Publications by authors named "Vahe Kehyayan"

12 Publications

  • Page 1 of 1

Death certification status in Eastern Mediterranean Region: A systematic review.

Death Stud 2021 Mar 6:1-10. Epub 2021 Mar 6.

Community Medicine Residency Program, Primary health care corporation (PHCC), Doha, Qatar.

A death certificate is an important public health surveillance tool that affects the quality of morbidity and mortality statistics. This systematic review examines death certification in the Eastern Mediterranean Region, uncovers the methodological qualities of published studies, the common errors committed by certifiers, and physicians' knowledge in filling out death certificates. We searched three databases, finding 19 studies, the majority of which reported errors in the underlying cause of death. Fewer than 25% of physicians reported training on filling out death certificates. Complexity of the cases and lack of training were reported as common difficulties facing physicians leading to errors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/07481187.2021.1890651DOI Listing
March 2021

Perceived Barriers to Colorectal Cancer Screening among Eligible Adults in Qatar and the Associated Factors: A Cross- Sectional Study

Asian Pac J Cancer Prev 2021 01 1;22(1):45-51. Epub 2021 Jan 1.

Department of Family and Community Medicine, Primary Health Care Corporation, Doha, Qatar.

Background: In Qatar, colorectal cancer (CRC) is the second most common cancer and is projected to be more than triple by 2035. Therefore, CRC periodic screening is vitally important because early detection will improve the success of treatment. In 2016, Qatar established a population-based screening program for CRC targetting average-risk adults. This study aimed to determine the perceived barriers to undergo CRC screening in eligible adults in Qatar and the associated factors.

Methods: This was a cross-sectional study of individuals aged 50-74 years who have been never screened, across six primary health centers between September 2018 and January 2019. A non-probability sampling method was used to recruit participants. Participants were interviewed using a structured questionnaire. Descriptive and analytic statistics were applied.

Results: A total of 188 individuals participated in the study. The mean age of the participants was 58.3 (SD ±6.4) years. Most participants were females (54.5%) and non-Qatari Arabs (54.3%). The top five reported barriers to CRC screening were: not at risk due to absence of symptoms (60.6%), not at risk due to absence of family history (55.1%), not at risk due to adopting a healthy lifestyle (52.7%), lack of time (41%), and lack of reminders by healthcare workers (39.4%). Bivariate analyses identified statistically significant associations between certain barriers and female gender, nationality, and educational level (primary school and below).

Conclusion: The present study identified several barriers to undergoing CRC screening among eligible adults in Qatar. Such results provide a basis for tailoring of future educational campaigns that are relevant, specific, and appealing to such a cohort.
.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.31557/APJCP.2021.22.1.45DOI Listing
January 2021

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar.

Drugs Real World Outcomes 2021 Mar 17;8(1):95-103. Epub 2020 Nov 17.

University of Calgary in Qatar, Doha, Qatar.

Background: Potentially inappropriate medications (PIMs) often lead to sub-optimal or poor health outcomes in older adults.

Objective: The objective of this study was to determine the prevalence and predictors of PIM prescription among older adults in Qatar.

Patients And Methods: This was a cross-sectional, retrospective study using data from the electronic medical records of Qatari patients (age ≥ 65 years) attending the 23 primary healthcare (PHC) centers in Qatar from April 1, 2017 to September 30, 2017. PIMs were identified based on the Beers 2015 criteria: (1) medications to avoid for many or most older adults, and (2) medications to be used with caution in older adults. Descriptive statistics were used to estimate the prevalence of PIM prescription; multivariable logistic regression analysis was performed to identify predictors of PIM prescription among the study population.

