@article{Angarita-Fonseca2023,

title = {Gender-related Factors Associated with Outcomes of Acute Coronary Syndrome in Young Females},

author = {A. Angarita-Fonseca and A. Peebles and L. Pilote},

doi = {10.1016/j.cjco.2023.11.019},

issn = {2589-790X},

year  = {2023},

date = {2023-12-00},

urldate = {2023-12-00},

journal = {CJC Open},

publisher = {Elsevier BV},

abstract = {Acute Coronary Syndrome (ACS) remains a significant global health concern, with a growing recognition of its impact on young adults, particularly young females. While gender-related factors, defined as a social construct that encompasses four distinct dimensions (gender roles, gender identity, gender relations, and institutionalized gender) are undoubtedly relevant across age groups, young females with ACS face specific challenges and disparities in outcomes compared to other populations. This narrative review examines the role of gender-related factors - specifically gender roles, gender identity, gender relations, and institutionalized gender - in influencing objective and subjective ACS outcomes in young females. In the five manuscripts identified, the objective outcomes included hospital readmission, door-to-ECG time, and coronary atherosclerosis progression. Subjective outcomes such as physical and mental functional status, quality of life, physical limitations, and vital exhaustion were also examined. Employment status, a gender role, emerged as a protective factor against hospital readmission. Gender identity factors like depression and stress correlated with negative outcomes, while anxiety influenced door-to-ECG times. Institutional factors, including income disparities, affected readmission likelihood. Strong social support improved physical limitations post-ACS, whereas financial challenges and lower education negatively impacted quality of life and vital exhaustion. These findings underscore the intricate interplay of gender dimensions in shaping ACS outcomes among young females. Integrating these insights into clinical practice and research can enhance care, mitigate disparities, and foster improved cardiovascular health in this vulnerable population.},

keywords = {Cardiology and Cardiovascular Medicine, Cardiovascular Diseases, Women's health},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37800356,

title = {Trajectories of opioid consumption as predictors of patient-reported outcomes among individuals attending multidisciplinary pain treatment clinics},

author = {A. Angarita-Fonseca and A. Lacasse and M. Choini\`{e}re and J. L. Kabor\'{e} and M. P. Sylvestre and G. D. Tchouangue Dinkou and J. Bruneau and M. O. Martel and R. Hovey and A. Motulsky and E. Rahme and M. G. Pag\'{e}},

doi = {10.1002/pds.5706},

issn = {1099-1557},

year  = {2023},

date = {2023-10-01},

urldate = {2023-10-01},

journal = {Pharmacoepidemiol Drug Saf},

abstract = {PURPOSE: This study aimed to identify opioid consumption trajectories among persons living with chronic pain (CP) and put them in relation to patient-reported outcomes 6 months after initiating multidisciplinary pain treatment.nnMETHODS: This study used data from the Quebec Pain Registry (2008-2014) linked to longitudinal Quebec health insurance databases. We included adults diagnosed with CP and covered by the Quebec public prescription drug insurance plan. The daily cumulative opioid doses in the first 6 months after initiating multidisciplinary pain treatment were transformed into morphine milligram equivalents. An individual-centered approach involving principal factor and cluster analyses applied to longitudinal statistical indicators of opioid use was conducted to classify trajectories. Multivariate regression models were applied to evaluate the associations between trajectory group membership and outcomes at 6-month follow-up (pain intensity, pain interference, depression, and physical and mental health-related quality of life).nnRESULTS: We identified three trajectories of opioid consumption: "no or very low and stable" opioid consumption (n = 2067, 96.3%), "increasing" opioid consumption (n = 40, 1.9%), and "decreasing" opioid consumption (n = 39, 1.8%). Patients in the "no or very low and stable" trajectory were less likely to be current smokers, experience polypharmacy, use opioids or benzodiazepine preceding their first visit, or experience pain interference at treatment initiation. Patients in the "increasing" opioid consumption group had significantly greater depression scores at 6-month compared to patients in the "no or very low and stable" trajectory group.nnCONCLUSION: Opioid consumption trajectories do not seem to be important determinants of most PROs 6 months after initiating multidisciplinary pain treatment.},

keywords = {Chronic Pain, Epidemiology, Pain Measurement, Patient-important outcome, Treatment},

pubstate = {published},

tppubtype = {article}

}

@article{2023-Angarita-COVID19,

title = {Exploring long COVID condition in Latin America: its impact on patients’ activities and associated healthcare use},

author = {A. Angarita-Fonseca and R. Torres-Castro and V. Benavides-Cordoba and S. Chero and Morales Satan M. and Hernandez Lopez B. and R. Salazar and S. Larrateguy and D.C. Sanchez-Ramirez},

doi = {10.3389/fmed.2023.1168628},

year  = {2023},

date = {2023-03-27},

journal = {Frontiers in Medicine},

volume = {10},

abstract = {Background: Studies exploring long COVID condition (LCC) in low- and middle-income countries are scarce. Further characterization of LCC patients experiencing activity limitations and their associated healthcare use is needed. This study aimed to describe LCC patients’ characteristics, it’s impact on activities, and associated healthcare use in Latin America (LATAM).

