS, Pantin, France
| | - Antoine Chéret
- Outpatient Medicine Service, University Hospital, Pointe-à-Pitre, Guadeloupe, France
- Internal Medicine Unit, Cochin Hospital, Paris, France
| | - Martin Duracinsky
- ECEVE, UMR-S 1123, Inserm, Université Paris Cité, Paris, France
- Patient-Reported Outcomes Research (PROQOL), Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Internal Medicine Unit, Le Kremlin Bicêtre Hospital, Bicêtre, France
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Palich R, Arias-Rodríguez A, Duracinsky M, Le Talec JY, Rousset Torrente O, Lascoux-Combe C, Lacombe K, Ghosn J, Viard JP, Pialoux G, Ohayon M, Duvivier C, Velter A, Ben Mechlia M, Beniguel L, Grabar S, Melchior M, Assoumou L, Supervie V. High proportion of post-migration HIV acquisition in migrant men who have sex with men receiving HIV care in the Paris region, and associations with social disadvantage and sexual behaviours: results of the ANRS-MIE GANYMEDE study, France, 2021 to 2022. Euro Surveill 2024; 29:2300445. [PMID: 38487889 PMCID: PMC10941311 DOI: 10.2807/1560-7917.es.2024.29.11.2300445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/03/2024] [Indexed: 03/17/2024] Open
Abstract
BackgroundSome migrant men who have sex with men (MSM) acquire HIV in France.AimsWe investigated, in migrant MSM receiving HIV care in France, the (i) rate of post-migration-HIV acquisition in France, (ii) delay between arrival and HIV acquisition and (iii) factors affecting HIV acquisition within 1 year after migration.MethodsThis cross-sectional study focused on ≥ 18-year-old MSM born outside France, receiving HIV care in the Paris region. Information on migration history, socioeconomic condition, sexual activity, and health was collected in May 2021-June 2022 through self-administered questionnaires and medical records. Post-migration-HIV-acquisition rate and delay between arrival in France and HIV acquisition were estimated from biographical data and CD4+ T-cell counts. Predictors of HIV acquisition within 1 year after migration were determined using logistic regression.ResultsOverall post-migration HIV-acquisition rate was 61.7% (715/1,159; 95%CI: 61.2-62.2), ranging from 40.5% (95%CI: 39.6-41.6) to 85.4% (95%CI: 83.9-86.0) in participants from Latin America and North Africa. Among post-migration-HIV acquisitions, those within 1 year after migration represented 13.1% overall (95%CI: 11.6-14.6), being highest in participants from sub-Saharan Africa (25%; 95%CI: 21.5-28.3). Participants ≥ 15-years old at migration, with post-migration-acquired HIV, had a 7.5-year median interval from arrival in France to HIV acquisition (interquartile range (IQR): 3.50-14.75). Older age at arrival, region of origin (sub-Saharan Africa and Asia), degree of social disadvantage and numbers of sexual partners were independently associated with acquiring HIV within 1 year in France.ConclusionOur findings may guide HIV prevention policies for most vulnerable migrants to Europe.
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Affiliation(s)
- Romain Palich
- Sorbonne University, Pitié-Salpêtrière hospital, AP-HP, Paris, France
- Sorbonne Université, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - Andrés Arias-Rodríguez
- Sorbonne Université, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - Martin Duracinsky
- Paris Cité University, Patient-Reported Outcomes Unit (PROQOL), INSERM 1123, Paris, France
| | - Jean-Yves Le Talec
- Toulouse Jean Jaurès University, CERTOP, CNRS UMR 5044, Toulouse, France
| | | | | | - Karine Lacombe
- Sorbonne University, Saint Antoine hospital, AP-HP, Paris, France
| | - Jade Ghosn
- Paris Cité University, Bichat hospital, AP-HP, Paris, France
| | - Jean-Paul Viard
- Paris Cité University, Hôtel-Dieu hospital, AP-HP, Paris, France
| | - Gilles Pialoux
- Sorbonne University, Tenon hospital, AP-HP, Paris, France
| | | | - Claudine Duvivier
- Paris Cité University, Necker hospital, AP-HP; INSERM U1016, CNRS UMR8104, Institut Cochin; IHU Imagine; Institut Pasteur Medical Center, Paris, France
| | | | - Mohamed Ben Mechlia
- French National Agency for Research on AIDS, Viral Hepatitis and Emerging Infectious Diseases (ANRS-MIE), Paris, France
| | - Lydie Beniguel
- Sorbonne Université, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - Sophie Grabar
- Sorbonne Université, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - Maria Melchior
- Sorbonne Université, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - Lambert Assoumou
- Sorbonne Université, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - Virginie Supervie
- Sorbonne Université, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
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Pindi Sala T, Matondo Masisa D, Crave JC, Belmokhtar C, LeNy G, Situakibanza H, Duracinsky M, Cherin P, Chassany O. Contribution of Flexig mobile application to assess adherence of patients treated with immunoglobulins in chronic diseases. J Allergy Clin Immunol Glob 2024; 3:100173. [PMID: 37915723 PMCID: PMC10616388 DOI: 10.1016/j.jacig.2023.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/09/2023] [Accepted: 07/12/2023] [Indexed: 11/03/2023]
Abstract
Background Long-term therapeutic adherence remains an essential challenge for better management of chronic diseases. It is estimated at 50% in developed countries. Objective The study aimed to evaluate, under real conditions, the influence of satisfaction with Flexig use on adherence to subcutaneous immunoglobulin home-treatment therapy in a sample of French patients with chronic dysimmune diseases. Methods This is a 2-year prospective cohort involving 241 patients from several hospitals in France whose data were extracted from the Flexig 2.0 mHealth application. Satisfaction was assessed by System Usability Scale (SUS) and user experience by User Experience Questionnaire (UEQ). Adherence to Ig therapy was assessed by medication possession rate. We analyzed the relationship between Flexig user satisfaction and adherence to treatment, as well as determinants of adherence. Results Most patients (82.7%) were being treated for an immunodeficiency, versus 17.3% for a chronic autoimmune and inflammatory disease. Almost all patients (97.9%) received subcutaneous immunoglobulin therapy. The patients' ages (means ± SDs) were 36.5 ± 18.3 years, disease duration was about 6 years, and 58.5% were men. Flexig user satisfaction was 76.2 ± 8 (System Usability Scale), associated with good user experience reported on UEQ. Adherence rate was 99.7%. Time on app, disease duration, and Flexig user satisfaction were statistically predictive of adherence to IgG therapy. High adherence to Ig therapy was associated with good satisfaction with using Flexig (P < .0001). Conclusion Adherence to Ig therapy in chronic dysimmune disease was strong and was associated with good satisfaction among Flexig users, suggesting that electronic support may be a valuable compliance aid.
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Affiliation(s)
- Taylor Pindi Sala
- ECEVE, UMR-S 1123, Université Paris Cité, Inserm, F-75004, Paris, France
| | | | | | | | | | - Hippolyte Situakibanza
- Département de Médecine Interne, Département de Médecine Tropical, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Martin Duracinsky
- ECEVE, UMR-S 1123, Université Paris Cité, Inserm, F-75004, Paris, France
- Patient-Reported Outcomes Research (PROQOL), Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Patrick Cherin
- Département de Médecine Interne et Immunologie Clinique, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France
| | - Olivier Chassany
- ECEVE, UMR-S 1123, Université Paris Cité, Inserm, F-75004, Paris, France
- Patient-Reported Outcomes Research (PROQOL), Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
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Veyrier CA, Roucoux G, Baumann-Coblentz L, Massol J, Karp JC, Wagner JP, Chassany O, Duracinsky M. Homeopathy as Praxis: Integration of Homeopathy as Supportive Care into Daily Life in Early Breast Cancer Patients. Integr Cancer Ther 2024; 23:15347354241233302. [PMID: 38721830 PMCID: PMC11084993 DOI: 10.1177/15347354241233302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/08/2024] [Accepted: 02/01/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Homeopathy is one of most widely used non-conventional supportive care methods used by women with breast cancer. This article aims to describe the routines and practices related to homeopathy as supportive care used by women with non-metastatic breast cancer in France. METHODS This qualitative study used Grounded Theory. Participants were women with early breast cancer and healthcare professionals (General Practitioner homeopaths & oncologists). Inclusion depended on specific criteria and the aim of theoretical sampling until data saturation. Data were collected through individual semi-structured interviews and focus groups following evolving topic guides. Transcribed interviews underwent in-depth thematic analysis. Inclusion, interviewing, transcription and coding occurred iteratively. Data was reported according to COREQ guidelines. RESULTS The therapeutic agency of homeopathy was distributed to different actors and ritualized material activities highly involving the patient. The choice of remedy was mostly delegated by patients to General Practitioner homeopaths (GPH) during consultations. Individualization, that is to say adaptation to the patient, differed from other modes of access to homeopathy (self-medication and oncologists). Self-medication was mostly limited to known products in a limited time frame. However, we identified a supported self-medication using trusted homeopathic protocols. Following homeopathic prescriptions involves a high level of commitment on behalf of the patient and follows different rules for homeopathy intake. This knowledge was either acquired earlier for users or discovered along breast cancer treatment for non-users. Taking homeopathy involved small daily actions for intake of different products at different times of the day. New users used strategies to ease the integration of homeopathy into their daily life. The stance toward such rules differed among patients. Some followed rules to optimize their effects while others simplified the rules and took those rituals as part of homeopathy benefits. CONCLUSION Homeopathy as supportive care in breast cancer is distributed toward different actors and ritualized activities. Homeopathy is a supported practice where GPH played a role in the prescription. Health Literacy in homeopathy played a role to ease its integration into daily life and identify the potential benefits. The high involvement of patients in their homeopathic treatment is a form of treatment reappropriation and empowerment.
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Affiliation(s)
- Clair-Antoine Veyrier
- URC ECO, Hotel-Dieu Hospital, AP-HP, Paris, France
- ECEVE UMR 1123, Inserm & Paris Cité University, Paris, France
| | - Guillaume Roucoux
- URC ECO, Hotel-Dieu Hospital, AP-HP, Paris, France
- ECEVE UMR 1123, Inserm & Paris Cité University, Paris, France
| | | | - Jacques Massol
- REMEDE Consulting & Axial, Boulogne-Billancourt, Paris, France
| | | | | | - Olivier Chassany
- URC ECO, Hotel-Dieu Hospital, AP-HP, Paris, France
- ECEVE UMR 1123, Inserm & Paris Cité University, Paris, France
| | - Martin Duracinsky
- URC ECO, Hotel-Dieu Hospital, AP-HP, Paris, France
- ECEVE UMR 1123, Inserm & Paris Cité University, Paris, France
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Brown C, Roucoux G, Dimi S, Fahmi S, Banou Jeevan R, Chassany O, Chaplin JE, Duracinsky M. Exploring the limitations of language interpretation: A qualitative study on clinicians' experiences at French Office of Immigration and Integration. PLOS Glob Public Health 2023; 3:e0002436. [PMID: 38109295 PMCID: PMC10727366 DOI: 10.1371/journal.pgph.0002436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023]
Abstract
The concordance of communication between patients and health professionals is essential to promoting positive health outcomes. However, concordance may be broken where language barriers exist therefore creating a need to use interpretation services. This is the case when rapid diagnostic testing (RDT) of HIV, HBV, and HCV is offered to migrants. The use of interpreters to establish communication with patients having limited French proficiency (LFP) however, is often not used and can be problematic. Despite being offered, interpretation services are frequently underutilised, which makes communication challenging. This problem has not received enough attention in the literature, particularly in a technologically advanced setting where solutions may be found. Our objective was to explore how interpreters are used within the context of medical consultations when RDT for HIV, HBV, and HCV is offered to legal migrants with LFP. A cross-sectional qualitative study was used with a purposive sample that included doctors and nurses who had conducted rapid screening tests with migrants in four centers in France and who had access to interpretive services. Semi-structured interviews explored healthcare providers' (HP) use of interpreters at the OFII. The use of professional or ad hoc interpreters, telephone interpreters, and the equivalence of concepts such as health literacy between the HP and the interpreter were explored. The utility of a new tool to promote communication concordance was evaluated. Twenty interviews were conducted with eleven doctors and nine nurses with a median age of 58 years (25-67 years). All participants had access to interpretive services although many did not solicit them because of 1) unawareness on how to use the services, 2) preconceived notions of the length of time to involve an interpreter and how this would add to consultation times, or 3) the proximity of an ad hoc interpreter. Not using interpreter services could result in RDTs not being offered to immigrants. Subjects such as confidentiality, the embarrassment of a third party's presence, the lack of appropriate training and differing levels of health literacy were also discussed by participants. Insight from HPs allows us to better understand how both telephone and in-person interpretation are used, viewed, and why they are underused to communicate with limited French language skills patients. Our findings will help us develop a conceptual model for a digital communication tool to overcome barriers with migrant patients with limited French language skills.
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Affiliation(s)
- Carter Brown
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, Paris, France
- Pierre Louis Doctoral School of Public Health Sorbonne University, Paris, France
| | - Guillaume Roucoux
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO) AP-HP Hôpital Hôtel-Dieu, Paris, France
| | - Svetlane Dimi
- International Vaccination and Travel Medicine Center, Centre de Santé Familia Sol, Creil, France
| | - Saleh Fahmi
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, Paris, France
| | - Raj Banou Jeevan
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, Paris, France
| | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO) AP-HP Hôpital Hôtel-Dieu, Paris, France
| | - John Eric Chaplin
- Institute of Health and Care Sciences The University of Gothenburg Centre for Person-Centred Care—GPCC Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO) AP-HP Hôpital Hôtel-Dieu, Paris, France
- Service de Médecine Interne et d’Immunologie Clinique, AP-HP Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Perrot S, Roucoux G, Bertin P, Beauvais C, Alliot-Launois F, Chassany O, Duracinsky M. Cross-perspectives on care pathways for painful osteoarthritis: A qualitative analysis in patients and healthcare professionals. Musculoskeletal Care 2023; 21:1142-1153. [PMID: 37404113 DOI: 10.1002/msc.1795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE To analyse and compare patients' and healthcare professionals' (HPs) perspectives concerning patient care pathways for painful osteoarthritis (OA). PATIENTS AND METHODS We performed a qualitative study of two focus groups corresponding to eight patients with painful OA and eight HPs involved in OA management. RESULTS Six key themes emerged from the interviews: (1) representations of OA, (2) OA pain, (3) quality of life, (4) care pathways, (5) actors involved in the care pathway, and (6) treatments. Both groups considered general practitioners, pharmacists and physiotherapists to be first-line HPs, and no well-defined OA specialist was identified. Patients and HPs reported similar difficulties concerning the adaptation of management to individual cases, late diagnosis and treatment, whereas only patients mentioned financial issues. Communication difficulties were identified as a major problem both between patients and HPs, and between HPs. Patients reported a lack of knowledge concerning pain and OA. The coordination between the various HPs is required, with education on both pain and OA. Several possible solutions were put forward by both patients and HPs. CONCLUSION The care pathways of patients with painful OA are complex, with an unclear definition of the roles of the various HPs and suboptimal coordination. The role of HPs should be defined and collaboration between HPs developed.
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Affiliation(s)
- Serge Perrot
- Pain Center, INSERM U987, Hôpital Cochin, Université Paris Cité University, Paris, France
| | - Guillaume Roucoux
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
- ECEVE, INSERM UMR 1123, Paris Cité University, Paris, France
| | - Philippe Bertin
- Rheumatology Department, University Hospital, Limoges, France
| | | | | | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
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Carrieri P, Bourlière M, Di Beo V, Lusivika-Nzinga C, Ramier C, Antwerpes S, Protopopescu C, Lacombe JM, Pol S, Fontaine H, Mourad A, Carrat F, Duracinsky M, Marcellin F. Impaired health-related quality of life in the HCV cure era: who is concerned? (ANRS CO22 HEPATHER French cohort). Qual Life Res 2023; 32:3427-3438. [PMID: 37587323 DOI: 10.1007/s11136-023-03496-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE Hepatitis C virus (HCV) cure after treatment with direct-acting antivirals (DAAs) can improve health-related quality of life (HRQoL). However, specific groups with chronic HCV may still exhibit worse post-cure HRQoL because of persisting severe liver fibrosis or social vulnerability factors (e.g. unhealthy alcohol use, living in poverty). We assessed the effect of such factors on longitudinal measures of HRQoL in chronic HCV patients. METHODS ANRS CO22 HEPATHER is a prospective cohort of chronic HCV patients receiving DAAs, which included notably patients with social vulnerability factors, a population usually under-represented in clinical trials. Multivariable mixed-effects linear regression models helped identify factors associated with longitudinal measures of HRQoL (PROQOL-HCV scores). RESULTS At enrolment, 52.4% of the 2740 participants were men, median age was 56 years [interquartile range 50-64], and 21.5% had severe liver fibrosis (FIB-4 > 3.25). Twenty-eight per cent reported current or past unhealthy alcohol use [> 2(3) alcohol units per day for women (men)], and 28.1% were living in poverty (standard of living under 1015€/month per household consumption unit). At first PROQOL-HCV completion, 54.0% of patients were HCV-cured. After multivariable adjustment, people with current or past unhealthy alcohol use, individuals living in poverty, those with severe liver fibrosis, and women had worse HRQoL in the dimensions explored. Conversely, HCV cure was associated with better HRQoL. CONCLUSIONS Specific socially vulnerable groups of patients with chronic HCV infection still experience impaired HRQoL, independently of HCV cure. Patient-centred interventions, including social support and referral for comorbidities, should be prioritized for them. Trial registration with ClinicalTrials.gov NCT01953458.