Results: 5639 older adults were included with a mean age of 72.8 (± 6.5) years; 53.8% were females. The prevalence of PIMs that should be avoided was 60.7%, with the most prevalent ones being gastrointestinal (84.2%), pain (49.9%), and central nervous system (10.4%) drugs. Most patients (61.1%) were prescribed one PIM, 26.9% two PIMs, and 12.0% three or more PIMs. The prevalence of PIMs that should be used with caution was 40.6%, with diuretics (83.1%), antidepressants (25.7%), and antiplatelets (18.3%) as the most prevalent drug classes. Multivariable logistic regression showed female gender, polypharmacy, and certain comorbidities to be significant predictors of PIM prescription.

Conclusions: Older adults attending Qatar's 23 PHC centers are prescribed a high number of PIMs. Because of the high risk of PIM prescription, the practice of medication reconciliation should be strengthened and reinforced.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40801-020-00220-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984128PMC
March 2021

The first few cases and fatalities of Corona Virus Disease 2019 (COVID-19) in the Eastern Mediterranean Region of the World Health Organization: A rapid review.

J Infect Public Health 2020 Oct 19;13(10):1367-1372. Epub 2020 Jun 19.

University of Calgary in Qatar, Doha, Qatar. Electronic address:

In December 2019, a cluster of atypical Pneumonia cases in Wuhan, China were reported to the World Health Organization (WHO). Later, those cases were attributed to a novel respiratory virus currently known as COVID-19. The infection is affecting every continent. It was characterized by WHO as a global pandemic on 11 March 2020. Countries worldwide are implementing various preventive measures to contain the spread of the infection such as travel and trade restrictions, closure of educational institutions and shops, and some took more strict measures such as imposing curfew. WHO is emphasizing the importance of early detection of cases, contact tracing, risk communications, implementing multisectoral approach in order to combat COVID-19 infection. Countries should provide the public with accurate, transparent information about the local and global situation of this escalating infection. Much uncertainty still surrounds this viral infection, its modes of transmission and dynamics. Epidemiological investigations particularly for the first few cases of COVID-19 infection are critical to expand our knowledge about this evolving pandemic. In this review we summarized the data available about the first few cases and fatalities of COVID-19 infection up to 18 March 2020 across Eastern Mediterranean Region of the World Health Organization. such data were only available in websites of ministries of health of the targeted countries, WHO situational reports, online newspapers, and other media channels and this gave us an idea about the amount and type of data available for the public regarding this evolving infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jiph.2020.06.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303600PMC
October 2020

Prevalence of polypharmacy and the association with non-communicable diseases in Qatari elderly patients attending primary healthcare centers: A cross-sectional study.

PLoS One 2020 11;15(6):e0234386. Epub 2020 Jun 11.

Community Medicine Residency Program, Primary Health Care Corporation, Doha, Qatar.

Background: Polypharmacy has become a global public health concern particularly in the elderly population. The elderly population is the most susceptible to the negative effects of polypharmacy due to their altered pharmacokinetics and decreased drug clearance. Therefore, polypharmacy can lead to poor health status and higher rates of morbidity and mortality.

Objective: The objective of this study was to determine the prevalence of polypharmacy (≥ 5 drugs) and its association with non-communicable diseases (NCDs) in elderly (≥65 years) Qatari patients attending Primary Healthcare (PHC) centers in Qatar.

Methods: A retrospective cross-sectional analysis was conducted using the Electronic Medical Record (EMR) database of all PHC centers in Qatar for six months (April-September 2017).

Results: Out of 5639 patients screened, 75.5% (95% CI: 74.3-76.6) were exposed to polypharmacy. Females were 1.18 times more likely to have polypharmacy compared to males (95% CI: 1.03-1.34). The multivariate analysis identified having hypertension (AOR 1.71; 95% CI: 1.38-2.13), diabetes (AOR 2.38; 95% CI: 1.97-2.87), dyslipidemia (AOR 1.29; 95% CI: 1.06-1.56), cardiovascular disease (AOR 1.56; 95% CI: 1.25-1.95) and asthma (AOR 1.39; 95% CI: 1.13-1.72) to be independent parameters associated with polypharmacy. Also, the Body Mass Index (BMI) and number of NCDs were found to be significant independent parameters associated with polypharmacy.

