Patient Compliance Rates Research Articles

Cloud platform to improve efficiency and coverage of asynchronous multidisciplinary team meetings for patients with digestive tract cancer.

Multidisciplinary team (MDT) meetings are the gold standard of cancer treatment. However, the limited participation of multiple medical experts and the low frequency of MDT meetings reduce the efficiency and coverage rate of MDTs. Herein, we retrospectively report the results of an asynchronous MDT based on a cloud platform (cMDT) to improve the efficiency and coverage rate of MDT meetings for digestive tract cancer. The participants and cMDT processes associated with digestive tract cancer were discussed using a cloud platform. Software programming and cMDT test runs were subsequently conducted to further improve the software and processing. cMDT for digestive tract cancer was officially launched in June 2019. The doctor response duration, cMDT time, MDT coverage rate, National Comprehensive Cancer Network guidelines compliance rate for patients with stage III rectal cancer, and uniformity rate of medical experts' opinions were collected. The final cMDT software and processes used were determined. Among the 7462 digestive tract cancer patients, 3143 (control group) were diagnosed between March 2016 and February 2019, and 4319 (cMDT group) were diagnosed between June 2019 and May 2022. The average number of doctors participating in each cMDT was 3.26 ± 0.88. The average doctor response time was 27.21 ± 20.40 hours, and the average duration of cMDT was 7.68 ± 1.47 min. The coverage rates were 47.85% (1504/3143) and 79.99% (3455/4319) in the control and cMDT groups, respectively. The National Comprehensive Cancer Network guidelines compliance rates for stage III rectal cancer patients were 68.42% and 90.55% in the control and cMDT groups, respectively. The uniformity rate of medical experts' opinions was 89.75% (3101/3455), and 8.97% (310/3455) of patients needed online discussion through WeChat; only 1.28% (44/3455) of patients needed face-to-face discussion with the cMDT group members. A cMDT can increase the coverage rate of MDTs and the compliance rate with National Comprehensive Cancer Network guidelines for stage III rectal cancer. The uniformity rate of the medical experts' opinions was high in the cMDT group, and it reduced contact between medical experts during the COVID-19 pandemic.

The 21-Gene Recurrence Score Assay Improved Multidisciplinary Treatment Compliance in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer Patients: An Analysis of 2,323 Patients.

The 21-gene recurrence score (RS) can guide adjuvant chemotherapy decisions in the multidisciplinary treatment (MDT) of patients with early breast cancer. This study aimed to evaluate the influence of the 21-gene RS assay on patient' compliance with MDT and its association with disease outcomes. Patients diagnosed with pN0-1, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer between January 2013 and June 2019 were enrolled. A logistic regression model was used to identify parameters associated with treatment adherence. Prognostic indicators were evaluated using the Cox proportional hazard models. After the assay, patients were less likely to violate the treatment plan (14.9% vs. 23.1%, p < 0.001), and higher compliance rates were observed for chemotherapy (p = 0.042), radiotherapy (p = 0.012), and endocrine therapy (p < 0.001). Multivariable analysis demonstrated that the 21-gene RS assay (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.09-1.88; p = 0.009) was independently associated with MDT compliance. Moreover, compliance with MDT was independently associated with better disease-free survival (hazard ratio, 0.43; 95% CI, 0.29-0.64; p < 0.001), regardless of the 21-gene RS assay (interaction p = 0.842). The 21-gene RS assay improved the MDT compliance rate in patients with early breast cancer. Adherence to MDT is associated with a better prognosis.

The Effect of PDCA Circulation on Improving The Up-to-Standard Rate of Wearing Time Length in OSAHS Patients with Non-Invasive Ventilator

Purpose: To investigate the clinical effect of PDCA（Plan-Do-Check-Act） circulation mode in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) using continuous positive air way pressure (CPAP) ventilator. Methods: 83 patients with OSAHS who were treated in the department of otorhinolaryngology head and neck surgery were randomly divided into PDCA group (n = 41) and control group (n = 42). The nursing outcomes of the two groups were compared. Result: The rate of reaching the standard wearing time length of non-invasive ventilator in the PDCA group was 80.49%, which was significantly higher than that in the control group (35.71%), and the difference was statistically significant (χ2=17.005, P&lt;0.05). The compliance rate of patients in the PDCA group (90.24%) was higher than that in the control group (73.80%), and the difference was statistically significant (Z= 2.571, P&lt;0.05). The incidence of adverse reactions in the PDCA group was 19.51% lower than that in the control group (64.29%), and the difference was statistically significant (χ2=17.005, P&lt;0.05). The score of fatigue in the PDCA group (4.17 ±1.223) was significantly lower than that in the control group (6.45 ±0.803). Conclusion: PDCA circulation nursing model can effectively improve the up-to-standard rate of time length of patients wearing non-invasive ventilator, reduce the incidence of adverse reactions, improve patient compliance and reduce patient fatigue, which is worthy of clinical promotion. Key words: PDCA circulation nursing model; the up-to-standard rate of time length of non-invasive ventilator; compliance; incidence of adverse reactions; fatigue degree.

