Medication Satisfaction Research Articles

The effect of face-to-face and online education provided to individuals with atrial fibrillation on medication adherence and satisfaction.

This randomized controlled study was conducted to investigate effects of face-to-face education and tele-education given to individuals with atrial fibrillation (AF) taking oral anticoagulants on their medication compliance and satisfaction levels. The study sample comprised 150 individuals. Of them, 50 were assigned to the control group, 50 to experimental Group 1, and 50 to experimental Group 2. Data were collected with the Descriptive Information Form, Medication Compliance Notification Scale, and Duke Anticoagulation Satisfaction Scale (DASS). Intervention Group 1 was given face-to-face education. Intervention Group 2 was given tele-education. The control group underwent no intervention. The scales were administered to all the groups twice. Intragroup analysis demonstrated that the Medication Compliance Notification Scale score of the face-to-face education group increased significantly in the final measurement compared to those of the control group and tele-education group. Intergroup analysis demonstrated that the DASS scores of the three groups significantly differed. The difference stemmed from intervention Group 1. Face-to-face education given to individuals with AF on oral anticoagulants improved their medication compliance and medication satisfaction levels. Nurses should primarily use face-to-face education in the care and education programs of individuals with AF.

Effectiveness of long-acting buprenorphine - A systematic review.

To analyse the evidence of the effectiveness of long-acting injection buprenorphine (LAI-B) in the management of opioid use disorder (OUD). Databases were searched for studies reporting on the effectiveness of LAI-B for the treatment of OUD. Risk of bias was assessed, and a narrative synthesis of data was presented. The study adhered to PRISMA guidelines and was registered with PROSPERO (CRD42023396033). Eighteen studies were included in the final review: two double-blind randomised control trials, two open-label randomised control trials, two retrospective cohort studies, one non-controlled pilot study, and eleven observational studies. In comparative trials, LAI-B was superior to placebo and superior or non-inferior to treatment as usual. LAI-B was positively associated with improvements in abstinence rates and patient-centred outcomes. There was limited data on the long-term effects of continuous LAI-B prescription. LAI-B is an effective treatment for OUD with advantages over existing forms of treatment. Patients reported high levels of medication satisfaction and there were no significant safety concerns. This review highlights the need for future research on long-term effectiveness outcomes, with participants of more varied demographics and psychiatric comorbidity, which is more reflective of the OUD population seen in community clinical settings.

SLE patient satisfaction with care in Jordan: A single-center study.

Systemic Lupus Erythematosus (SLE) is a chronic multi-systemic autoimmune disease that mainly affects young females. SLE's chronicity and high level of complications yield frequent clinic visitations & hospital admissions, increasing the necessity to investigate the healthcare system and improve patient satisfaction and quality of life. This study aimed to understand SLE patients' points of view on the healthcare system in Jordan, especially given the chronic nature of the disease. With a clearer understanding, improvements can be made to benefit both the patients and the healthcare system. A cross-sectional study of 79 patients following up at the University of Jordan Hospital, rheumatology clinics were interviewed over the phone. The majority of patients were satisfied overall with the treatment services and medications as rated on a Likert scale of 1-5 (4.28 ± 1.01 and 4.19 ± 0.96, respectively) despite a quarter of patients complaining of adverse effects from the medications. The use of oral corticosteroids was significantly associated with a lower General Satisfaction Rate (p = 0.050), while high income (1000 Jordanian Dinars and above) and fatigue contributed to a lower Medication Satisfaction Rate (p = 0.016 and 0.000, respectively). A good physician-patient relationship was the most commonly cited reason for general satisfaction (73.4%) and was positively associated with the general (p = 0.000) and medication satisfaction (p = 0.004) rates. SLE patients perceived high satisfaction rates despite adverse effects and symptoms. These higher satisfaction rates were seen predominantly due to good physician-patient relationships.

