Greater Improvement In Quality Of Life Research Articles

Two types of vidian neurectomy show efficacy in treating allergic rhinitis and vasomotor rhinitis

This study aimed to evaluate the efficacies of endoscopic vidian neurectomy (VN) and highly selective vidian neurectomy (HSVN) for the treatment of allergic rhinitis (AR) and vasomotor rhinitis (VMR). All AR and VMR patients were divided into two groups, Group VN and Group HSVN. The efficacy evaluation methods were visual analog scale (VAS), rhinoconjunctivitis quality of life questionnaire (RQLQ), and medication score. The efficacy evaluations were used to assess patient rhinitis symptoms, quality of life and drug usage. The time points of follow-up period were preoperative, 3 months, 6 months, 1 year, 2 years, and 3 years post operation. By analyzing pre- and postoperative VAS, medication score and RQLQ score, the results showed that rhinitis symptoms and quality of life in both VN and HSVN groups were significantly improved at 3 years, and the rate of improvement decreased gradually with time. Post operation, there were no significant differences in VAS and medication scores between the VN and HSVN groups. With respect to RQLQ, postoperative 2 years and 3 years improvements in sleep disorders, non-nasal symptoms and eye symptoms were significantly greater in the HSVN group than in the VN group. Improvements in rhinitis symptoms and quality of life in AR and VMR were sustained by VN and HSVN until 3 years post operation, with greater quality of life improvements in the HSVN group.

Matching-Adjusted Indirect Comparison of Risankizumab Versus Deucravacitinib in Patients with Moderate-to-Severe Plaque Psoriasis.

Despite advancements in the treatment of psoriasis (PsO), there are few head-to-head studies assessing comparative effectiveness of the newest therapies approved to treat PsO. Our objective was to assess the comparative clinical effectiveness of risankizumab and deucravacitinib in patients with moderate-to-severe PsO. This placebo-anchored matching-adjusted indirect comparison (MAIC) analysis utilized data from UltIMMa-1/2 risankizumab and POETYK PSO-1/2 deucravacitinib trials. Individual patient data from UltiMMA-1/2 were weighted via propensity score to match POETYK PSO-1/2 published summary data. Rate differences between risankizumab and deucravacitinib were assessed for Psoriasis Area and Severity Index (PASI) 75/90/100, the Static Physician Global Assessment (sPGA = 0 or 0/1), and the Dermatology Life Quality Index (DLQI) 0/1. At 16weeks, risankizumab-treated patients demonstrated statistically significantly higher rates of skin clearance and greater improvement in quality of life (QoL) compared to those treated with deucravacitinib. Across all outcomes, risankizumab demonstrated a lower number needed to treat compared to deucravacitinib. Limitations are potential bias due to unobserved/unmeasurable differences and limited generalizability of the results. This indirect comparison demonstrates that risankizumab has higher rates of skin clearance and greater improvements in QoL than deucravacitinib. This study will help inform healthcare providers in their treatment and management strategy of PsO.

Postoperative pain following laser fistula closure versus ligation of the intersphincteric fistula tract: A prospective double-blinded randomized controlled trial.

Prior studies focus primarily on surgical outcomes of anal fistula treatment, such as healing rates, rather than patient-reported outcomes, such as postoperative pain, which could influence surgical choice. To compare pain scores at 6 and 24h postoperatively between laser closure and ligation of the intersphincteric tract for anal fistula. Prospective, double-blinded randomized controlled trial. A quaternary hospital in Malaysia. Patients aged 18-75years with high transsphincteric fistulas. Fistula laser closure versus ligation of the fistula tract (LIFT) treatment. Pain scores, continence, quality of life (QOL), operative time, and treatment failure were compared using chi-square, Fisher's exact test, student t-test, or Mann-Whitney with p<0.05 denoting statistical significance. Fifty-six patients were recruited (laser, n=28, LIFT, n=28). Median pain scores for laser versus LIFT at 6h postoperatively were 1.0 versus 2.0 (Rest, p=0.213) and 3.0 versus 4.0 (Movement, p=0.448), respectively. At 24h, this reduced to 2.5 in both arms at rest (p=0.842) but increased to 4.8 versus 3.5 on movement (p=0.383). Median operative time for laser was significantly shorter (32.5min) than LIFT (p<0.001). Laser treated patients trended toward quicker return to work (10.5 vs. 14.0, p=0.181) but treatment failure was similar (54% vs. 50%, p=0.71). No patients developed postoperative incontinence. Mean SF-36 scores increased from baseline (67.1±17.0; 95% CI 63.6-82.4 vs. 71.3±11.4; 95% CI 64.0-75.0) to 6months postoperatively (77.7±21.0; 95% CI 57.0-80.3 vs. 74.0±14.3; 95% CI 67.6-81.4) regardless of the type of surgery (P>0.05). Patients with prior fistula surgery (approximately 20%) led to heterogeneity. The total laser energy delivered varied depending on fistula anatomy. Laser fistula closure is an alternative to LIFT, with similar postoperative pain and shorter operative time despite more complex fistula anatomy in the laser arm, with a greater improvement in QOL. ClinicalTrials.gov: NCT06212739.

