The Effect of Passive Smoking on Early Clinical Outcomes After Total Knee Arthroplasty Among Female Patients
The aim of this study was to assess whether passive smoking affects clinical outcomes among female patients with knee osteoarthritis after being treated with total knee arthroplasty (TKA). The study prospectively enrolled 216 female patients who did not smoke and those patients were classified into...
Gespeichert in:
| Veröffentlicht in: | Risk management and healthcare policy 2021-01, Vol.14, p.2407-2419 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2419 |
|---|---|
| container_issue | |
| container_start_page | 2407 |
| container_title | Risk management and healthcare policy |
| container_volume | 14 |
| creator | An, Xiao Wang, Junliang Shi, Weiqing Ma, Rui Li, Zhirui Lei, Mingxing Liu, Yaosheng Lin, Feng |
| description | The aim of this study was to assess whether passive smoking affects clinical outcomes among female patients with knee osteoarthritis after being treated with total knee arthroplasty (TKA).
The study prospectively enrolled 216 female patients who did not smoke and those patients were classified into three groups in terms of the severity of exposure to environmental tobacco smoke. A three-month follow-up was conducted to assess the physical and mental outcomes between the three groups. The physical outcomes were evaluated by the visual analogue score (VAS), range of motion (ROM), hospital for special surgery (HSS) knee score, and postoperative complications. The mental outcomes were assessed by the anxiety and depression scale (HADS) and medical outcome study short form 36 (SF-36). Subgroup analysis of patients with and without surgical site infection (SSI) was also calculated.
Baseline characteristics were similarly distributed between the three groups (P>0.05). Patients in the heavy passive smoking group had a higher VAS and a lower ROM score as compared with patients in the no and mild passive smoking group at discharge (P |
| doi_str_mv | 10.2147/RMHP.S309893 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8187102</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A679924049</galeid><sourcerecordid>A679924049</sourcerecordid><originalsourceid>FETCH-LOGICAL-c510t-73100027c7f07525825432b67826e3b253e55a0064c1aff9d2f6d29c8f951c6a3</originalsourceid><addsrcrecordid>eNptklGLGyEQx5fS0juu99bnIhRKH5p01XVdXwoh5HqlV-7opc9izJh4dTWn7kG-fQ2XhqRUBWX8zX_GcarqLa7HBDf8888f13fje1qLTtAX1TnGXIwwE83Lo_NZdZnSQ11GIzre8dfVGW0wpliw88rN14BmxoDOKBh0p1KyT4Du-_Db-hUKHs1UdFs0ddZbrRy6HbIOPSQ0MRkimodcjN89AJrEvI5h41TKWzTpQ3G_gl45KKrZgs_pTfXKKJfgcr9fVL-uZvPp9ejm9uu36eRmpBmu84hTXJIlXHNTc0ZYR1hDyaLlHWmBLgijwJiq67bRWBkjlsS0SyJ0ZwTDulX0ovryrLsZFj0sdYkdlZObaHsVtzIoK09vvF3LVXiSHe44rkkR-LgXiOFxgJRlb5MG55SHMCRZEqoZZiWhgr7_B30IQ_TleTuK8obSsg7UqtRDWm9Ciat3onLSciFIUz6nUOP_UGUuobc6eDC22E8cPhw5rEG5vE7BDdkGn07BT8-gjiGlCOZQDFzLXSfJXSfJfScV_N1xAQ_w376hfwCcs8B8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2543743343</pqid></control><display><type>article</type><title>The Effect of Passive Smoking on Early Clinical Outcomes After Total Knee Arthroplasty Among Female Patients</title><source>DOAJ Directory of Open Access Journals</source><source>Dove Press Free</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>Access via Taylor & Francis (Open Access Collection)</source><source>PubMed Central</source><creator>An, Xiao ; Wang, Junliang ; Shi, Weiqing ; Ma, Rui ; Li, Zhirui ; Lei, Mingxing ; Liu, Yaosheng ; Lin, Feng</creator><creatorcontrib>An, Xiao ; Wang, Junliang ; Shi, Weiqing ; Ma, Rui ; Li, Zhirui ; Lei, Mingxing ; Liu, Yaosheng ; Lin, Feng</creatorcontrib><description>The aim of this study was to assess whether passive smoking affects clinical outcomes among female patients with knee osteoarthritis after being treated with total knee arthroplasty (TKA).