7377 CAM2029, Octreotide Subcutaneous Depot, Improves Patient-Reported Outcomes From Standard-of-Care Baseline in Patients With Acromegaly: Interim Results From a Phase 3 Study (ACROINNOVA 2)

Abstract Disclosure: D. Ferone: Consulting Fee; Self; Camurus AB, Ipsen, Novartis-AAA, Recordati. Grant Recipient; Self; Camurus AB, Ipsen, Novartis-AAA, Recordati. Research Investigator; Self; Camurus AB. P. Maffei: Research Investigator; Self; Camurus AB. J. Silverstein: Consulting Fee; Self; Xeris Pharmaceuticals. Research Investigator; Self; Camurus AB. J.L. Spencer-Segal: Advisory Board Member; Self; Camurus AB. Research Investigator; Self; Camurus AB. A. Gilis-Januszewska: None. M. Doknic: Speaker; Self; Pfizer, Inc., Novo Nordisk, Merck, Sandoz. P. Kadioglu: None. P. Freda: Research Investigator; Self; Camurus AB. L. Katznelson: Advisory Board Member; Self; Camurus AB, Recordati. G. Fidan Yaylali: None. M. Harrie: Employee; Self; Camurus AB. Stock Owner; Self; Camurus AB. A. Svedberg: Employee; Self; Camurus AB. Stock Owner; Self; Camurus AB. A.M. Pedroncelli: Employee; Self; Camurus AB. Stock Owner; Self; Camurus AB. F. Tiberg: Employee; Self; Camurus AB. Stock Owner; Self; Camurus AB. Introduction: Standard-of-care (SoC) therapies for acromegaly typically require healthcare provider administration and can pose a significant treatment burden. CAM2029 is a novel subcutaneous octreotide depot designed for convenient once-monthly self-administration as a ready-to-use syringe or injection pen. In a 24-week Phase 3 trial (ACROINNOVA 1), CAM2029 achieved superior insulin-like growth factor 1 (IGF-1) response vs placebo in acromegaly patients (pts) previously controlled with SoC (octreotide LAR/lanreotide Autogel). We report patient-reported outcome (PRO) data from an interim analysis of a Phase 3, open-label trial of CAM2029 (ACROINNOVA 2; NCT04125836). Methods: ACROINNOVA 2 enrolled pts with acromegaly who completed ACROINNOVA 1 (prior CAM2029 or placebo groups) and new pts with IGF-1 ≤2x upper limit of normal during stable SoC. Pts received once-monthly CAM2029 20 mg for up to 52 weeks (28 weeks for prior placebo pts [week 24−52]). Primary endpoint was adverse events. PROs were assessed using Acromegaly Index of Severity (AIS, 0−18; sum of 6 scores [0−3; none−severe] for headache, sweating, fatigue, joint pain, paresthesia, soft tissue swelling) for symptoms; Acromegaly Quality of Life Questionnaire (AcroQoL, 0−100) for QoL; Treatment Satisfaction Questionnaire for Medication (TSQM, 0−100) and patient satisfaction scale (0−5) for treatment satisfaction; and Self-Injection Assessment Questionnaire (SIAQ v2.0, 0−10) for satisfaction with self-administration. Higher scores signify improvements, except for AIS. Data are shown for the overall population. Results: At data cutoff (May 23, 2023), 54 roll-over pts (prior CAM2029 n=36; prior placebo n=18) and 81 new pts were enrolled; mean CAM2029 exposure was 56.3 weeks. CAM2029 was well tolerated with no unexpected side effects. Mean AIS score improved from baseline SoC to week 52 (−1.2; 95% CI: −1.8, −0.7); estimated proportion of pts with any acromegaly symptoms reduced by 15.1% (95% CI: −23.9, −6.3). At week 52 vs baseline: mean total AcroQoL increased by 3.5 (95% CI: 1.3, 5.7); mean TSQM increased for ‘convenience’ by 15.6 (95% CI: 11.8, 19.3), ‘effectiveness’ by 6.3 (95% CI: 2.8, 9.8), ‘satisfaction’ by 4.7 (95% CI: 1.1, 8.4), and for ‘side effects’ by 2.4 (95% CI: −2.0, 6.8). Mean patient satisfaction score at week 52 was 4.1 (95% CI: 3.9, 4.3); 32.6% and 19.3% of pts reported a ‘much better’ or ‘slightly better’ experience, respectively, with CAM2029 vs prior SoC. Mean SIAQ increased at week 48 vs pre-treatment, ‘satisfaction with way of taking medication’ by 1.6 (95% CI: 0.9, 2.2) and ‘feelings about injections’ by 0.8 (95% CI: 0.3, 1.3). Conclusion: CAM2029 improved symptom burden, QoL, treatment convenience, and patient satisfaction vs baseline SoC, including in pts with stable or controlled disease at baseline, supporting the clinical benefit of CAM2029 and its potential to address unmet needs for pts with acromegaly. Presentation: 6/2/2024

Assessing the Effectiveness of Telepharmacy Services in Rural and Underserved Areas