Assessing the Impact of Multidisciplinary Collaboration on Quality of Life in Older Patients Receiving Primary Care: Cross Sectional Study.

The growing aging population presents unique challenges in maintaining their quality of life (QoL), which encompasses physical, psychological, and social wellbeing. This study aimed to assess the impact of multidisciplinary collaboration on QoL among older patients receiving primary care. A cross-sectional study was conducted involving a purposive sampling of 200 participants aged 60 years and above from Primary Healthcare Centers in Al-Ahsa, Saudi Arabia, between March and May 2024. Data were collected using standardized tools: SF-36 for health-related QoL, Multidisciplinary Collaboration Evaluation Tool (MCET), and Lubben Social Network Scale (LSNS). Multivariate regression analyses were performed to examine the associations between multidisciplinary collaboration, social support, and QoL outcomes. Multidisciplinary collaboration exhibited a significant positive association with improvements in physical functioning (β = 2.35, p < 0.001), mental health (β = 3.01, p < 0.001), and general health perceptions (β = 2.12, p < 0.001). Key drivers of effective collaboration included effective communication (β = 0.48, p < 0.001), coordination (β = 0.42, p < 0.001), and patient involvement (β = 0.40, p < 0.001). Social support, particularly from friends (β = 0.33, p < 0.001) and family (β = 0.28, p < 0.001), was also a robust predictor of better QoL. Younger age, female gender, married status, and absence of chronic conditions were associated with greater QoL improvements from multidisciplinary care. Multidisciplinary collaboration and social support networks significantly enhance QoL among older primary care patients. Healthcare systems should prioritize developing collaborative care models, fostering interdisciplinary teamwork, and integrating strategies to promote social connectedness for the aging population.

Moving beyond symptom reduction: A meta-analysis on the effect of exposure therapy for PTSD on quality of life.

Quality of life (QOL) is a multidimensional construct including emotional well-being, life satisfaction, and physical health. Individuals with posttraumatic stress disorder (PTSD) consistently report low QOL, highlighting the importance of assessing the effectiveness of first-line PTSD treatments (e.g., exposure-based therapies) on QOL. This meta-analysis examined the efficacy of exposure therapy for PTSD on QOL compared to control conditions (e.g., waitlist, medication, treatment-as-usual) at posttreatment and follow-up (ranging from 1 month to 2 years). Building on a previous meta-analysis of exposure-based therapy for PTSD, we searched PsycINFO and Medline in December 2021, July 2022, and March 2023 to include randomized controlled trials of exposure-based treatments for adult PTSD assessing QOL. We screened 295 abstracts for initial eligibility; 20 articles met inclusion criteria and were included (N = 2729 participants). Risk of bias was evaluated using the Cochrane Risk of Bias tool 2.0. At posttreatment, exposure-based therapies showed a medium effect on QOL relative to control conditions (k = 25, g = 0.67). This effect was not observed at follow-up for the small subset of studies with follow-up data (k = 8, g = 0.16). At posttreatment, effect size varied significantly as a function of the control condition (p < .0001). There were no differences in QOL effects across exposure therapies at posttreatment or follow-up (p = .09). Exposure therapy was associated with greater improvement in QOL compared to control conditions at posttreatment. Exposure was not superior to control conditions at follow-up, and the longer-term impact of exposure on QOL is unclear. The implications of these findings are discussed, along with the need for more PTSD treatment studies to examine QOL outcomes at posttreatment and follow-up.

Catheter ablation for persistent atrial fibrillation: patterns of recurrence and impact on quality of life and health care utilization.

