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The Evidence Speaks

The Evidence Speaks (July 2021)

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Tuberculosis patients are more likely to develop depression

Basham CA, Karim ME, Cook VJ, Patrick DM, Johnston JC. Tuberculosis-associated depression: a population-based cohort study of people immigrating to British Columbia, Canada, 1985-2015. Ann Epidemiol. 2021 Jun 16 epub ahead of print. doi:10.1016/j.annepidem.2021.06.002

CHÉOS Scientist Dr. Ehsan Karim collaborated with researchers from B.C. to estimate the risk of tuberculosis (TB)-associated depression and determine if depression risk was impacted by hospital length of stay (LOS). Of the 755,836 participants who immigrated to B.C. between 1985 and 2015, 2,295 were diagnosed with TB and 128,963 were diagnosed with depression. Further analysis of these findings indicated that people with TB were 24 per cent more likely to develop depression compared to TB-free controls and depression risk was strongly affected by hospital LOS. Overall, this study highlights that TB patients could benefit from depression screening and support; however, additional research is needed to identify the precise association between hospital LOS and depression.


Emergency physicians need further education to improve care for suicidal patients

Fernandes J, Scheuermeyer FX, Chakraborty AT, Honer WG, Barbic D. What are Canadian emergency physicians’ attitudes and self-perceived competence toward patients who present with suicidal ideation? Can J Emerg Med. 2021 Jul 1 epub ahead of print. doi:10.1007/s43678-021-00157-0

CHÉOS’ Drs. Frank Scheuermeyer and David Barbic joined colleagues from UBC to analyze the attitudes of emergency physicians (EPs) towards suicidal patients and measure the skills and training of EPs to care for these patients. A total of 188 EPs responded to an online survey. The majority said they treat around 5–15 suicidal patients per month and 64 per cent stated they had the skills to screen for suicidal ideation. While just 17 per cent of EPs had received specific training for suicidal ideation treatment in the past five years and only 30 per cent felt confident in their ability to create personal safety plans for patients, 60 per cent were confident in referring patients to appropriate resources. Overall, the responding EPs had a generally positive attitude towards treating suicidal patients, but more education may be required to further improve care.


More research needed to provide adequate guidance for at-home blood pressure monitoring in pregnant people

Tran K, Padwal R, Khan N, Wright M-D, Chan WS. Home blood pressure monitoring in the diagnosis and treatment of hypertension in pregnancy: a systematic review and meta-analysis. CMAJ Open. 2021 Jun 15;9(2):E642-E650.

Through a systematic review and meta-analysis, CHÉOS Scientists Drs. Karen Tran and Nadia Khan compared home and medical office blood pressure (BP) monitoring for pregnant people. The researchers analyzed data from 2,843 pregnant people across 19 studies and found that mean home-measured BP was slightly lower than mean office-measured BP in pregnant people, but this varied between the studies. In addition, they noted issues associated with home BP monitoring, such as incorrect technique, inconsistent monitoring schedule, and unknown target BP values. In order to develop evidence-based guidance for home BP monitoring, additional studies are needed to define diagnostic and treatment thresholds and generate information on when home monitoring results could indicate clinically important outcomes.