Health-related quality of life associated with nocturnal leg cramps in primary care: a mixed methods study.

BACKGROUND: Although nocturnal leg cramps are common, little research is available about their impact on quality of life. This mixed-methods study explored the impact of nocturnal leg cramps on health-related quality of life (HRQoL). METHODS: The study included primary care patients (>50 years) who reported suffering from nocturnal leg cramps (2016-2017). In the quantitative phase, patients completed a questionnaire about their HRQoL (SF-36) and the frequency of their cramps, and we computed the SF-36 scores. Then, we conducted a qualitative study using semi-structured interviews with patients with various levels of HRQol to explore their perception of the impact of cramps on their lives. RESULTS: A total of 114 patients (49%) agreed to participate in the quantitative study (mean age: 71, women: 62%) and 15 patients were included in the qualitative study (mean age: 69, women: 67%). The number of cramps in the previous week was low (mean: 1.6 (SD 1.5)). The SF-36 mean physical and mental summary scores were 43 and 50, respectively, and the domain scores were similar to a comparative general population. Whilst some patients reported little interference with their daily lives, others reported a major decrease in their HRQoL. SF-36 scores were not sufficient to describe the cramp-related impairment, as patients from all levels of SF-36 scores reported major impacts of NLC in the interviews. CONCLUSIONS: Some patients describe a specific impact of cramps on their lives, regardless of their HRQoL. These patients should be the target of future intervention trials.

[Management of hypertension in hospitalized patients]. / Modification du traitement antihypertenseur durant le séjour hospitalier.

International guidelines for high blood pressure are regularly updated for outpatient monitoring, but there is currently no consensus on its definition and management in hospitalized patients. Recent evidence in the literature suggests that extrapolation of treatment targets from the outpatient to the inpatient setting may be at best unnecessary and at worst detrimental to the patient, increasing the risk of adverse events and the rate of avoidable readmission.

Les directives internationales pour l'hypertension artérielle sont régulièrement mises à jour pour le suivi ambulatoire. Toutefois, à l'heure actuelle, il n'existe pas de consensus quant à sa définition et sa prise en charge en milieu hospitalier. Selon des données récentes de la littérature, l'extrapolation des cibles thérapeutiques du milieu ambulatoire au milieu hospitalier peut au mieux s'avérer inutile et au pire préjudiciable pour le patient, en augmentant le risque d'effets indésirables et le taux de réadmission évitable.