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Affiliation(s)
- Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France
| | - Marc Bourlière
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France
- Hôpital St Joseph, Service d'Hépato-Gastroentérologie, Marseille, France
| | - Vincent Di Beo
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France
| | - Clovis Lusivika-Nzinga
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Hôpital Saint-Antoine, Unité de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Clémence Ramier
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France
| | - Saskia Antwerpes
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France
| | - Camelia Protopopescu
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France.
| | | | - Stanislas Pol
- Université de Paris, AP-HP, Département d'hépatologie, Hôpital Cochin, Paris, France
| | - Hélène Fontaine
- Université de Paris, AP-HP, Département d'hépatologie, Hôpital Cochin, Paris, France
| | - Abbas Mourad
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France
| | - Fabrice Carrat
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Hôpital Saint-Antoine, Unité de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Martin Duracinsky
- Département de Médecine Interne et d'immunologie Clinique, Hôpital Bicêtre, AP-HP, Kremlin-Bicêtre, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Université de Paris, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO) AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385, Marseille, France
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Brown C, Roucoux G, Rousset-Torrente O, Ali S, Yombo-Kokule L, Chaplin J, Chassany O, Duracinsky M. Fostering Patient-Clinician Communication to Promote Rapid HIV, Hepatitis B Virus, and Hepatitis C Virus Diagnostic Testing: Conceptual Development of a Multilingual App. JMIR Form Res 2023; 7:e49251. [PMID: 37971810 PMCID: PMC10690526 DOI: 10.2196/49251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Migrants are disproportionately affected by HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV). Clinicians, at times, fail to offer rapid diagnostic testing (RDT) for these viruses when a language barrier exists in the patient-clinician relationship, therefore creating missed testing opportunities. Although their effectiveness has been demonstrated elsewhere, conventional, in-person interpreters are costly and underused in practice. Furthermore, clinicians often call upon ad hoc interpreters, which introduces complexities in the clinical relationship. Digital solutions exist to diminish the burden of language barriers; however, the challenges of developing a multilingual and multicultural app have yet to be documented with respect to RDT in the nonfrancophone migrant population in France. OBJECTIVE Our goal was to design a multilingual app to overcome language barriers, health literacy barriers, and fears related to being tested to promote RDT of HIV, HBV, and HCV in the nonfrancophone migrant population in France. METHODS A combination of qualitative methods, agile development, and user-centered design was used. We conducted 2 focus groups (FGs) with 12 participants, including physicians, nurses, and social workers conducting RDT, as well as 1 modified Delphi survey with 68 participants including physicians and nurses. FGs explored the content (risk factors and medical history), functions (cultural adaptation and instant translation), and interface ergonomics (graphics and font) needed in the app. The Delphi presented 95 content items that the researchers sought to include in the app. RESULTS Using FGs to inform the Delphi survey, we scientifically determined the app's content consisting of 95 items using expert consensus, developed a mock-up, and conducted initial user testing. We created an app that contains both migrant and clinician interfaces and includes a sociodemographic, risk assessment, health literacy, and testing barrier questionnaires available in 11 languages. Educational content is related to HIV, HBV, and HCV, along with the ability to understand whether the migrant agrees to be tested. CONCLUSIONS This study allowed us to conceptualize a multilingual app that aims to increase the acceptance of RDT for HIV, HBV, and HCV. The specific features of the Assistant intelligent au dépistage des allophones app were designed to overcome the testing barriers in the nonfrancophone migrant population. The next phase will be an implementation study, as we intend to validate our app.
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Affiliation(s)
- Carter Brown
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - Guillaume Roucoux
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Olivia Rousset-Torrente
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Saleh Ali
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - Lisa Yombo-Kokule
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - John Chaplin
- Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Olivier Chassany
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Martin Duracinsky
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, General Administration of Public Assistance of Paris, Le Kremlin,-Bicêtre, France
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10
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El Chami C, Cousin L, Rousset Torrente O, Roucoux G, Brown C, Thonon F, Petit AS, Ducarroz S, Duracinsky M. [Smoking and smoking cessation among migrants in France: A qualitative study]. Bull Cancer 2023; 110:991-1001. [PMID: 37468339 DOI: 10.1016/j.bulcan.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION The aim of this study is to identify factors related to smoking and smoking cessation as well as preferences for cessation methods reported by migrants in France. METHODS Qualitative study using semi-directive interviews with migrants in the Parisian area thematically analyzed using an inductive approach. RESULTS Sixteen interviews conducted. The stress and isolation induced by migration favor the increase of tobacco consumption. These two factors, as well as the lack of information on the resources available for quitting smoking, were identified as obstacles to cessation. The main motivations for quitting are the identified or experienced effects of smoking on their health and pressure from family members, especially children. Quitting is essentially a personal strategy centered on the true will to quit. The most popular method identified by the participants as the most effective in helping them to quit, is follow-up or therapy by a health professional combining listening and psychological support. DISCUSSION For migrants, smoking is a resource to combat stress that increases during the migration process and upon arrival in the host country and presents a psychosocial dimension for the most isolated individuals. Smoking cessation must be accompanied and must take into account the specificities of this population as well as the expressed need for psychosocial support, as suggested by our results, to be most effective.
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Affiliation(s)
- Carole El Chami
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Paris Cité, ECEVE, UMR 1123, Inserm, 75010 Paris, France
| | - Lorraine Cousin
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Paris Cité, ECEVE, UMR 1123, Inserm, 75010 Paris, France; Aix Marseille université, Inserm, IRD, SESSTIM, sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France.
| | - Olivia Rousset Torrente
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Paris Cité, ECEVE, UMR 1123, Inserm, 75010 Paris, France
| | - Guillaume Roucoux
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Paris Cité, ECEVE, UMR 1123, Inserm, 75010 Paris, France
| | - Carter Brown
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Paris Cité, ECEVE, UMR 1123, Inserm, 75010 Paris, France
| | - Frédérique Thonon
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Paris Cité, ECEVE, UMR 1123, Inserm, 75010 Paris, France
| | - Anne Sophie Petit
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Lyon 2, groupe de recherche en psychologie sociale (UR GRePS), Bron, France
| | - Simon Ducarroz
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, IPLESP, équipe de recherche en épidémiologie sociale, 75012 Paris,, France; CNRS, institut convergences migration, Aubervilliers, France
| | - Martin Duracinsky
- AP-HP, hôpital Hôtel-Dieu galerie B1 3(e) étage, unité de recherche clinique en économie de la santé (URC-ECO), 75004 Paris, France; Université Paris Cité, ECEVE, UMR 1123, Inserm, 75010 Paris, France; AP-HP, hôpital Bicêtre, département de médecine interne et d'immunologie clinique, 94275 Kremlin-Bicêtre, France
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11
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Cousin Cabrolier L, Di Beo V, Marcellin F, Rousset Torrente O, Mahe V, Valderas JM, Chassany O, Carrieri PM, Duracinsky M. Negative representations of night-shift work and mental health of public hospital healthcare workers in the COVID-19 era (Aladdin survey). BMC Health Serv Res 2023; 23:187. [PMID: 36814276 PMCID: PMC9946706 DOI: 10.1186/s12913-023-09101-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/24/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Many risk factors impact the health of hospital night workers, which can lead to physical and mental health disorders. During the recent period, night hospital workers have been particularly stressed. This study therefore aims to: (i) To document the prevalence of depression, anxiety, sleep disorders, and symptoms suggestive of post-traumatic stress disorder in night shift workers (NSHW) working in Parisian public hospitals after France's first COVID-19 wave ended; (ii) To estimate the effect of negative representations and perceptions of night shift work on these mental health outcomes. METHODS An observational cross-sectional online survey of NSHW (June to September 2020) in 39 public hospitals in Paris, France. Standard scales were used to measure mental health outcomes. Weighted multinomial logistic regression models supported the identification of predictors of depression (score > 10 on the Hospital Anxiety and Depression Scale, HADS, for depression), anxiety (score > 10 on the HADS for anxiety), severe insomnia (score > 21 on the Insomnia Severity Index, ISI) and symptoms suggestive of post-traumatic stress disorder (score > 36 on the Impact of Event Scale-Revised, IES-R). RESULTS The weighted prevalence rates [95% confidence interval] of depression, anxiety, severe insomnia, and symptoms of post-traumatic stress disorder were, respectively, 18.9% [16.5-21.2], 7.6% [6.0-9.1], 8.6% [6.9-10.2] and 11.7% [9.7-13.6]. After multiple adjustment, organizational changes in NSHW professional lives due to the COVID-19 pandemic (such as moving to another hospital department and modified schedules) and NSHW-perceived negative representations of night work were significantly associated with all studied mental health outcomes. CONCLUSION Our findings confirm the importance of monitoring mental health and sleep quality among NSHW in Parisian public hospitals, even more during health crises. Multilevel interventions aiming at reducing negative representations and improving work organization are urgently needed to improve overall health of this frontline healthcare providers group.
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Affiliation(s)
- Lorraine Cousin Cabrolier
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France ,grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Vincent Di Beo
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Fabienne Marcellin
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Olivia Rousset Torrente
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France
| | - Véronique Mahe
- Service de Santé Au Travail, Hôpitaux Lariboisière-Fernand Widal, AP-HP Nord, Paris, France
| | - José Maria Valderas
- grid.4280.e0000 0001 2180 6431Department of Medicine, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Olivier Chassany
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France
| | - Patrizia Maria Carrieri
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004, Paris, France. .,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010, France. .,Département de Médecine Interne Et d'immunologie Clinique, Hôpital Bicêtre, AP-HP, 94275, Kremlin Bicêtre, France.
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12
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Kushniruk A, Roucoux G, Dimi S, Fahmi S, Jeevan RB, Chassany O, Chaplin J, Duracinsky M. Evaluating Clinician Expectations of mHealth Solutions to Increase Rapid-Screening for HIV and Hepatitis in Migrant Populations in France: Qualitative Study. JMIR Hum Factors 2023; 10:e41861. [PMID: 36735323 PMCID: PMC9938434 DOI: 10.2196/41861] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/28/2022] [Accepted: 12/11/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Migrants underuse screening opportunities for HIV, hepatitis B, and hepatitis C despite elevated risk factors for contracting these infections. Language barriers are an often given as reasons for limiting access to services. Translation and communication apps increase communication and overall patient satisfaction in the patient-provider relationship. In the development and adoption of new technology, expectations play an important role. OBJECTIVE This study aimed to explore health care professionals' opinions and attitudes regarding their screening practices with migrants and their expectations for a new communication tool that could improve migrants' screening use. METHODS In this qualitative study, a purposive (diverse) sampling method was used to invite doctors and nurses who conduct rapid screening tests with migrants from 4 centers of the French Office of Immigration and Integration in 3 geographic regions of France. Semistructured interviews were conducted to survey their opinions on the rapid testing of migrants, the use of telephone interpreters, the concept of health literacy, and their expectations of a new communication tool that could overcome language barriers and promote rapid screening in the new migrant population. RESULTS In all, 20 interviews were conducted with 11 doctors and 9 nurses with a median age of 58 (range 25-67) years. Participants favored the integration of an innovative communication tool in the context of rapid screening of migrants. However, there were concerns related to the implementation and added value of the tool while migrants were already reluctant to be screened. Expectations were for a tool that would present information in simplified French or a chosen language but also supports a positive attitude toward screening. Health professionals also expressed the wish that the technology could help with the collection of health data. CONCLUSIONS Feedback from health professionals provides a better understanding of potential formats, characteristics, functions, content, and use of an innovative, digital method to communicate with migrants with limited French proficiency. Findings contribute to the conceptual development of an electronic app and its implementation within the ApiDé study, which aims to validate a digital app to address language barriers to increase the use of screening among migrants with limited French proficiency in France.
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Affiliation(s)
| | - Guillaume Roucoux
- Patient-Reported Outcomes Unit, UMR 1123, Inserm, Université de Paris, Paris, France.,Unité de Recherche Clinique en Economie de la Santé, Assistance Publique - Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Svetlane Dimi
- International Vaccination and Travel Medicine Center, Centre de Santé Familia Sol, Creil, France
| | - Saleh Fahmi
- Patient-Reported Outcomes Unit, UMR 1123, Inserm, Université de Paris, Paris, France
| | - Raj-Banou Jeevan
- Patient-Reported Outcomes Unit, UMR 1123, Inserm, Université de Paris, Paris, France
| | - Olivier Chassany
- Patient-Reported Outcomes Unit, UMR 1123, Inserm, Université de Paris, Paris, France.,Unité de Recherche Clinique en Economie de la Santé, Assistance Publique - Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France
| | - John Chaplin
- Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, The University of Gothenburg Centre for Person-Centred Care, Gothenburg, Sweden
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit, UMR 1123, Inserm, Université de Paris, Paris, France.,Unité de Recherche Clinique en Economie de la Santé, Assistance Publique - Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France.,Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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13
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Rodriguez S, Yaya I, Huntingdon B, Juraskova I, Preau M, Etemadi F, Dimi S, Carrieri MP, Bessonneau P, Chassany O, Duracinsky M. Positive relations between sexual quality of life and satisfaction with healthcare in women living with HIV and/or HCV: Results from a multicountry study. PLoS One 2023; 18:e0278054. [PMID: 36662750 PMCID: PMC9858467 DOI: 10.1371/journal.pone.0278054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/08/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION The sexual quality of life is a neglected concern in women living with HIV (WHIV) or with HCV (WHCV), which can further be affected by their experience with stigma, social instability, fear of transmission and reduced access to treatment. The objective of this study was to identify sociodemographic, psychosocial, and behavioural factors associated with sexual quality of life (SQoL) in this study group. METHODS Between December 2017 and December 2018, PROQoL-Sex Life questionnaire was administered to 404 WHIV and WHCV in five countries. PROQoL-SQoL consists of four dimensions: positive sexual perception (Psp), stigma and social distress (Sti), soft sexual practices (Sof), sexual practices with a partner (Sp), all of which were scored from 0 to 100 and considered as main outcomes, lower scores mean better sexual quality of life. Linear mixed effects models were used to evaluate the association with sociodemographic and psychosocial factors. RESULTS Of the participants analyzed, 191 were living with HCV, 180 with HIV and 33 with HIV and HCV, median age was 48. Among WHIV, a higher satisfaction with health care, and talking about sexuality with healthcare workers were associated with lower scores in all the dimensions of the SQoL, while psychoactive substance use was associated with lower scores of Sti and Sof. Moreover, higher satisfaction with health care, talking about sexuality with healthcare workers, and psychoactive substance use (except cocaine use) in WHCV were associated with lower scores in Psp, Sti, and Sof. Besides, cocaine use was associated with higher scores of Sof. CONCLUSION This study highlighted strong relationship between the quality of health care, and psychoactive substance use (except cocaine) and the sexual quality of life in WHIV and WHCV in these five countries. These findings draw attention to the different interventions that can be proposed for improving the sexual quality of life.
