Lily D. Yan's research while affiliated with Weill Cornell Medical College and other places

Publications (20)

Article
Neighborhood factors have been associated with health outcomes, but this relationship is underexplored in low-income countries like Haiti. We describe perceived neighborhood cohesion and perceived violence using the Neighborhood Collective Efficacy and the City Stress Inventory scores. We hypothesized lower cohesion and higher violence were associa...
Article
Full-text available
Background Multidrug therapy is a World Health Organization “best buy” for the prevention and control of noncommunicable diseases. CVD polypills, including ≥2 blood pressure medications, and a statin with or without aspirin, are an effective, scalable strategy to close the treatment gap that exists in many low- and middle-income countries, includin...
Article
Full-text available
Haiti is a low-income country whose population lives under repeated and chronic stress from multiple natural disasters, civil unrest, and extreme poverty. Stress has been associated with cardiovascular (CVD) risk factors including hypertension, and the impact of stress on blood pressure may be moderated by support. The distribution of stress, suppo...
Article
Aims: Modeling estimates indicate that heart failure (HF) prevalence may be lowest in low-income (LICs). Conversely, HF has been shown to be the leading cause of hospital admission in hospitals in many LICs. This disconnect between estimates and hospital-based observations may be explained by the underlying data. Modeling studies may have selection...
Article
Full-text available
Background: Cardiovascular diseases (CVD) are rapidly increasing in low-middle income countries (LMICs). Accurate risk assessment is essential to reduce premature CVD by targeting primary prevention and risk factor treatment among high-risk groups. Available CVD risk prediction models are built on predominantly Caucasian risk profiles from high-in...
Article
Background Sub-Saharan Africa (SSA) has the highest age-adjusted burden of hypertension and cardiovascular disease (CVD). SSA also experiences many viral infections due to unique environmental and societal factors. The purpose of this narrative review is to examine evidence around how hypertension, CVD, and emerging viral infections interact in SSA...
Article
Introduction: Neighborhood social context including violence and cohesion may impact cardiovascular disease risk factors in countries like Haiti with high civil unrest. We describe these factors using validated instruments (Neighborhood Collective Efficacy, City Stress Inventory), and hypothesized higher cohesion and lower violence were associated...
Article
Introduction: Stress is associated with multiple adverse health outcomes, including hypertension. The impact of stress on health may be moderated by social support. The distribution of stress, support, and their association with hypertension have not been well described in low-income countries that face severe poverty. Over the past decade, Haiti h...
Article
Introduction: Cardiovascular diseases (CVD) are rapidly increasing in low-middle income countries. Accurate risk assessment is essential to reduce premature CVD by targeting primary prevention. Available CVD risk prediction models are built on predominantly Caucasian, high-income country populations, and have not been evaluated in lower-income coun...
Article
Introduction: Cardiovascular disease is the leading cause of death in Haiti and many low-middle income countries. Environmental lead exposure is associated with higher blood pressure (BP) and cardiovascular disease mortality in high income countries but has not been systematically evaluated in lower income countries where 6.5 billion people reside....
Article
Full-text available
Introduction Diabetes mellitus is a chronic noncommunicable disease associated with death and major disability, with increasing prevalence in low- and middle-income countries. There is limited population-based data about diabetes in Haiti. The objective of this study was to assess the prevalence of diabetes and associated factors among adults in Po...
Article
Full-text available
Poor diets are responsible for a large burden of noncommunicable disease (NCD). The prevalence of modifiable dietary risk factors is rising in lower-income countries such as Haiti, along with increasing urbanization and shifts to diets high in sugar, salt, and fat. We describe self-reported dietary patterns (intake of fruits, vegetables, fried food...
Article
Full-text available
Cardiovascular disease (CVD) is the number one cause of death in low‐income countries including Haiti, with hypertension (HTN) being the leading risk factor. This study aims to identify gaps in the HTN continuum of screening, diagnosis, treatment, and blood pressure (BP) control. Sociodemographic and clinical data were collected from a population‐b...
Article
Cardiovascular disease is the leading cause of death in lower-income countries including Haiti. Environmental lead exposure is associated with high blood pressure and cardiovascular mortality in high-income countries but has not been systematically measured and evaluated as a potential modifiable cardiovascular risk factor in lower-income countries...
Article
Full-text available
Background People living with HIV (PLWH) are at increased risk of cardiovascular disease (CVD) and death, with greater burdens of both HIV and CVD in lower-middle income countries. Treating prehypertension in PLWH may reduce progression to hypertension, CVD risk and potentially mortality. However, no trial has evaluated earlier blood pressure treat...
Preprint
Full-text available
Background Cardiovascular diseases (CVD) are rapidly increasing in low-middle income countries (LMICs). Accurate risk assessment is essential to reduce premature CVD by targeting primary prevention and risk factor treatment among high-risk groups. Available CVD risk prediction models are built on predominantly Caucasian, high-income country populat...
Article
In this retrospective cohort study of patients presenting to a national direct-to-consumer medical practice, we found that provider geographic location is a stronger driver of antibiotic prescribing than patient location. Physicians in the Northeast and South are significantly more likely than physicians in the West to prescribe antibiotics for upp...
Preprint
Full-text available
Background People living with HIV (PLWH) are at increased risk of cardiovascular disease (CVD) and death, with greater burdens of both HIV and CVD in lower-middle income countries. Treating prehypertension in PLWH may reduce progression to hypertension, CVD risk and potentially mortality. However, no trial has evaluated earlier blood pressure treat...
Article
Background Antibiotics prescribed for acute respiratory tract infections in the telemedicine setting are often unwarranted.Objective We hypothesized that education plus individualized feedback, compared with education alone, would significantly reduce antibiotic prescription rates for upper respiratory infections, bronchitis, sinusitis, and pharyng...
Article
Full-text available
Background Direct-to-patient (DTP) telemedicine has been noted to have highly variable antibiotic prescribing practices. This study explores the effect of education and individualized provider prescribing feedback on antibiotic prescribing for acute upper respiratory tract infections (ARTIs) in a telemedicine practice. Methods Doctor on Demand is...