Patterns of atrial fibrillation (AF) recurrence post-catheter ablation for persistent AF (PsAF) are not well described. This study aimed to describe the pattern of AF recurrence seen following catheter ablation for PsAF and the implications for healthcare utilization and quality of life (QoL). This was a post-hoc analysis of the CAPLA study, an international, multicentre study that randomized patients with symptomatic PsAF to pulmonary vein isolation plus posterior wall isolation or pulmonary vein isolation alone. Patients underwent twice daily single lead ECG, implantable device monitoring or three monthly Holter monitoring. 154 of 333 (46.2%) patients (median age 67.3 years, 28% female) experienced AF recurrence at 12-month follow-up. Recurrence was paroxysmal in 97 (63%) patients and persistent in 57 (37%). Recurrence type did not differ between randomization groups (P = .508). Median AF burden was 27.4% in PsAF recurrence and .9% in paroxysmal AF (PAF) recurrence (P < .001). Patients with PsAF recurrence had lower baseline left ventricular ejection fraction (PsAF 50% vs. PAF 60%, P < .001) and larger left atrial volume (PsAF 54.2 ± 19.3 mL/m² vs. PAF 44.8 ± 11.6 mL/m², P = .008). Healthcare utilization was significantly higher in PsAF (45 patients [78.9%]) vs. PAF recurrence (45 patients [46.4%], P < .001) and lowest in those without recurrence (17 patients [9.5%], P < .001). Patients without AF recurrence had greater improvements in QoL as assessed by the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire (Δ33.3 ± 25.2 points) compared to those with PAF (Δ24.0 ± 25.0 points, P = .012) or PsAF (Δ13.4 ± 22.9 points, P < .001) recurrence. AF recurrence is more often paroxysmal after catheter ablation for PsAF irrespective of ablation strategy. Recurrent PsAF was associated with higher AF burden, increased healthcare utilization and antiarrhythmic drug use. The type of AF recurrence and AF burden may be considered important endpoints in clinical trials investigating ablation of PsAF.

Promising Directions: A Systematic Review of Psychosocial and Behavioral Interventions with Cultural Incorporation for Advanced and Metastatic Cancer.

Improving quality of life (QOL) in advanced and metastatic cancer is a priority with increasing survivorship. This systematic review synthesizes psychosocial and behavioral interventions incorporating culture with the goal of examining their benefit for understudied and medically underserved populations with advanced and metastatic cancer. Reports were systematically screened for (1) a focus on advanced and metastatic cancer survivors, (2) psychosocial or behavioral intervention intended to improve QOL, (3) evidence of incorporating the culture(s) of understudied/underserved populations, and (4) availability in English. Bias was evaluated using the JBI Critical Appraisal Checklist and the Methodological index for non-randomized studies. Qualitative synthesis and quantitative meta-analyses were completed. Eighty-six reports containing 5981 participants' data were examined. Qualitative synthesis of 23 studies identified four overarching themes relevant for incorporating culture in interventions. Meta-analysis of 19 RCTs and 4 quasi-experimental studies containing considerable heterogeneity indicated greater improvements in QOL (g = 0.84), eudaimonic well-being (g = 0.53), distress (g = -0.49), and anxiety (g = -0.37) for main intervention conditions compared to controls. Meta-analysis of 10 single-arm trials containing minimal to moderate heterogeneity found benefit for anxiety (g = -0.54), physical symptoms (g = -0.39), and depression (g = -0.38). Psychosocial and behavioral interventions with cultural incorporation appear beneficial for improving QOL-related outcomes in advanced and metastatic cancer. Studies incorporating culture in psychosocial or behavioral interventions offer noteworthy insight and suggestions for future efforts such as attending to deep cultural structure.

Quality of Life After Cataract Surgery in Patients with Age-Related Macular Degeneration: A Literature Review

Abstract&#x0D; Introduction &amp; Objectives : Age-related macular degeneration (AMD) is a common ocular disease that affects millions of people worldwide. Cataract surgery is one of the most performed surgical procedures in the world and is effective to improve visual function and quality of life (QoL) in individuals with cataracts. Both cataract and AMD are conditions that occur in late age. However, the presence of AMD may complicate the postoperative outcomes and QoL of these patients. This review aims to examine the impact of cataract surgery on the QoL of patients with AMD.&#x0D; Methods : A search of the literature was conducted using electronic databases. Studies were included if they evaluated QoL outcomes in patients with AMD who underwent cataract surgery.&#x0D; Results : The results of the review suggest that cataract surgery can improve visual acuity and QoL in patients with AMD. However, the degree of improvement is influenced by the severity of AMD. Patients with mild to moderate AMD tended to have greater improvements in QoL and visual acuity compared to those with advanced AMD. Incidentally, it is still cost effective to perform cataract surgery in patients with advanced AMD.&#x0D; Conclusion : Overall, patients with AMD who underwent cataract surgery experienced improvements in their QoL. Nevertheless, individual characteristics including severity of AMD must be considered to optimize the procedure outcomes. Further research, particularly with longer follow up times, is needed to determine the long-term effects of cataract surgery on QoL in patients with AMD.