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Affiliation(s)
- Sara Rodriguez
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Issifou Yaya
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
| | - Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), The University of Sydney, Sydney, New South Wales, Australia
| | - Marie Preau
- Groupe de Recherche en Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France
| | - Fatima Etemadi
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Svetlane Dimi
- Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - Pascal Bessonneau
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
- Département de Médecine Interne et d’Immunologie Clinique, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
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14
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Mateo‐Otobia A, Chassany O, Duracinsky M. Patient‐reported outcomes measurements in dry eye patients after 84 days of daily treatment with a preservative‐free combination containing sodium hyaluronate and trehalose: The
TEARS
study. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
| | - Olivier Chassany
- Hotel‐Dieu Hospital, AP‐HP, Patient‐Reported Outcomes, Health Economics Clinical Trial unit Paris France
| | - Martin Duracinsky
- Hotel‐Dieu Hospital, AP‐HP, Patient‐Reported Outcomes, Health Economics Clinical Trial unit Paris France
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15
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Duracinsky M, Chassany O, Gryparis A, Bodeveix A. Psychometrics properties of a new scale to evaluate the impact of dry eye on daily life and the patient satisfaction using eye drops. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Martin Duracinsky
- Hotel‐Dieu Hospital, AP‐HP & University Paris Cité, Patient‐Reported Outcomes, Health Economics Clinical Trial unit Paris France
| | - Olivier Chassany
- Hotel‐Dieu Hospital, AP‐HP & University Paris Cité, Patient‐Reported Outcomes, Health Economics Clinical Trial unit Paris France
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16
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Duracinsky M, Dimi S, Carrieri MP, Yaya I, Villes V, Valin N, Farfour E, Chassany O, Zucman D. Risk Prediction Score for Screening Asymptomatic Sexually Transmitted Infections in HIV-positive French Men Who Have Sex with Men (ANRS 9520 DRIVER). Am J Health Behav 2022; 46:558-566. [PMID: 36333826 DOI: 10.5993/ajhb.46.5.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Asymptomatic sexually transmitted infections (STI) are frequent among men who have sex with men (MSM). Identifying asymptomatic STIs is a crucial issue, not only for secondary but also for primary prevention, as early treatment can reduce transmission risk. We aimed to develop a self-reported predictive score for early identification of asymptomatic STIs. METHODS Participants provided clinical data and completed a self-administered questionnaire including sociodemographic variables and behaviors during the 6 previous months. We used multivariable logistic regression to identify factors associated with asymptomatic STIs. We calculated the accuracy of the model by the non-parametric area (AUC) under the receiver-operating-characteristic (ROC) curve to find the optimal discriminant threshold for screening. RESULTS A total of 781 HIV-positive MSM were included with a mean age of 46.8 years. Asymptomatic STI prevalence was 13.2%. Detectable plasma HIV RNA (adjusted odds ratio (aOR [95% CI): 2.54 [1.23;5.25]), inconsistent condom use during anal sex (2.20 [1.36;3.56]), group sex (2.00 [1.15;3.45]), during or-genital practices (1.83 [1.12;3.01]), not being in stable relationship (1.70 [1.01;2.66] and an item from a sensation-seeking behavioral scale "I don't like watching porn videos" (1.61 [1.01;2.59] were associated with asymptomatic STI. AUC was 0.7 and with optimal threshold of 0.1082 for this model; sensitivity was 80.4%. Self-reported asymptomatic STI predictive score was built with this threshold according to the 6 factors in the final model. CONCLUSIONS As this predictive score is not designed to be diagnostic, but to provide indications for diagnostic tests, its ease of administration and sensitivity remain the most important features. Its use in clinical practice for early detection of asymptomatic STIs potentially can reinforce STI primary and secondary prevention.
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Affiliation(s)
- Martin Duracinsky
- Unité de Recherche Clinique en Economie de la Sant?? (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France. Patient-Centered Outcomes Research (PROQOL), UMR 1123, Université Paris cité, Inserm, Paris, France. Département de Médecine Interne et d???Immunologie Clinique, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - Svetlane Dimi
- Hôpital Foch, Service de Médecine Interne, Suresnes, France
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l???Information Médicale, ISSPAM, Marseille, France
| | - Issifou Yaya
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France. Patient-Centered Outcomes Research (PROQOL), UMR 1123, Université Paris cité, Inserm, Paris, France
| | - Virginie Villes
- ORS Paca Observatoire régional de la santé Provence-Alpes-Côte-d???Azur, Marseille, France
| | - Nadia Valin
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (APHP), France
| | - Eric Farfour
- Service de biologie Clinique, Hôpital Foch, Suresnes, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France. Patient-Centered Outcomes Research (PROQOL), UMR 1123, Université Paris cité, Inserm, Paris, France
| | - David Zucman
- Hôpital Foch, Service de Médecine Interne, Suresnes, France
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17
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Barthélémy H, Mougenot E, Duracinsky M, Salmon-Ceron D, Bonini J, Péretz F, Chassany O, Carrieri P. Smoking increases the risk of post-acute COVID-19
syndrome: Results from a French community-based survey. Tob Induc Dis 2022; 20:59. [PMID: 35799625 PMCID: PMC9204712 DOI: 10.18332/tid/150295] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION METHODS RESULTS CONCLUSIONS
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Affiliation(s)
- Hugues Barthélémy
- Unité de Recherche Clinique, Centre Hospitalier d’Auxerre, Auxerre, France
| | | | - Martin Duracinsky
- Patient-Centered Reported Outcomes, Université de Paris, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Dominique Salmon-Ceron
- Service Maladies Infectieuses et Tropicales, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France
| | | | | | - Olivier Chassany
- Patient-Centered Reported Outcomes, Université de Paris, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
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18
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Cousin L, Roucoux G, Petit AS, Baumann-Coblentz L, Torrente OR, Cannafarina A, Chassany O, Duracinsky M, Carrieri P. Perceived stigma, substance use and self-medication in night-shift healthcare workers: a qualitative study. BMC Health Serv Res 2022; 22:698. [PMID: 35610623 PMCID: PMC9128768 DOI: 10.1186/s12913-022-08018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many risk factors related to altered circadian rhythms impact the health of night-shift hospital workers (NSHW), resulting in mental and somatic disorders. Easy access to psychoactive substances (PS) may facilitate addictive behaviors in NSHW. They are also exposed to a stressful work environment, which may further affect sleep quality. This study aimed to explore the link between sleep deprivation, work-related psychosocial stress and psychoactive substance use as a self-medication response in NSHW. Methods Qualitative study to verify the plausibility of the self-medication theory applied to addictive behaviors. Semi-structured interviews (N = 18 NSHW) and thematic analysis, following consolidated criteria for reporting qualitative research recommendations. Results Stigma against NSHW was a primary element of a stressful work environment. The stressful and stigmatizing environment, together with night-shift work, further affected NSHW sleep and their mental and physical health. The use of PS appeared to be for self-medication, encouraged by social and professional environments, source(s) of stress, discrimination, and isolation. The work environment, through aggravated sleep disorders, led NSHW to use non-prescribed sleeping pills. Alcohol after work and smoking were used as a social break but also as a means to reduce stress. Conclusion Anti-stigma interventions in the healthcare setting and screening of mental/somatic disorders in NSHW can help reduce harmful self-medication behaviors and improve hospital care in the COVID-19 era. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08018-x.
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Affiliation(s)
- Lorraine Cousin
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France. .,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France. .,Groupe de Recherche en Psychologie Sociale (UR GRePS), Université Lyon 2, Bron, France.
| | - Guillaume Roucoux
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Anne Sophie Petit
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Groupe de Recherche en Psychologie Sociale (UR GRePS), Université Lyon 2, Bron, France
| | | | - Olivia Rousset Torrente
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Adriano Cannafarina
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France.,Département de Médecine Interne Et d'immunologie Clinique, Hôpital Bicêtre, AP-HP, 94275, Kremlin Bicêtre, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale, ISSPAM, Marseille, France
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19
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Chaumont S, Quinquis L, Monnerie B, Six C, Hébel P, Chassany O, Duracinsky M, Le Nevé B. A poor diet quality is associated with more gas-related symptoms and a decreased quality of life in French adults. Br J Nutr 2022; 129:1-27. [PMID: 35603426 PMCID: PMC9899566 DOI: 10.1017/s0007114522001593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 05/05/2022] [Accepted: 05/16/2022] [Indexed: 11/06/2022]
Abstract
This study evaluated the association between dietary patterns, Gas-Related Symptoms (GRS) and their impact on quality of life (QoL) in a representative sample (n=936) of the French adult population. During the 2018-2019 "Comportements et Consommations Alimentaires en France" (CCAF) survey (Behaviors and Food Consumption in France), online evaluation of GRS in adult participants was performed using the validated Intestinal Gas Questionnaire (IGQ), which captures the perception of GRS and their impact on QoL via 6 symptom dimensions scores (range 0-100; 100=worse) and a global score (mean of the sum of the 6 symptom dimensions scores). Socio-demographics, lifestyle parameters and dietary habits (7-day e-food diary) were also collected online. Quality of diet was determined using the NRF9.3 score (range 0-900; 900=best). Univariate and multivariate linear regression models were applied to identify factors associated with IGQ global score. K-means was used to identify clusters of subjects based on their dietary records. Data from 936 adults who completed both the IGQ and the food diary showed a mean (SD) IGQ global score of 11.9 (11.2). Younger age and female gender were associated with a higher IGQ global score. Only 7% of subjects reported no symptom at all and nearly 30% of study participants reported a high impact of GRS on their QoL. Two dietary clusters were identified: cluster1, characterized by a higher consumption of fruits and vegetables, lower sugars intake and higher NRF9.3 score and cluster 2, characterized by higher intake of sugars, lower intake in dietary fibers and lower NRF9.3 score. The IGQ global score was lower in cluster1 and higher in cluster2 vs. the total sample average (p<0.001). Prevalence of GRS in the French adult population is high and is associated with impaired QoL and dietary patterns. A change in food habits towards healthier patterns could help reducing the burden of GRS.
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Affiliation(s)
| | | | | | - Chloé Six
- CREDOC, Centre de Recherche pour l’Etude et l’Observation des Conditions de vie, Paris, France
| | - Pascale Hébel
- CREDOC, Centre de Recherche pour l’Etude et l’Observation des Conditions de vie, Paris, France
| | - Olivier Chassany
- Patient-Reported Outcomes Research Unit, Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Université de Paris, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Research Unit, Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Université de Paris, Paris, France
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20
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Marcellin F, Cousin L, Di Beo V, Mahé V, Rousset-Torrente O, Carrieri P, Chassany O, Duracinsky M. Impact of the COVID-19 crisis on healthcare workers: The need to address quality of working life issues. Respirology 2022; 27:469-471. [PMID: 35474259 PMCID: PMC9115523 DOI: 10.1111/resp.14265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022]
Abstract
See relatedReply
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Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Lorraine Cousin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale, ISSPAM, Marseille, France.,Université de Paris, Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Paris, France.,Unité de recherche clinique en économie de la santé (URC-ECO) AP-HP, hôpital Hôtel-Dieu, Paris, France
| | - Vincent Di Beo
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Véronique Mahé
- Service central de santé au travail, hôpitaux Lariboisière-Fernand Widal, AP-HP Nord, Paris, France
| | - Olivia Rousset-Torrente
- Université de Paris, Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Paris, France.,Unité de recherche clinique en économie de la santé (URC-ECO) AP-HP, hôpital Hôtel-Dieu, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Olivier Chassany
- Université de Paris, Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Paris, France.,Unité de recherche clinique en économie de la santé (URC-ECO) AP-HP, hôpital Hôtel-Dieu, Paris, France
| | - Martin Duracinsky
- Université de Paris, Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Paris, France.,Unité de recherche clinique en économie de la santé (URC-ECO) AP-HP, hôpital Hôtel-Dieu, Paris, France.,Département de médecine interne et d'immunologie clinique, hôpital Bicêtre, AP-HP, Kremlin-Bicêtre, France
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21
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Duracinsky M, Marcellin F, Cousin L, Di Beo V, Mahé V, Rousset-Torrente O, Carrieri P, Chassany O. Social and professional recognition are key determinants of quality of life at work among night-shift healthcare workers in Paris public hospitals (AP-HP ALADDIN COVID-19 survey). PLoS One 2022; 17:e0265724. [PMID: 35390061 PMCID: PMC9045406 DOI: 10.1371/journal.pone.0265724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/08/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Documenting the perceptions and experiences of frontline healthcare workers
during a sanitary crisis is key to reinforce healthcare systems. We identify
the determinants of quality of working life (QWL) among night-shift
healthcare workers (NSHW) in Paris public hospitals shortly after the
first-wave of the COVID-19 pandemic. Methods The ALADDIN cross-sectional online survey (15 June to 15 September 2020)
collected QWL, socio-economic, behavioral, and work-related information
among 1,387 NSHW in the 39 hospitals of the Assistance Publique—Hôpitaux de
Paris (AP-HP). Data were weighted (margin calibration) to be representative
of the entire population of 12,000 AP-HP hospitals’ NSHW regarding sex, age,
and professional category. Linear regression was used to identify correlates
of QWL (WRQoL scale). Results New night position during the COVID pandemic, difficulties in getting
screened for COVID, and considering protective measures inadequate were
associated with poorer QWL, after adjustment for socio-economic
characteristics, professional category, perceived health, physical activity,
and history of harassment at work. Under-estimation of night-shift work by
day-shift colleagues, reporting night work as a source of tension with
friends, or feeling more irritable since working at night also impaired QWL.
By contrast, satisfaction regarding COVID information received from the
employer, and feeling valued by the general population during the pandemic
improved QWL. Conclusions Insufficient access to screening, information, and protective measures
impaired QWL of NSHW after the first wave of COVID-19 in Paris public
hospitals. Social and professional recognition of night-shift work were the
key determinants of QWL in this population.
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Affiliation(s)
- Martin Duracinsky
- Département de Médecine Interne et d’immunologie Clinique, Hôpital
Bicêtre, AP-HP, Kremlin-Bicêtre, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Université de
Paris, Paris, France
- Unité de Recherche Clinique en Économie de la Santé (URC-ECO) AP-HP,
Hôpital Hôtel-Dieu, Paris, France
| | - Fabienne Marcellin
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et
Traitement de l’Information Médicale, ISSPAM, Aix Marseille Univ, Marseille,
France
- * E-mail:
| | - Lorraine Cousin
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Université de
Paris, Paris, France
- Unité de Recherche Clinique en Économie de la Santé (URC-ECO) AP-HP,
Hôpital Hôtel-Dieu, Paris, France
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et
Traitement de l’Information Médicale, ISSPAM, Aix Marseille Univ, Marseille,
France
| | - Vincent Di Beo
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et
Traitement de l’Information Médicale, ISSPAM, Aix Marseille Univ, Marseille,
France
| | - Véronique Mahé
- Service Central de Santé au Travail, Hôpitaux Lariboisière-Fernand Widal,
AP-HP Nord, Paris, France
| | - Olivia Rousset-Torrente
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Université de
Paris, Paris, France
- Unité de Recherche Clinique en Économie de la Santé (URC-ECO) AP-HP,
Hôpital Hôtel-Dieu, Paris, France
| | - Patrizia Carrieri
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et
Traitement de l’Information Médicale, ISSPAM, Aix Marseille Univ, Marseille,
France
| | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Inserm, Université de
Paris, Paris, France
- Unité de Recherche Clinique en Économie de la Santé (URC-ECO) AP-HP,
Hôpital Hôtel-Dieu, Paris, France
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22
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Cousin L, Di Beo V, Marcellin F, Coscas S, Mahé V, Chavignaud I, Rousset Torrente O, Chassany O, Duracinsky M, Carrieri MP. Use of psychoactive substances by night-shift hospital healthcare workers during the first wave of the COVID-19 pandemic: a cross-sectional study based in Parisian public hospitals (ALADDIN). BMJ Open 2022; 12:e055699. [PMID: 35246420 PMCID: PMC8918090 DOI: 10.1136/bmjopen-2021-055699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of psychoactive substance (PAS) use in night-shift healthcare workers (NSHW) during France's first COVID-19 wave (March-May 2020). DESIGN Observational cross-sectional online survey. SETTING 39 public hospitals in the Assitance Publique des Hôpitaux de Paris (AP-HP) network in the Parisian area. PARTICIPANTS A total of 1238 nurses, assistant nurses, X-ray technicians, managers, lab technicians, midwives and childcare assistants working at night or alternating between days and nights answered the questionnaire. INTERVENTION Online survey. OUTCOME MEASURES PAS use prevalence after weighting data for sex, age and profession using calibration on margins, in order to be representative of all AP-HP NSHW. We used the Fagerström scale and the Alcohol Use Disorders Identification Test Concise to assess PAS use. RESULTS The weighted estimated prevalences of daily smoking, alcohol drinking and tranquilliser use in participating NSHW were 21.4, 1.3 and 2.4%, respectively. Twelve per cent (11.7%) of our study sample used opioids. During the first COVID-19 wave, PAS use remained stable except for tobacco use, with 8.6% of participants reporting an increase. Previous 3-month prevalences of tranquilliser and opioid use were significantly higher than in the general population. CONCLUSION Daily smoking (especially in younger men) and tranquilliser and opioid use were highly prevalent in NSHW in the AP-HP network during France's first COVID-19 wave. Specific interventions for quitting smoking and addressing determinants of tranquilliser and opioid use in NSHW need to be developed and evaluated to improve quality of life in these essential, underdiagnosed and undertreated health personnel.
