Measure Yourself Medical Outcome Profile Research Articles

A clinical audit of patient outcomes in real-world acupuncture practice.

Clinical auditing represents a valuable and cost-effective method for the collection of patient outcomes and is increasingly being used to inform clinical guidelines. The aim of this clinical audit was to assess patient outcomes across a small subset of acupuncture practitioners and private practices in the United Kingdom. The Measure Yourself Medical Outcomes Profile (MYMOP) questionnaire and the Patient Global Impression of Change (PGIC) scale were used as outcome measures. Additional questions assessed adverse events and patient experience with care. Clinical data were collected utilising an electronic patient-reported outcome measures (ePROMs) system. Baseline data were collected for a total of 233 health complaints (from 232 patients), of which 45.9% were musculoskeletal and 26.2% were psychological. Follow-up outcomes data were available for 144 health complaints (61.8% completion rate). For PGIC responses, >90% of health complaints were reported as at least 'minimally improved'. This was reduced to >51% when controlling for missing data. There was a gradual improvement in both mean MYMOP scores (24.5%-43.0%) and PGIC responses of 'very much improved' (12.3%-56.3%) over a 6-month period. A clinically significant improvement (>1 point change, p ⩽ 0.001) was seen in mean MYMOP scores compared to baseline from 4 to 8 weeks and symptom 1 MYMOP scores from 1 to 4 weeks. A moderately strong, negative correlation was seen between outcome measures (r = -0.507, p < 0.001). The majority of patients reported clinically meaningful improvements for their main health complaints/symptoms, which appeared to be sustained in the medium to long-term.

A clinical audit in a UK-based acupuncture private practice: assessing patient demographics, outcomes and experience.

The aim of this clinical audit was to assess patient demographics, outcomes and experience with care in patients who received acupuncture in a private practice setting in the United Kingdom. Demographic and clinical data were extracted from patients' records over a 7-year period. The Measure Yourself Medical Outcomes Profile (MYMOP) questionnaire and an adapted Patient Global Impression of Change (PGIC) scale were used routinely to monitor patient outcomes over an 18-month period. Finally, a retrospective questionnaire was used to assess patient beliefs regarding treatment effectiveness, adverse events and overall experience with care. Patients not providing consent or known to be deceased were excluded. Data were collected for 306 patients presenting with 376 separate health complaints, 58% of which were musculoskeletal. Follow-up outcomes (MYMOP scores (n = 51) and PGIC scale responses (n = 50)) showed a clinically significant improvement compared to baseline for the majority of health complaints (93% of PGIC scores were 'improved' and 79% MYMOP demonstrated > 1 point change). Total mean MYMOP severity scores were reduced by almost 50% (p < 0.001) after 1-4 weeks, and this was sustained in the medium-to-long term. There was a strong negative correlation (r = -0.767, p < 0.001) between the MYMOP and PGIC scores. A total of 118 health complaints were reported by 85/255 patients who responded to a retrospective questionnaire. Over 84% of patients believed that the treatments they received were 'effective' at addressing their health complaints. Seven minor adverse events were reported and four patients experienced negative treatment outcomes. Although musculoskeletal conditions were the most common, this audit found that patients sought treatment for a wide range of predominantly chronic health complaints, for many of which there is a currently a lack of quality evidence to support the use of acupuncture. Overall, the small sample of patients who responded to outcome questionnaires reported clinically meaningful and sustained improvements.

OA31 Moving forward with fibromyalgia: a collaboration between NHS Greater Glasgow and Clyde and Renfrewshire Health and Social Care Partnership