Feasibility of a pregnancy intervention mimicking viral transmission mitigation measures on the incidence of preterm birth in high-risk pregnant women enrolled in antenatal clinics in Melbourne, Australia: protocol for a pilot, randomised trial

IntroductionPreterm birth is a leading cause of perinatal morbidity and mortality. During the COVID-19 pandemic, reduction in rates of preterm birth in women exposed to viral mitigation measures was reported...

Lipid-Based Nano-Formulation Development to Enhance Oral Bioavailability of Weakly Aqueous-Soluble Drug for Obesity and Hypertension

The most practical method of drug delivery is oral administration because it has a high rate of patient compliance. However, there are significant obstacles to effective oral medication delivery, including low drug enzymatic/metabolic stability and poor water solubility. Especially in the development of drug formulations for the treatment of obesity and hypertension. This research article aims to formulate solid lipid nanoparticles (SLN) of Fucoxanthin and Ramipril by the emulsification and ultrasonication methods. The nanoparticles size, polydispersity index, and the zeta potential, among other parameters, were computed. In addition, FT-IR analysis of compatibility tests between the SLNs and the loaded drug and in vitro drug release experiments were carried out. Lipid-based nano preparations have drawn plenty of interest as efficient vehicles to increase the oral bioavailability of these kinds of medications. We observed that lipid nanoparticles, have enhanced the oral bioavailability of poorly water-soluble drugs used for obesity and hypertension. Provided the above information, formulated SLNs should be further investigated using cutting-edge scientific methodologies to improve its bioavailability.

Repeat Transurethral Resection (TUR) + Bacillus Calmette-Guérin (BCG) Versus Upfront Induction BCG After TUR in High-risk Non–muscle-invasive Bladder Cancer: Feasibility Phase of a Randomized Controlled Study

BackgroundHigh-level evidence supporting the role of repeat transurethral resection (reTUR) in non–muscle-invasive bladder cancer (NMIBC) is lacking. A randomized controlled trial (RCT) assessing whether immediate reTUR has an impact on patient prognosis is essential. However, since such a RCT will require enrollment of a high number of patients, a preliminary feasibility study is appropriate. ObjectiveTo assess the feasibility of an RCT investigating the impact of immediate reTUR + adjuvant bacillus Calmette-Guérin (BCG) versus upfront induction BCG after initial TUR in NMIBC. Design, setting, and participantsEligible patients were randomly assigned to receive either reTUR + adjuvant BCG or upfront induction BCG after TUR. Patients with macroscopically completely resected high-grade T1 NMIBC, with or without concomitant carcinoma in situ, and with detrusor muscle (DM) present in the initial TUR specimen were considered eligible for inclusion. Exclusion criteria included lymphovascular invasion (LVI), histological subtypes, hydronephrosis, concomitant upper tract urothelial carcinoma (UTUC), or urothelial carcinoma within the prostatic urethra. The aim was to enroll 30 patients in this feasibility study. Outcome measurements and statistical analysisThe patient recruitment rate was the primary outcome. Oncological outcomes (recurrence-free and progression-free survival) were secondary endpoints. Results and limitationsOverall, 30 patients (15 per arm) were randomized over a period of 14 mo (August 2020–October 2021). Two eligible patients refused the randomization, resulting in a patient compliance rate of 93.3% for the study protocol. We excluded 49 ineligible patients before randomization because of histological subtypes (n = 16, 33%), LVI (n = 9, 18%), DM absence in the TUR specimen (n = 12, 24%), metastatic disease (n = 5, 10%), concomitant UTUC (n = 3, 6%), or hydronephrosis (n = 4, 8%). At reTUR, persistent disease was found in four patients (29%) and upstaging to muscle-invasive disease in one (7%). Over median follow-up of 17 mo, disease recurrence was detected in three patients (23%) in the reTUR arm and six patients (40%) in the upfront BCG arm. Progression to muscle-invasive disease was observed in one patient treated with upfront BCG. ConclusionsThe feasibility of conducting an RCT comparing upfront BCG versus reTUR + BCG in high-grade T1 NMIBC has been demonstrated. Our results underline the need to screen a large number of patients owing to characteristics meeting the exclusion criteria in a high percentage of cases. Patient summaryWe found that a clinical trial of the role of a repeat surgical procedure to remove bladder tumors through the urethra would be feasible among patients with high-grade non–muscle-invasive bladder cancer. These preliminary results may help in refining the role of this repeat procedure for patients in this category.