Conclusions: The prevalence of polypharmacy among Qatari elderly attending PHC Centers is very high. Our findings confirm the strong relationship between polypharmacy and BMI, and certain NCDs. Healthcare professionals should be educated about the magnitude of polypharmacy, its negative effects, and its associated factors. Best practice guidelines should be developed for improved medical practice in the prescription of medications for such a vulnerable population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234386PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289385PMC
August 2020

Hearing the Voice of the Resident in Long-Term Care Facilities-An Internationally Based Approach to Assessing Quality of Life.

J Am Med Dir Assoc 2018 03 10;19(3):207-215. Epub 2017 Oct 10.

Department of Geriatric Medicine, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; Faculty of Health and Social Sciences, South Bohemian University, Ceske Budejovice, Czech Republic.

Objectives: interRAI launched this study to introduce a set of standardized self-report measures through which residents of long-term care facilities (LTCFs) could describe their quality of life and services. This article reports on the international development effort, describing measures relative to privacy, food, security, comfort, autonomy, respect, staff responsiveness, relationships with staff, friendships, and activities. First, we evaluated these items individually and then combined them in summary scales. Second, we examined how the summary scales related to whether the residents did or did not say that the LTCFs in which they lived felt like home.

Design: Cross-sectional self-report surveys by residents of LTCFs regarding their quality of life and services.

Setting/participants: Resident self-report data came from 16,017 individuals who resided in 355 LTCFs. Of this total, 7113 were from the Flanders region of Belgium, 5143 residents were from Canada, and 3358 residents were from the eastern and mid-western United States. Smaller data sets were collected from facilities in Australia (20), the Czech Republic (72), Estonia (103), Poland (118), and South Africa (87).

Measurements: The interRAI Self-Report Quality of Life Survey for LTCFs was used to assess residents' quality of life and services. It includes 49 items. Each area of inquiry (eg, autonomy) is represented by multiple items; the item sets have been designed to elicit resident responses that could range from highly positive to highly negative. Each item has a 5-item response set that ranges from "never" to "always."

Results: Typically, we scored individual items scored based on the 2 most positive categories: "sometimes" and "always." When these 2 categories were aggregated, among the more positive items were: being alone when wished (83%); decide what clothes to wear (85%); get needed services (87%); and treated with dignity by staff (88%). Areas with a less positive response included: staff knows resident's life story (30%); resident has enjoyable things to do on weekends (32%); resident has people to do things with (33%); and resident has friendly conversation with staff (45%). We identified 5 reliable scales; these scales were positively associated with the resident statement that the LTCF felt like home. Finally, international score standards were established for the items and scales.

Conclusions: This study establishes a set of standardized, self-report items and scales with which to assess the quality of life and services for residents in LTCFs. The study also demonstrates that these scales are significantly related to resident perception of the home-like quality of the facilities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamda.2017.08.010DOI Listing
March 2018

Predictors of Long-Term Care Facility Residents' Self-Reported Quality of Life With Individual and Facility Characteristics in Canada.

J Aging Health 2016 Apr 6;28(3):503-29. Epub 2015 Jul 6.

University of Waterloo, Ontario, Canada.

Objective: Identify predictors of long-term care (LTC) facility residents' self-reported quality of life (QoL).

Method: QoL of a convenience sample of 928 residents from 48 volunteer LTC facilities across six Canadian provinces was assessed using the inter-Resident Assessment Instrument (interRAI) Self-Report Nursing Home Quality of Life Survey. Multivariate regression models were used to identify predictors.

Results: In logistic regression modeling, residents who were religious and socially engaged, had a positive global disposition, or resided in rural, private, or municipal facilities were less likely to report low QoL. Those with post-secondary education and who were dependent on activities of daily living were more likely to report low QoL. These factors, except for religiosity and residence in municipal facilities, were significant in generalized estimating equation (GEE) modeling.