Abstract Background/Aims Fibromyalgia is a condition defined by a number of symptoms including the presence of widespread chronic pain, fatigue, poor quality sleep, cognitive symptoms and depression. The UK's Getting it Right First Time programme recommends that management of people with fibromyalgia should centre on primary care, but it remains unclear how best to organise health systems to deliver services to optimise patient outcomes. Within NHS Greater Glasgow and Clyde (NHSGGC) there was no consistency with how these patients were managed, but Clyde rheumatology physiotherapy had an innovative hospital-based programme which proved to be the model for "Moving Forward with Fibromyalgia". Methods A programme was developed between NHSGGC and Renfrewshire Health and Social Care Partnership (Renfrewshire HSCP) using monies from the Primary Care Transformation Fund. A physiotherapist from NHSGGC coordinated the programme and delivered information and advice on managing fibromyalgia using written, video-based and online resources. Instructors from Renfrewshire Leisure delivered 8x weekly sessions of tai chi. GPs make the initial diagnosis based on ACR diagnostic criteria and then make the referral. Patients are not required to be referred to secondary care. Patients then receive a telephone consultation with a physiotherapist prior to being appointed to an 8 week programme. This allows them to discuss their diagnosis, which many report as being very useful and reassuring. Tai chi was selected as there is a growing body of evidence that it is both suitable for and well tolerated by people with fibromyalgia. The programme began in 2019 with the aim to run for two years but, due to COVID, it has been extended to run until March 2024. Results So far, 710 patients have been referred to the programme. The Fibromyalgia Impact Questionnaire (FIQ) and Measure Yourself Medical Outcome Profile (MYMOP) questionnaire are completed prior to starting the programme and again on completion. Fibromyalgia programmes historically have high levels of drop out - before and during COVID we had only 44.1% participation. However, since resuming face to face programmes post-COVID, our participation has increased to 60%. FIQ scores were shown to improve in 60% of cases, and MYMOP scores improved in 67.5% of cases. The majority of patients who completed the programme felt good benefit from attending: "Initially sceptical but love it." "Very useful." "Absolutely fabulous." Conclusion The programme is enjoyed and felt to be beneficial by most patients who complete it. Treating these patients in a community-based setting reduces the demand on secondary care and hopefully has a similar effect on primary care resources. It also means that they are managed by people familiar with fibromyalgia. Many patients say that being part of a group is as important as any exercise. The programme has potential to be rolled out more widely to offer a service to a patient group who often feel forgotten or neglected. Disclosure F.M. Collins: None.

The importance of setting and therapeutic relationships when delivering chiropractic care to those living with disadvantage

BackgroundChiropractic is a mostly privatised health profession within Australia, with people experiencing disadvantage typically having limited access due to financial barriers. However, some universities within Australia offer community outreach clinics where students provide chiropractic care to people living with disadvantage. This demographic experiences higher rates of chronic conditions including musculoskeletal complaints and requires subsidisation to access privatised care. This need also offers opportunity for the chiropractic profession to work within community healthcare teams. A mixed-methods observational study was used to investigate how the unique setting of a student chiropractic community clinic may influence the experience and outcomes of those who attend.MethodsThree patient-reported outcome measures (PROMs) investigated client outcomes: Measure Yourself Medical Outcome Profile (MYMOP); European Five Domain Five Level Quality of Life Questionnaire (EQ-5D-5L); and the Patient Enablement Instrument. The PROMs data were analysed descriptively and inferentially. Interviews were conducted with clients who had received chiropractic care, chiropractic students, clinical supervisors and staff of the centre. Interview data were coded using thematic analysis, and themes were formed using Bronfenbrenner’s socio-ecological systems framework and non-participant observations.ResultsThirty-seven participants completed baseline PROMs and 17 completed follow-ups after four treatments. Seventy-two percent of participants nominated their primary complaint as chronic. Significant change was noted in general health and wellbeing for the MYMOP, pain and disability for the EQ-5D-5L and index scores for the EQ-5D-5L suggested improved health and wellbeing. Most clients experienced higher levels of enablement post treatment. Twelve participants were interviewed (four were clients), with five themes emerging from the interview data. Clients reported their lived experiences impacted their health problems and attending the clinic offered benefits beyond improvement of pain and disability.ConclusionsInterview data suggested that these benefits were due to a combination of therapy, the setting and the relationships formed within that setting. Complementing this, PROM data suggested clients experienced better levels of health and wellbeing and decreased levels of pain and disability. Findings indicated that people who experienced disadvantage may receive broader benefits from attending community centres offering chiropractic care. Services such as chiropractic may be complementary in meeting the healthcare needs of those experiencing disadvantage.