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Affiliation(s)
- Lorraine Cousin
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Vincent Di Beo
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Fabienne Marcellin
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Sarah Coscas
- Mission FIDES, AP-HP, hôpital Paul Brousse, Villejuif, Assistance Publique - Hopitaux de Paris, Paris, France
- UR psychiatrie-comorbidités-addictions (PSYCOMadd), Assistance Publique - Hopitaux de Paris, Villejuif, France
| | - Véronique Mahé
- Service de santé au travail, hôpitaux Lariboisière-Fernand Widal, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Isabelle Chavignaud
- Mission FIDES, AP-HP, hôpital Paul Brousse, Villejuif, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Olivia Rousset Torrente
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
- Département de médecine interne et d'immunologie clinique, Assistance Publique - Hopitaux de Paris, Kremlin Bicêtre, France
| | - Maria Patrizia Carrieri
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
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Duracinsky M, Archbold S, Lobo B, Bessonneau P, Thonon F, Santos J, Guagnozzi D, Payakachat N, Coffin B, Azpiroz F, Whorwell PJ, Chassany O. The Intestinal Gas Questionnaire (IGQ): Psychometric validation of a new instrument for measuring gas-related symptoms and their impact on daily life among general population and irritable bowel syndrome. Neurogastroenterol Motil 2022; 34:e14202. [PMID: 34145682 PMCID: PMC9285021 DOI: 10.1111/nmo.14202] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/20/2021] [Accepted: 05/20/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Gas-related symptoms (GRS) are common in the general population (GPop) and among patients with disorders of gut-brain interactions but there is no patient-reported outcome evaluating these symptoms and their impact on daily life. We have previously developed a 43-item intestinal gas questionnaire (IGQ). The aim of the present study is to perform a psychometric validation of this instrument. METHODS Participants (119 from the GPop and 186 irritable bowel syndrome (IBS) patients) were recruited from 3 countries (UK, Spain, France). IBS patients fulfilled ROME IV criteria with an IBS severity score between 150 and 300. Participants completed the IGQ, the functional Digestive Disorders Quality of Life (FDDQL), and the EQ-5D. A subgroup (n = 90) repeated the IGQ completion after 7 days on paper or electronically. RESULTS From the original IGQ questionnaire, 26 items were deleted because of poor performance. Confirmatory factorial analysis on the remaining 17 items (7 symptom and 10 impact items) yielded a 6-factor structure accounting for 67% of the variance for bloating (6 items), flatulence (3), belching (2), bad breath (2), stomach rumbling (2), and difficult gas evacuation (2). Global score (0-100) was worse among IBS vs GPop (40 ± 15 vs 33 ± 17; p = 0.0016). At the second visit, the intraclass correlation coefficient of IGQ scores was between 0.71 and 0.86 (n = 67) for test-retest reliability and 0.61-0.87 (n = 64) for equivalence between electronic and paper versions of IGQ. CONCLUSION The IGQ available in paper and electronic versions in 3 languages is a robust instrument for capturing and measuring GRS and their impact on daily life.
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Affiliation(s)
- Martin Duracinsky
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance,Health Economics Clinical Trial Unit (URC‐ECO)Hotel‐Dieu HospitalAP‐HPParisFrance
| | - Sharon Archbold
- Neurogastroenterology UnitSchool of Medical SciencesFaculty of Biology, Medicine and HealthWythenshawe HospitalUniversity of ManchesterManchesterUK
| | - Beatriz Lobo
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Pascal Bessonneau
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance
| | - Frédérique Thonon
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance
| | - Javier Santos
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Danila Guagnozzi
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Nalin Payakachat
- Department of Pharmacy PracticeCollege of PharmacyUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | - Benoit Coffin
- Gastroenterology DepartmentLouis‐Mourier HospitalAP‐HPColombesFrance
| | - Fernando Azpiroz
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Peter J. Whorwell
- Neurogastroenterology UnitSchool of Medical SciencesFaculty of Biology, Medicine and HealthWythenshawe HospitalUniversity of ManchesterManchesterUK
| | - Olivier Chassany
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance,Health Economics Clinical Trial Unit (URC‐ECO)Hotel‐Dieu HospitalAP‐HPParisFrance
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Wymant C, Bezemer D, Blanquart F, Ferretti L, Gall A, Hall M, Golubchik T, Bakker M, Ong SH, Zhao L, Bonsall D, de Cesare M, MacIntyre-Cockett G, Abeler-Dörner L, Albert J, Bannert N, Fellay J, Grabowski MK, Gunsenheimer-Bartmeyer B, Günthard HF, Kivelä P, Kouyos RD, Laeyendecker O, Meyer L, Porter K, Ristola M, van Sighem A, Berkhout B, Kellam P, Cornelissen M, Reiss P, Fraser C, Aubert V, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kouyos R, Kovari H, Ledergerber B, Martinetti G, de Tejada BM, Marzolini C, Metzner K, Müller N, Nadal D, Nicca D, Pantaleo G, Rauch A, Regenass S, Rudin C, Schöni-Affolter F, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Weber R, Yerly S, van der Valk M, Geerlings SE, Goorhuis A, Hovius JW, Lempkes B, Nellen FJB, van der Poll T, Prins JM, Reiss P, van Vugt M, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, Hazenberg A, van Hes AMH, Rajamanoharan S, Robinson T, Taylor B, Brewer C, Mayr C, Schmidt W, Speidel A, Strohbach F, Arastéh K, Cordes C, Pijnappel FJJ, Stündel M, Claus J, Baumgarten A, Carganico A, Ingiliz P, Dupke S, Freiwald M, Rausch M, Moll A, Schleehauf D, Smalhout SY, Hintsche B, Klausen G, Jessen H, Jessen A, Köppe S, Kreckel P, Schranz D, Fischer K, Schulbin H, Speer M, Weijsenfeld AM, Glaunsinger T, Wicke T, Bieniek B, Hillenbrand H, Schlote F, Lauenroth-Mai E, Schuler C, Schürmann D, Wesselmann H, Brockmeyer N, Jurriaans S, Gehring P, Schmalöer D, Hower M, Spornraft-Ragaller P, Häussinger D, Reuter S, Esser S, Markus R, Kreft B, Berzow D, Back NKT, Christl A, Meyer A, Plettenberg A, Stoehr A, Graefe K, Lorenzen T, Adam A, Schewe K, Weitner L, Fenske S, Zaaijer HL, Hansen S, Stellbrink HJ, Wiemer D, Hertling S, Schmidt R, Arbter P, Claus B, Galle P, Jäger H, Jä Gel-Guedes E, Berkhout B, Postel N, Fröschl M, Spinner C, Bogner J, Salzberger B, Schölmerich J, Audebert F, Marquardt T, Schaffert A, Schnaitmann E, Cornelissen MTE, Trein A, Frietsch B, Müller M, Ulmer A, Detering-Hübner B, Kern P, Schubert F, Dehn G, Schreiber M, Güler C, Schinkel CJ, Gunsenheimer-Bartmeyer B, Schmidt D, Meixenberger K, Bannert N, Wolthers KC, Peters EJG, van Agtmael MA, Autar RS, Bomers M, Sigaloff KCE, Heitmuller M, Laan LM, Ang CW, van Houdt R, Jonges M, Kuijpers TW, Pajkrt D, Scherpbier HJ, de Boer C, van der Plas A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Buiting A, Reuwer A, Veenemans J, Wintermans B, Pronk MJH, Ammerlaan HSM, van den Bersselaar DNJ, de Munnik ES, Deiman B, Jansz AR, Scharnhorst V, Tjhie J, Wegdam MCA, van Eeden A, Nellen J, Brokking W, Elsenburg LJM, Nobel H, van Kasteren MEE, Berrevoets MAH, Brouwer AE, Adams A, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Phaf S, van de Ven B, van der Ven B, Buiting AGM, Murck JL, de Vries-Sluijs TEMS, Bax HI, van Gorp ECM, de Jong-Peltenburg NC, de Mendonç A Melo M, van Nood E, Nouwen JL, Rijnders BJA, Rokx C, Schurink CAM, Slobbe L, Verbon A, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, de Groot J, Boucher CAB, Koopmans MPG, van Kampen JJA, Fraaij PLA, van Rossum AMC, Vermont CL, van der Knaap LC, Visser E, Branger J, Douma RA, Cents-Bosma AS, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van Ijperen JM, Geilings J, van der Hut G, van Burgel ND, Leyten EMS, Gelinck LBS, Mollema F, Davids-Veldhuis S, Tearno C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, Kruiper MSM, van der Bliek GL, Bor PCJ, Debast SB, Wagenvoort GHJ, Kroon FP, de Boer MGJ, Jolink H, Lambregts MMC, Roukens AHE, Scheper H, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, El Moussaoui R, Pogany K, Brouwer CJ, Smit JV, Struik-Kalkman D, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, van Wolfswinkel ME, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, van Vonderen MGA, Kampschreur LM, Faber S, Steeman-Bouma R, Al Moujahid A, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Scheiberlich L, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, Jansen ER, Hoogewerf M, Rozemeijer W, van der Reijden WA, Sinnige JC, Brinkman K, van den Berk GEL, Blok WL, Lettinga KD, de Regt M, Schouten WEM, Stalenhoef JE, Veenstra J, Vrouenraets SME, Blaauw H, Geerders GF, Kleene MJ, Kok M, Knapen M, van der Meché IB, Mulder-Seeleman E, Toonen AJM, Wijnands S, Wttewaal E, Kwa D, van Crevel R, van Aerde K, Dofferhoff ASM, Henriet SSV, Ter Hofstede HJM, Hoogerwerf J, Keuter M, Richel O, Albers M, Grintjes-Huisman KJT, de Haan M, Marneef M, Strik-Albers R, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, Lauw FN, van Broekhuizen MC, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Middel A, Postma DF, Schölvinck EH, Stienstra Y, Verhage AR, Wouthuyzen-Bakker M, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Arends JE, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, van Welzen BJ, Aarsman K, Griffioen-van Santen BMG, de Kroon I, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Bont LJ, Geelen SPM, Loeffen YGT, Wolfs TFW, Nauta N, Rooijakkers EOW, Holtsema H, Voigt R, van de Wetering D, Alberto A, van der Meer I, Rosingh A, Halaby T, Zaheri S, Boyd AC, Bezemer DO, van Sighem AI, Smit C, Hillebregt M, de Jong A, Woudstra T, Bergsma D, Meijering R, van de Sande L, Rutkens T, van der Vliet S, de Groot L, van den Akker M, Bakker Y, El Berkaoui A, Bezemer M, Brétin N, Djoechro E, Groters M, Kruijne E, Lelivelt KJ, Lodewijk C, Lucas E, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Schnörr P, Scheigrond A, Tuijn E, Veenenberg L, Visser KM, Witte EC, Ruijs Y, Van Frankenhuijsen M, Allegre T, Makhloufi D, Livrozet JM, Chiarello P, Godinot M, Brunel-Dalmas F, Gibert S, Trepo C, Peyramond D, Miailhes P, Koffi J, Thoirain V, Brochier C, Baudry T, Pailhes S, Lafeuillade A, Philip G, Hittinger G, Assi A, Lambry V, Rosenthal E, Naqvi A, Dunais B, Cua E, Pradier C, Durant J, Joulie A, Quinsat D, Tempesta S, Ravaux I, Martin IP, Faucher O, Cloarec N, Champagne H, Pichancourt G, Morlat P, Pistone T, Bonnet F, Mercie P, Faure I, Hessamfar M, Malvy D, Lacoste D, Pertusa MC, Vandenhende MA, Bernard N, Paccalin F, Martell C, Roger-Schmelz J, Receveur MC, Duffau P, Dondia D, Ribeiro E, Caltado S, Neau D, Dupont M, Dutronc H, Dauchy F, Cazanave C, Vareil MO, Wirth G, Le Puil S, Pellegrin JL, Raymond I, Viallard JF, Chaigne de Lalande S, Garipuy D, Delobel P, Obadia M, Cuzin L, Alvarez M, Biezunski N, Porte L, Massip P, Debard A, Balsarin F, Lagarrigue M, Prevoteau du Clary F, Aquilina C, Reynes J, Baillat V, Merle C, Lemoing V, Atoui N, Makinson A, Jacquet JM, Psomas C, Tramoni C, Aumaitre H, Saada M, Medus M, Malet M, Eden A, Neuville S, Ferreyra M, Sotto A, Barbuat C, Rouanet I, Leureillard D, Mauboussin JM, Lechiche C, Donsesco R, Cabie A, Abel S, Pierre-Francois S, Batala AS, Cerland C, Rangom C, Theresine N, Hoen B, Lamaury I, Fabre I, Schepers K, Curlier E, Ouissa R, Gaud C, Ricaud C, Rodet R, Wartel G, Sautron C, Beck-Wirth G, Michel C, Beck C, Halna JM, Kowalczyk J, Benomar M, Drobacheff-Thiebaut C, Chirouze C, Faucher JF, Parcelier F, Foltzer A, Haffner-Mauvais C, Hustache Mathieu M, Proust A, Piroth L, Chavanet P, Duong M, Buisson M, Waldner A, Mahy S, Gohier S, Croisier D, May T, Delestan M, Andre M, Zadeh MM, Martinot M, Rosolen B, Pachart A, Martha B, Jeunet N, Rey D, Cheneau C, Partisani M, Priester M, Bernard-Henry C, Batard ML, Fischer P, Berger JL, Kmiec I, Robineau O, Huleux T, Ajana F, Alcaraz I, Allienne C, Baclet V, Meybeck A, Valette M, Viget N, Aissi E, Biekre R, Cornavin P, Merrien D, Seghezzi JC, Machado M, Diab G, Raffi F, Bonnet B, Allavena C, Grossi O, Reliquet V, Billaud E, Brunet C, Bouchez S, Morineau-Le Houssine P, Sauser F, Boutoille D, Besnier M, Hue H, Hall N, Brosseau D, Souala F, Michelet C, Tattevin P, Arvieux C, Revest M, Leroy H, Chapplain JM, Dupont M, Fily F, Patra-Delo S, Lefeuvre C, Bernard L, Bastides F, Nau P, Verdon R, de la Blanchardiere A, Martin A, Feret P, Geffray L, Daniel C, Rohan J, Fialaire P, Chennebault JM, Rabier V, Abgueguen P, Rehaiem S, Luycx O, Niault M, Moreau P, Poinsignon Y, Goussef M, Mouton-Rioux V, Houlbert D, Alvarez-Huve S, Barbe F, Haret S, Perre P, Leantez-Nainville S, Esnault JL, Guimard T, Suaud I, Girard JJ, Simonet V, Debab Y, Schmit JL, Jacomet C, Weinberck P, Genet C, Pinet P, Ducroix S, Durox H, Denes É, Abraham B, Gourdon F, Antoniotti O, Molina JM, Ferret S, Lascoux-Combe C, Lafaurie M, Colin de Verdiere N, Ponscarme D, De Castro N, Aslan A, Rozenbaum W, Pintado C, Clavel F, Taulera O, Gatey C, Munier AL, Gazaigne S, Penot P, Conort G, Lerolle N, Leplatois A, Balausine S, Delgado J, Timsit J, Tabet M, Gerard L, Girard PM, Picard O, Tredup J, Bollens D, Valin N, Campa P, Bottero J, Lefebvre B, Tourneur M, Fonquernie L, Wemmert C, Lagneau JL, Yazdanpanah Y, Phung B, Pinto A, Vallois D, Cabras O, Louni F, Pialoux G, Lyavanc T, Berrebi V, Chas J, Lenagat S, Rami A, Diemer M, Parrinello M, Depond A, Salmon D, Guillevin L, Tahi T, Belarbi L, Loulergue P, Zak Dit Zbar O, Launay O, Silbermann B, Leport C, Alagna L, Pietri MP, Simon A, Bonmarchand M, Amirat N, Pichon F, Kirstetter M, Katlama C, Valantin MA, Tubiana R, Caby F, Schneider L, Ktorza N, Calin R, Merlet A, Ben Abdallah S, Weiss L, Buisson M, Batisse D, Karmochine M, Pavie J, Minozzi C, Jayle D, Castel P, Derouineau J, Kousignan P, Eliazevitch M, Pierre I, Collias L, Viard JP, Gilquin J, Sobel A, Slama L, Ghosn J, Hadacek B, Thu-Huyn N, Nait-Ighil L, Cros A, Maignan A, Duvivier C, Consigny PH, Lanternier F, Shoai-Tehrani M, Touam F, Jerbi S, Bodard L, Jung C, Goujard C, Quertainmont Y, Duracinsky M, Segeral O, Blanc A, Peretti D, Cheret A, Chantalat C, Dulucq MJ, Levy Y, Lelievre JD, Lascaux AS, Dumont C, Boue F, Chambrin V, Abgrall S, Kansau I, Raho-Moussa M, De Truchis P, Dinh A, Davido B, Marigot D, Berthe H, Devidas A, Chevojon P, Chabrol A, Agher N, Lemercier Y, Chaix F, Turpault