QUALITY OF LIFE AFTER CATARACT SURGERY IN PATIENTS WITH AGE-RELATED MACULAR DEGENERATION: A LITERATURE REVIEW

Objective: Age-related macular degeneration (AMD) is a common ocular disease that affects millions of people worldwide. Cataract surgery is one of the most performed surgical procedures in the world and is effective to improve visual function and quality of life (QOL) in individuals with cataracts. Both cataract and AMD are conditions that occur in late age. However, the presence of AMD may complicate the postoperative outcomes and quality of life (QOL) of these patients. This review aims to examine the impact of cataract surgery on the QOL of patients with AMD. Methods: A search of the literature was conducted using electronic databases. Studies were included if they evaluated QOL outcomes in patients with AMD who underwent cataract surgery. Result: The results of the review suggest that cataract surgery can improve visual acuity and QOL in patients with AMD. However, the degree of improvement is influenced by the severity of AMD. Patients with mild to moderate AMD tended to have greater improvements in QOL and visual acuity compared to those with advanced AMD. Incidentally, it is still cost effective to perform cataract surgery in patients with advanced AMD. Conclusion: Overall, cataract surgery is found to be able to improve QOL and visual acuity in patients with AMD. Nevertheless, individual characteristics including severity of AMD must be considered to optimize the outcomes. Further research, particularly with longer follow up times, is needed to determine the long-term effects of cataract surgery on QOL in patients with AMD.

Cutaneous Manifestations in Patients on Hemodialysis and Assessment of the Changes in Quality of Life After 12 Weeks of Treatment by a Dermatologist.

Cutaneous manifestations are frequently observed in end-stage kidney disease (ESKD) and affect the quality of life (QoL) of patients undergoing maintenance hemodialysis (HD). Even patients undergoing HD who frequently visit hospitals do not receive active dermatological care. The aims of this study were to assess the cutaneous manifestations of patients undergoing HD and investigate changes in their QoL before and after active treatment by dermatologists. A 12-week prospective study was conducted in two HD centers. Patients in one center received dermatological intervention, while patients in the other center received conservative management by a nephrologist. Patients scored their QoL using the Dermatology Life Quality Index (DLQI) and the Skindex-29 at the start of the study and 12 weeks later. Two matched groups were formed using propensity score matching. Simple and multiple linear regression analyses were used to identify associations between dermatological treatment and the improvement in QoL. In total, 120 patients were included, of whom 65 and 55 were in the intervention and control groups, respectively. Approximately 93.8% of the patients had dermatological manifestations, with pallor and xerosis being the most common. Improvement in QoL, as assessed using the DLQI, was confirmed after 12 weeks in the overall population. However, active intervention by a dermatologist did not significantly improve QoL. Patients treated with dermatological intervention by a dermatologist did not achieve greater improvements in QoL than control patients. Therefore, careful assessment of skin issues in patients with ESKD should be undertaken by nephrologists, and the best possible treatment should be administered.

Awe Walks Improve Quality of Life, Attention, Orientation, Mood &amp; Social Behaviour in Dementia

AbstractBackgroundResearch has consistently shown decreased quality of life (QoL) in people with dementia, with predictors of QoL ranging from education to emotional status. This study investigated the impact of Awe Walks as an intervention targeting emotional status for the first time in dementia. Awe—a positive emotion elicited when in the presence of vast things not immediately understood—promotes social connection and fosters well‐being by encouraging a “small self”.MethodParticipants with dementia between the ages of 60 and 85 took biweekly 15‐min outdoor walks for 4 weeks; a total of 53 participants were matched and randomly assigned either to an awe walk group, which oriented them to experience awe during their walks, or to a waitlist control group. Pre‐ and post‐intervention measures of QoL, cognitive functioning, behavioural pathology relevant to daily functioning, and clinical global impression were completed.ResultCompared to degenerative deterioration in controls, individuals who participated in the Awe Walk intervention exhibited greater improvements in QoL, attention, orientation, mood, and social behaviour.ConclusionThese results suggest cultivating awe enhances positive emotions that improve quality of life and diminishes negative emotions that hasten decline. An intervention such as this, cost‐effective and simply executed, has important implications for providing quality care to this population served by neuropsychologists.