Outcome of consecutive new patients seen in the Outpatient department of the NHS Centre for Integrative Care, measured using the ‘Measure yourself Medical Outcome Profile (MYMOP) as a Patient Reported Outcome Measure (PROM)

Outcome of consecutive new patients seen in the Outpatient department of the NHS Centre for Integrative Care, measured using the ‘Measure yourself Medical Outcome Profile (MYMOP) as a Patient Reported Outcome Measure (PROM)

English

BACKGROUND Headache is the most common disabling condition worldwide that can be treated with massage therapy. But due to not practising by us there is a gap in applying massage therapy, as a non-pharmacological, along with pharmacological intervention for the treatment of headache which improves symptoms. There is negligible information on the effectiveness of that combined therapy to treat headaches. We wanted to study the effectiveness of combined therapy in a study group as compared to the control group and also to check the statistical significance among the study group (combined therapy) and control group (mono-therapy). METHODS A total of 30 study groups and 30 control groups of both sex with the age group of 18 - 65 years were included. The study group was explained about the structured massage therapy and encouraged to take the pharmacological drug along with it. The severity of headache was determined by using the HIT-6 scale and the subjects were assessed by themselves using the measure yourself medical outcome profile (MYMOP) questionnaire. The study was conducted in tertiary care hospitals which included both in-patient and out-patient departments. It was a prospective study. Descriptive and Inferential statistics were used. RESULTS Compared with the initial visit, the severity of headache symptoms significantly reduced within two weeks of the massage protocol along with pharmacological intervention as compared to the control group. The severity of associated symptoms also reduced significantly following massage therapy. CONCLUSIONS Our study proved that combined therapy was very effective as compared to the control group who were on monotherapy. Needs to apply it clinically in future. Since both act at different sites, our study proved that combined therapy is effective in reducing headache along with associated symptoms significantly. KEY WORDS Massage Therapy, Headache, Amitriptyline, MTrPs (Myofascial Trigger Points)

An evaluation of a ScarWork service for cancer survivors experiencing adverse effects of surgery and/or radiotherapy

IntroductionIn the UK, 68% of early stage cancer patients undergo surgical resection, which may result in troublesome physiological and psychosocial symptoms from scars associated with this curative- intent surgery. We evaluated a 12-month service offering ScarWork, a light-touch manual therapy, to improve our understanding of this novel intervention. MethodsA National Health Service (NHS) cancer centre offered eight ScarWork treatments to survivors who had undergone surgery (and/or radiotherapy) for breast, colorectal, gynaecological, head and neck cancers or melanoma. Outcome measures administered at beginning and end-of-treatment included the Patient Scar Assessment Questionnaire (PSAQ) and Measure Yourself Medical Outcome Profile (MYMOP). Patients could specify one or more scars. A semi-structured questionnaire administered at end-of-treatment collected patients’ impressions of ScarWork. ResultsNineteen patients, reporting 25 scars with a mean scar age of 4.2 years (range: 0.5-17 years) received a median of six ScarWork treatments (range: 0-12). PSAQ showed significant improvements for subscales Appearance, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms; symptom improvements included itching, frequency of discomfort, sensations of numbness and overall troublesomeness. Mean MYMOP profile score showed 1.8 (SE=0.3) points improvement on a 7-point scale, where change of ≥0.5-1.0 points is clinically significant. In written feedback, patients reported benefits including improved appearance, texture, mobility, wellbeing and acceptance of scars. No serious adverse events were reported. ConclusionsFeedback from this service assured funding for continued clinical activity. Valuable experience in administering outcome measures, especially PSAQ, was gained. This will facilitate improved data collection and analysis for future service development.

Action plans in idiopathic pulmonary fibrosis: a qualitative study—‘I do what I can do’

BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive, incurable fibrotic lung disease in which patients and caregivers report a high symptom burden. Symptoms are often poorly managed and patients and caregivers...