This study evaluates the effectiveness of telepharmacy services in improving healthcare delivery in rural and underserved areas. Utilizing a mixed-methods design, both quantitative and qualitative data were collected over a 12-month period. The study involved 200 patients who used telepharmacy services, providing remote access to pharmacists for medication dispensing, consultations, and patient education. Quantitative data included patient surveys on medication adherence and satisfaction, along with medication records to assess dispensing errors. Qualitative data were obtained through interviews with patients and pharmacists to explore their experiences. Results indicated a significant increase in medication adherence rates from 60.0% to 85.0% post-telepharmacy implementation. Patient satisfaction scores across various domains improved notably, with mean scores for access to pharmacists, quality of consultations, and overall satisfaction showing significant enhancements (p < 0.001). Additionally, there was a substantial reduction in medication errors, with dispensing errors decreasing from 15.0% to 5.0% (p < 0.01) and prescription errors from 10.0% to 4.0% (p < 0.05). Economic analysis revealed a decrease in healthcare costs per patient from $2000 to $1500, along with a reduction in hospitalizations per 1000 patients from 50 to 30 (p < 0.01). These findings are consistent with previous studies and underscore the potential of telepharmacy as a cost-effective and efficient solution to healthcare disparities in rural and underserved regions. Despite technological and regulatory challenges, telepharmacy represents a promising approach to enhancing healthcare access, improving clinical outcomes, and achieving significant cost savings in rural healthcare systems.

Treatment for chronic idiopathic constipation: Use and satisfaction from a nationwide survey of US participants.

Chronic idiopathic constipation (CIC) is a disorder of gut-brain interaction characterized by a variety of bowel movement-related and abdominal symptoms. A greater understanding of medication use and satisfaction with symptom control may provide insights to optimize patient care. Therefore, we explored these aspects of the disorder in adults with CIC. This study assessed data collected from a large nationwide survey of adult participants in the United States, querying demographics, clinical characteristics, and comorbid conditions, as well as medication use, care-seeking behaviors, and satisfaction with symptom control. Participants were grouped into the CIC cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self-reported. Two thousand five hundred and thirty-three participants with CIC were matched 1:1 to controls. In the CIC cohort, abdominal pain was the most reported symptom leading to medication use: 15.9% of respondents were receiving a prescription medication in addition to an over-the-counter medication, while 26.3% were taking neither. In addition, only one-third were satisfied with the control of their symptoms; however, satisfaction was significantly higher in respondents taking a prescription medication (p < 0.001). The proportion of reported comorbidities was significantly higher in the CIC cohort versus the control cohort, with chronic pain, anxiety, and depression among the highest (p < 0.001 for all). This study emphasizes the need for better communication regarding prescription medications and their benefits, with the goal of further improving CIC patients' overall symptoms.

Effects of intensive, targeted education by pharmacists on anticoagulant patients with atrial fibrillation: a multicenter randomized controlled trial from China.

Many people diagnosed with atrial fibrillation (AF) may lack awareness of AF and anticoagulants. The purpose of this study is to investigate the effects of intensive, targeted education by pharmacists on anticoagulant patients with AF. Three hundred seventy-six AF patients were randomly assigned to receive standard care or pharmacist education. Follow-up is scheduled after 1, 3, 6, and 12 months. Pharmacists provided intensive education on knowledge deficits revealed by the Jessa Atrial Fibrillation Knowledge Questionnaire (JAKQ) during each visit. Patients also completed two questionnaires to assess their medication adherence and satisfaction. Clinical outcomes were recorded during follow-up. 361 patients completed follow-up. Baseline scores on the JAKQ were similar in the education group (median: 31.3%) and the standard care group (median: 31.3%) (p = 0.911). Over time, the knowledge score of the education group increased significantly (1 month: 68.8%, 3 months: 81.3%; P <0.001), while there was no significant improvement in the standard care group (1 month: 37.5%, 3 months: 37.5%; P = 0.314). Adherence scores improved significantly over time in the education group (P < 0.001) but not in the standard care group (P =0.101). Compared with standard care, pharmacist education was associated with a significantly lower risk of bleeding (P=0.034). Given the knowledge deficiency of AF patients in China, standardized patient education should be a part of their daily care. Pharmacist-led education intervention can significantly improve the disease-related knowledge, medication adherence, and drug treatment satisfaction of AF patients while significantly reducing the risk of bleeding.

Patients' satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study.

Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients. To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023. After obtaining ethical approval, a multi-center cross-sectional study was conducted at four cancer care centers in northern Ethiopia. The data were collected using an interviewer-administered structured questionnaire that included the Lubeck Medication Satisfaction Questionnaire (LMSQ). The severity of pain was assessed by a numerical rating scale from 0 to 10 with a pain score of 0 = no pain, 1-3 = mild pain, 4-6 = moderate pain, and 7-10 = severe pain Binary logistic regression analysis was employed, and the strength of association was described in an adjusted odds ratio with a 95% confidence interval. A total of 397 cancer patients participated in this study, with a response rate of 98.3%. We found that 70.3% of patients were satisfied with their cancer pain treatment. Being married (AOR = 5.6, CI = 2.6-12, P < 0.001) and being single (never married) (AOR = 3.5, CI = 1.3-9.7, P = 0.017) as compared to divorced, receiving adequate pain management (AOR = 2.4, CI = 1.1-5.3, P = 0.03) as compared to those who didn't receive it, and having lower pain severity (AOR = 2.6, CI = 1.5-4.8, P < 0.001) as compared to those who had higher level of pain severity were found to be associated with satisfaction with cancer pain treatment. The majority of cancer patients were satisfied with cancer pain treatment. Being married, being single (never married), lower pain severity, and receiving adequate pain management were found to be associated with satisfaction with cancer pain treatment. It would be better to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management and lower pain severity scores.

Analysis of Therapy Satisfaction on the Quality-of-Life of Type 2 Diabetes Mellitus Patients at Anutapura Hospital Palu

Background: Type 2 Diabetes Mellitus (Type 2 DM) is a chronic disease characterized by increased blood glucose levels caused by impaired insulin function. In Palu City, Type 2 DM is the 2nd most common in Central Sulawesi with a total of 26,204 people. Objective: This study aims to determine the relationship between therapy satisfaction and the quality of life of Type 2 DM patients who perform outpatient treatment at Anutapura General Hospital, Palu. Methods: With a random sample approach, 100 respondents were used in this cross-sectional study that employed an observational method. Data collection used instruments in the form of a DMSAT (Diabetes Medication Satisfaction Tool) therapy satisfaction questionnaire and a DQOL (Diabetes Quality Of Life) quality of life questionnaire. Results: The results of the study were obtained on therapy satisfaction from Type 2 DM patients with the number of respondents in the very satisfied (1.0%), satisfied (90.0%), and quite satisfied (9.0%) categories while the results of the study of the quality of life of Type 2 DM patients 2 fall into the good category (38.0%), and the bad category (62.0%). The statistical analysis test used was the Spearman Rank Correlation test. The results of the Spearman Rank Correlation test value p = 0.037 or p &lt;α (0.05), then H0 is rejected, which means that there is a relationship between satisfaction with therapy and quality of life in patients with Type 2 DM which is very weak. Conclusion: The conclusion in this study is that there is a very weak relationship between therapy satisfaction and quality of life of patients.

Analysis of the feelings in the reviews of patients versus the evaluation of the ease of use, effectiveness, and satisfaction of prescribed medications

The sentimental polarity of patients' medical treatments is decisive for therapeutic adherence, especially in managing chronic diseases. Patients value the effects of medications differently, while health personnel do it from a practical perspective. For this, patient reviews have been taken in unstructured text to the diversity of drugs available on the WebMD site. A numerical assessment accompanies these data on a Likert scale of the variables for "EaseofUse", "Effectiveness," and "Satisfaction". Using an NLP model called RoBERTa; the opinions have been analyzed, finding that neutral opinions are maintained against positive scales of "EaseofUse" and "Effectiveness," but negative opinions regarding "Satisfaction," where the evaluations are divided into the extremes. The analysis has been done statistically using frequencies and diagrams of pairs between feelings and variables of interest. Keywords: Natural language processing; sentiment analysis; BERT; medication satisfaction

Association Between Fear of Hypoglycemia and Treatment Satisfaction Among Patients With Diabetes Mellitus