The study prospectively enrolled 216 female patients who did not smoke and those patients were classified into three groups in terms of the severity of exposure to environmental tobacco smoke. A three-month follow-up was conducted to assess the physical and mental outcomes between the three groups. The physical outcomes were evaluated by the visual analogue score (VAS), range of motion (ROM), hospital for special surgery (HSS) knee score, and postoperative complications. The mental outcomes were assessed by the anxiety and depression scale (HADS) and medical outcome study short form 36 (SF-36). Subgroup analysis of patients with and without surgical site infection (SSI) was also calculated.
Baseline characteristics were similarly distributed between the three groups (P>0.05). Patients in the heavy passive smoking group had a higher VAS and a lower ROM score as compared with patients in the no and mild passive smoking group at discharge (P<0.01), 1 month (P<0.01), and 3 months (P<0.01) after surgery. Patients in the heavy passive smoking group also had a higher rate of HADS more than 8 at postoperative 1 month (P=0.01) and 3 months (P=0.03) and lower SF-36 summary (P<0.01) and HSS score (P<0.01) at postoperative 3 months. Forty-five postoperative complication events were observed during follow-up. Patients in the heavy passive smoking group (8.51%) had the highest SSI rate, followed by patients in the mild (1.82%) and no passive smoking group (0.88%) at discharge (P=0.02) and postoperative 1 month (P=0.03).
Passive smoking negatively affects TKA among female patients. It may trigger poor pain and functional outcomes, aggravate depression and anxiety, and deteriorate quality of life after discharge from hospital. Avoiding exposure to smoking environment may be beneficial among TKA female patients before and after surgery.</description><identifier>ISSN: 1179-1594</identifier><identifier>EISSN: 1179-1594</identifier><identifier>DOI: 10.2147/RMHP.S309893</identifier><identifier>PMID: 34113195</identifier><language>eng</language><publisher>England: Dove Medical Press Limited</publisher><subject>Anxiety ; Arthritis ; Body mass index ; Care and treatment ; Clinical outcomes ; Complications and side effects ; Depression, Mental ; Diabetes ; Disease ; Electronic health records ; Females ; Health aspects ; Hospitals ; Joint replacement surgery ; Joint surgery ; Knee ; Medical records ; Medical research ; Medicine, Experimental ; Mental depression ; Original Research ; Osteoarthritis ; Pain ; Passive smoking ; Patient outcomes ; Patients ; Quality of life ; Risk factors ; Skin ; Smoking ; Surgical site infections ; Sutures ; Tobacco smoke ; Variance analysis ; Women</subject><ispartof>Risk management and healthcare policy, 2021-01, Vol.14, p.2407-2419</ispartof><rights>2021 An et al.</rights><rights>COPYRIGHT 2021 Dove Medical Press Limited</rights><rights>2021. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 An et al. 2021 An et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-73100027c7f07525825432b67826e3b253e55a0064c1aff9d2f6d29c8f951c6a3</citedby><cites>FETCH-LOGICAL-c510t-73100027c7f07525825432b67826e3b253e55a0064c1aff9d2f6d29c8f951c6a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187102/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187102/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,3862,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34113195$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>An, Xiao</creatorcontrib><creatorcontrib>Wang, Junliang</creatorcontrib><creatorcontrib>Shi, Weiqing</creatorcontrib><creatorcontrib>Ma, Rui</creatorcontrib><creatorcontrib>Li, Zhirui</creatorcontrib><creatorcontrib>Lei, Mingxing</creatorcontrib><creatorcontrib>Liu, Yaosheng</creatorcontrib><creatorcontrib>Lin, Feng</creatorcontrib><title>The Effect of Passive Smoking on Early Clinical Outcomes After Total Knee Arthroplasty Among Female Patients</title><title>Risk management and healthcare policy</title><addtitle>Risk Manag Healthc Policy</addtitle><description>The aim of this study was to assess whether passive smoking affects clinical outcomes among female patients with knee osteoarthritis after being treated with total knee arthroplasty (TKA).
The study prospectively enrolled 216 female patients who did not smoke and those patients were classified into three groups in terms of the severity of exposure to environmental tobacco smoke. A three-month follow-up was conducted to assess the physical and mental outcomes between the three groups. The physical outcomes were evaluated by the visual analogue score (VAS), range of motion (ROM), hospital for special surgery (HSS) knee score, and postoperative complications. The mental outcomes were assessed by the anxiety and depression scale (HADS) and medical outcome study short form 36 (SF-36). Subgroup analysis of patients with and without surgical site infection (SSI) was also calculated.