I, Bouchaud O, Honore P, Rouveix E, Reimann E, Belan AG, Godin Collet C, Souak S, Mortier E, Bloch M, Simonpoli AM, Manceron V, Cahitte I, Hiraux E, Lafon E, Cordonnier F, Zeng AF, Zucman D, Majerholc C, Bornarel D, Uludag A, Gellen-Dautremer J, Lefort A, Bazin C, Daneluzzi V, Gerbe J, Jeantils V, Coupard M, Patey O, Bantsimba J, Delllion S, Paz PC, Cazenave B, Richier L, Garrait V, Delacroix I, Elharrar B, Vittecoq D, Bolliot C, Lepretre A, Genet P, Masse V, Perrone V, Boussard JL, Chardon P, Froguel E, Simon P, Tassi S, Avettand Fenoel V, Barin F, Bourgeois C, Cardon F, Chaix ML, Delfraissy JF, Essat A, Fischer H, Lecuroux C, Meyer L, Petrov-Sanchez V, Rouzioux C, Saez-Cirion A, Seng R, Kuldanek K, Mullaney S, Young C, Zucchetti A, Bevan MA, McKernan S, Wandolo E, Richardson C, Youssef E, Green P, Faulkner S, Faville R, Herman S, Care C, Blackman H, Bellenger K, Fairbrother K, Phillips A, Babiker A, Delpech V, Fidler S, Clarke M, Fox J, Gilson R, Goldberg D, Hawkins D, Johnson A, Johnson M, McLean K, Nastouli E, Post F, Kennedy N, Pritchard J, Andrady U, Rajda N, Donnelly C, McKernan S, Drake S, Gilleran G, White D, Ross J, Harding J, Faville R, Sweeney J, Flegg P, Toomer S, Wilding H, Woodward R, Dean G, Richardson C, Perry N, Gompels M, Jennings L, Bansaal D, Browing M, Connolly L, Stanley B, Estreich S, Magdy A, O'Mahony C, Fraser P, Jebakumar SPR, David L, Mette R, Summerfield H, Evans M, White C, Robertson R, Lean C, Morris S, Winter A, Faulkner S, Goorney B, Howard L, Fairley I, Stemp C, Short L, Gomez M, Young F, Roberts M, Green S, Sivakumar K, Minton J, Siminoni A, Calderwood J, Greenhough D, DeSouza C, Muthern L, Orkin C, Murphy S, Truvedi M, McLean K, Hawkins D, Higgs C, Moyes A, Antonucci S, McCormack S, Lynn W, Bevan M, Fox J, Teague A, Anderson J, Mguni S, Post F, Campbell L, Mazhude C, Russell H, Gilson R, Carrick G, Ainsworth J, Waters A, Byrne P, Johnson M, Fidler S, Kuldanek K, Mullaney S, Lawlor V, Melville R, Sukthankar A, Thorpe S, Murphy C, Wilkins E, Ahmad S, Green P, Tayal S, Ong E, Meaden J, Riddell L, Loay D, Peacock K, Blackman H, Harindra V, Saeed AM, Allen S, Natarajan U, Williams O, Lacey H, Care C, Bowman C, Herman S, Devendra SV, Wither J, Bridgwood A, Singh G, Bushby S, Kellock D, Young S, Rooney G, Snart B, Currie J, Fitzgerald M, Arumainayyagam J, Chandramani S. A highly virulent variant of HIV-1 circulating in the Netherlands. Science 2022; 375:540-545. [PMID: 35113714 DOI: 10.1126/science.abk1688] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Affiliation(s)
- Chris Wymant
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.,IAME, UMR 1137, INSERM, Université de Paris, Paris, France
| | - Luca Ferretti
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Astrid Gall
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Matthew Hall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tanya Golubchik
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Swee Hoe Ong
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Lele Zhao
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George MacIntyre-Cockett
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucie Abeler-Dörner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Norbert Bannert
- Division for HIV and Other Retroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jacques Fellay
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Kate Grabowski
- Department of Pathology, John Hopkins University, Baltimore, MD, USA
| | | | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Pia Kivelä
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurence Meyer
- INSERM CESP U1018, Université Paris Saclay, APHP, Service de Santé Publique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| | - Matti Ristola
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | | | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Kellam
- Kymab Ltd., Cambridge, UK.,Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Molecular Diagnostic Unit, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, Netherlands.,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Landman R, de Truchis P, Assoumou L, Lambert S, Bellet J, Amat K, Lefebvre B, Allavena C, Katlama C, Yazdanpanah Y, Molina JM, Petrov-Sanchez V, Gibowski S, Alvarez JC, Leibowitch J, Capeau J, Fellahi S, Duracinsky M, Morand-Joubert L, Costagliola D, Alvarez JC, Girard PM, LAMAURY I, BANI-SADR F, FORCE G, CHABROL A, CABY F, PATEY O, FRESARD A, GAGNEUX-BRUNON A, CHIROUZE C, DUVIVIER C, LOURENCO J, TOLSMA V, JANSSEN C, LEROLLE N, CATALAN P, RAMI A, DE PONTHAUD L, PICHANCOURT G, NASRI S, LANDOWSKI S, BOTTERO J, MFUTILA KAYKAY F, PIALOUX G, BOUCHAUD O, ABGRALL S, GATEY C, WEISS L, PAVIE J, SALMON-CERON D, ZUCMAN D, LELIEVRE JD, PALICH R, SIMON A, MEYOHAS MC, GRAS J, CABIE A, PIRCHER M, MORLAT P, HESSAMFAR M, NEAU D, CAZENAVE C, GENET C, FAUCHER JF, MAKHLOUFI D, BOIBIEUX A, BREGIGEON-RONOT S, LAROCHE H, SAUTEREAU A, REYNES J, MAKINSON A, RAFFI F, BOLLENGIER-STRAGIER O, NAQVI A, CUA E, ROSENTHAL E, ARVIEUX C, BUZELE R, REY D, BATARD ML, BERNARD L, DELOBEL P, PIFFAUT M, VERDON R, PIROTH L, BLOT M, LECLERCQ P, SIGNORI-SCHMUCK A, HULEUX T, MEYBECK A, MAY T, MIAILHES P, PERPOINT T, GREDER-BELAN A, ELHARRAR B, KHUONG MA, POUPARD M, BLUM L, MICHAU C, PRAZUCK T, PHILIBERT P, SLAMA L, HIKOMBO H, DARASTEANU I, GIRARD PM, ALVAREZ JC, MATHEZ D, DE TRUCHIS P, LANDMAN R, MEYNARD JL, MORAND-JOUBERT L, LAMBERT S, LE DU D, PERRONNE C, ASSOUMOU L, COSTAGLIOLA D, MELCHIOR JC, DURACINSKI M, PETROV-SANCHEZ V, AMAT K, BENALYCHERIF A, SYLLA B, GELLEY A, GIBOWSKI S, LE MEUT G, THIEBAUT R, CLUMECK N, LECLERCQ V, CECCHERINI-SILBERSTEIN F, DECOSTER L, LAMAURY I, BANI-SADR F, FORCE G, CHABROL A, CABY F, PATEY O, FRESARD A, GAGNEUX-BRUNON A, CHIROUZE C, DUVIVIER C, LOURENCO J, TOLSMA V, JANSSEN C, LEROLLE N, CATALAN P, RAMI A, DE PONTHAUD L, PICHANCOURT G, NASRI S, LANDOWSKI S, BOTTERO J, MFUTILA KAYKAY F, PIALOUX G, BOUCHAUD O, ABGRALL S, GATEY C, WEISS L, PAVIE J, SALMON-CERON D, ZUCMAN D, LELIEVRE JD, PALICH R, SIMON A, MEYOHAS MC, GRAS J, CABIE A, PIRCHER M, MORLAT P, HESSAMFAR M, NEAU D, CAZENAVE C, GENET C, FAUCHER JF, MAKHLOUFI D, BOIBIEUX A, BREGIGEON-RONOT S, LAROCHE H, SAUTEREAU A, REYNES J, MAKINSON A, RAFFI F, BOLLENGIER-STRAGIER O, NAQVI A, CUA E, ROSENTHAL E, ARVIEUX C, BUZELE R, REY D, BATARD ML, BERNARD L, DELOBEL P, PIFFAUT M, VERDON R, PIROTH L, BLOT M, LECLERCQ P, SIGNORI-SCHMUCK A, HULEUX T, MEYBECK A, MAY T, MIAILHES P, PERPOINT T, GREDER-BELAN A, ELHARRAR B, KHUONG MA, POUPARD M, BLUM L, MICHAU C, PRAZUCK T, PHILIBERT P, SLAMA L, HIKOMBO H, DARASTEANU I, GIRARD PM, ALVAREZ JC, MATHEZ D, DE TRUCHIS P, LANDMAN R, MEYNARD JL, MORAND-JOUBERT L, LAMBERT S, LE DU D, PERRONNE C, ASSOUMOU L, COSTAGLIOLA D, MELCHIOR JC, DURACINSKI M, PETROV-SANCHEZ V, AMAT K, BENALYCHERIF A, SYLLA B, GELLEY A, GIBOWSKI S, LE MEUT G, THIEBAUT R, CLUMECK N, LECLERCQ V, CECCHERINI-SILBERSTEIN F, DECOSTER L. A 4-days-on and 3-days-off maintenance treatment strategy for adults with HIV-1 (ANRS 170 QUATUOR): a randomised, open-label, multicentre, parallel, non-inferiority trial. The Lancet HIV 2022; 9:e79-e90. [DOI: 10.1016/s2352-3018(21)00300-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/22/2021] [Accepted: 11/11/2021] [Indexed: 12/31/2022]
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Herrmann S, Power B, Rashidi A, Cypher M, Mastaglia F, Grace A, McKinnon E, Sarrot P, Michau C, Skinner M, Desai R, Duracinsky M. Supporting Patient-Clinician Interaction in Chronic HIV Care: Design and Development of a Patient-Reported Outcomes Software Application. J Med Internet Res 2021; 23:e27861. [PMID: 34328442 PMCID: PMC8367117 DOI: 10.2196/27861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/19/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The consideration of health-related quality of life (HRQL) is a hallmark of best practice in HIV care. Information technology offers an opportunity to more closely engage patients with chronic HIV infection in their long-term management and support a focus on HRQL. However, the implementation of patient-reported outcome (PRO) measures, such as HRQL in routine care, is challenged by the need to synthesize data generated by questionnaires, the complexity of collecting data between patient visits, and the integration of results into clinical decision-making processes. OBJECTIVE Our aim is to design and pilot-test a multimedia software platform to overcome these challenges and provide a vehicle to increase focus on HRQL issues in HIV management. METHODS A multidisciplinary team in France and Australia conducted the study with 120 patients and 16 doctors contributing to the design and development of the software. We used agile development principles, user-centered design, and qualitative research methods to develop and pilot the software platform. We developed a prototype application to determine the acceptability of the software and piloted the final version with 41 Australian and 19 French residents using 2 validated electronic questionnaires, the Depression, Anxiety and Stress Scale-21 Items, and the Patient Reported Outcomes Quality of Life-HIV. RESULTS Testing of the prototype demonstrated that patients wanted an application that was intuitive and without excessive instruction, so it felt effortless to use, as well as secure and discreet. Clinicians wanted the PRO data synthesized, presented clearly and succinctly, and clinically actionable. Safety concerns for patients and clinicians included confidentiality, and the potential for breakdown in communication if insufficient user training was not provided. The final product, piloted with patients from both countries, showed that most respondents found the application easy to use and comprehend. The usability testing survey administered found that older Australians had reduced scores for understanding the visual interface (P=.004) and finding the buttons organized (P=.02). Three-fourths of the respondents were concerned with confidentiality (P=.007), and this result was more prevalent in participants with higher anxiety and stress scores (P=.01), as measured by the Depression, Anxiety and Stress Scale-21 Items. These statistical associations were not observed in 15 French patients who completed the same questionnaire. CONCLUSIONS Digital applications in health care should be safe and fit for purpose. Our software was acceptable to patients and shows potential to overcome some barriers to the implementation of PROs in routine care. The design of the clinicians' interface presents a solution to the problem of voluminous data, both synthesizing and providing a snapshot of longitudinal data. The next stage is to conduct a randomized controlled trial to determine whether patients experience increased satisfaction with care and whether doctors perceive that they deliver better clinical care without compromising efficiency.
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Affiliation(s)
- Susan Herrmann
- Medical School, University of Western Australia, Crawley, Australia
| | - Brad Power
- College of Arts, Business, Law & Social Sciences, Murdoch University, Murdoch, WA, Australia
| | - Amineh Rashidi
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Mark Cypher
- College of Arts, Business, Law & Social Sciences, Murdoch University, Murdoch, WA, Australia
| | - Frank Mastaglia
- College of Arts, Business, Law & Social Sciences, Murdoch University, Murdoch, WA, Australia
| | - Amy Grace
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, Australia
| | | | - Pierre Sarrot
- Patient-Centered Outcomes Research, Health Economics Clinical Trial Unit, Hospital Hotel-Dieu, AP-HP, University de Paris, Paris, France
| | | | | | - Renae Desai
- Perron Institute for Neurological & Translational Science, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia
| | - Martin Duracinsky
- Patient-Centered Outcomes Research, Health Economics Clinical Trial Unit, Hospital Hotel-Dieu, AP-HP, University de Paris, Paris, France.,Department of Internal Medicine & Immunology, Hospital Bicetre, AP-HP, Kremlin-Bicetre, France
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Farfour E, Dimi S, Chassany O, Fouéré S, Valin N, Timsit J, Ghosn J, Duvivier C, Duracinsky M, Zucman D. Trends in asymptomatic STI among HIV-positive MSM and lessons for systematic screening. PLoS One 2021; 16:e0250557. [PMID: 34166379 PMCID: PMC8224955 DOI: 10.1371/journal.pone.0250557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 04/11/2021] [Indexed: 11/18/2022] Open
Abstract
The burden of STIs is particularly high in HIV-infected MSM patients. A recent increase in STIs prevalence has been noticed in the US and western European countries. We aim to assess trends in asymptomatic STIs following the publication of recommendations for STIs screening, i.e. Chlamydia (CT) and gonorrhea (NG). Seventeen centers located in the Paris area participated in the study. All asymptomatic HIV-infected MSM patients attending a follow up consultation were proposed to participated in the study. Asymptomatic patients were included over 2 periods: period 1 from April to December 2015 and period 2 from September to December 2017. Etiologic diagnosis of STIs including hepatitis B, C, syphilis, was performed using a serological test, including a non-treponemal titer with a confirmatory treponemal assay for syphilis. CT and NG were screened using a nucleic acid amplification test (NAATs) on 3 anatomical sites, i.e. urine, rectal and pharyngeal. Overall, 781 patients were included: 490 and 291 in periods 1 and 2 respectively. Asymptomatic CT, NG, and syphilis were diagnosed in 7.5%, 4.8% and, 4.2% respectively. The rate of patients having a multisite asymptomatic infection was 10.2% and 21.1% for CT and NG respectively. The most frequently involved anatomical sites for CT and NG asymptomatic infections were anorectal (66.1% and 55.2% respectively) and pharyngeal (47.4% and 60.5% respectively). CT and NG asymptomatic infection increased by 1.3- and 2-fold respectively between the two periods while syphilis decreased by 3 folds. Our results encourage to reconsider multisite screening for CT and NG in asymptomatic HIV positive MSM as the yield of screening urinary samples only might be low. Despite the more systematic STI screening of asymptomatic HIV positive MSM the prevalence of STI is increasing in MSM in France. Therefore, this strategy has not led to alter CT and NG transmission. The decrease of syphilis might involve self-medication by doxycycline, and the intensification of syphilis screening.
