Redefining asthma treatment success: bridging remission goals with patient-centred outcomes

Reconceptualizing Care Transitions Research From the Patient Perspective.

Phenomenon : Student-run free clinics (SRFCs) serve an integral role in most United States (US) medical schools and contribute substantially to literature on the quality of care to uninsured persons. There has been substantial growth over the past decade of scholarly work produced by SRFCs as they have increased in size and number. Research on patient care outcomes informs better care structures for patients, however there is no current synthesis of patient care outcomes research among SRFCs. This article provides an overview of SRFC research on patient outcomes to understand current research domains and to identify gaps in the literature. Approach : We completed a scoping review by searching Scopus, PubMed, and Journal of Student Run Clinics in June 2021. All peer-reviewed, English-language articles focused on patient-centered outcomes at SRFCs in the US were included. Two independent reviewers performed title, abstract, and full-text screening of relevant works, and eight reviewers conducted data extraction. Descriptive data analysis was performed along with relevant content analysis of patient-centered outcomes. Findings : The search strategy identified 784 studies, of which 87 met inclusion criteria. Most studies were published within the last six years (81.6%), located in California, New York, or Florida (43.7%), and intervention based (33.3%). Many studies (46.0%) had a specific disease of focus of which diabetes was the most researched(19.5%). Patient-centered studies were the leading focus of the study aims (40.2%), where key findings demonstrated primarily improved outcomes in clinic metrics post-intervention (36.8%) or equivalent/better clinical performance than national metrics (20.7%). Insights : This review brings to light gaps in the literature reporting research in SRFCs and can be applied to other low-resource settings. Future efforts to expand SRFC outcomes research should focus on community relationship building, understanding institutional support, and ensuring education on best practices for research within SRFCs. Doing so informs patient care improvement as SRFCs continue to operate as safety net clinics for marginalized populations.

Beyond "a chance to cut is a chance to cure": surgical quality in the cancer care continuum.

Value-based insurance design (VBID) initiatives have been associated with modest improvements in adherence based on evaluations of administrative claims data. The objective of this prospective cohort study was to report the patient-centered outcomes of a VBID program that eliminated co-payments for diabetes-related medications and supplies for employees and dependents with diabetes at a large health system. The authors compared self-reported values of medication adherence, cost-related nonadherence, health status, and out-of-pocket health care costs for patients before and 1 year after program implementation. Clinical metrics and satisfaction with the program also are reported. In all, 188 patients completed the follow-up evaluation. Overall, patients reported a significant reduction in monthly out-of-pocket costs (P<0.001), which corresponded to a significant reduction in cost-related nonadherence from 41% to 17.5% (P<0.001). Self-reported medication adherence increased for hyperglycemic medications (P=0.011), but there were no apparent changes in glycemic control. Overall, 89% of participants agreed that the program helped them take better care of their diabetes. The authors found that a VBID program for employees and dependents with diabetes was associated with self-reported reductions in cost-related nonadherence and improvements in medication adherence. Importantly, the program was associated with high levels of satisfaction among participants and strongly perceived by participants to facilitate medication utilization and self-management for diabetes. These findings suggest that VBID programs can accomplish the anticipated goals for medication utilization and are highly regarded by participants. Patient-centered outcomes should be included in VBID evaluations to allow decision makers to determine the true impact of VBID programs on participants.

Device advisories due to potential hardware failure comprise one of the downsides of implantable cardioverter defibrillator (ICD) therapy. The impact of advisories on patient-centered outcomes has largely been overlooked. We examined the impact of ICD advisories on patient-centered outcomes via a systematic literature review. PubMed was searched in the period from 1980 to present using a combination of at set of a priori search terms. The reference lists of the included papers were searched by hand. A total of six studies were identified. All advisories were Class I, Class II, or a combination. The sample size across studies varied between 30 and 86 patients subject to an advisory; four of six studies used a case-control design and two of six a prospective study design. There was considerable variability between notification of the advisory and assessment of the patient-centered outcomes, ranging from 1 to 24 months. A mixture of generic and disease-specific patient-centered outcome measures was used. The evidence for an impact on device advisories was mixed, with the two prospective studies showing an increase in anxiety over time, whereas none of the larger case-control studies found a difference in patient-centered outcomes between cases and controls. Evidence for an impact of device advisories on patient-centered outcomes is mixed. In order to incorporate a patient-centered approach in clinical care, patient-centered outcomes should form part of standard clinical practice and if available the assessments entered into ICD registries. Such registries would provide important insights into the impact of ICD advisories on patients' well being.