Citations

... intelligence quotient alteration) [58], and can be associated with increased aggressiveness, anxiety, attention deficit hyperactivity disorder, autism-spectrum disorder, and depression [59]. In addition, epidemiological studies showed an association between blood and/or bone lead levels and hypertension [60,61]. ...
... 3,4 Geographic location, clinical setting, individual clinician practice, and patient demographics are strong predictors of non-adherence to antibiotic guideline recommendations for ARIs across EDs and UCCs. 5,6 For patients seen via telemedicine applications, direct-to-consumer groups were more than twice as likely to be prescribed an antibiotic for ARIs than patients presenting in the ED despite identical technologies and physician groups. 7 Unaffiliated, vendor-supplied emergency physicians were more likely to prescribe an antibiotic than those who were system employed. ...
... Of the examined studies, 83% (10/12) of telehealth antimicrobial stewardship programs consisted of a remote ID physician (one study utilized an internal medicine trained associated medical director [19], and another consisted of pharmacists [22]) and 25% (3/12) included a remote pharmacist [14,20,22]. One-third (4/12) of local sites created a local ASP team consisting of local providers, infection prevention nurses, and pharmacists [12,16,17,23]. ...
... And I think that it does allow me to think of, "Does this patient really need an antimicrobial?" and will lead me to be a little bit more judicious when I'm choosing my antimicrobial therapy in the future. of being able to visualize their antimicrobial prescribing patterns using different metrics. Antimicrobial stewardship initiatives involving the provision of periodic feedback to clinicians on their antimicrobial prescribing have been used successfully in human medicine (6,(30)(31)(32)(33)(34) and in animal agriculture (7,35,36). In veterinary hospitals, such initiatives are being proposed (37, 38). ...