RESUMEN
Three south-London hospital trusts undertook a feasibility study, comparing data from 93 patients who received the 14-day adhesive ambulatory electrocardiography (ECG) patch Zio XT with retrospective data from 125 patients referred for 24-hour Holter for cryptogenic stroke and transient ischaemic attack following negative 12-lead ECG. As the ECG patch was fitted the same day as the clinical decision for ambulatory ECG monitoring was made, median time to the patient having the monitor fitted was significantly reduced in all three hospital trusts compared with 24-hour Holter being ordered and fitted. Hospital visits reduced by a median of two for patients receiving Zio XT. This project supports that it is feasible to use a patch as part of routine clinical care with a positive impact on care pathways.
RESUMEN
The NHS Long Term Plan aims to transform how we tackle cardiovascular disease by improving the detection and treatment of high-risk conditions. One in five strokes are linked to atrial fibrillation (AF) and it is estimated that 500,000 people in the UK have undiagnosed AF. To increase detection of AF, in 2017 NHS England commissioned the Academic Health Science Networks to procure 6,000 mobile electrocardiography (ECG) devices, which were distributed to community settings across the county. The Health Innovation Network as the Academic Health Science Network for south London was responsible for the distribution of approximately 400 mobile ECG devices to a range of settings. A total of 14,835 pulse rhythm checks were performed, detecting 597 people with possible AF. This project provides insight into effectiveness of a wide range of settings in providing opportunistic testing for AF using mobile ECG devices.
RESUMEN
AIMS: To explore the relationship between diabetes distress, glucose control and awareness of hypoglycaemia in adults with type 1 diabetes. METHODS: We performed a cross-sectional study using data collected from 280 consecutive type 1 diabetes patients who used a routine clinic consultation tool that recorded HbA1c, hypoglycaemia awareness (measured using the Gold score) and diabetes distress (measured using the Diabetes Distress Scale 2 [DDS2]). We assessed correlations between DDS2 and HbA1c and DDS2 and Gold score and performed an ordinal regression analysis to identify factors contributing to distress. RESULTS: Diabetes distress was significantly correlated with HbA1c (r = .319, P < .001) and Gold score (r = .258, P < .001) independently and with synergistic effect. Female gender was also associated with diabetes distress, while age, BMI, duration of diabetes, severity of complications and use of CSII pumps were not. Occurrence of severe hypoglycaemia (SH) episodes increased with Gold score in a linear manner throughout the scale. CONCLUSIONS: This study has identified new evidence of a significant, independent relationship between diabetes distress measured by the DDS2 and reduced awareness of hypoglycaemia in people with type 1 diabetes. It also demonstrates that diabetes distress is significantly associated with HbA1c and female gender independently. The DDS2 identifies distress associated with both hypo- and hyperglycaemia and can be a useful creening tool. Additionally, the occurrence of SH increases with increasing Gold score.