Participants: Individuals who (cared for someone or) had COVID-19 and could read, write, and comprehend Spanish and lived in a LATAM country were invited to complete a virtual survey. Sociodemographic characteristics, COVID-19 and LCC symptoms, activity limitations, and healthcare use.

Results: Data from 2466 people from 16 countries in LATAM was analyzed (females = 65.9%; mean age of 39.5 ± 53.3 years). 1178 (48%) of the respondents had LCC symptoms (≥3 months). These were more likely to have COVID-19 earlier in the pandemic, were older, had no COVID vaccines, had more comorbidities, needed supplementary oxygen and reported significantly more COVID-19 symptoms during the infectious period. 33% of the respondents visited a primary care provider, 13% went to the emergency department, 5% were hospitalized, 21% visited a specialist, and 32% consulted ≥1 therapist for LCC symptoms mainly extreme fatigue, sleep difficulties, headaches, muscle or joint pain, and shortness of breath with activity. The most consulted therapists were respiratory therapists (15%) and psychologists (14%), followed by physical therapists (13%), occupational therapists (3%) and speech pathologists (1%). One-third of LCC respondents decreased their regular activities (e.g., work, school) and 8% needed help with activities of daily living (ADLs). LCC respondents who reduced their activities reported more difficulty sleeping, chest pain with activity, depression, and problems with concentration, thinking and memory; while those who needed help with ADLs were more likely to have difficulty walking, and shortness of breath at rest. Approximately 60% of respondents who experienced activity limitations sought a specialist and 50% consulted therapists.

Conclusions and relevance: Results supported previous findings in terms of the LCC demographics, and provided insight into LCC impact on patients’ activities and healthcare services used in LATAM. This information is valuable to inform service planning and resource allocation in alignment with the needs of this population.},

key = {Activity limitations, Long Covid, healthcare use, long COVID disability, Latin America},

keywords = {COVID-19, Health services, Mobility limitations, Respiratory system},

pubstate = {published},

tppubtype = {article}

}

@article{RN380,

title = {The Canadian version of the NIH minimum dataset for chronic low back pain research: reference values from the Quebec Low Back Pain Study},

author = {A. Angarita-Fonseca and M. G. Pag\'{e} and Carolina B. Meloto and Erika Lauren Gentile and Guillaume L\'{e}onard and Hugo Mass\'{e}-Alarie and Iulia Tufa and Jean-S\'{e}bastien Roy and Laura S. Stone and Manon Choini\`{e}re and Maryse Fortin and Mathieu Roy and Monica Sean and Pascal T\'{e}treault and Pierre Rainville and Simon Deslauriers and A. Lacasse},

url = {https://journals.lww.com/pain/Fulltext/2023/02000/The_Canadian_version_of_the_National_Institutes_of.15.aspx},

doi = {10.1097/j.pain.0000000000002703},

issn = {0304-3959},

year  = {2023},

date = {2023-01-21},

urldate = {2023-01-21},

journal = {PAIN},

volume = {64},

issue = {2},

pages = {325-335},

abstract = {The National Institutes of Health (NIH) minimum dataset for chronic low back pain (CLBP) was developed in response to the challenge of standardizing measurements across studies. Although reference values are critical in research on CLBP to identify individuals and communities at risk of poor outcomes such as disability, no reference values have been published for the Quebec (Canada) context. This study was aimed to: 1) provide reference values for the Canadian version of the NIH minimum dataset among individuals with CLBP in Quebec, both overall and stratified by gender, age, and pain impact stratification (PIS) subgroups; and 2) assess the internal consistency of the minimum dataset domains (pain interference (PI), physical function (PF), emotional distress/depression (EDD), sleep disturbance (SD), and PIS score). We included 2847 individuals living with CLBP who completed the baseline web survey of the Quebec Low Back Pain Study (age: 44.0±11.2 years, 48.1% women), and were recruited through social media and health care settings. The mean score was 6.1±1.8 for pain intensity. PI, PF, EDD, SD, and PIS scores were 12.9±4.1, 14.4±3.9, 9.8±4.4, 13.0±3.6, and 26.4±6.6, respectively. EDD showed floor effects. Good to excellent internal consistency was found overall and by language, gender, and age subgroups for all domains (alpha: 0.81-0.93) and poor to excellent internal consistency for PIS subgroups (alpha: 0.59\textendash0.91). This study presents reference values and recommendations for using the Canadian version of the NIH minimum dataset for CLBP that can be useful for researchers and clinicians. },