The use and benefits of Craniosacral Therapy in primary health care: A prospective cohort study

BackgroundPatients frequently use treatments complementary to standard primary care. This prospective cohort-study examined the use, benefits, and safety of Craniosacral Therapy (CST). MethodsConsecutive out-patients utilizing CST from 2015 to 2019 were asked to provide anonymized data on symptom intensity, functional disability, and quality of life before and after treatment using an adapted 11-point numerical rating scale (NRS) version of the Measure Yourself Medical Outcome Profile (MYMOP). Treatment expectations were assessed as were concurrent therapies/medication and safety. Mean differences were analyzed using paired sample t-tests with 95 % confidence intervals (CI), predictors of treatment response using linear regression modelling. ResultsCST therapists submitted 220 patient records (71.4 % female) including 15.5 % infants and toddlers, 7.7 % children, and 76.8 % adolescents and adults. Patients received on average 7.0 ± 7.3 CST sessions to treat 114 different, acute and chronic conditions. Symptom intensity significantly decreased by -4.38 NRS (95 %CI=-4.69/-4.07), disability by -4.41 NRS (95 %CI=-4.78/-4.05), and quality of life improved by 2.94 NRS (95 %CI = 2.62/3.27). Furthermore, CST enhanced personal resources by 3.10 NRS (95 %CI = 1.99/4.21). Independent positive predictors of change in the adapted total MYMOP score included patients’ expectations (p = .001) and therapists’ CST experience (p = .013), negative predictors were symptom duration (p < .002) and patient age (p = .021); a final categorical predictor was CST type (p = .023). Minor but no serious adverse events occurred. ConclusionsIn primary care, patients and parents of underage children use CST for preventive and therapeutic purposes. Considering the design limitations, CST appears to be overall effective and safe in infants, children, and adults.

A pragmatic case series of clients living with medically diagnosed migraines self-referred to reflexology

Migraine affects approximately 2% of the population of the UK with around 190,000 people experiencing a migraine daily. This study investigated the effectiveness of reflexology on migraine symptoms provided under pragmatic, personally funded conditions. Data was gathered on a case series of 20 reflexology clients with medically diagnosed migraine. All participants self-referred to a member of the Association of Reflexologists (AoR). The Measure Yourself Medical Outcome Profile (MYMOP) was completed at each appointment. All participants received six reflexology sessions. In terms of an improvement in the overall MYMOP profile, 75% (n=15) of clients had an improvement of two or more points. The minimal clinically important difference for the MYMOP change score is 1.0; this was achieved by 90% (n=18) of participants. The mean difference in scores for each of the MYMOP aspects was calculated and the greatest improvement was found with symptom 1, their chosen primary symptom, which changed an average of 3.40 points (95% CI: 2.35, 4.45.) CONCLUSION: The results indicate the potential for reflexology to relieve the symptoms of migraine.

Individualized health-related quality of life instrument Measure Yourself Medical Outcome Profile (MYMOP) and its adaptations: a critical appraisal.

Health-related quality of life (HRQL) is increasingly recognized for its importance in health research. As there is increasing recognition of the inter-individual difference in response to therapeutic interventions, it may be helpful to apply individualized measures of HRQL. The MYMOP is a commonly used example of such measures, although several adaptations have been developed. This review was conducted to identify adaptations of MYMOP, and evaluate the measurement properties of MYMOP and its adaptations. Adaptations were identified using MYMOP website and personal communication, supplemented by a SCOPUS search in April 2017. Bibliographies of included studies were hand-searched. COSMIN criteria were used to evaluate the measurement properties. Sixteen studies were included in this review. Adaptations were developed to evaluate individualized therapies in cancer, psychiatry, and acupuncture. The included measures were MYMOP, measure yourself concern and wellbeing, psychological outcome profiles (PSYCHLOPS), and MYMOP-pictorial (MYMOP-P). The quality of the measurement properties varied; none of the included measures met all currently recommended quality criteria for measurement properties. Current literature provides evidence that MYMOP and its adaptations offer individualized assessment of patient-centered outcomes, and thereby provide a means to understand heterogeneity of treatment effects. However, current recommendations for psychometric testing suggest further validation of these measures would be beneficial.

Patient-Reported Outcome of Physical Therapy in Amyotrophic Lateral Sclerosis: Observational Online Study.

