Background: Home blood pressure monitoring (HBPM) predicts cardiovascular risk and increases hypertension control. Non-participation in HBPM is prevalent and decreases the potential benefit.Methods: Telephone surveys were conducted with a random quota sample of non-participants in a HBPM program, which supplied a complimentary automated blood pressure cuff and utilized a centralized reporting system. Questioning assessed use of monitors, perceived benefit, communication with providers, and barriers.Results: There were 320 completed surveys (response rate 53%). Of non-participants, 70.2% still used HBPM cuffs and 58% communicated values to providers. Spanish-speakers were 4.4 times more likely to not use cuffs (95% CI, 2.22-8.885). Barriers to participation were largely personal (forgetting, not having time, or self-described laziness). Reasons for not communicating readings with providers were largely clinic factors (no doctor visit, doctor didn't ask, thinking doctor wouldn't care). Lack of knowledge of HBPM and program design also contributed. After being surveyed, patients were over three times more likely to use the central reporting system. Discussion: Most non-participants still used HBPM and communicated values to providers, suggesting many "drop-outs" may still receive clinical benefit. However, much valuable information is not utilized. Future programs should focus on reminder systems, patient motivation, education, and minimizing time involvement.
Melanoma is the most lethal form of skin cancer and it is the second most common cancer among adolescents and young adults. The aim of this work is to determine if surgical intervals differ between four different clinics and between departments within the hospitals, and to compare these to industry standards. Surgical intervals were measured through retrospective chart review at four dermatology clinics. Of 205 melanoma cases, clinic and departmental median surgical intervals ranged 15–36.5 days and 26–48 days, respectively. There was significant association between clinic and time between biopsy and pathology report, time between pathology report and excision, and total surgical interval (P<0.0001, P=0.03, and P<0.0001 respectively). There was significant association between department and time between pathology report and excision, and surgical interval (P<0.0001, and P=0.003 respectively). Pair-wise comparisons detected significantly longer intervals between some clinics and departments (maximum difference 67.3%, P<0.0001). Hypothesis-based, informal guidelines recommend treatment within 4–6 weeks. In this study, median surgical intervals varied significantly between clinics and departments, but nearly all were within a 6-week frame.
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