Background: Treatment satisfaction is one of the main factors of assessing care quality in patients with chronic diseases. Some factors may influence treatment satisfaction and improve or impair clinical outcomes. This study aimed to determine the relationship between fear of hypoglycemia and satisfaction with treatment in patients with type 2 diabetes treated with oral antidiabetic drugs. Methods: This cross-sectional study was carried out in one of the hospitals of Qazvin Province, Iran, in 2021. The research sample was 390 patients with type 2 diabetes who used oral antidiabetic drugs, selected through convenience sampling. The data were collected using the hypoglycemic fear survey (HFS) and the diabetes medication satisfaction (DiabMedSat) questionnaire. Then, the obtained data were analyzed using the independent t-test, one-way analysis of variance, and multiple linear regression in SPSS software, version 26. Statistical significance was set at P&lt;0.05. Results: Patients’ Mean±SD age was 53.4±11.49 years, and most (57.4%) were female. Treatment satisfaction score was lower in females (β=-0.12, P&lt;0.007) and patients with diabetes complications (β=-0.138, P&lt;0.005). Patients with college education had higher treatment satisfaction (β=0.173, P&lt;0.001). Patients with very severe (β=-0.29, P&lt;0.001) or severe hypoglycemia (β=-0.157, P&lt;0.034) experienced lower treatment satisfaction than those with mild hypoglycemia. Low treatment satisfaction scores were associated with fear of hypoglycemia (β=-0.39, P&lt;0.001). Conclusion: In this study, fear of hypoglycemia was associated with a decreased level of satisfaction with treatment. As a consequence, patients with type 2 diabetes must be assessed for hypoglycemia fears and their adverse effects. Also, to prevent complications caused by not taking antihyperglycemic drugs, nursing managers and clinical nurses are recommended to prepare appropriate programs to implement psychological interventions to reduce the fear of hypoglycemia.

Gas-Bloat Syndrome after Magnetic Sphincter Augmentation: Incidence, Natural History, Risk Factors, and Impact on Surgical Outcomes Over Time.

The notion that gas-bloat syndrome (GBS) after magnetic sphincter augmentation (MSA) is less detrimental has not been substantiated by data. This study aimed to identify the incidence, natural history, risk factors, and impact on outcomes of GBS after MSA. Records of patients who underwent MSA at our institution were reviewed. GBS was defined as a score of 4 or more on the gas bloat-specific item within the GERD health-related quality-of-life (GERD-HRQL) questionnaire. Preoperative clinical and objective testing data were compared between those with and without GBS at 1 year using univariate followed by multivariable analysis. GBS evolution over time and its impact on outcomes were assessed in those with 1- and 2-year follow-up. A total of 489 patients underwent MSA. At a mean (SD) follow-up of 12.8 (2.1) months, patient satisfaction was 88.8%, 91.2% discontinued antisecretory medications, and 74.2% achieved DeMeester score normalization.At 1 year, 13.3% of patients developed GBS, and had worse GERD-HRQL scores and antisecretory medication use and satisfaction (p < 0.0001). DeMeester score normalization was comparable (p = 0.856). Independent predictors of GBS were bloating (odds ratio [OR] 1.8, p = 0.043), GERD-HRQL score greater than 30 (OR 3, p = 0.0010), and MSA size 14 or less beads (OR 2.5, p = 0.004). In a subgroup of 239 patients with 2-year follow-up, 70.4% of patients with GBS at 1 year had resolution by 2 years. The GERD-HRQL total score improved when GBS resolved from 11 (7 to 19) to 7 (4 to 10), p = 0.016. Patients with persistent GBS at 2 years had worse 2-year GERD-HRQL total scores (20 [5 to 31] vs 5 [3 to 12], p = 0.019). GBS affects 13.3% of patients at 1 year after MSA and substantially diminishes outcomes. However, GBS resolves spontaneously with quality-of-life improvement. Patients with preoperative bloating, high GERD-HRQL scores, or small MSA devices are at greatest risk of this complication.

Risk-stratified thromboprophylaxis effects of aspirin versus low-molecular-weight heparin in orthopedic trauma patients: A secondary analysis of the PREVENT CLOT trial.