keywords = {Back pain, Chronic Pain, Low Back Pain, Pain Measurement},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36444387,

title = {Distinct care trajectories among persons living with arthritic conditions: A two-year state sequence analysis},

author = {H. L. Nguena Nguefack and M. G. Pag\'{e} and M. Choini\`{e}re and A. Vanasse and S. Deslauriers and A. Angarita-Fonseca and M. A. Blanchette and A. Lacasse},

doi = {10.3389/fpain.2022.1014793},

issn = {2673-561X},

year  = {2022},

date = {2022-11-12},

urldate = {2022-01-01},

journal = {Front Pain Res (Lausanne)},

volume = {3},

pages = {1014793},

abstract = {OBJECTIVES: Developing solutions to optimize care trajectories (CareTs) requires examining patient journeys through the health care system. This study aimed to describe CareTs among people living with arthritis and evaluate their association with self-reported health outcomes.



METHODS: Analyses were conducted using the TorSaDE Cohort ( = 102,148), which connects the 2007 to 2016 Canadian Community Health Surveys (CCHS) with Quebec administrative databases (longitudinal claims). CareTs of participants living with arthritis according to CCHS ( = 16,631), over the two years before CCHS completion, were clustered using state sequence analysis (months as a time unit). CareT group membership was then put in association with self-reported outcomes (pain intensity and interference, self-perceived general and mental health).



RESULTS: The analysis revealed five CareT groups characterized predominantly by: (1) arthritis-related visits to a specialist ( = 2,756; 16.6%), (2) arthritis-related emergency department visits ( = 2,928; 17.6%), (3) very high all-cause health care utilization and arthritis-related hospitalizations ( = 1,570; 9.4%), (4) arthritis-related medical visits to general practitioners and specialists ( = 2,708; 16.3%), (5) low all-cause health care utilization ( = 6,669; 40.1%). Multivariable results revealed that CareT group membership was associated with higher levels of pain interference (CareT group #3 vs. #5: OR: 1.4, 95%CI: 1.1-1.8) and fair/poor self-perceived general health (CareT group #1 vs. #5: OR: 1.551, 95%CI: 1.319-1.824; #2 vs. #5: OR: 1.244, 95%CI: 1.062-1.457; #3 vs. #5: OR: 1.771, 95%CI: 1.451-2.162; #4 vs. #5: OR: 1.481, 95%CI: 1.265-1.735).



DISCUSSION: Sate sequence analysis is an innovative method of studying CareTs and valuable for making evidence-based decisions taking into account inter- and intra-individual variability.},

keywords = {Health services, Musculoskeletal system, Trends},

pubstate = {published},

tppubtype = {article}

}

@article{JA0622,

title = {Handgrip strength is associated with risk of falls in physically active older women},

author = {P. C. VillamizarPita and A. Angarita-Fonseca and H. C. Dutra de Souza and R. Mart\'{i}nez-Rueda and M. C. Villamizar-Garc\'{i}a and J. C. S\'{a}nchez-Delgado},

doi = {10.1080/07399332.2022.2055759},

year  = {2022},

date = {2022-05-13},

urldate = {2022-05-13},

journal = {Health care for women international},

pages = {1-14},

abstract = {The authors of this study inquire about the association between handgrip strength (HGS) and the risk of falls in physically active older women. A cross-sectional study was conducted on 135 women between 50 and 90 years of age who were referred for the follow-up evaluations of HGS using dynamometry and the Tinetti scale to determine the risk of falls. The mean age was 68.8 ± 8.5 years. A total of 31.9% of women had a high risk of falls, and 55% reported five or more falls in the past six months. In addition, our results indicated that grip strength decreases as risk of falls increases (minimal risk = 42.8, 95% confidence interval [CI]: 39.8, 45.8; moderate risk = 31.3, 95% CI: 29.1, 33.5; high risk = 21.9, 95% CI: 19.3, 24.6). It should be considered that in physically active women aged over 50 years, the grip strength could be a predictor of falls and risk of falls. Evaluation of grip strength is a low-cost type of assessment that can be included as a part of physical tests.},