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Affiliation(s)
- Eric Farfour
- Service de Biologie Clinique, Hôpital Foch, Suresnes, France
| | - Svetlane Dimi
- Centre de Vaccinations Internationales et Médecine de Voyage, Creil, France
| | - Olivier Chassany
- Patient-Reported Outcomes Research, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France.,Unité de Recherche Clinique en Economie de la Santé, Hôpital Hôtel-Dieu, Assistance Publique Hôpital de Paris, Paris, France
| | - Sébastien Fouéré
- Centre for Genital and Sexually Transmitted Diseases, Dermatology Department, APHP Hospital Saint-Louis, Paris, France
| | - Nadia Valin
- Hôpital Saint Antoine, Service des Maladies Infectieuses, Paris, France
| | - Julie Timsit
- Centre for Genital and Sexually Transmitted Diseases, Dermatology Department, APHP Hospital Saint-Louis, Paris, France
| | - Jade Ghosn
- Assistance Publique-Hôpitaux de Paris, Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Paris Nord Val de Seine, Site Bichat-Claude Bernard, Paris, France.,INSERM UMR 1137 IAME, PRES Sorbonne Paris Cité, Université Paris Diderot, Paris, France
| | - Claudine Duvivier
- APHP-Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France.,IHU Imagine, Paris, France.,Institut Cochin, CNRS 8104, INSERM U1016, RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France.,Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Research, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France.,Unité de Recherche Clinique en Economie de la Santé, Hôpital Hôtel-Dieu, Assistance Publique Hôpital de Paris, Paris, France.,Médecine Interne et Immunologie Clinique, Hôpital Bicêtre, Assistance Publique Hôpital de Paris, Paris, France
| | - David Zucman
- Réseau Ville-Hôpital, Service de Médecine Interne, Hôpital Foch, Suresnes, France
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Péretz F, Bonini-Vuillod J, Grivaux M, Duracinsky M, Chassany O. [Letter to the editor regarding the article entitled "COVID-19 and medical publications: How three articles have influenced the media and public decisions in France." - Reply]. Rev Med Interne 2021; 42:593. [PMID: 33966902 DOI: 10.1016/j.revmed.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
- F Péretz
- Abelia Science, 1 allée des Sablons, 89000 Saint-Georges-sur-Baulche, France.
| | - J Bonini-Vuillod
- Abelia Science, 1 allée des Sablons, 89000 Saint-Georges-sur-Baulche, France
| | - M Grivaux
- Centre de recherche clinique, Hôpital de Meaux, 77100 Meaux, France
| | - M Duracinsky
- Département de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Unité de Recherche Clinique en Economie de la Santé, URC-ECO, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Patient-Centered Outcomes Research, UMR 1123, Université Paris-Inserm, Paris, France
| | - O Chassany
- Unité de Recherche Clinique en Economie de la Santé, URC-ECO, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Patient-Centered Outcomes Research, UMR 1123, Université Paris-Inserm, Paris, France
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Thonon F, Perrot S, Yergolkar AV, Rousset-Torrente O, Griffith JW, Chassany O, Duracinsky M. Electronic Tools to Bridge the Language Gap in Health Care for People Who Have Migrated: Systematic Review. J Med Internet Res 2021; 23:e25131. [PMID: 33955837 PMCID: PMC8138704 DOI: 10.2196/25131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND People who have migrated or with a language barrier may face significant hurdles in accessing health care. Some apps have been specifically developed to facilitate the dialogue between health care professionals and people who have migrated who have low-level language proficiency or to promote health among people who have migrated. OBJECTIVE We conducted a systematic review to investigate development, acceptability, and effectiveness of these types of apps. METHODS We conducted a search of PubMed, Scopus, and Embase databases. We included all study designs (qualitative, quantitative, mixed) reporting development, evaluation of efficacy, or acceptability of apps facilitating dialogue with a health professional or promoting health for people who have migrated, minorities, or tourists with a language barrier, using any outcome. Two researchers selected the studies independently. We collected general information about the app, information about health literacy and cultural adaptation, information about the development of the app, evidence on acceptability or efficacy, and information on app use. Data were collected by 2 researchers independently and results were reviewed to verify agreement and reported according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis). RESULTS Positive results for translation apps included better communication, but with possible limitations, and reduced consultation time. Positive results for health promotion apps included improved quality of life and better management of chronic illnesses. CONCLUSIONS Overall, the apps had good levels of acceptability, though only half had their efficacy evaluated. In those evaluations, the endpoints were mostly related to reported behavior change and knowledge improvement, which is common for evaluations of health promotion programs. In the future, as more health apps are created, it is essential that apps that claim to have a public health objective undergo a rigorous evaluation of their acceptability, efficacy, and actual use. Indicators of outcomes beyond changes in behavior and knowledge should be reported; change in health status or access to care should also be reported. This systematic review has helped us note the characteristics associated with improved acceptability and efficacy, which can be helpful for the development of future apps.
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Affiliation(s)
- Frédérique Thonon
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Swati Perrot
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
| | | | - Olivia Rousset-Torrente
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - James W Griffith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, F94270, Le Kremlin Bicêtre, France
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Thonon F, Fahmi S, Rousset-Torrente O, Bessonneau P, Griffith JW, Brown C, Chassany O, Duracinsky M. Promoting HIV, Hepatitis B Virus, and Hepatitis C Virus Screening Among Migrants With a Language Barrier: Protocol for the Development and Evaluation of an Electronic App (Apidé). JMIR Res Protoc 2021; 10:e22239. [PMID: 33949963 PMCID: PMC8135028 DOI: 10.2196/22239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022] Open
Abstract
Background Late diagnoses of HIV, hepatitis B, and hepatitis C are important public health problems that affect the population at large and migrants in particular. Missed opportunities of HIV and hepatitis screening are numerous, with language differences being a significant barrier to testing. Several studies have shown that migrants who do not speak the language of the health provider are less likely to get tested, due to health providers’ reluctance to offer a test and to migrants’ reluctance to accept testing. Objective The aim of our study is to develop a multilingual electronic tool (app) that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier and to evaluate its acceptability and impact in terms of public health. Methods The study will go through 3 stages: (1) concept development, (2) app development, and (3) app evaluation. A qualitative study has been undertaken to explore language barriers during health care encounters and their effect on communication, specifically when a screening test is offered. In parallel, a systematic review of the literature was conducted to have a comprehensive overlook of electronic tools designed to help health care providers communicate with migrants with a language barrier. To generate a list of items to be translated for inclusion in the app, we will conduct a focus group and Delphi survey. The development of the app will include translation and voice recording of items. The electronic development will also include 3 steps of user testing. The acceptability of the app will be evaluated using the System Usability Scale. Evaluation of the app’s efficacy will consist of a stepped wedge randomized controlled trial. The study will be carried out in 16 centers that treat migrants and offer them screening tests for infectious diseases. The primary outcome is the percentage of screening tests realized. The secondary outcomes are the rate of screening proposal by health professionals, acceptance rate by migrants, number of positive cases using this app, and frequency of use of the app. Results The app evaluation study received a 3-year grant from the Agence Nationale de la Recherche contre le SIDA et les hépatites virales (ANRS) and from the Office Français de l’Immigration et Intégration (OFII). At the time of publication of this protocol, the initial qualitative study and systematic literature review were completed. Conclusions This study will develop an app that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier and measure its acceptability and effectiveness in terms of public health. When completed, this app could be distributed to numerous professionals carrying out screening with migrant populations in various health care settings. International Registered Report Identifier (IRRID) PRR1-10.2196/22239
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Affiliation(s)
- Frédérique Thonon
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Saleh Fahmi
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
| | - Olivia Rousset-Torrente
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Pascal Bessonneau
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - James W Griffith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Carter Brown
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
| | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, F94270, Le Kremlin-Bicêtre, France
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Chaumont S, Quinquis L, Monnerie B, Six C, Hebel P, Duracinsky M, Chassany O, Le Nevé B. Une alimentation de moindre qualité nutritionnelle est associée à des symptômes digestifs plus fréquents affectant la qualité de vie des adultes Français. NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Péretz F, Bonini-Vuillod J, Grivaux M, Duracinsky M, Chassany O. [COVID-19 and medical publications: How three articles have influenced the media and public decisions in France]. Rev Med Interne 2021; 42:583-590. [PMID: 33771408 PMCID: PMC7986470 DOI: 10.1016/j.revmed.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/20/2021] [Accepted: 03/13/2021] [Indexed: 11/19/2022]
Abstract
Cet article détaille le processus et les aléas de publication de trois articles se rapportant au SARS-CoV-2 et à la maladie qu’il provoque (COVID-19). Ces trois articles ont été publiés à un mois d’intervalle, entre mars et mai 2020. Leur médiatisation a conduit les autorités de santé françaises à intervenir. Notre article ne s’intéresse pas et n’évalue pas la qualité scientifique des articles présentés, mais a pour unique objectif d’ouvrir la réflexion sur la publication médicale. En décrivant ces trois cas particuliers, il soulève des questions sur la rétractation des articles, l’évaluation par les pairs, la prépublication, la paternité des articles, et la diffusion des informations scientifiques médicales y compris via les médias de masse. Il discute des nouveaux modes d’édition qui se profilent et de la diffusion des informations publiées en recherche clinique.
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Affiliation(s)
- F Péretz
- Abelia Science, 1, allée des Sablons, 89000 Saint-Georges-sur-Baulche, France.
| | - J Bonini-Vuillod
- Abelia Science, 1, allée des Sablons, 89000 Saint-Georges-sur-Baulche, France
| | - M Grivaux
- Centre de recherche clinique, hôpital de Meaux, 77100 Meaux, France
| | - M Duracinsky
- Département de médecine interne et d'immunologie clinique, hôpital Bicêtre, Assistance Publique-hôpitaux de Paris (AP-HP), Paris, France; Unité de recherche clinique en economie de la santé, URC-ECO, hôpital Hôtel-Dieu, AP-HP, Paris, France; Patient-centered outcomes research, UMR 1123, université Paris-Inserm, Paris, France
| | - O Chassany
- Unité de recherche clinique en economie de la santé, URC-ECO, hôpital Hôtel-Dieu, AP-HP, Paris, France; Patient-centered outcomes research, UMR 1123, université Paris-Inserm, Paris, France
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Huntingdon B, Muscat DM, de Wit J, Duracinsky M, Juraskova I. Factors Associated with General Sexual Functioning and Sexual Satisfaction among People Living with HIV: A Systematic Review. J Sex Res 2020; 57:824-835. [PMID: 31755793 DOI: 10.1080/00224499.2019.1689379] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual difficulties, experienced by half of the people living with HIV (PLWH), not only affect quality of life but have been associated with lower adherence to antiretroviral medication. This systematic review synthesizes studies published since 1997 which used statistical methods to investigate factors associated with general sexual functioning or sexual satisfaction of PLWH. We searched Medline, PsycINFO, Embase, Cinahl and Scopus with terms: HIV AND sexual dysfunction AND factors. Of 5552 records, 26 studies met selection criteria. Twenty-one studies on general sexual function, and five studies on sexual satisfaction. Two researchers separately extracted data and applied standardized quality assessment criteria. (Registration: CRD42018094146.) Regarding general sexual dysfunction, older age, general physical health, depression, body image and psychological distress were the most relevant factors. There was inconsistent evidence for: CD4, viral load, HIV symptom severity, HIV disease progression and time since diagnosis. From limited available evidence on sexual satisfaction, age, unemployment, and psychosocial factors were significant. Overall, anxiety and relational factors were under-researched, treatment center studies were over-represented and non-validated measurement of outcomes was common. Future research is required to build theoretical models of sexual well-being specific to PLWH to guide effective research and intervention to promote sexual quality of life of PLWH.
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Affiliation(s)
- Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney
| | - Danielle Marie Muscat
- Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, The University of Sydney
| | - John de Wit
- Centre for Social Research in Health, UNSW Sydney
- Department of Interdisciplinary Social Science, Utrecht University
| | - Martin Duracinsky
- Patient-Centered Outcomes Research, Université Paris-Diderot, Sorbonne Paris Cité
- Service de Médecine Interne et d'Immunologie Clinique, Hospital Bicetre , France
- Unité de Recherche Clinique (URC-ECO), Hospital Hotel-Dieu
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney
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Huntingdon B, de Wit J, Duracinsky M, Juraskova I. The current state of qualitative research on sexual functioning with HIV in developed nations: a thematic synthesis. Sexual and Relationship Therapy 2020. [DOI: 10.1080/14681994.2018.1543944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
| | - John de Wit
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Martin Duracinsky
- Sorbonne Paris Cité, Université Paris-Diderot, France Patient-Centered Outcomes Research, Paris, France
- Service de Médecine Interne et d’Immunologie Clinique, hopital Bicetre, Kremlin-Bicetre, France
- Unité de recherche clinique (URC-ECO), hopital Hotel-Dieu, Paris, France
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, Australia
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Duracinsky M, Thonon F, Bun S, Ben Nasr I, Dara AF, Lakhdari S, Coblentz-Baumann L, Lert F, Dimi S, Chassany O. Good acceptability of HIV, HBV, and HCV screening during immigration medical check-up amongst migrants in France in the STRADA study. PLoS One 2020; 15:e0235260. [PMID: 32589652 PMCID: PMC7319329 DOI: 10.1371/journal.pone.0235260] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/11/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction The prevalence of HIV, hepatitis B, and hepatitis C amongst migrants in France is high. Thus, effective screening and follow-up is needed. The mandatory medical check-up for residency application is an opportunity to offer rapid HIV and hepatitis testing. The main objective of the STRADA study is to create a feasible and acceptable screening strategy for migrants. Within the STRADA study, this qualitative research examined the acceptability of conducting screening tests in the context of residency application. Methods We conducted a qualitative study amongst legal migrants over 18 years of age with sufficient knowledge of the French, English, or Arabic language. Interviews were performed following a semi-structured interview guide of open-ended questions. Interviews were transcribed verbatim and subsequently analyzed through thematic analysis. Results We interviewed 34 migrants. Mean age was 32.6 (min-max: 19, 59) years. The participants’ region of origin was mostly Sub-Saharan Africa and the main reason for migrating to France was family reunification. Migrants' acceptability of HIV and hepatitis testing was high. Participants who accepted testing indicated a benefit for individual health and to avoid transmission. Most preferred rapid tests; reluctance was related to anxiety about the immediate results and the perceived reliability of rapid tests. Migrants' knowledge about HIV was satisfactory, but inadequate for hepatitis. Screening in the context of a compulsory medical visit did not present an obstacle for acceptability. Some expressed concern in the case of HIV but when explained, the independence between obtaining the residence permit along with screening and access to medical care was well understood. Discussion Medical check-ups at immigration centers is an opportunity to screen for HIV and hepatitis which is considered acceptable by migrants. Informing migrants that test results do not affect residency applications, and incorporating their preferences, are all important to optimize the acceptability of screening.
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Affiliation(s)
- Martin Duracinsky
- Université Paris-Diderot & Inserm, UMR1123, Patient-Centered Outcomes Research, Paris, France
- Hôpital Bicêtre, Service d’infectiologie, Le Kremlin Bicêtre, France
- AP-HP, hôpital Hôtel-Dieu, Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Paris, France
- * E-mail:
| | - Frédérique Thonon
- Université Paris-Diderot & Inserm, UMR1123, Patient-Centered Outcomes Research, Paris, France
| | - Sonia Bun
- Université Paris-Diderot & Inserm, UMR1123, Patient-Centered Outcomes Research, Paris, France
| | - Imène Ben Nasr
- Université Paris-Diderot & Inserm, UMR1123, Patient-Centered Outcomes Research, Paris, France
| | - Aïchata Fofana Dara
- Université Paris-Diderot & Inserm, UMR1123, Patient-Centered Outcomes Research, Paris, France
| | - Sabrina Lakhdari
- Université Paris-Diderot & Inserm, UMR1123, Patient-Centered Outcomes Research, Paris, France
| | | | - France Lert
- Agence nationale de recherche sur le sida et les hépatites virales (ANRS), Paris, France
| | - Svetlane Dimi
- Hôpital Foch, Service d’Hépatologie, Suresnes, France
| | - Olivier Chassany
- Université Paris-Diderot & Inserm, UMR1123, Patient-Centered Outcomes Research, Paris, France
- AP-HP, hôpital Hôtel-Dieu, Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Paris, France
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Huntingdon B, de Wit J, Duracinsky M, Juraskova I. Belief, Covariates, and Impact of the "Undetectable = Untransmittable" Message Among People Living with HIV in Australia. AIDS Patient Care STDS 2020; 34:205-212. [PMID: 32396476 DOI: 10.1089/apc.2019.0300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is effectively no risk of transmission of HIV from an HIV-positive person with consistent undetectable viral load (UDVL) to an HIV-negative person during sex. This has been publicly disseminated by an international health campaign called "undetectable = untransmittable" (U = U). This study extends previous research by examining confidence in the U = U message and potential covariates of confidence in U = U, as well as by assessing the perceived personal risk and sexual outcomes in a sample of people living with HIV (PLWH) in Australia. Between October 2017 and June 2018, 139 adult PLWH were recruited through clinics or community-based strategies. They completed an online questionnaire assessing participant characteristics, general agreement with the U = U message, confidence in U = U as an effective HIV prevention strategy, perceived personal risk of onward transmission, and sexual outcomes. While the majority of participants (70.5%) agreed with the general U = U message, only 48.2% were confident in U = U as an effective HIV transmission prevention strategy across sexual situations. Lack of confidence in U = U was more pronounced in the community subsample, minority group participants, and lower educated participants. A minority of PLWH with self-reported UDVL thought they could pass on HIV and indicated poor sexual outcomes, including sexual inactivity, reduced frequency of sex, and reduced sexual satisfaction. General agreement with the U = U message among PLWH may mask lack of confidence in U = U. Community-based information and education tailored to culturally diverse groups and people with low health literacy are required to promote accurate perception of risk of transmission of HIV with consistent UDVL.