PCR229 Achieving Increasingly Stringent Disease Control Criteria Was Associated with Greater Quality of Life Improvements in Patients with Active Psoriatic Arthritis: Results from BE OPTIMAL and BE COMPLETE/BE VITAL up to 1 Year

PCR229 Achieving Increasingly Stringent Disease Control Criteria Was Associated with Greater Quality of Life Improvements in Patients with Active Psoriatic Arthritis: Results from BE OPTIMAL and BE COMPLETE/BE VITAL up to 1 Year

Exploring Potential Predictors of Treadmill Training Effects in People With Parkinson Disease

ObjectiveTo explore the potential predictors of people with Parkinson disease (PD) who would benefit the most from treadmill training. DesignA cohort study. SettingMedical university rehabilitation settings. ParticipantsSeventy participants diagnosed of idiopathic PD. InterventionsTwelve sessions of treadmill training. Main Outcome MeasuresHierarchical logistic regression models were used to explore significant predictors of the treadmill training effect with respect to 3 health domains: Unified Parkinson's Disease Rating Scales part III (UPDRS III); gait speed; Parkinson's Disease Questionnaire-39 (PDQ-39). A receiver operating characteristic (ROC) curve analysis was conducted to identify proper cut-off points for clinical use. ResultsMale sex (adjusted odds ratio [OR]: 3.73, P=.036) significantly predicted the improvement of UPDRS III. Individuals with a slower baseline gait speed (cut-off: 0.92 m/s, adjusted OR: 14.06, P<.001) and higher baseline balance confidence measured by the Activity-specific Balance Confidence scale (cut-off: 84.5 points, adjusted OR: 4.66, P=.022) have greater potential to achieve clinically relevant improvements in gait speed. A poorer baseline PDQ-39 score (cut-off: 23.1, adjusted OR: 7.47, P<.001) predicted a greater quality of life improvement after treadmill training. ConclusionsThese findings provide a guideline for clinicians to easily identify suitable candidates for treadmill training. Generalization to more advanced patients with PD warrants further investigation.

Improved Glycaemic and Weight Management Are Associated with Better Quality of Life in People with Type 2 Diabetes Treated with Tirzepatide.

Limited data are available on the relationship between quality of life (QoL) change and significant degrees of reduction in glycated haemoglobin (HbA1c) and/or weight loss in people with type 2 diabetes (T2D). We explored the associations between HbA1c targets and/or weight loss achieved and patient-reported outcomes (PROs) in adults with T2D treated with tirzepatide, a first-in-class once weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, using pooled data from SURPASS-1 to -5 Phase 3 clinical trials. PROs were assessed using five instruments at baseline and endpoint (Week 40 in SURPASS-1, -2 and -5; Week 52 in SURPASS-3 and -4): Impact of Weight on Quality of Life-Lite Clinical Trials Version; Impact of Weight on Self-Perception (IW-SP) questionnaire; Ability to Perform Physical Activities of Daily Living (APPADL); Diabetes Treatment Satisfaction Questionnaire change; and EQ-5D-5L. All PROs were assessed in participants receiving pooled doses of tirzepatide (5, 10 or 15mg) and achieving HbA1c targets of < 5.7%, ≥ 5.7-≤ 6.5% and > 6.5% or achieving ≥ 0-< 5%, ≥ 5-< 10%, ≥ 10-< 15% and ≥ 15% weight loss from baseline at endpoint. The APPADL, IW-SP and EQ visual analogue scores were evaluated in participants achieving each combination of HbA1c target and weight loss. Achievement of lower HbA1c targets or higher body weight percentage losses were each associated with greater improvements in QoL than achievement of higher HbA1c targets or lower body weight percentage losses, respectively. Achievement of lower HbA1c targets in combination with greater weight loss was generally associated with the best QoL ratings. Our findings demonstrate that HbA1c targets and significant percentage body weight reduction thresholds need to be achieved for people with T2D to help substantially increase their overall health-related QoL. Tirzepatide treatment may allow a high proportion of people with T2D to achieve these targets, enabling improved QoL. SURPASS-1: NCT03954834; SURPASS-2: NCT03987919; SURPASS-3: NCT03882970; SURPASS-4: NCT03730662; SURPASS-5: NCT04039503.