keywords = {Muscle Strength, Physical Activity, Women's health, Women's health},

pubstate = {published},

tppubtype = {article}

}

@article{JA0522,

title = {Gender differences in medication adverse effects experienced by people living with chronic pain},

author = {H. L. Nguena Nguefack and M. G. Pag\'{e} and L. Gu\'{e}nette and L. Blais and M. Diallo and M. Godbout-Parent and A. Angarita-Fonseca and A. Lacasse},

doi = {10.3389/fpain.2022.830153},

year  = {2022},

date = {2022-05-10},

journal = {Frontiers in Pain Research},

volume = {3},

number = {830153},

abstract = {Objectives: Understanding gender differences in chronic pain (CP) outcome research is essential to optimal treatment delivery. This study explored the associations between gender identity, gender roles, and the number of non-life-threatening pain medication adverse effects reported as severe by people living with CP.



Methods: The analyses were conducted using the COPE Cohort, a dataset generated through a web-based recruitment of adults with CP. Participants were asked how they identified themselves (women, men, unknown, unspecified) and gender roles were measured using the Bem Sex-Role Inventory (subgroups were formed applying the median split method). Pain medication adverse effects were assessed using a standardized checklist (none/mild/moderate/severe). A zero-inflated Poisson model was used to assess gender identity, gender roles and their interaction as potential predictors of the number of pain medication adverse effects.



Results: A total of 1,343 participants reported using pain medications. Adjusting for potential confounders, both gender identity (men vs. women: \ss = −0.32, p = 0.0024) and gender roles (androgynous vs. undifferentiated: \ss = 0.26, p = 0.0030) were associated with the number of pain medication adverse effects reported as severe, and they interacted with each other. The stratified analysis by gender roles showed that women reported a greater number of severe adverse effects than men among those classified as masculine and androgynous.



Discussion: Although we are unable to confirm whether the associations can be explained by differences in the experience or in the reporting of effects, gender identity and gender roles should both be explored when studying pain medication adverse effects.},

key = {sex, gender, chronic pain, adverse effects, side effects},

keywords = {Chronic Pain, Pharmacoepidemiology, Women's health},

pubstate = {published},

tppubtype = {article}

}

@article{JA0422,

title = {Prevalence of Cannabis Use for Pain Management in Quebec: A Post-Legalization Estimate Among Generations Living with Chronic Pain},

author = {M. Godbout-Parent and H. L. Nguena Nguefack and A. Angarita-Fonseca and C. Audet and A. Bernier and G. Zahlan and N. Julien and M. G. Pag\'{e} and L Guenette and L. Blais and A. Lacasse},

url = {https://www.tandfonline.com/doi/epub/10.1080/24740527.2022.2051112?needAccess=true, CJP},

doi = {https://doi.org/10.1080/24740527.2022.2051112},

year  = {2022},

date = {2022-03-30},

urldate = {2022-03-30},

journal = {Canadian Journal of Pain},

abstract = {Background

While medical cannabis has been legal in Canada since 2001, recreational cannabis was legalized in October 2018 which has led to a widespread increase in the accessibility of cannabis products.

Aims

This study aimed to estimate the prevalence of cannabis use among adults living with chronic pain (CP) and investigate the relationship between age and cannabis use for CP management.

Methods

A cross-sectional analysis of the COPE Cohort dataset, a large Quebec sample of 1,935 adults living with CP, was conducted. Participants completed a web-based questionnaire in 2019 that contained three yes/no questions about past-year use of cannabis (i.e., for pain management, management of other health-related conditions, recreational purposes).

Results

Among the 1,344 participants who completed the cannabis use section of the questionnaire, the overall prevalence of cannabis use for pain management was 30.1% (95%CI:27.7-32.7). Differences were found between age groups with the highest prevalence among participants aged ≤26 years (36.5%) and lowest for those aged ≥74 years (8.8%). A multivariable logistic model revealed that age, region of residence, generalized pain, use of medications or non-pharmacological approaches for pain management, alcohol/drug consumption, and smoking were associated with the likelihood of using cannabis for pain management.