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Affiliation(s)
- Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
| | - John de Wit
- Center for Social Research in Health, UNSW Sydney, Sydney, Australia
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Martin Duracinsky
- Hopital Hotel-Dieu, Unité de Recherche Clinique (URC-ECO), Paris, France
- EA 7334, Patient-Centered Outcomes Research, Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hopital Bicetre, Kremlin-Bicetre, France
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
- School of Psychology, Center for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, Australia
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Chérin P, Pindi Sala T, Clerson P, Dokhan A, Fardini Y, Duracinsky M, Crave JC, Chassany O. Recovering autonomy is a key advantage of home-based immunoglobulin therapy in patients with myositis: A qualitative research study. Medicine (Baltimore) 2020; 99:e19012. [PMID: 32049796 PMCID: PMC7035045 DOI: 10.1097/md.0000000000019012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Immunoglobulins are 2nd or 3rd-line treatments in dermatomyositis (DM) or polymyositis (PM) refractory to high-dose corticosteroids and immunosuppressants. Immunoglobulins (2 g/kg/mo) are usually administered intravenously (IVIg) once a month and the patients stay at hospital for a few days. Recently, subcutaneous injections (SCIg) were proposed 2 to 3 times per week, in some dysimmune diseases. SCIg are administered at home preferably by the patient or by a nurse. We investigated the needs and attitudes of DM and PM patients with experience of IVIg and SCIg.Seven patients (6 PM and 1 DM) from a single center participated in a focus group (N = 6) or underwent in-depth interview (N = 1). Six had the experience of both IVIg at hospital and SCIg at home; 1 has received only IVIg at hospital. Verbatim was recorded and transcribed for further content analysis and computer-aided textual analysis.Clinical profiles and stories were heterogeneous. At diagnosis, muscle weakness, severe pain, and fatigue were at the forefront of patients' complaints impairing daily life. Patients reported considerable improvement with immunoglobulins. SCIg were described as easy, less disruptive for daily life, well tolerated, and less time-consuming. SCIg self-administration at home restored the feeling of autonomy and control.Interviews of DM and PM patients revealed that recovering autonomy and control was a central advantage of home-based SCIg that were efficient, well tolerated, and perceived as a good compromise between treatment burden and efficacy.
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Affiliation(s)
- Patrick Chérin
- Department of Internal Medicine and Clinical Immunology, La Pitié Salpétrière Hospital
| | | | | | | | | | | | | | - Olivier Chassany
- University Paris-Diderot, Patient-Centered Outcomes Research, Paris
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Huntingdon B, Sharpe L, de Wit J, Duracinsky M, Juraskova I. A new grounded theory model of sexual adjustment to HIV: facilitators of sexual adjustment and recommendations for clinical practice. BMC Infect Dis 2020; 20:31. [PMID: 31931733 PMCID: PMC6958581 DOI: 10.1186/s12879-019-4727-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Life expectancy of people living with HIV (PLWH) is increasing. Effective biomedical prevention methods (treatment as prevention and preexposure prophylaxis) are being widely implemented in high-income nations. Therefore, research into quality of life, including sexual adjustment, is of increasing importance to HIV care. Yet, sexual adjustment of PLWH has been neglected in past research. We propose a new model of sexual adjustment to HIV which explores the dynamic process, facilitators and barriers characterising sexual life of PLWH overtime. METHOD Thirty PLWH (19 male, 11 female) recruited from two HIV treatment centres as well as community groups, completed semi-structured interviews which were audio-recorded and transcribed verbatim for analysis using grounded theory. RESULTS The model of sexual adjustment to HIV is the first to establish how undue fears of transmission of HIV during sex and/or fear of rejection by sexual partners determine initial sexual behaviour after diagnosis and also sexual adjustment over time. Within the model, sexual adjustment to HIV is facilitated by factors which assist PLWH to overcome such fears, including: partner acceptance, peer, community and health professional support, and accurate knowledge of risk of transmission including of undetectable viral load and pre-exposure prophylaxis. Adjustment is inhibited when undue fears of transmission and of rejection persist long term, resulting in maladaptive behaviours to cope with such fears including avoidance of sex and problematic drug and alcohol use. CONCLUSION This model offers clear directions for promoting sexual adjustment to HIV. Health professionals should: (a) assess and intervene for sexual quality of life (not just risk) among PLWH; (b) be aware that serosorting facilitates adjustment in the short to medium term, but may interfere with adjustment long-term, (c) promote opportunities for positive connection between PLWH, and (d) intervene directly with PLWH and HIV negative sexual partners to promote accurate risk of transmission knowledge, including how this applies to their own sexual practices, and whether they are experiencing undue fear of transmission over time.
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Affiliation(s)
- Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Brennan MacCallum Building (A18), NSW, Sydney, Australia.
| | - Louise Sharpe
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Brennan MacCallum Building (A18), NSW, Sydney, Australia
| | - John de Wit
- Centre for Social Research in Health, UNSW Sydney, Kensington, NSW, Australia
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Martin Duracinsky
- Sorbonne Paris Cité, EA 7334, Patient-Centered Outcomes Research, Université Paris-Diderot, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hopital Bicetre, Kremlin-Bicetre, France
- Unité de Recherche Clinique (URC-ECO), hopital Hotel-Dieu, Paris, France
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Brennan MacCallum Building (A18), NSW, Sydney, Australia
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, Australia
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Jaunay LB, Zerr P, Peguin L, Renouard L, Ivanoff AS, Picard H, Griffith J, Chassany O, Duracinsky M. Development and Evaluation of a New Serious Game for Continuing Medical Education of General Practitioners (Hygie): Double-Blinded Randomized Controlled Trial. J Med Internet Res 2019; 21:e12669. [PMID: 31746775 PMCID: PMC6893567 DOI: 10.2196/12669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/17/2019] [Accepted: 07/19/2019] [Indexed: 11/14/2022] Open
Abstract
Background Continuing medical education is important but time-consuming for general practitioners (GPs). Current learning approaches are limited and lack the ability to engage some practitioners. Serious games are new learning approaches that use video games as engaging teaching material. They have significant advantages in terms of efficiency and dissemination. Objective The aim of this study was to create a serious game and to evaluate it in terms of effectiveness and satisfaction, comparing it with a traditional method of continuing education—article reading. Methods We produced a prototype video game called Hygie on the 5 most common reasons of consultation in general practice using 9 articles from independent evidence-based medicine journals (reviews from Prescrire and Minerva). We created 51 clinical cases. We then conducted a double-blinded randomized trial comparing the learning provided by a week of access to the game versus source articles. Participants were GPs involved as resident supervisors in 14 French university departments of family practice, recruited by email. Primary outcomes were (1) mean final knowledge score completed 3 to 5 weeks after the end of the intervention and (2) mean difference between knowledge pretest (before intervention) and posttest (3 to 5 weeks after intervention) scores, both scaled on 10 points. Secondary outcomes were transfer of knowledge learned to practice, satisfaction, and time spent playing. Results A total of 269 GPs agreed to participate in the study. Characteristics of participants were similar between learning groups. There was no difference between groups on the mean score of the final knowledge test, with scores of 4.9 (95% CI 4.6-5.2) in the Hygie group and 4.6 (95% CI 4.2-4.9) in the reading group (P=.21). There was a mean difference score between knowledge pre- and posttests, with significantly superior performance for Hygie (mean gain of 1.6 in the Hygie group and 0.9 in the reading group; P=.02), demonstrating a more efficient and persistent learning with Hygie. The rate of participants that reported to have used the knowledge they learned through the teaching material was significantly superior in the Hygie group: 77% (47/61) in the Hygie group and 53% (25/47) in the reading group; odds ratio 2.9, 95% CI 1.2-7.4. Moreover, 87% of the opinions were favorable, indicating that Hygie is of interest for updating medical knowledge. Qualitative data showed that learners enjoyed Hygie especially for its playful, interactive, and stimulating aspects. Conclusions We conclude that Hygie can diversify the offering for continuing education for GPs in an effective, pleasant, and evidence-based way. Trial Registration ClinicalTrials.gov NCT03486275; https://clinicaltrials.gov/ct2/show/NCT03486275
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Affiliation(s)
- Louis-Baptiste Jaunay
- Département de Médecine Générale, Sorbonne Paris Cité, Université Paris-Descartes, Paris, France.,Département de Médecine Générale, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - Philippe Zerr
- Département de Médecine Générale, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - Lino Peguin
- Département de Médecine Générale, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - Léandre Renouard
- Département de Médecine Générale, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - Anne-Sophie Ivanoff
- Département de Médecine Générale, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - Hervé Picard
- Service de Recherche Clinique, Fondation Rothschild, Paris, France.,Pole Recherche et Evaluation Scientifique, Cabinet Ipso, Paris, France
| | - James Griffith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Olivier Chassany
- Patient-Reported Outcomes Research, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France.,Unité de Recherche Clinique en Economie de la Santé, Hôpital Hôtel-Dieu, Assistance Publique Hôpital de Paris, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Research, Sorbonne Paris Cité, Université Paris-Diderot, Paris, France.,Unité de Recherche Clinique en Economie de la Santé, Hôpital Hôtel-Dieu, Assistance Publique Hôpital de Paris, Paris, France.,Médecine Interne et Immunologie Clinique, Hôpital Bicêtre, Assistance Publique Hôpital de Paris, Paris, France
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Roux P, Marcellin F, Ndiaye K, Suzan-Monti M, Mayet A, Duracinsky M, Briand-Madrid L, Maradan G, Mora M, Préau M, Verger P, Carrieri P, Dray-Spira R, Spire B. Posttraumatic Stress Disorder as a Significant Correlate of Voluntary Antiretroviral Treatment Interruption in Adult HIV-Infected Patients Followed up in French Hospitals: Data From the ANRS-VESPA2 National Survey. J Clin Psychiatry 2019; 79. [PMID: 29659208 DOI: 10.4088/jcp.17m11659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/11/2017] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Although antiretroviral treatment (ART) no longer requires 100% adherence, voluntary treatment interruption (VTI) still may have a negative impact on virologic success. Previous studies have shown that posttraumatic stress disorder (PTSD) is more prevalent in HIV-infected patients than in the general population. However, no study has yet investigated the relationship between PTSD and VTI. We analyzed this relationship using data from a French national survey representative of HIV-infected adults followed up in hospitals. METHODS A total of 3,022 HIV-infected adults participated in the ANRS-VESPA2 survey (April 2011-January 2012) and answered a face-to-face questionnaire that included the Composite International Diagnostic Interview Short-Form to diagnose PTSD and assess sociobehavioral variables such as VTI. Multivariable logistic regression models were used to study the relationship between PTSD and VTI. RESULTS Among the 2,768 ART-treated participants with available data for both PTSD screening and ART interruption (study sample), prevalence of PTSD was 13.3%, and 7.2% of individuals reported VTI during the previous month. After adjustment for being a female Sub-Saharan African immigrant and reporting harmful alcohol consumption (Alcohol Use Disorders Identification Test score ≥ 8), lifetime PTSD was found to be independently associated with VTI (adjusted odds ratio [95% CI] = 1.64 [1.07-2.53], P = .025). CONCLUSIONS PTSD is highly prevalent in HIV-infected patients followed up in French hospitals and is a significant predictor of VTI. PTSD is a psychiatric disorder that is still underdiagnosed and undertreated in many countries despite its negative consequences on health behaviors. As there is evidence of effective treatment for PTSD, HIV care providers need to be trained in screening for this disorder.
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Affiliation(s)
- Perrine Roux
- Inserm UMR-S912, IHU-Méditerranée Infection, 19-21 Blvd Jean Moulin, 13005 Marseille, France. .,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Khadim Ndiaye
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marie Suzan-Monti
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Aurélie Mayet
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,Centre d'Épidémiologie et de Santé Publique des Armées, Marseille, France
| | - Martin Duracinsky
- EA 7334 REMES, Patient-Centered Outcomes Research, Sorbonne Paris Cité, Paris-Diderot University, Paris, France.,URC-ECO, Hôpital Hôtel-Dieu, AP-HP, Paris, France.,Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, AP-HP, Kremlin-Bicêtre, France
| | - Laélia Briand-Madrid
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaëlle Maradan
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marie Préau
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,Groupe de Recherche en Psychologie Sociale, Université Lyon 2, Lyon, France
| | - Pierre Verger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Rosemary Dray-Spira
- INSERM, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in Social Epidemiology, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in Social Epidemiology, Paris, France
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Huntingdon B, Muscat DM, de Wit J, Duracinsky M, Juraskova I. Factors associated with erectile dysfunction among men living with HIV: a systematic review. AIDS Care 2019; 32:275-285. [PMID: 31394923 DOI: 10.1080/09540121.2019.1653443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Erectile dysfunction (ED) is more prevalent among men with HIV than HIV negative men. This study systematically reviewed quantitative studies published since 1997 which sampled men with HIV to examine factors associated with ED. Searches on PsycINFO, Medline, Scopus, Embase and Cinahl databases produced 5552 records, and 14 studies met inclusion criteria. Two researchers independently extracted data and assessed the quality studies using standardized criteria. Age and depression were found to be significantly associated with ED. Importantly, factors unique to HIV emerged as consistently significant across studies, including time on antiretroviral medication and protease inhibitor medication use. However, these relate to organic cause factors associated with ED only. Only four studies examined social factors with inconsistent findings. There was a paucity of research related to psychosocial factors associated with ED. This systematic review used a broad search strategy employed across multiple data-bases, however, it is limited by the over-representation of treatment centre based studies conducted in high-income nations. Future research should examine psychosocial factors, such as undue fear of transmission of HIV or fear of rejection by a sexual partner and develop a psychosocial model of sexual difficulties with HIV, from which casual hypotheses can be derived and tested.
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Affiliation(s)
- Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Danielle Marie Muscat
- Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, The University of Sydney, Sydney, NSW, Australia
| | - John de Wit
- Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia.,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Martin Duracinsky
- Patient-Centered Outcomes Research, Université Paris-Diderot, Paris, France.,Service de Médecine Interne et d'Immunologie Clinique, Hopital Bicetre, Kremlin-Bicetre, France.,Unité de recherche clinique (URC-ECO), Hopital Hotel-Dieu, Paris, France
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), The University of Sydney, Sydney, NSW, Australia
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Carrieri P, Duracinsky M, Marcellin F, Lazarus JV. Letter to the Editor: Patient-Reported Outcomes for Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis: Rationale for Expanded Use. Hepatology 2019; 70:443-444. [PMID: 30472796 DOI: 10.1002/hep.30356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Martin Duracinsky
- AP-HP, Bicetre Hospital, Internal Medicine and Clinical Immunology Department, Le Kremlin-Bicetre, France.,AP-HP, Hotel-Dieu Hospital, Health Economics Clinical Trial Center, Paris, France.,University Paris-Diderot, Patient-Centered Outcomes Research, EA7334, Paris, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain
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Duracinsky M, Thonon F, Rousset Torrente O, Dehouve V, Lert F, Zucman D, Roudot-Thoraval F, Chassany O. Evaluation de l’acceptabilité du dépistage par TROD au sein de la population de migrants lors de la visite médicale à l’Office français de l’immigration et de l’intégration (OFII). Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dimi S, Zucman D, Chassany O, Lalanne C, Prazuck T, Mortier E, Majerholc C, Aubin-Auger I, Verger P, Duracinsky M. Patients' high acceptability of a future therapeutic HIV vaccine in France: a French paradox? BMC Infect Dis 2019; 19:401. [PMID: 31072394 PMCID: PMC6509812 DOI: 10.1186/s12879-019-4056-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 05/01/2019] [Indexed: 12/23/2022] Open
Abstract
Background France is the European country with the lowest level of confidence in vaccines. Measurement of patients’ acceptability towards a future therapeutic HIV vaccine is critically important. Thus, the aim of this study was to evaluate patients’ acceptability of a future therapeutic HIV vaccine in a representative cohort of French patients living with HIV-AIDS (PLWHs). Methods This multicentre study used quantitative and qualitative methods to assess PLWHs’ opinions and their potential acceptance of a future therapeutic HIV vaccine. Cross-sectional study on 220 HIV-1 infected outpatients, aged 18–75 years. Results The participants’ characteristics were similar to those of the overall French PLWH population. Responses from the questionnaires showed high indices of acceptance: the mean score for acceptability on the Visual Analog Scale VAS was 8.4 of 10, and 92% of patients agreed to be vaccinated if a therapeutic vaccine became available. Acceptability depended on the expected characteristics of the vaccine, notably the duration of its effectiveness: 44% of participants expected it to be effective for life. This acceptance was not associated with socio-demographic, clinical (mode of contamination, duration of disease), quality of life, or illness-perception parameters. Acceptability was also strongly correlated with confidence in the treating physician. Conclusion The PLWHs within our cohort had high indices of acceptance to a future therapeutic HIV vaccine. Trial registration This study was retroactively registered on ClinicalTrials.gov with ID: NCT02077101 in February 21, 2014.