BackgroundPhysical therapy is an essential component of multidisciplinary treatment in amyotrophic lateral sclerosis (ALS). However, the meaning of physical therapy beside preservation of muscular strength and functional maintenance is not fully understood.ObjectiveThe purpose of this study was to examine patients’ perception of physical therapy during symptom progression using an internet assessment approach.MethodsA prospective, longitudinal, observational study was performed. Recruitment took place in an ALS center in Berlin, Germany. Online self-assessment was established on a case management platform over 6 months. Participants self-assessed the progression of the disease with the ALS Functional Rating Scale-Revised (ALSFRS-R) and tracked the efficacy of targeted physical therapy using Measure Yourself Medical Outcome Profile (MYMOP). We used the net promoter score (NPS) to inquire into recommendation levels of physical therapy.ResultsForty-five participants with ALS were included in the study. Twenty-seven (60.0%) started the online assessment. The mean duration of physical therapy sessions per week was 142.7 minutes (SD 60.4) with a mean frequency of 2.9 (SD 1.2) per week. As defined by MYMOP input, the most concerning symptoms were reported in the legs (62.2%), arms (31.1%), and less frequently in the torso (6.7%). As expected for a progressive disease, there was a functional decline of 3 points in the ALSFRS-R at the end of the observation period (n=20). Furthermore, the MYMOP showed a significant loss of 0.8 in the composite score, 0.9 in the activity score and 0.8 in the targeted symptom. In spite of functional decline, the recommendation for physical therapy jumped from a baseline value of 20 NPS points to a very high 50 points at the end of study (P=.05).ConclusionsPhysical therapy is perceived as an important treatment method by patients with ALS. Despite functional deterioration, patients are satisfied with physical therapy and recommend this intervention. The results also underline how the meaning of physical therapy changes throughout the disease. Physical therapy in ALS has to be regarded as a supportive and palliative health care intervention beyond functional outcome parameters.

Patient understanding of two commonly used patient reported outcome measures for primary care: a cognitive interview study

BackgroundStandardised generic patient-reported outcome measures (PROMs) which measure health status are often unresponsive to change in primary care. Alternative formats, which have been used to increase responsiveness, include individualised PROMs (in which respondents specify the outcomes of interest in their own words) and transitional PROMs (in which respondents directly rate change over a period). The objective of this study was to test qualitatively, through cognitive interviews, two PROMs, one using each respective format.MethodsThe individualised PROM selected was the Measure Yourself Medical Outcomes Profile (MYMOP). The transitional PROM was the Patient Enablement Instrument (PEI). Twenty patients who had recently attended the GP were interviewed while completing the questionnaires. Interview data was analysed using a modification of Tourangeau’s model of cognitive processing: comprehension, response, recall and face validity.ResultsPatients found the PEI simple to complete, but for some it lacked face validity. The transitional scale was sometimes confused with a status scale and was problematic in situations when the relevant GP appointment was part of a longer episode of care. Some patients reported a high enablement score despite verbally reporting low enablement but high regard for their GP, which suggested hypothesis-guessing. The interpretation of the PEI items was inconsistent between patients.MYMOP was more difficult for patients to complete, but had greater face validity than the PEI. The scale used was open to response-shift: some patients suggested they would recalibrate their definition of the scale endpoints as their illness and expectations changed.ConclusionsThe study provides information for both users of PEI/MYMOP and developers of individualised and transitional questionnaires.Users should heed the recommendation that MYMOP should be interview-administered, and this is likely to apply to other individualised scales. The PEI is open to hypothesis-guessing and may lack face-validity for a longer episode of care (e.g. in patients with chronic conditions). Developers should be cognisant that transitional scales can be inconsistently completed: some patients forget during completion that they are measuring change from baseline. Although generic questionnaires require the content to be more general than do disease-specific questionnaires, developers should avoid questions which allow broad and varied interpretations.