Baseline characteristics were similarly distributed between the three groups (P>0.05). Patients in the heavy passive smoking group had a higher VAS and a lower ROM score as compared with patients in the no and mild passive smoking group at discharge (P<0.01), 1 month (P<0.01), and 3 months (P<0.01) after surgery. Patients in the heavy passive smoking group also had a higher rate of HADS more than 8 at postoperative 1 month (P=0.01) and 3 months (P=0.03) and lower SF-36 summary (P<0.01) and HSS score (P<0.01) at postoperative 3 months. Forty-five postoperative complication events were observed during follow-up. Patients in the heavy passive smoking group (8.51%) had the highest SSI rate, followed by patients in the mild (1.82%) and no passive smoking group (0.88%) at discharge (P=0.02) and postoperative 1 month (P=0.03).
Passive smoking negatively affects TKA among female patients. It may trigger poor pain and functional outcomes, aggravate depression and anxiety, and deteriorate quality of life after discharge from hospital. Avoiding exposure to smoking environment may be beneficial among TKA female patients before and after surgery.</description><subject>Anxiety</subject><subject>Arthritis</subject><subject>Body mass index</subject><subject>Care and treatment</subject><subject>Clinical outcomes</subject><subject>Complications and side effects</subject><subject>Depression, Mental</subject><subject>Diabetes</subject><subject>Disease</subject><subject>Electronic health records</subject><subject>Females</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Knee</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mental depression</subject><subject>Original Research</subject><subject>Osteoarthritis</subject><subject>Pain</subject><subject>Passive smoking</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Quality of life</subject><subject>Risk factors</subject><subject>Skin</subject><subject>Smoking</subject><subject>Surgical site infections</subject><subject>Sutures</subject><subject>Tobacco smoke</subject><subject>Variance analysis</subject><subject>Women</subject><issn>1179-1594</issn><issn>1179-1594</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptklGLGyEQx5fS0juu99bnIhRKH5p01XVdXwoh5HqlV-7opc9izJh4dTWn7kG-fQ2XhqRUBWX8zX_GcarqLa7HBDf8888f13fje1qLTtAX1TnGXIwwE83Lo_NZdZnSQ11GIzre8dfVGW0wpliw88rN14BmxoDOKBh0p1KyT4Du-_Db-hUKHs1UdFs0ddZbrRy6HbIOPSQ0MRkimodcjN89AJrEvI5h41TKWzTpQ3G_gl45KKrZgs_pTfXKKJfgcr9fVL-uZvPp9ejm9uu36eRmpBmu84hTXJIlXHNTc0ZYR1hDyaLlHWmBLgijwJiq67bRWBkjlsS0SyJ0ZwTDulX0ovryrLsZFj0sdYkdlZObaHsVtzIoK09vvF3LVXiSHe44rkkR-LgXiOFxgJRlb5MG55SHMCRZEqoZZiWhgr7_B30IQ_TleTuK8obSsg7UqtRDWm9Ciat3onLSciFIUz6nUOP_UGUuobc6eDC22E8cPhw5rEG5vE7BDdkGn07BT8-gjiGlCOZQDFzLXSfJXSfJfScV_N1xAQ_w376hfwCcs8B8</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>An, Xiao</creator><creator>Wang, Junliang</creator><creator>Shi, Weiqing</creator><creator>Ma, Rui</creator><creator>Li, Zhirui</creator><creator>Lei, Mingxing</creator><creator>Liu, Yaosheng</creator><creator>Lin, Feng</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7XB</scope><scope>88C</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>KB0</scope><scope>M0T</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210101</creationdate><title>The Effect of Passive Smoking on Early Clinical Outcomes After Total Knee Arthroplasty Among Female Patients</title><author>An, Xiao ; Wang, Junliang ; Shi, Weiqing ; Ma, Rui ; Li, Zhirui ; Lei, Mingxing ; Liu, Yaosheng ; Lin, Feng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-73100027c7f07525825432b67826e3b253e55a0064c1aff9d2f6d29c8f951c6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anxiety</topic><topic>Arthritis</topic><topic>Body mass index</topic><topic>Care and treatment</topic><topic>Clinical outcomes</topic><topic>Complications and side effects</topic><topic>Depression, Mental</topic><topic>Diabetes</topic><topic>Disease</topic><topic>Electronic health records</topic><topic>Females</topic><topic>Health aspects</topic><topic>Hospitals</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Knee</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mental depression</topic><topic>Original Research</topic><topic>Osteoarthritis</topic><topic>Pain</topic><topic>Passive smoking</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Quality of life</topic><topic>Risk factors</topic><topic>Skin</topic><topic>Smoking</topic><topic>Surgical site infections</topic><topic>Sutures</topic><topic>Tobacco smoke</topic><topic>Variance analysis</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>An, Xiao</creatorcontrib><creatorcontrib>Wang, Junliang</creatorcontrib><creatorcontrib>Shi, Weiqing</creatorcontrib><creatorcontrib>Ma, Rui</creatorcontrib><creatorcontrib>Li, Zhirui</creatorcontrib><creatorcontrib>Lei, Mingxing</creatorcontrib><creatorcontrib>Liu, Yaosheng</creatorcontrib><creatorcontrib>Lin, Feng</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Risk management and healthcare policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>An, Xiao</au><au>Wang, Junliang</au><au>Shi, Weiqing</au><au>Ma, Rui</au><au>Li, Zhirui</au><au>Lei, Mingxing</au><au>Liu, Yaosheng</au><au>Lin, Feng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Passive Smoking on Early Clinical Outcomes After Total Knee Arthroplasty Among Female Patients</atitle><jtitle>Risk management and healthcare policy</jtitle><addtitle>Risk Manag Healthc Policy</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>14</volume><spage>2407</spage><epage>2419</epage><pages>2407-2419</pages><issn>1179-1594</issn><eissn>1179-1594</eissn><abstract>The aim of this study was to assess whether passive smoking affects clinical outcomes among female patients with knee osteoarthritis after being treated with total knee arthroplasty (TKA).