The PREVENT CLOT trial concluded that thromboprophylaxis with aspirin was noninferior to low-molecular-weight heparin (LMWH) in preventing death after orthopedic trauma. However, it was unclear if these results applied to patients at highest risk of thrombosis. Therefore, we assessed if the effect of aspirin versus LMWH differed based on patients' baseline risk of venous thromboembolism (VTE). The PREVENT CLOT trial enrolled 12,211 adult patients with fractures. This secondary analysis stratified the study population into VTE risk quartiles: low (<1%) to high (>10%) using the Caprini score. We assessed stratum-specific treatment effects using the win ratio method, in which each patient assigned to aspirin was paired with each assigned to LMWH. In each pair, we compared outcomes hierarchically, starting with death, then pulmonary embolism, deep vein thrombosis, and bleeding. The secondary outcome added patients' medication satisfaction as a fifth composite component. In the high-risk quartile (n = 3052), 80% had femur fracture, pelvic, or acetabular fractures. Thoracic (47%) and head (37%) injuries were also common. In the low risk quartile (n = 3053), most patients had a tibia fracture (67%), 5% had a thoracic injury, and less than 1% had head or spinal injuries. Among high risk patients, thromboembolic events did not differ statistically between aspirin and LMWH (win ratio, 0.94; 95% confidence interval [CI], 0.82-1.08, p = 0.42). This result was consistent in the low (win ratio, 1.15; 95% CI, 0.90-1.47, p = 0.27), low-medium (win ratio, 1.05; 95% CI, 0.85-1.29, p = 0.68), and medium-high risk quartiles (win ratio, 0.94; 95% CI, 0.80-1.11, p = 0.48). When medication satisfaction was considered, favorable outcomes were 68% more likely with aspirin (win ratio, 1.68; 95% CI, 1.60-1.77; p < 0.001). Thromboembolic outcomes were similar with aspirin or LMWH, even among patients at highest risk of VTE. Aspirin was favored if medication satisfaction was also considered. Therapeutic/Care Management; Level II.

Supervised and unsupervised learning models for pharmaceutical drug rating and classification using consumer generated reviews

Optimization of medication therapy depends on maximizing benefits and minimizing side effects of medications. This research showed how a joint approach using text mining, natural language processing, and machine learning can provide information for personalized and optimized medication therapy. Reviews on the benefits and side effects of prescription and over-the-counter medications were used to determine how well an integrated supervised and unsupervised learning could learn medication satisfaction. Supervised learning with naïve-Bayes, non-linear support vector machine with radial basis function kernels, and random forests with CART decision trees was measured by a micro-aggregated Matthews correlation coefficient and a macro-averaged F1 measure. Random forests outperformed support vector machines by almost 250% and naive-Bayes by 600% on the two evaluation metrics. All models did better with three rating levels, instead of five. Topic modeling and stacked cluster analysis were coupled with parts-of-speech tagging and text mining operations to establish a robust data preprocessing procedure to eliminate noisy features from the data. Unsupervised topic modeling and clustering represented an exploratory validation of how easy supervised classification would be. Well-defined latent topics were discovered including topics on “sleep quality”, “the opportunity to get back to work”, and “weight gain”. Overlapping clusters revealed that incorporating more information on social, demographic, or medical history variables could improve classifier performance. This research provided evidence that medication satisfaction can be learned with carefully designed joint supervised, unsupervised, and natural language learning techniques.

Study protocol for virtual leisure investigating the effect of virtual reality-delivered stress reduction, entertainment and distraction on the use of coercion and need-based medication and patient satisfaction at a closed psychiatric intensive care unit - a mixed-methods pilot clinical trial

IntroductionThe environment at a psychiatric inpatient ward can lead to emotional distress and behavioural deviations in vulnerable individuals potentially resulting in conflicts, increased use of need-based medication and coercive actions,...

The Efficacy and Safety of Remimazolam Besylate Combined with Esketamine for Outpatient Colonoscopy: A Prospective, Randomized, Controlled Clinical Trial.

Evaluate the efficacy and safety of remimazolam besylate combined with esketamine for outpatient colonoscopy. A total of 150 outpatients undergoing colonoscopy were randomized into two groups. A MOAA/S score ≤3 was maintained. The primary outcome was the rate of successful colonoscopy completion. Time indicators, hemodynamic parameters, the consumption of lidocaine, esketamine, propofol and remimazolam besylate, MOAA/S scores and bispectral index (BIS) values, the lowest SpO2, body movement, the use of rescue medication, endoscopist and patient satisfaction, recall of the procedure, mini-mental state examination (MMSE), fatigue level and adverse events were recorded. Procedure completion was equivalent between groups (P > 0.05). Both induction and awakening times were significantly shorter in the P group (P < 0.05). There were no significant differences in colonoscopy time and discharge time (P > 0.05). The lowest SpO2 was significantly lower in the P group, while the level of fatigue was higher (P < 0.05). Patient satisfaction was significantly higher in the R group (P < 0.05). Endoscopist satisfaction was significantly higher in the P group (P < 0.05). There were no significant differences in both systolic and diastolic blood pressure between groups except at T5 and T6 (P > 0.05). Both HR and RR were significantly lower in the P group from T3 to T5 (P < 0.05). BIS values were significantly lower in the P group from T3 to T5, while MOAA/S was significantly lower in the P group at T3 and T4 (P < 0.05). Pain on injection was significantly higher in the P group (P < 0.05). Remimazolam besylate has a similar efficacy to propofol when combined with subanesthetic doses of esketamine during outpatient colonoscopy. Remimazolam besylate combined with esketamine resulted in less injection pain and more stable hemodynamics, although it prolonged induction and awakening time.