Discussion: QoL is significantly associated with select resident and LTC facility characteristics with implications for improving residents' QoL and LTC facility programming, and guiding future research and social policy development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0898264315594138DOI Listing
April 2016

Residents' self-reported quality of life in long-term care facilities in Canada.

Can J Aging 2015 Jun 10;34(2):149-64. Epub 2015 Mar 10.

School of Public Health & Health Systems,University of Waterloo.

Quality of life (QoL) of long-term care (LTC) facility residents is an important outcome of care. This cross-sectional, descriptive study examined the self-reported QoL of LTC facility residents in Canada using the interRAI Self-Report Nursing Home Quality of Life Survey instrument. A secondary purpose was to test the instrument's psychometric properties. Psychometric testing of the instrument supported its reliability and its convergent and content validity for assessing the residents' QoL. Findings showed that residents rated positively several aspects of their life, such as having privacy during visits (76.9%) and staff's being honest with them (73.6%). Residents gave lower ratings to other aspects such as autonomy, staff-resident bonding, and personal relationships. The findings point to gaps between facility philosophies of care and their translation into a care environment where care is truly resident-directed. Moreover, the findings have potential implications for resident care planning, facility programming, social policy development, and future research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S0714980814000579DOI Listing
June 2015

Profile of patients with amyotrophic lateral sclerosis across continuum of care.

Can J Neurol Sci 2014 Mar;41(2):246-52

Objective: This study describes the socio-demographic and clinical profile of persons with amyotrophic lateral sclerosis (ALS) in home care, nursing homes and complex continuing care settings in several Canadian jurisdictions.

Methods: A cross-sectional study was conducted using available Resident Assessment Instrument (RAI 2.0 and RAI Home Care) national databases from 1996- 2011. The profile of ALS patients was compared with patients without pre-specified neurological conditions.

Results: There were 2,092 ALS patients identified in these settings. Persons with ALS were more likely than those in the comparison group to suffer from health instability (25.4%) and minor to major depressive symptoms (27.2%) , to experience falls (44.0%) and weight loss (22.9%), to require extensive assistance in activities of daily living (54.9%), and to receive rehabilitation services: physical (23.9%), speech language pathology (8.9%), and occupational therapy 43.3%).

Conclusions: The ALS population in this study are greatly affected by a number of health issues. They are more likely than the comparison group to require therapies, medical interventions, and psychotropic drug use. While persons with ALS have a poor prognosis, a great deal could be done to enhance their quality of life and the quality of care they receive.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/s0317167100016656DOI Listing
March 2014

Education and employment needs and receipt of services in community and inpatient mental health settings.

Community Ment Health J 2014 Aug 28;50(6):637-45. Epub 2014 Jan 28.

School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada,

The interRAI Education and Employment Clinical Assessment Protocol (EdEmp CAP) identifies three groups of individuals in community and inpatient mental health settings: those who are at risk of losing their employment or disrupting their education; those who require support in employment or educational participation; or those for whom interventions related to education and employment are not triggered. The EdEmp CAP was effective in identifying subpopulations who were at risk, but who did not receive any vocational rehabilitation or counseling. The EdEmp CAP can be used in clinical practice to identify individuals who might benefit from specific interventions in these areas.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10597-014-9694-yDOI Listing
August 2014

Advocacy: critical component in a comprehensive mental health system.

Am J Orthopsychiatry 2012 Jan;82(1):115-20

Psychiatric Patient Advocate Office Ministry of Health and Long-Term Care, 55 St. Clair Avenue W., Toronto, Ontario, Canada.

Although rights protection and best interest perspectives are frequently viewed as diametric opposites, mental health advocacy is an important strategy in pursuit of both civil rights and therapeutic goals for people with mental illness. Independent, client-centered advocacy supports the attainment of consumer-identified goals for recovery, equality, and social inclusion and mitigates the negative consequences of stigma and discrimination. Advocacy strives to return decision-making authority to consumers and thus to empower them to play a more central role in their own care, treatment, rehabilitation, and life choices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1939-0025.2011.01143.xDOI Listing
January 2012