A Secondary Analysis to Identify Patient-Centered Outcomes in the ACR’s Appropriateness Criteria

Background: Chronic wounds pose a significant global health challenge, profoundly impacting patients' quality of life. While traditional care focuses on biological healing, there is growing emphasis on patient-centered outcomes (PROs). Non-pharmacological interventions are increasingly recognized as essential components of comprehensive care, yet a comprehensive synthesis of their effects on PROs is needed. Objective: This narrative review aims to identify and synthesize the evidence on the effects of various non-pharmacological interventions on PROs in adults with chronic wounds. Methods: A systematic search was conducted in PubMed, Embase, CINAHL, Web of Science, Cochrane Library, and CNKI from inception until October 18, 2025. Studies involving adults with chronic wounds that evaluated non-pharmacological, non-surgical interventions and measured at least one PRO were included. Results: The review included 14 studies. The interventions were categorized into four types: 1) Physical and Energy-Based Therapies, which showed benefits in reducing procedural pain and improving comfort; 2) Psychological and Behavioral Interventions, which demonstrated positive effects on emotional distress and disease-specific quality of life; 3) Advanced Wound Dressings, associated with reduced pain and accelerated healing; and 4) Innovative Care Models, which consistently improved multiple PROs, including pain, self-efficacy, and general quality of life. Conclusion: A diverse range of non-pharmacological interventions can significantly improve PROs in chronic wound management, addressing critical aspects of patient well-being such as pain, psychological state, and self-efficacy. Integrating these interventions into a multifaceted, patient-centered care approach is recommended. Future research should focus on larger, high-quality trials with standardized outcome measures to strengthen the evidence base.

This study presents a clinical utility-driven machine learning framework for retinal Optical Coherence Tomography classification, addressing challenges posed by manual interpretation variability and dataset heterogeneity. The methodology integrates biomimetic data partitioning, deep biomarker extraction via pretrained VGG16 networks, and automated model selection optimized for clinical decision-making. Stratified data curation preserved pathological distributions across training, validation, and testing subsets, while SMOTE optimization mitigated class imbalance. Cross-pathology testing evaluated generalizability on anatomically distinct retinal conditions excluded from training, assessing the framework’s robustness to unseen pathologies. Clinical utility metrics prioritized alignment with ophthalmological imperatives, emphasizing negative predictive value to minimize false negatives and enhance diagnostic reliability. The framework advances AI-driven Optical Coherence Tomography diagnostics by harmonizing computational performance with patient-centered outcomes, enabling standardized disease detection across diverse clinical datasets through robust feature generalization.

Shifting From Volume to Value: Opportunities and Challenges for the Field of Orthopaedic Surgery.

Health outcomes can be captured and reported from a number of perspectives, and the patient’s perspective is central to successful healthcare delivery and optimizing health outcomes. A patient-centered approach is important in dermatology. We discussed the meaning and application of “patient centeredness,” “patient-centered outcome measures (PCOM),” and “patient-reported outcomes (PROs)” in dermatology. We highlighted the important roles that organizations such as the Patient-Centered Outcomes Research Institute (PCORI) and the International Dermatology Outcome Measures (IDEOM) play in advancing patient centeredness in skin diseases. We examined classic patient-reported outcome measures such as the Dermatology Life Quality Index (DLQI) and the Skindex. We also explored patient-centered outcomes in dermatologic surgery. With the development of patient-centered outcome measures, patients are able to express how their skin disease affects their lives in a systematic and valid fashion. These responses are highly valuable in guiding clinical decision-making and improving all aspects of patients’ well-being.

This longitudinal study investigates the effectiveness of multifaceted interventions in improving patient outcomes in diabetes and cardiovascular health. With an increasing prevalence of these conditions worldwide, there is a pressing need for holistic approaches that address multiple facets of patient care. Our study follows a cohort of individuals diagnosed with diabetes and cardiovascular diseases over five years, examining the impact of comprehensive interventions on various patient-centric outcomes. These interventions encompassed a combination of lifestyle modifications, medication adherence programs, dietary counseling, physical activity promotion, and psychological support. Through rigorous data collection and analysis, we assessed changes in key clinical indicators such as HbA1c levels, lipid profiles, blood pressure, and body mass index, alongside patient-reported outcomes including quality of life, self-efficacy, and satisfaction with care. Additionally, we explored healthcare utilization patterns and economic implications associated with the interventions. Our findings reveal significant improvements in both clinical and patient-reported outcomes among participants engaged in multifaceted interventions compared to those receiving standard care. The interventions demonstrated sustained benefits over the follow-up period, suggesting their long-term efficacy in managing chronic conditions and enhancing overall well-being. Furthermore, our study highlights the importance of personalized, patient-centered approaches in chronic disease management, emphasizing the need for integrated care models that prioritize individual needs and preferences. These insights have profound implications for healthcare policymakers, providers, and stakeholders seeking to optimize outcomes and reduce the burden of diabetes and cardiovascular diseases on patients and healthcare systems.