Conclusions

Cannabis is a common treatment for the management of CP, especially in younger generations. The high prevalence of use emphasizes the importance of better knowledge translation for people living with CP, rapidly generating evidence regarding the safety and efficacy of cannabis, and clinicians’ involvement in supporting people who use cannabis for pain management.},

keywords = {Chronic Pain, Pharmacoepidemiology},

pubstate = {published},

tppubtype = {article}

}

@article{JA0322,

title = {Low back pain definitions: effect on patient inclusion and clinical profiles},

author = {H. Mass\'{e}-Alarie and A. Angarita-Fonseca and A. Lacasse and M. G. Pag\'{e} and P. T\'{e}treault and M. Fortin and L. S. Stone and Roy J. S. and Quebec Low Back Pain Consortium },

editor = {A. Angarita-Fonseca},

url = {https://journals.lww.com/painrpts/Fulltext/2022/04000/Low_back_pain_definitions__effect_on_patient.11.aspx, Pain Reports},

doi = {http://dx.doi.org/10.1097/PR9.0000000000000997},

year  = {2022},

date = {2022-03-22},

urldate = {2022-03-22},

journal = {Pain Reports},

volume = {7},

issue = {2},

pages = {e997},

abstract = {Introduction: 

Numerous definitions of acute low back pain (aLBP) exist. The use of different definitions results in variability in reported prevalence or incidence, conflicting data regarding factors associated with the transition to chronic LBP (cLBP), and hampers comparability among studies.



Objective: 

Here, we compare the impact of 3 aLBP definitions on the number of aLBP cases and participants' characteristics and explore the distribution of participants across definitions.



Methods: 

A sample of 1264 participants from the Quebec Low Back Pain Study was included. Three definitions of aLBP were used: (1) not meeting the National Institutes of Health (NIH) cLBP definition (“nonchronic”), (2) pain beginning \<3 months ago (“acute”), and (3) pain beginning \<3 months with a preceding LBP-free period (“new episode”).



Results: 

There were 847, 842, and 489 aLBP cases meeting the criteria for the 3 definitions, respectively. Participants included in the “nonchronic” had lower pain interference, greater physical function scores, and fewer participants reporting \>5 years of pain than in the other definitions. Half the participants meeting the “acute” definition and one-third of participants meeting the “new episode” definition were also classified as cLBP based on the NIH definition.



Conclusions: 

Our results highlight the importance of the definition used for aLBP. Different definitions influence the sample size and clinical profiles (group's characteristics). We recommended that cohort studies examining the transition from aLBP to cLBP ensure that the definitions selected are mutually exclusive (ie, participants included [aLBP] differ from the expected outcome [cLBP]).},

keywords = {Chronic Pain, Low Back Pain, Musculoskeletal system},

pubstate = {published},

tppubtype = {article}

}

@article{JA2022a,

title = {Examining Facilitators and Barriers to Cardiac Rehabilitation Adherence in a Low-Resource Setting in Latin America from Multiple Perspectives},

author = {D. M. Rangel-cubillos and A. V. Vega-Silva and Y. F. Corzo-Vargas and M. C. Molano-Tordecilla and Y. P. Pe\~{n}uela-Ar\'{e}valo and K. M. Lagos-Pe\~{n}a and A. M. J\'{a}come-Hort\'{u}a and C. J. Villamizar Jaimes and S. L. Grace and H. C. Dutra de Souza and A. Angarita-Fonseca and J. C. S\'{a}nchez Delgado },

url = {https://www.mdpi.com/1660-4601/19/4/1911 Journal},

doi = {https://doi.org/10.3390/ijerph19041911},

year  = {2022},

date = {2022-02-09},

urldate = {2022-02-09},

journal = {Int. J. Environ. Res. Public Health},

volume = {19},

number = {4},

pages = {1911},

abstract = {Cardiac rehabilitation (CR) is under-used, particularly in low-resource settings. There are few studies of barriers and facilitators to CR adherence in these settings, particularly considering multiple perspectives. In this multiple-method study, a cross-sectional survey including the Cardiac Rehabilitation Barriers Scale (each item scored on a five-point Likert scale) was administered to patients treated between February and July, 2019, in three CR centers in Colombia. A random subsample of 50 participants was invited to a focus group, along with an accompanying relative. Physiotherapists from the programs were invited to an interview, with a similar interview guide. Audio-recordings were transcribed and analyzed using interpretive description. A total of 210 patients completed the survey, and 9 patients, together with 3 of their relatives and 3 physiotherapists, were interviewed. The greatest barriers identified were costs (mean = 2.8 ± 1.6), distance (2.6 ± 1.6) and transportation (2.5 ± 1.6); the logistical subscale was highest. Six themes were identified, pertaining to well-being, life roles, weather, financial factors, healthcare professionals and health system factors. The main facilitators were encouragement from physiotherapists, relatives and other patients. The development of hybrid programs where patients transition from supervised to unsupervised sessions when appropriate should be considered, if health insurers were to reimburse them. Programs should consider the implications regarding policies of family inclusion.},

keywords = {Cardiac Rehabilitation, Hearth diseases, Rehabilitation, Treatment adherence},

pubstate = {published},

tppubtype = {article}

}