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Affiliation(s)
- Svetlane Dimi
- Department of Internal Medicine, Réseau Ville Hôpital Val de Seine, Foch Hospital, Suresnes, France.
| | - David Zucman
- Department of Internal Medicine, Réseau Ville Hôpital Val de Seine, Foch Hospital, Suresnes, France
| | - Olivier Chassany
- EA 7334 REMES, Patient-Centered Outcomes Research, University Paris-Diderot, Sorbonne Paris Cité, Paris, France.,Clinical Research Unit in Health Economics (URC-ECO), Fernand Widal Hospital, AP-HP, Paris, France
| | - Christophe Lalanne
- EA 7334 REMES, Patient-Centered Outcomes Research, University Paris-Diderot, Sorbonne Paris Cité, Paris, France
| | - Thierry Prazuck
- Department of Infectious Diseases, Regional Hospital Orléans, Orléans, France
| | - Emmanuel Mortier
- Department of Internal Medicine, Louis Mourier Hospital, Colombes, France
| | - Catherine Majerholc
- Department of Internal Medicine, Réseau Ville Hôpital Val de Seine, Foch Hospital, Suresnes, France
| | | | - Pierre Verger
- Observatoire régional de la santé Paca, Marseille, France.,AMU-UMR912 SESSTIM-IRD, Marseille France, Marseille, France
| | - Martin Duracinsky
- EA 7334 REMES, Patient-Centered Outcomes Research, University Paris-Diderot, Sorbonne Paris Cité, Paris, France.,Clinical Research Unit in Health Economics (URC-ECO), Fernand Widal Hospital, AP-HP, Paris, France.,Department of Internal Medicine & Clinical Immunology, Bicetre Hospital, AP-HP, Kremlin-Bicetre, Paris, France
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de Truchis P, Assoumou L, Landman R, Mathez D, Le Dû D, Bellet J, Amat K, Katlama C, Gras G, Bouchaud O, Duracinsky M, Abe E, Alvarez JC, Izopet J, Saillard J, Melchior JC, Leibowitch J, Costagliola D, Girard PM, Perronne C. Four-days-a-week antiretroviral maintenance therapy in virologically controlled HIV-1-infected adults: the ANRS 162-4D trial. J Antimicrob Chemother 2019; 73:738-747. [PMID: 29186458 DOI: 10.1093/jac/dkx434] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/25/2017] [Indexed: 11/12/2022] Open
Abstract
Background Intermittent treatment could improve the convenience, tolerability and cost of ART, as well as patients' quality of life. We conducted a 48 week multicentre study of a 4-days-a-week antiretroviral regimen in adults with controlled HIV-1-RNA plasma viral load (VL). Methods Eligible patients were adults with VL < 50 copies/mL for at least 1 year on triple therapy with a ritonavir-boosted PI (PI/r) or an NNRTI. The study protocol consisted of the same regimen taken on four consecutive days per week followed by a 3 day drug interruption. The primary outcome was the proportion of participants remaining in the strategy with VL < 50 copies/mL up to week 48. The study was designed to show an observed success rate of > 90%, with a power of 87% and a 5% type 1 error. The study was registered with ClinicalTrials.gov (NCT02157311) and EudraCT (2014-000146-29). Results One hundred patients (82 men), median age 47 years (IQR 40-53), were included. They had been receiving ART for a median of 5.1 (IQR 2.9-9.3) years and had a median CD4 cell count of 665 (IQR 543-829) cells/mm3. The ongoing regimen included PI/r in 29 cases and NNRTI in 71 cases. At 48 weeks, 96% of participants (95% CI 90%-98%) had no failure while remaining on the 4-days-a-week regimen. Virological failure occurred in three participants, who all resumed daily treatment and became resuppressed. One participant stopped the strategy. No severe treatment-related events occurred. Conclusions Antiretroviral maintenance therapy 4 days a week was effective for 48 weeks in 96% of patients, leading to potential reduction of long-term toxicities, high adherence to the antiretroviral regimen and drug cost saving.
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Affiliation(s)
- Pierre de Truchis
- Hôpitaux Universitaires Paris-Ile de France-Ouest, Hôpital Raymond Poincaré APHP, Garches, Université Versailles-Saint-Quentin, France
| | - Lambert Assoumou
- Sorbonne Universités, INSERM, UPMC Université Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Roland Landman
- Institut de Médecine et Epidémiologie Appliquée, Hôpital Bichat, Université Paris 7, Paris, France.,IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris, France
| | - Dominique Mathez
- Hôpitaux Universitaires Paris-Ile de France-Ouest, Hôpital Raymond Poincaré APHP, Garches, Université Versailles-Saint-Quentin, France
| | - Damien Le Dû
- Hôpitaux Universitaires Paris-Ile de France-Ouest, Hôpital Raymond Poincaré APHP, Garches, Université Versailles-Saint-Quentin, France
| | - Jonathan Bellet
- Sorbonne Universités, INSERM, UPMC Université Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Karine Amat
- Institut de Médecine et Epidémiologie Appliquée, Hôpital Bichat, Université Paris 7, Paris, France
| | - Christine Katlama
- Sorbonne Universités, INSERM, UPMC Université Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,APHP, Hôpital Pitié-Salpétrière, Service Maladies Infectieuses et Tropicales, Paris, France
| | - Guillaume Gras
- Centre Hospitalier Universitaire Bretonneau, Tours, France
| | - Olivier Bouchaud
- APHP, Centre Hospitalier Universitaire Avicenne, APHP, Bobigny 93, France
| | - Martin Duracinsky
- Université Paris Sorbonne-Diderot, EA 7334, APHP Hotel-Dieu, URC-ECO, Paris, France
| | - Emuri Abe
- APHP Hôpital R Poincaré, Département de Pharmacologie, Inserm U-1173, Université Paris-Ile de France Ouest, Garches 92, France
| | - Jean-Claude Alvarez
- APHP Hôpital R Poincaré, Département de Pharmacologie, Inserm U-1173, Université Paris-Ile de France Ouest, Garches 92, France
| | - Jacques Izopet
- INSERM U1043/CNRS5282, Université de Toulouse, CHU Purpan, Toulouse, France
| | - Juliette Saillard
- INSERM-ANRS, Agence Nationale pour la Recherche sur le Sida et les Hépatites, Paris, France
| | - Jean-Claude Melchior
- Hôpitaux Universitaires Paris-Ile de France-Ouest, Hôpital Raymond Poincaré APHP, Garches, Université Versailles-Saint-Quentin, France
| | - Jacques Leibowitch
- Hôpitaux Universitaires Paris-Ile de France-Ouest, Hôpital Raymond Poincaré APHP, Garches, Université Versailles-Saint-Quentin, France
| | - Dominique Costagliola
- Sorbonne Universités, INSERM, UPMC Université Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Pierre-Marie Girard
- Sorbonne Universités, INSERM, UPMC Université Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Institut de Médecine et Epidémiologie Appliquée, Hôpital Bichat, Université Paris 7, Paris, France.,APHP, Hôpital Saint Antoine, Service Maladies Infectieuses, Paris, France
| | - Christian Perronne
- Hôpitaux Universitaires Paris-Ile de France-Ouest, Hôpital Raymond Poincaré APHP, Garches, Université Versailles-Saint-Quentin, France
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Bergamaschi A, d'Arripe-Longueville F, Gray LL, Colson SS, Goujard C, Ferez S, Rouanet I, Durant J, Rosenthal E, Pradier C, Duracinsky M, Schuft L. Perceived HIV-related physical fatigue, sociodemographic characteristics and physical activity: A cross-sectional study. J Clin Nurs 2019; 28:2147-2156. [PMID: 30667107 DOI: 10.1111/jocn.14793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 11/22/2018] [Accepted: 12/05/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To get a deeper understanding of correlates of perceived HIV-related fatigue by exploring its associations with sociodemographic characteristics and physical activity level of HIV-infected people. BACKGROUND Previous studies on HIV-related fatigue have mainly focused on physiological and psychological characteristics, but few have considered its associations with sociodemographic variables. In addition, while physical activity has been found to reduce acute fatigue among HIV-infected people, its links with chronic HIV-related fatigue remain to be explored. DESIGN The study employed an observational and cross-sectional survey design. The manuscript was organised according to STROBE guidelines. METHOD A total of 560 people living with HIV in France completed a measure of perceived physical fatigue using the Fatigue Intensity Scale. The predictors targeted sociodemographic characteristics and two measures of individuals' reported level of physical activity. Data were analysed by a stepwise multiple regression model. RESULTS The results showed that lower age, higher physical activity level and socio-economic status were significantly associated with reduced perceived physical fatigue, explaining 25% of the variance. CONCLUSIONS The results highlighted the importance of considering sociodemographic and lifestyle characteristics to better characterise HIV-related fatigue, in particular in an era where HIV as a chronic illness challenges questions of quality of life throughout increasingly longer lifespans. RELEVANCE TO CLINICAL PRACTICE The results of this study have implications for HIV care professionals in terms of improving strategies for managing chronic fatigue or promoting physical activity according to more specific profiles of HIV-infected people.
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Affiliation(s)
| | | | | | | | - Cecile Goujard
- Department of Internal Medicine and Clinical Immunology, Hôpital Bicêtre, AP-HP, Paris, France
| | - Sylvain Ferez
- Laboratory Health, Education, Handicap Situations (EA 4614 SANTESIH), University of Montpellier, Montpellier, France
| | - Isabelle Rouanet
- Department of Infectious Diseases, Hospital of Nîmes, Nîmes, France
| | - Jacques Durant
- LAMHESS, Université Côte d'Azur, Nice, France.,Department of Infectious Diseases, Université Côte d'Azur, CHU, Nice, France
| | - Eric Rosenthal
- LAMHESS, Université Côte d'Azur, Nice, France.,Department of Infectious Diseases, Université Côte d'Azur, CHU, Nice, France
| | - Christian Pradier
- LAMHESS, Université Côte d'Azur, Nice, France.,Department of Public Health, Université Côte d'Azur, CHU, Nice, France
| | - Martin Duracinsky
- Department of Internal Medicine and Clinical Immunology, Hôpital Bicêtre, AP-HP, Paris, France.,Patient-Centered Outcomes Research (EA 7334 REMES), University of Paris-Diderot, Paris, France
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Faraut B, Malmartel A, Ghosn J, Duracinsky M, Leger D, Grabar S, Viard JP. Sleep Disturbance and Total Sleep Time in Persons Living with HIV: A Cross-Sectional Study. AIDS Behav 2018; 22:2877-2887. [PMID: 29855973 DOI: 10.1007/s10461-018-2179-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Short and long sleep durations have been associated with inflammation and chronic diseases. To study the association between sleep duration/quality and HIV disease severity, a cross-sectional study was conducted in patients living with HIV (PLWHs) using self-administered questionnaires assessing total sleep time, insomnia (ICSD-3 criteria), and poor sleep quality (PSQI > 5). Multivariable logistic regression identified the factors associated with sleep disorders and with HIV features. 640 Parisian ambulatory PLWHs were included. The prevalence of insomnia was 50 and 68% of patients had a PSQI > 5. Patients with CD4 count < 500 cells/mm3 were more likely to be long sleepers (> 8 h/day) (OR 1.49; 95% CI [1.10-1.99]: p < 0.01), and less likely to be short sleepers (< 6 h/day) (OR 0.69; 95% CI[0.50-0.96]; p = 0.04) or to experience insomnia (OR 0.59; 95% CI[0.40-0.86]; p < 0.01). HIV features were not associated with a PSQI > 5. Thus, insomnia and impaired sleep quality were highly prevalent in well-controlled PLWHs and the severity of HIV infection was associated with long sleep times.
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Sala TP, Crave JC, Duracinsky M, Lepira Bompeka F, Tadmouri A, Chassany O, Cherin P. Efficacy and patient satisfaction in the use of subcutaneous immunoglobulin immunotherapy for the treatment of auto-immune neuromuscular diseases. Autoimmun Rev 2018; 17:873-881. [PMID: 30005853 DOI: 10.1016/j.autrev.2018.03.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/06/2018] [Indexed: 01/01/2023]
Abstract
We reviewed the efficacy of SCIg administration in terms of muscle strength maintenance and patient satisfaction comparing with IVIg in the treatment of auto-immune neuromuscular diseases. A systematic review was conducted, and identified studies from databases (PUBMED, EMBASE, EBSCO, Web of Science and Google Scholar) which were analyzed. The methodological quality of the selected publications was evaluated using the Newcastle-Ottawa Scale. Data were extracted from a total of 11 studies Fixed and random-effect model meta-analyses were performed. For the maintenance of muscle strength, Overall Neuropathy Limitations Scale (ONLS) data from 100 patients diagnosed with multifocal mononeuropathy (MMN) or chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) were pooled together. Switching to subcutaneous immunoglobulin administration led to a significant improvement (fixed effects model, p = 0.002). In data collected using the Medical Research Council Scale for Muscle Strength data from 140 patients with a wider range of disorders, a small but significant improvement in overall strength was observed in the SCIg group (p < 0.0001). In addition, the results of two studies measuring health-related quality of life and patient satisfaction were pooled. Data from 49 patients suffering from MMN, CIDP, and a variety of different myopathies demonstrated a small but significant increase in the mean 36-Item Short Form Survey (SF-36) scores (p < 0.0001). A highly significant difference was revealed when comparing data from 119 patients' responses to the Life Quality Index questionnaire (LQI) assessing patient satisfaction (p < 0.0001). This is the first analysis showing that SCIg is more effective than IVIg in improving Patient Reported Outcomes in auto-immune neuromuscular disease. These results should permit a broad range of patients to self-administer immunoglobulin treatments at home, potentially improving patient acceptability while reducing hospital visits and healthcare costs for the treatment of chronic auto-immune neuropathies.
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Affiliation(s)
| | | | - Martin Duracinsky
- AP-HP, Bicetre Hospital, Internal Medicine and Clinical Immunology Department, Kremlin-Bicetre, France; AP-HP, Hotel-Dieu Hospital, Health Economics Clinical Trial Center, Paris, France; University Paris-Diderot, EA7334, Patient-Centered Outcomes Research, Paris, France
| | | | - Abir Tadmouri
- ClinSearch, Health Economics and Outcome Research Department, Malakoff, France
| | - Olivier Chassany
- AP-HP, Hotel-Dieu Hospital, Health Economics Clinical Trial Center, Paris, France; University Paris-Diderot, EA7334, Patient-Centered Outcomes Research, Paris, France
| | - Patrick Cherin
- AP-HP, Pitié-Salpetrière Hospital, Department of Internal Medicine and Clinical Immunology, Paris, France
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Duracinsky M, Dimi S, Piroth L, Thonon F, Zucman D, Chassany O, Carreri P. La précarité sociale dans la population française de VIH est fréquente et liée à l’anxiété, à la dépression et la dégradation de la qualité de vie. Résultats de l’étude électronique EQUIPIER. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Askari S, Fellows L, Brouillette MJ, Moriello C, Duracinsky M, Mayo NE. Development of an Item Pool Reflecting Cognitive Concerns Expressed by People With HIV. Am J Occup Ther 2018; 72:7202205070p1-7202205070p9. [PMID: 29426385 DOI: 10.5014/ajot.2018.023945] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The overall aim of this study is to create an item pool reflecting the cognitive concerns expressed by people with HIV as a first step toward developing such a measure. METHOD Semiqualitative interviews with 292 people with HIV were carried out. Their concerns were mapped to neurocognitive domains to identify concern content areas and were compared with existing cognitive questionnaires. A questionnaire was developed to estimate the prevalence and importance of the items. RESULTS Sixty of 125 items were retained in the questionnaire based on ratings of their prevalence, importance, and clarity. Memory and behavioral and emotional concerns were the most common content areas (15 each); other domains were attention (7), executive function (6), language (5), and cognitive change (12). CONCLUSION People living with HIV experience difficulties in all domains of cognition. By recognizing all domains, this new measure can help clinicians better understand areas of perceived cognitive difficulty and plan interventions accordingly.
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Affiliation(s)
- Sorayya Askari
- Sorayya Askari, PhD, is Occupational Therapist, School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lesley Fellows
- Lesley Fellows, MD, DPhil, is Assistant Dean, Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Marie-Josée Brouillette
- Marie-Josée Brouillette, MD, is Associate Professor, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Carolina Moriello
- Carolina Moriello, is Research Assistant, Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Martin Duracinsky
- Martin Duracinsky, MD, PhD, is Scientific Director, Patient-Centered Outcomes Research, Université Paris Diderot, Sorbonne Paris Cité, France, and Médecin, Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Kremlin-Bicêtre, France
| | - Nancy E Mayo
- Nancy E. Mayo, PhD, is James McGill Professor, School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada, and Research Scientist, Center of Outcome Research and Evaluation, Research Institute of McGill University Health Center, Montreal, Quebec, Canada;
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