#5821 CLINICALLY MEANINGFUL IMPROVEMENT IN QUALITY OF LIFE ACCOMPANIES ITCH RELIEF IN PATIENTS WITH CHRONIC KIDNEY DISEASE ASSOCIATED PRURITUS

Abstract Background and Aims The impairing effect of chronic kidney disease-associated pruritus (CKD-aP) on the quality of life (QoL) of patients undergoing haemodialysis (HD) is well-established. The aim of this post-hoc analysis was to assess the impact of itch relief on QoL, as measured by the 5-D itch scale, in patients with CKD-aP enrolled in the Phase 3 KALM-1 and -2 clinical trials. This study also aimed to confirm the use of ≥5-point reduction in 5-D itch scale total score as a threshold for clinically meaningful improvement in itch-related QoL, by comparing to notable improvement on the Patients’ Global Impression of Change (PGI-C) scale. Method Data were pooled from 851 patients with moderate-to-severe CKD-aP undergoing HD in the KALM-1 and -2 trials testing difelikefalin vs placebo. Sustained responders were defined as patients who achieved a ≥3-point improvement in the weekly mean 24-hour Worst Itching Intensity Numerical Rating Scale [WI-NRS] score at Week 12 of the study, whereas non-sustained responders were defined as patients that reported a ≥3-point improvement in any week of the study but not at Week 12. Improvements in QoL, as measured by the mean change in 5-D itch scale total score from baseline to Week 12, were compared in sustained responders vs non-sustained responders. Data were analysed by ANCOVA multiple imputation, with a missing-at-random assumption. The mean change in 5-D itch scale total score was analysed in relation to patients’ reporting on the five categories of the PGI-C scale. Results In pooled analysis, 305 patients undergoing HD with CKD-aP qualified as sustained responders, whereas 128 patients were non-responders. Reduction in 5-D itch scale total score over 12 weeks was significantly higher in sustained responders compared with non-sustained responders (least squares [LS] mean ±standard error; –7.1±0.2 vs –4.0±0.3, LS mean difference –3.0±0.3, p&amp;lt;0.001) (Figure 1). Greater reductions in 5-D itch scale total score were observed in patients reporting more substantial improvements in PGI-C. Specifically, patients reporting much, or very much, improvement in PGI-C scored ≥5-point reduction on the 5-D itch scale (mean ±standard error; –5.3±0.2 and –8.2±0.3, respectively) (Figure 2). Conclusion This study observed a greater improvement in QoL, as measured by the 5-D itch scale total score, in patients with CKD-aP who reported a clinically meaningful reduction in itch, as measured by WI-NRS, at Week 12. These results also support the use of ≥5-point reduction in the 5-D itch scale total score as a threshold for clinically meaningful improvement in the QoL of patients with CKD-aP. As only sustained responders exceeded this threshold, these data suggest that continued treatment of itch may be necessary to maximally improve QoL in these patients.

#5500 THE IMPACT OF CHRONIC KIDNEY DISEASE-ASSOCIATED PRURITUS RELIEF ON SKINDEX-10 DISEASE AND SOCIAL FUNCTIONING DOMAINS

Abstract Background and Aims Chronic kidney disease-associated pruritus (CKD-aP) is a serious condition that greatly impacts patients’ quality of life (QoL). Moderate-severe pruritus affects up to 47% of patients undergoing haemodialysis (HD) [1]. The aim of this analysis was to assess the impact of itch relief on the disease and social functioning domains of the Skindex-10 questionnaire in a post hoc analysis of the difelikefalin (DFK) Phase 3 studies in patients with CKD-aP undergoing HD. Method Patients with moderate-to-severe CKD-aP (mean Worst Itch Numerical Rating Scale [WI-NRS] score ≥4 [KALM-1] or ≥5 [Study 3105 and KALM-2]) undergoing HD were enrolled and randomised 1:1 to receive intravenous DFK 0.5 µg/kg or placebo (KALM-1 and -2) or open-label DFK (Study 3105) 3 times/week for 12 weeks. Data from all patients who completed the studies were included in the present analysis irrespective of study drug exposure; data were pooled for patients receiving DFK and placebo from the KALM studies. The 12-week change from baseline in the Skindex-10 questionnaire subdomains were assessed for disease (Q1–3) and social functioning (Q7–10). Change from baseline in the mood/emotional distress domain has previously been reported (Q4–6) [2]. Results Skindex-10 scores were available for 914 patients (KALM studies: n = 720; Study 3105: n = 194). At Week 12, patients with a clinically relevant (WI-NRS ≥3-point) change (decrease) in itch (KALM: n = 305; 3105: n = 143) reported a relative mean (± standard error) corresponding improvement of 59.7%±2.0 (KALM) and 65.9%±2.6 (3105) from baseline in the disease domain of Skindex-10, compared with 18.4%±2.3 and 30.7%±4.4 of patients with &amp;lt;3-point WI-NRS improvement (KALM: n = 415 [Figure A]; 3105: n = 51 [Figure B]). In addition, a much greater improvement in QoL was reported for the social functioning domain for patients with ≥3-point WI-NRS improvement, compared with patients with &amp;lt;3-point improvement (66.2%±3.5 vs 11%±7.6 in the KALM studies; 75.5%±4.0 vs 49.4%±8.5 in Study 3105). Overall, the patients with ≥3-point WI-NRS change reported relative mean improvement from baseline ranging from 64%±2.3 to 70.2%±2.6 across the total Skindex-10 scale compared with 15.1%±4.8 to 35.4%±5.5 of patients with &amp;lt;3-point improvement at Week 12 across all studies. Conclusion In this post hoc analysis, patients with CKD-aP undergoing HD who reported a clinically meaningful reduction in itch intensity also achieved a substantially greater improvement in both the disease and social functioning domains of Skindex-10, as well as overall itch-related QoL.

