Hypertension is a chronic disease that is mostly managed by the patients themselves inbetween consultation with their physicians. Self-efficacy, which is an individual's belief in their capabilities to produce given attainments, is a desirable quality to enable the person to take charge of their health and any long-term illness. Assessment of self-efficacy is thus pivotal in developing a holistic patient-centric care plan to optimize their disease control. For hypertension, self-efficacy is associated with better self-care and outcomes of the disease.This literature review aims to identify self-efficacy assessment instruments, evaluate their origin, quality and development, compare their strengths and limitations, and applicability in specific target population.Searches performed using PubMed, Scopus and The Cochrane Library eventually yielded 34 relevant articles and 12 instruments. All instruments were validated in specific populations. Two instruments were specific to hypertension, two instruments measured multiple domains of self-management, while medication adherence was the most common single domain assessed. To select an appropriate instrument, one should take into consideration the clinical context and study design. An algorithm is proposed to facilitate the selection of instrument that is best suited for the specific purpose.
Results From 943 citations, we included a total of 11 studies (10 observational and 1 randomized trial) evaluating 4 types of DOACs (rivaroxaban, apixaban, edoxaban and dabigatran) that fulfilled the inclusion criteria. 3 studies included patients with Child-Turcott-Pugh (CTP)-C cirrhosis. The overall pooled rate of PVT recanalization, PVT progression, major bleeding and death were 46.0%, 12.9%, 7.9% and 10.2%, respectively. We found that DOACs were associated with a higher pooled rate of PVT recanalization (RR=1.67, 95%CI: 1.02, 2.74, I2=79%) and lower risk of PVT progression (RR= 0.14, 95%CI: 0.03-0.57, I2=0%). The pooled risk of major bleeding (RR= 0.29, 95%CI: 0.08-1.01, I2=0%), variceal bleeding (RR=1.29, 95%CI: 0.64-2.59, I2=0%) and death (RR=0.31, 95%CI: 0.01-9.578, I2=80%) were similar between DOACs and VKAs. (IDDF2021-ABS-0172 Figure 2, IDDF2021-ABS-0172 Figure 3, IDDF2021-ABS-0172 Figure 4) Conclusions For the treatment of PVT in patients with cirrhosis, the bleeding risk was comparable between DOACs and VKAs. However, DOACs were associated with a higher pooled rate of PVT recanalization.
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