Self-Reported Effects of Energy Healing: A Prospective Observational Study With Pre–Post Design

Healing is reported to be used by 16.8% of the population, however utilization may be considerably higher in selected patient groups. The aim of this study was to map the symptoms the participants reported when visiting a healer for the first time, and to evaluate the subjectively experienced benefits and risks from the healing sessions. Data were obtained from the Measure Yourself Medical Outcome Profile (MYMOP) questionnaire. One-hundred adults who, for the first time, referred themselves to a healer in southern Norway between January 2016 and January 2017 were included in the study. Eligible for analyses were 92 participants who fulfilled their treatment plan and returned both the baseline (pre) and post-treatment questionnaire. The occurring symptoms were grouped according to their nature into four symptom groups: pain, psychological problems, fatigue and other. With regard to the observational character of the study, all results were described and interpreted descriptively and exact p-values were given and interpreted as measures of effect. The participants who visited the healers in this study were mainly women (80%) with chronic disease (82%), with pain, fatigue and/or psychological problems as main complaints. They experienced an improvement of symptoms, well-being and improved activity level of approximately 50% regardless of the nature of the complaints. Women reported more improvement than men did. The pre-post changes was found after an average of 4.1 treatments. Forty percent of the participants reported adverse effects, which occurred directly after the healing session, generally lasting for less than one day. The study participants reported substantial improvement of, and major reduction of the burden of symptoms, improved well-being and activity level after healing sessions. Due to the observational nature of the study, no interpretations about specificity of the descriptive results or the mechanisms of effect can be made.

A pragmatic randomised controlled trial of healing therapy in a gastroenterology outpatient setting

IntroductionTo determine the benefits of healing therapy (spiritual healing) as an adjunct to conventional management in irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Methods200 outpatients with IBS or IBD were randomised to either conventional treatment (control) or conventional plus five sessions of healing therapy (intervention). After 12 weeks controls also had healing therapy. Outcomes used were, the Measure Yourself Medical Outcomes Profile (MYMOP). IBS-QOL, IBDQ, and symptom measures. ResultsThere was a significant improvement in the MYMOP score at week 6 (p<0.001) which was maintained to week 12 (p<0.001) and 24 (p<0.001). Improvements in MYMOP were significantly greater in the intervention group at both 6 (p<0.001) and 12 weeks (p<0.001) with effect sizes of 0.7 (95% CI: 0.4–1.1) and 0.8 (95% CI: 0.4–1.2). Condition-specific data for IBS showed that most QoL dimensions had a significant minimum 10-point score improvement at 6 and 12 weeks. The overall score improvement was 12.9 units at week 6 (p<0.001), 12.4 units at week 12 (p<0.001) and 13.8 units at week 24 (p<0.001). In IBD there was also similar score improvement, but only up to week 12 were there associations of improved social and bowel functions (p<0.001, respectively). Between group differences were identified for QoL scores in IBS at both week 6 (p<0.001) and 12 (p<0.001) but only for week 12 (p<0.001) in the IBD group. ConclusionsThe addition of healing therapy to conventional treatment was associated with improvement in symptoms and QoL in IBS, and to a lesser extent in IBD.

PRM181 - Translation of Chinese Version of Measure Yourself Medical Outcome Profile (MYMOP) And Application In The Coronary Heart Disease

PRM181 - Translation of Chinese Version of Measure Yourself Medical Outcome Profile (MYMOP) And Application In The Coronary Heart Disease

PTU-141 A Pragmatic Randomised Controlled Trial of Healing Therapy in a Gastroenterology Outpatient Setting

Introduction To determine benefits of healing therapy as an adjunct to conventional management in irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Methods : 200 outpatients with IBS or IBD were randomised to either conventional treatment or conventional plus 5 sessions of healing therapy. After 12 weeks Controls also had healing therapy. Outcomes used were, the Measure Yourself Medical Outcomes Profile (MYMOP). IBS-QOL and IBDQ and symptom measures. Results There was a significant improvement in the MYMOP score at week 6 (p Conclusion The addition of healing therapy in IBS was associated with improvements in symptoms and QoL in IBS, and to a lesser extent in IBD. Disclosure of Interest None Declared