The Influence of Hyperparathyroidism Patient Profile on Quality of Life After Parathyroidectomy.

Improvements in quality of life (QoL) after parathyroidectomy in patients with primary hyperparathyroidism (PHPT) is discussed. It has not been analyzed whether these improvements can be influenced by a specific socio-personal or clinical patient profile. to analyze QoL differences after parathyroidectomy and to determine a socio-personal and clinical profile that influences improvement after parathyroidectomy. A longitudinal prospective cohort study in patients with PHPT. SF-36 and PHPQOL questionnaires were completed by the patients. A comparative preoperatory analysis was carried out, at three and twelve months after surgery. Student's t test was used for the correlations. The size of the effect was assessed using G*Power software. A multivariate analysis was performed to evaluate the socio-personal and clinical variables affecting the improvement in QoL after surgery. Forty-eight patients were analyzed. Three months after surgery an improvement was found in physical function, general health, vitality, social function, emotional role, mental health and in the patient's declared health assessment. One year after the intervention a general improvement was observed, with a greater effect on mental health and declared health evolution. Patients with bone pain presented with a higher probability of improvement after surgery. Patients with prior psychological disease had a lower associated probability of an improvement and high levels of PTH related to a greater probability of improvement after surgery. There is an improvement in the QoL of PHPT patients after parathyroidectomy. Patients with bone pain and high PTH levels prior to the parathyroidectomy present with a greater probability of having a greater improvement in QoL after surgery.

Improving Post-Operative Psychiatric Outcomes in Surgical Epilepsy Patients (P1-1.008)

<h3>Objective:</h3> Accurately forecasting post-operative (PO) psychopathology is beneficial for achieving a better, sustainable QOL in the long-term. <h3>Background:</h3> Psychiatric disorders (PD) represent a substantial comorbidity in epilepsy, affecting 1 in 3 patients (PWE). PD may be overlooked in preliminary evaluations despite their ability to exacerbate epilepsy, impair quality of life (QOL), and worsen preexisting psychiatric diagnoses (PPDx). This study aims to determine the effect of epilepsy surgery (ES) on incidences of psychiatric comorbidity and identify potential predictors of outcome. <h3>Design/Methods:</h3> 18 patients who underwent ES at the NIH in the past 5 years were identified from our database. Reviewed factors include presence of PPDx and location of epileptogenicity. The QOLIE-31, NDDI-E, and GAD7 questionnaires were administered at 3 time points: Baseline (BL), 3 Months (3M) PO, 1 year (1Y) PO. Patients were organized into limbic (LB) vs non-limbic (NL) categories based on involvement of the amygdala and hippocampus—vital for emotional regulation. Education, employment, and driving status were evaluated with demographics. <h3>Results:</h3> NL patients saw improvement in QOLIE score (p=0.0012) over time as did PWE with PPDx (p&lt;0.0001) who were unemployed (p=0.0066). Least Square-Mean (LSM) was lower at BL (PPDx: LSM=39.3) than at follow-up (LSM=62.0 at 3M, 61.3 at 1Y). Irrespective of PPDx, there was no change in NDDI-E score over time (p=0.4633). There was significant reduction in GAD7 scores among non-driving patients (p=0.0461) with a higher LSM at BL (10.0) than at follow-up (4.9 at 3M, 2.2 at 1Y). <h3>Conclusions:</h3> Patients with PPDx and those not driving or employed at BL saw significant improvement in their overall QOL and anxiety PO; however, patients without PPDx did not. NL patients saw the greatest improvement in QOL, suggesting intact emotional regulation compared to those with resected limbic structures. ES may improve mood symptoms and QOL in PWE dealing with a greater burden of PD or lacking independence. <b>Disclosure:</b> Ms. Najimi has received research support from National Institutes of Health’s Intramural Research Program.