Satisfaction with medication in older adult patients with chronic respiratory diseases: a multicenter cross-sectional observational study.

To gain insight into medication satisfaction and factors associated with chronic respiratory disease, particularly chronic obstructive pulmonary disease (COPD) in older adults, focusing on public health issues and improving the health of the older adult population. This cross-sectional study was conducted from October 2022 to November 2022 in 24 hospitals in different regions of Hunan Province, China. Older adult patient treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication version II. Multiple regression analysis was used to identify factors independently associated with patient treatment satisfaction. Only 15.9% of all patients scored above 80 in the effectiveness domain, while 11.6 and 16.5% scored above 80 in the convenience and global satisfaction domains, respectively, while 17.3% reported having side effects. Interstitial lung disease was associated with lower drug satisfaction than other disorders (p < 0.05). Multifactorial regression analysis showed that age, education background, profession, and smoking status were independently associated with satisfaction among patients with chronic respiratory diseases (p < 0.05). Education background, profession, CAT score, number of acute exacerbations, duration of home oxygenation and duration of home ventilator use were independently associated with satisfaction in patients with COPD (p < 0.05). Low satisfaction with chronic respiratory drug therapy was associated with age, education background, profession and smoking status. Satisfaction was lower for patients with interstitial lung disease. For COPD, CAT score, education background, profession, number of acute exacerbations, home oxygen and ventilator use influence satisfaction. Clinicians can identify appropriate patients and communicate effectively with them throughout treatment and follow-up, vigorously promote smoking cessation and home oxygen therapy, increase medication satisfaction, especially among older adults, and in turn improve public health and the quality of life of older adults.

Cancer-related post-treatment pain and its impact on treatment satisfaction with medication in women with breast cancer: a cross-sectional study from Palestine.

Pain after therapy is an important clinical problem in patients with breast cancer. Unfortunately, cancer patients have a lower quality of life due to inadequate treatment of posttreatment pain; therefore, improving medication management plans and palliative care has become one of the most important targets of cancer therapy. Therefore, the current study aimed to examine the impact of posttreatment pain on medication satisfaction in patients with various stages of breast cancer in Palestine. A cross-sectional analytical study was conducted et al.-Watani Hospital and An-Najah National University Hospital in the Nablus area. Using the Brief Pain Inventory (BPI), the intensity and interference of pain were evaluated. In addition, patients' satisfaction with cancer management medications was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM). Two hundred fifty-four patients were included in this study. All were women, with a mean ± SD age of 53.1 ± 10.7years. The median score for pain severity was 7.0. Pain in the lower extremities was the most reported location. There was a negative association between the global satisfaction domain and the presence of posttreatment pain (p < 0.001). Furthermore, significant differences and negative correlations were found between global satisfaction and posttreatment pain on the day of the interview (p = 0.001), pain medication (p < 0.001), paracetamol use (p < 0.001), and the presence of side effects (p = 0.003). There were significant negative correlations (p < 0.05) between pain severity and interference with effectiveness (r = -0.258, -0.319, respectively), side effects (r = -0.414, -0.514, respectively), convenience (r = -0.274, -0.307, respectively), and global satisfaction domain scores (r = -0.293, -0.287, respectively). Exposure to chemotherapy was the only significant positive correlation with global satisfaction (p = 0.007). The regression analysis results indicated an independent association between chemotherapy use and a higher global satisfaction score (p = 0.011). Patients with posttreatment pain, side effects, and greater interference of pain with their functioning had lower satisfaction scores. Therefore, better management of their treatment medications, side effects, and pain medications is recommended to enhance their satisfaction and quality of life. Several aspects of palliative care should be organized to improve the patient's satisfaction and quality of life in addition to conducting longitudinal studies to evaluate the pain and satisfaction of different types of cancers.