Hay fever & homeopathy: a case series evaluation

Seasonal allergic rhinitis (hay fever) is common and can considerably reduce the quality of life of sufferers. Despite the wide everyday application and promising results with homeopathy, scientific evidence of its effectiveness for most ailments is scarce. The assessment of the clinical effectiveness of homeopathic remedies in the alleviation of hay fever symptoms in a typical clinical setting. We performed a clinical observational study of eight patients in the treatment of hay fever symptoms over a two-year period (2012 and 2013) using Measure Yourself Medical Outcome Profile (MYMOP) self-evaluation questionnaires at baseline and again after two weeks and four weeks of homeopathic treatment. The individualized prescription - either a single remedy or multiple remedies - was based on the totality of each patient's symptoms. The average MYMOP scores for the eyes, nose, activity and wellbeing had improved significantly after two and four weeks of homeopathic treatment. The overall average MYMOP profile score at baseline was 3.83 (standard deviation, SD, 0.78). After 14 and 28 days of treatment the average score had fallen to 1.14 (SD, 0.36; P<0.001) and 1.06 (SD, 0.25; P<0.001) respectively. Individualized homeopathic treatment was associated with significant alleviation of hay fever symptoms, enabling the reduction in use of conventional treatment. The results presented in this study can be considered as a step towards a pilot pragmatic study that would use more robust outcome measures and include a larger number of patients prescribed a single or a multiple homeopathic prescription on an individualized basis.

Acupuncture differential effect on chronic and acute low back pain using fMRI

the third day:20mg/d). Both EA andHA groupwere addedwith acupuncture on Baihui(GV20), Yingtang(GV29), Fengchi(GB20), Sanyinjiao(SP6), Neiguan(PC6) and some other acupoints according to patients’ different conditions for 30min every other day, totally for 6 weeks. The EA group used electrical acupuncture acupoint stimulator (2/15Hz alternating, LH-202H) at Baihui(GV20), Fengchi(GB20) and Yingtang(GV29). Acupuncture practionors manipulated needles every 15min and last for 5-10s for each patients in HA group. Hamilton Rating Scale for Depression (HAMD) and Measure Yourself Medical Outcome Profile (MYMOP) were used to evaluate the effectiveness before and after treatment. Results: There was no significant difference among three groups on the baseline. After six weeks, satistical results showed that HAMD Ratio of points of HA and EA are 92.00% and 89.28% respectively, which were higher than paroxetine group (84.71%) (p 0.05). The scores in each domain of MYMOP in EA group and HA group were obviously lower than that of paroxetine group after treatment (p<0.05). Conclusion: Acupuncture significantly reduced the HAMD and MYMOP scores of depression patients. In addition, acupuncture was shown to enhance the effectiveness of conventional drug treatments and also alleviate the main symptoms of depression, thus improving the overall quality of life and make depression patients felt better themselves. Contact: Xuehong Ma, maxh9713@163.com

A brief patient-reported outcome instrument for primary care: German translation and validation of the Measure Yourself Medical Outcome Profile (MYMOP).

BackgroundMeasure Yourself Medical Outcome Profile (MYMOP) is a patient-generated outcome instrument capable of measuring effects from a wide range of health care interventions. This paper reports the translation of this instrument into German (MYMOP-D) and the assessment of validity and sensitivity to change for the MYMOP-D. The instrument was piloted in a German primary care context.MethodsThe translation process was conducted according to international guidelines. Recruited patients of both general practitioners and non-medical Complementary and Alternative Medicine (CAM) practitioners (“Heilpraktiker”) in the German state of Baden-Wuerttemberg completed a questionnaire comprised of the MYMOP-D and the EQ-5D. Responses were analysed to assess construct validity. For assessing the instrument’s sensitivity to change, patients received the MYMOP-D again after four weeks at which point they were also asked for their subjective views on change of symptoms. Correlation between MYMOP-D and EQ-5D and sensitivity to change as gradient in score change and as standardized response mean (SRM) were calculated.Results476 patients from general practices and 91 patients of CAM practitioners were included. Construct validity of the MYMOP-D was given with a correlation of r = .47 with the EQ-5D. Sensitivity to change for subjective change of symptoms could only be analysed for improvement or no change of symptoms, as only 12 patients reported deterioration of symptoms. Results showed the expected smooth gradient with 2.2, 1.3, and 0.5 points of change for large, little improvement and no change, respectively. SRM for MYMOP-D Profile Score was 0.88.ConclusionsThe MYMOP-D shows excellent construct validity. It is able to detect changes when symptoms in patients improve or remain unchanged. Deterioration of symptoms could not be evaluated due to too few data. With its brevity and simplicity, it might be an important tool for enhancing patient-centred care in the German health care context.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-014-0112-5) contains supplementary material, which is available to authorized users.