Ultrasound-Guided Thoracic Paravertebral Block Using Paraventricular Oblique Sagittal (POS) Approach for the Treatment of Acute Herpes Zoster: A Two-Blind Randomized Controlled Trial.

The aim of this work is to examine the efficacy and benefits of ultrasound (US)-guided thoracic paravertebral block (TPVB) using paraventricular oblique sagittal (POS) approach for the treatment of herpes zoster related acute pain (ZAP) and its preventive effects on post-herpetic neuralgia (PHN). A total of 136 patients suffering from ZAP within 2weeks of rash onset were randomly allocated to transverse short axial approach (TSA) and paraventricular oblique sagittal (POS) group in 1:1 ratio. All patients received a standard antiviral treatment and rescue analgesics besides TPVB. Primary outcome was HZ illness burden (HZ-BOI) measured by a severity-by-duration composite pain assessment during 30days. The non-inferiority margin (NIM) was set at - 10. Secondary outcomes included visual analog pain scores (VAS) and Kolcaba's General Comfort Questionnaire discomfortable scores (GCQ) during block needle insertion, quality of life (QoL), and PHN incidence during follow-up. Adverse events were also recorded. VAS pain scores (30 (IQR: 20, 40) vs. 65 (IQR: 45, 90), p < 0.001) and GCQ discomfortable scores (p < 0.001) were significantly lower in the POS group during needle insertion. The POS approach was not inferior to the proved TSA method in terms of BOI-30AUC when the lower limit of 95% confidence interval (CI) of two mean differences (13.54 (95% CI - 3.55, 30.63)) lay within the NIM. There were no differences between the two groups in BOI-30-90AUC, and BOI-90-180AUC (p = 0.260 and 0.182). Greater QoL improvement and lower PHN incidence were comparable between the two groups. No serious adverse events occurred. US-guided TPVB using less-invasive POS technique was as an optimal early intervention to reduce ZAP and a possible preventive strategy for PHN. The study was retrospectively registered in the Chinese Clinical Trial Registry on November 15, 2022 (ChiCTR2200065783).

Shenlingcao oral liquid for patients with non-small cell lung cancer receiving adjuvant chemotherapy after radical resection: A multicenter randomized controlled trial

BackgroundLow quality of life (QoL) in patients with non-small cell lung cancer (NSCLC) receiving adjuvant chemotherapy after radical resection is a major global health issue. High-quality evidence for the effectiveness of Shenlingcao oral liquid (SOL) as a complementary treatment in this patients is lacking at present. PurposeTo determine whether complementary SOL treatment in NSCLC patients receiving adjuvant chemotherapy would yield greater improvements in QoL than chemotherapy alone. Study designWe conducted a multicenter, randomized controlled trial of stages IIA-IIIA NSCLC patients undergoing adjuvant chemotherapy in seven hospitals. MethodsUsing stratified blocks, participants were randomized in a 1:1 ratio to receive SOL combined with conventional chemotherapy or conventional chemotherapy alone. The primary outcome was the change in global QoL from baseline to the fourth chemotherapy cycle, and intention-to-treat analysis was applied with a mixed-effect model. Secondary outcomes were functional QoL, symptoms, and performance status scores at the 6-month follow-up. Missing data were handled with multiple imputation and a pattern-mixture model. ResultsAmong 516 randomized patients, 446 (86.43%) completed the study. After the fourth chemotherapy cycle, in comparison with the control group, patients receiving SOL showed a lower reduction in mean global QoL (-2.76 vs. -14.11; mean difference [MD], 11.34; 95% confidence interval [CI], 8.28 to 14.41), greater improvement in physical function (MD, 11.61; 95% CI, 8.57 to 14.65), role function (MD, 10.15; 95% CI, 5.75 to 14.54), and emotional function (MD, 4.71; 95% CI, 1.85 to 7.57), and greater improvements in lung cancer-related symptoms (e.g., fatigue, nausea/vomiting, and appetite loss) and performance status during the 6-month follow-up period (treatment main effect, p < 0.05). ConclusionSOL treatment for NSCLC patients receiving adjuvant chemotherapy can significantly improve QoL and performance status within 6 months after radical resection. Trial registrationClinicalTrials.gov identifier: NCT03712969.