BackgroundEven though evidence based medicine, guidelines and algorithms still represent the pillars of the management of chronic diseases (i.e: hypertension, diabetes mellitus), a patient centred approach has been recently proposed as a successful strategy, in particular to improve drug adherence. Aim of the present review is to evaluate the unmet needs in LUTS/BPH management and the possible impact of a patient centered approach in this setting.MethodsA National Center for Biotechnology Information (NCBI) PubMed search for relevant articles published from January 2000 until December 2016 was performed by combining the following MESH terms: patients centred medicine, patient centered care, person centered care, patient centered outcomes, value based care, shared decision making, male, Lower Urinary Tract Symptoms, Benign Prostatic Hyperplasia, treatment. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). All studies reporting on patient centred approach, shared decision making and evidence-based medicine were included in the review. All original article, reviews, letters, congress abstracts, and editorials comments were included in the review. Studies reporting single case reports, experimental studies on animal models and studies not in English were not included in the review.ResultsOverall 751 abstracts were reviewed, out of them 87 full texts were analysed resulting in 36 papers included. The evidence summarised in this systematic review confirmed how a patient centred visit may improve patient’s adherence to medication. Although a patient centred model has been rarely used in urology, management of Low Urinary Tract Symptoms (LUTS) and Benign Prostatic Obstruction (BPO) may represent the perfect ground to experiment and improve this approach. Notwithstanding all the innovations in LUTS/BPO medical treatment, the real life picture is far from ideal.ConclusionsRecent evidence shows a dramatical low drug adherence and satisfaction to medical treatment in LUTS/BPH patients. A patient centred approach may improve drug adherence and some unmet needs in this area, potentially reducing complications and costs. However further well designed studies are needed to confirm this data.

BackgroundWith a shift in the healthcare paradigm towards a more patient-centered approach, data on inflammatory bowel disease (IBD) needs to be further explored. This study aimed to determine patient perspectives on the effect of IBD and features of patients with lower satisfaction level and compare patient and physician perception of IBD-related Quality of Care (QoC).MethodsA previously developed pre-standardised set of questions regarding patient-centered outcome (PRO) measures for IBD, comprising 36 items, was administered in five centers, and a concomitant questionnaire for specialised physicians was adapted and administered.ResultsOverall, 1005 patients with IBD met the inclusion criteria. Sixty-five questionnaires were administered to specialised physicians. Both patients and physicians perceived the IBD-related QoC as being satisfactory. Furthermore, this study revealed areas of shortcomings where it comes to patient perceptions. Female sex and the presence of negatively impacting disease characteristics (presence of significant pain or discomfort, lack of energy, feeling fatigued most of the time, experiencing anxiety or depression in the last 2 weeks) were associated with lower satisfaction levels.ConclusionsOur findings can be used in establishing strategies aimed at improving patient QoC and defining strategic priorities. These data can aid in improving the communication of the pressing needs of IBD patients, to both the public payers and health authorities.

ObjectiveWe aimed to explore the patient-centred outcomes (PCOs) radiologists and radiologic technologists perceive to be important to patients undergoing imaging procedures.DesignWe conducted a qualitative study of individual semi-structured interviews.ParticipantsWe recruited...

BackgroundDespite effective treatments, asthma outcomes remain suboptimal. Interest exists in complementary therapies, particularly in herbal remedies for asthma treatment, currently with inconclusive evidence of efficacy. The encapsulated botanical mixture AKL1 has anecdotal evidence of effectiveness in asthma.MethodsWe performed a randomised controlled cross over study comparing the effectiveness of AKL1 with indistinguishable placebo as add-on therapy in patients uncontrolled on standard asthma treatment. Thirty two adult asthmatics completed a 36 week trial consisting of a 4 week single blind run in period, during which placebo was added to usual treatment, a 12 week double blind active phase in which subjects received AKL1 or placebo, a single blind 8 week washout period receiving placebo and a final 12 week double blind cross-over active treatment phase. Daily diaries were kept of peak expiratory flow and symptoms, and spirometry, validated symptom and health status questionnaire scores and adverse events were monitored at study visits. Paired T tests were used to compare the effects of placebo and AKL1 on outcomes. Changes in outcome measures over treatment phases are presented as means and 95% confidence intervals (CI) of means.ResultsNo significant differences in lung function (active-placebo) were found (Forced Expiratory Volume in 1 second: mean difference [95% CI] = 0.01 [-0.12 to 0.14] L, p = 0.9. Peak Expiratory Flow: -4.08 [-35.03 to 26.89]. L/min, p = 0.8).Trends to clinical improvements favouring active treatment were however consistently seen in the patient-centered outcomes: Asthma Control Questionnaire mean difference (active – placebo) [95% CI] = -0.35 [-0.78 to 0.07], p = 0.10, Asthma Quality of Life Questionnaire mean difference 0.42 [-0.08 to 0.93], p = 0.09, Leicester Cough Questionnaire mean difference 0.49, [-0.18 to 1.16], p = 0.15.Nine exacerbations occurred during placebo treatment and five whilst on AKL1. No significant adverse events were noted.ConclusionAKL1 treatment was well tolerated. No significant improvements in lung function, symptoms, or quality of life were seen, although consistent trends were seen to improvements in patient-centered outcomes. Further studies are needed.