Efficacy of Cervical Facet Joint Radiofrequency Ablation Using a Multitined Cannula, a Technical Note, and Observational Study

BACKGROUND: Chronic cervical facet joint pain is a leading cause of pain and disability. In patients nonresponsive to conservative treatment, cervical facet radiofrequency ablation (RFA) has shown to be efficacious. However, the conventional RFA technique can be cumbersome. A novel RFA technique with a multitined cannula allows for a lateral approach and represents an attractive alternative option for cervical facet RFA. It offers a potentially shorter, less cumbersome procedure, with consequently less x-ray exposure and patient discomfort than the conventional cervical RFA. OBJECTIVES: To describe the novel RFA technique using the lateral approach with the multitined cannula at the cervical facet joints and to assess its efficacy in chronic cervical facet joint pain. STUDY DESIGN: This is a single-center observational study. SETTING: Interventional Pain Management Center, Switzerland. METHODS: The aim of this study is to describe the RFA technique using the lateral approach with the multitined cannula at the cervical facet joints and to assess its efficacy in chronic cervical facet joint pain. Eligible adult patients with chronic (&gt; 3 months) cervical facet joint pain refractory to conservative treatment and confirmed by dual positive medial branch blocks, received a fluoroscopic-guided cervical facet RFA treatment using the multitined cannula. The primary outcome was pain relief. Secondary outcome measures included the proportion of patients reporting a &gt;= 30% reduction of pain intensity 2 months after RFA, patient global impression of change (PGIC), need for pain medication, sleep quality, and patient satisfaction. RESULTS: We included 26 patients. The patients showed a clinically meaningful and significant pain relief at 2 months after cervical facet RFA (mean Numeric Rating Scale of 7.5 [1.9] at baseline to 4.2 [2.4]) and 58% of the patients reported &gt;= 30% reduction of pain. An improvement on the PGIC was reported by 88.2% of the patients. No severe side effects or complications were observed. LIMITATIONS: Key limitations of our study were the relatively small sample size, the lack of a control group, and a relatively short-term follow-up duration. CONCLUSIONS: Our results suggest that cervical facet joint RFA using the novel technique with the multitined cannula results in significant pain reduction and improvement on the PGIC. While the conventional technique requires multiple ablations at each target level, the RFA with the multitined needle requires only a singular ablation, likely sparing time, radiation dose, discomfort, and costs. Our results merit consideration of replacement of the conventional technique with the novel technique using the multitined cannula. However, larger-scale clinical trials with an adequate long-term follow-up period are needed to prove the efficacy of RFA using the multitined cannula in cervical facet joint pain. KEY WORDS: Neck pain, facet joint pain, cervical, radiofrequency, ablation, denervation, multitined cannula, lateral approach, observational study

Comparison of the Prolonged- and Immediate-Release Tacrolimus Capsule Formulation: The Patient's View and Medication Satisfaction of Patients After Pediatric Heart Transplantation

Medication adherence is essential for long-term success after pediatric organ transplantation. Causes of reduced adherence should be detected early to improve the consequent medication intake. We describe the influence of switching from tacrolimus twice daily (tacrolimus-BID) to tacrolimus once daily (tacrolimus-QD) on medication satisfaction and medication adherence in patients after pediatric heart transplantation. A retrospective analysis was conducted regarding patient satisfaction and adherence to the immunosuppressant tacrolimus after pediatric heart transplantation, before and after conversion from tacrolimus-BID to tacrolimus-QD, using questionnaires. Thirty-eight patients were enrolled (tacrolimus-BID: n=35, mean age 15.7 ± 5.2 years; tacrolimus-QD: n=38, mean age 16.2 ± 5.6 years). The amount of unadministered medication in the last 3 months did not differ between the 2 pharmaceutical forms. However, 17% (n=6) reported unstable tacrolimus trough levels when taking tacrolimus-BID, vs 8% (n=3) under tacrolimus-QD (P=.453). However, there was no statistically significant difference in the stability of the last 6 trough levels of each patient (P=.074). A total of 57% (n=20) of patients had subjective side effects before conversion, compared to only 29% (n=11) after conversion (P=.013). Regarding the intensity of the side effects, 6 patients reported strong/very strong side effects when taking tacrolimus-BID vs 1 patient when taking tacrolimus-QD (P=.250). In addition, the overall satisfaction with the immunosuppressant was higher under tacrolimus-QD (92% vs 83%; P=.508). However, this improvement was statistically not significant and may not be clinically relevant. The amount of forgotten medication was not reduced after conversion from tacrolimus-BID to tacrolimus-QD. However, subjective side effects as well as patient satisfaction improved under tacrolimus-QD.