The study prospectively enrolled 216 female patients who did not smoke and those patients were classified into three groups in terms of the severity of exposure to environmental tobacco smoke. A three-month follow-up was conducted to assess the physical and mental outcomes between the three groups. The physical outcomes were evaluated by the visual analogue score (VAS), range of motion (ROM), hospital for special surgery (HSS) knee score, and postoperative complications. The mental outcomes were assessed by the anxiety and depression scale (HADS) and medical outcome study short form 36 (SF-36). Subgroup analysis of patients with and without surgical site infection (SSI) was also calculated.
Baseline characteristics were similarly distributed between the three groups (P>0.05). Patients in the heavy passive smoking group had a higher VAS and a lower ROM score as compared with patients in the no and mild passive smoking group at discharge (P<0.01), 1 month (P<0.01), and 3 months (P<0.01) after surgery. Patients in the heavy passive smoking group also had a higher rate of HADS more than 8 at postoperative 1 month (P=0.01) and 3 months (P=0.03) and lower SF-36 summary (P<0.01) and HSS score (P<0.01) at postoperative 3 months. Forty-five postoperative complication events were observed during follow-up. Patients in the heavy passive smoking group (8.51%) had the highest SSI rate, followed by patients in the mild (1.82%) and no passive smoking group (0.88%) at discharge (P=0.02) and postoperative 1 month (P=0.03).
Passive smoking negatively affects TKA among female patients. It may trigger poor pain and functional outcomes, aggravate depression and anxiety, and deteriorate quality of life after discharge from hospital. Avoiding exposure to smoking environment may be beneficial among TKA female patients before and after surgery.</abstract><cop>England</cop><pub>Dove Medical Press Limited</pub><pmid>34113195</pmid><doi>10.2147/RMHP.S309893</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1179-1594 |
| ispartof | Risk management and healthcare policy, 2021-01, Vol.14, p.2407-2419 |
| issn | 1179-1594 1179-1594 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8187102 |
| source | DOAJ Directory of Open Access Journals; Dove Press Free; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Access via Taylor & Francis (Open Access Collection); PubMed Central |
| subjects | Anxiety Arthritis Body mass index Care and treatment Clinical outcomes Complications and side effects Depression, Mental Diabetes Disease Electronic health records Females Health aspects Hospitals Joint replacement surgery Joint surgery Knee Medical records Medical research Medicine, Experimental Mental depression Original Research Osteoarthritis Pain Passive smoking Patient outcomes Patients Quality of life Risk factors Skin Smoking Surgical site infections Sutures Tobacco smoke Variance analysis Women |
| title | The Effect of Passive Smoking on Early Clinical Outcomes After Total Knee Arthroplasty Among Female Patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T05%3A58%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Effect%20of%20Passive%20Smoking%20on%20Early%20Clinical%20Outcomes%20After%20Total%20Knee%20Arthroplasty%20Among%20Female%20Patients&rft.jtitle=Risk%20management%20and%20healthcare%20policy&rft.au=An,%20Xiao&rft.date=2021-01-01&rft.volume=14&rft.spage=2407&rft.epage=2419&rft.pages=2407-2419&rft.issn=1179-1594&rft.eissn=1179-1594&rft_id=info:doi/10.2147/RMHP.S309893&rft_dat=%3Cgale_pubme%3EA679924049%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2543743343&rft_id=info:pmid/34113195&rft_galeid=A679924049&rfr_iscdi=true |