Use of Health Information Exchange in the Continuity of Care as Viewed by Patients and Nurses: A Cross-Sectional Study.

Patients' attitudes toward sharing their personal health information are critical for implementation of health information exchange. Nurses contribute significantly to information sharing within the care continuum in hospitals and community. This study aimed to examine the awareness and readiness of patients with chronic illness and nurses to the use health information exchange. A cross-sectional study was conducted among 314 inpatients with a chronic illness, 110 nurses working in internal wards, and 55 contact nurses working in a large health maintenance organization. The findings showed that the mean level of awareness was low across all three groups. Contact nurses expressed more positive attitudes than internal ward nurses or patients and were more willing than patients to share information with healthcare workers. Knowledge, attitudes, and being a nurse predicted the intention to share information with medical healthcare providers and with agents not involved in direct care. Before implementation of a health information exchange system, it is important to raise awareness, readiness, and intention to use it among the public, nurses, and other medical staff. Policy makers should organize national campaigns under the auspices of the Ministry of Health to present the advantages and provide detailed information about the system.

In Vitro and In Vivo Performance of a Pre-Filled, Electrochemically-Actuated Infusion System.

PURPOSE: A novel infusion system (PatchPump®) has been developed using an electrochemical actuator and a semi-flexible container to deliver liquid formulations through an infusion set. In vitro studies characterized pump performance, and clinical studies evaluated functionality and pharmacokinetic (PK) performance in humans. METHODS: Total delivered volume and flow rate accuracy were determined in vitro by real-time gravimetric analysis. Functionality was evaluated in vivo using prototype devices delivering saline for 18 h in a clinical study enrolling 10 healthy volunteers. A second clinical study examined the PK of delivering treprostinil at an average dose of 2.3 ng/kg/min to 5 healthy volunteers for 18 h. RESULTS: Relative to a design target of 0.042 mL/hr, the average flow rate of 23 PatchPumps operating for 48 continuous hours was 0.043 ± 0.007 mL/hr as tested in vitro. In vivo functionality was confirmed by complete infusion of saline for the entire duration with only mild and transient adverse effects. PK results with an infusion rate of 0.045 mL/hr of treprostinil resulted in mean Css of 297 pg/mL and T1/2 of 4.44 h, comparable to prior studies using conventional infusion pumps. CONCLUSIONS: The results of these studies demonstrate a successful proof-of-concept for the PatchPump technology.

Prevalence and risk factors for erectile dysfunction in men with diabetes, hypertension, or both diseases: a community survey among 1,412 Israeli men.

BACKGROUND: Erectile dysfunction (ED) and cardiovascular disease share common risk factors and may be further aggravated by medical treatment for reducing them. HYPOTHESIS: The study was undertaken to assess the prevalence of ED in patients with diabetes (DM), hypertension (HTN), or both diseases, and to evaluate the effect of patient age, medical treatment, and disease duration and control on the prevalence of ED in this population. METHODS: A group of 150 primary practitioners who had patients with known DM and/or HTN conducted a survey, utilizing IIEF-15, a 15-item multidimensional, self-administered questionnaire used for the clinical assessment of ED. RESULTS: In all, 1,412 patients were included: 37% had DM, 38% had HTN, and 25% had both diseases. Their mean age was 55, 58, and 60 years, and 62, 46, and 67% had some degree of ED, respectively. The prevalence of ED increased with age and disease duration in each age group and was higher in subjects with DM than in those with HTN, especially in those aged < 65 years. Poor glycemic control was associated with a higher prevalence rate of ED early in the course of the disease. There was no significant difference in the prevalence of ED according to type and number of antihypertensive drugs. CONCLUSIONS: Erectile dysfunction is common among patients at high risk for cardiovascular disease because of diabetes and/or HTN. Diabetic men are affected earlier than those with HTN. Given the high frequency of ED in young patients with these risk factors, physicians should encourage an open discussion on the subject during routine visits to promote early detection and treatment.