Design and evaluation of an offloading orthosis for medial knee osteoarthritis

Knee osteoarthritis is an incurable degenerative joint disease that affects millions of people. Characterized by stiffness and knee pain in the early stages, it can cause loss of function and mobility. Most treatment options are either not sustainable, invasive, or costly. Alternatively, offloading knee orthoses are a cost-effective option that provides immediate pain relief when worn. Offloading knee orthoses, however, have low patient compliance rates. To improve patient compliance and optimize patient benefit, current orthosis designs must be enhanced to improve comfort, increase the perceived effect, and be adjustable to the patient. Consequently, this research presents the design, fabrication, and testing of a new offloading knee orthosis joint. The novel modular orthosis features an offloading mechanism intended to relieve the load on the joint solely during stance phase and reduce the moment during swing phase when offloading is not needed. Three-point bending tests of the experimental prototype demonstrated an offloading moment of 3.36 Nm, creating a noticeable offloading effect during stance, and reduced the moment to less than 0.5 Nm after 35° of knee flexion, thus, potentially increasing comfort during swing phase and sitting when offloading forces are not needed.

A multifaceted quality improvement intervention on venous thromboembolism prophylaxis compliance in hospitalized medical patients at a comprehensive cancer center.

Previous studies suggest that quality improvement initiatives focused on hospital-acquired venous thromboembolism have a positive impact on prescribing rates of venous thromboembolism prophylaxis, especially those that incorporate computerized changes. We conducted a quality improvement project to determine whether education and computerized prescriber order entry system changes affect venous thromboembolism prophylaxis compliance rates in hospitalized medical patients at a Comprehensive Cancer Center. Between 1 January 2021 and 31 January 2023, 37,739 non-surgical, adult patient encounters with a length of stay > 48 h were analyzed in our study. From 18 December 2021 to 8 March 2022, provider education was delivered to the three largest admitting services, and computerized prescriber order entry changes were implemented incorporating a mandatory requirement to either order venous thromboembolism prophylaxis or document a contraindication for all patients at moderate venous thromboembolism risk. Monthly venous thromboembolism prophylaxis compliance rates, as defined by the Centers for Medicare and Medicaid Services VTE-1 metric, increased from a mean of 74% to 93% after the interventions. This change was driven primarily by an increased utilization of mechanical venous thromboembolism prophylaxis from 37% to 53%. Our study demonstrated that a multi-faceted intervention incorporating provider education and computerized prescriber order entry system changes can significantly increase venous thromboembolism prophylaxis compliance rates in cancer patients.

Music curriculum innovation construction on postgraduate mania from the perspective of curriculum ideology and politics

BackgroundGraduate students, as highly intelligent individuals, are more likely to experience mania during their studies than the general population. They are affected by learning pressure, environmental factors, and other factors and manifested as high spirits and irritability. Art therapy, as a relatively effective treatment method, is often used for psychological intervention and treatment. Therefore, this study innovatively constructs music courses from the perspective of ideological and political education to alleviate graduate students’ mania.Subjects and MethodsFifty graduate students with mania from a certain university were selected as the research subjects and randomly divided into Group A and Group B. Group A used traditional treatment methods, while Group B added innovative music courses to the traditional treatment methods for combined treatment. After the experiment, the data were processed and analyzed using SPSS 20.0.ResultsAfter the combination of results and intervention treatment, the overall compliance rate of student patients reached 98%, significantly higher than 60% in Group A; In the quality of life score, the social function score of Group B was 65.95 ± 4.20, the mental health score was 64.54 ± 4.89, and the psychological function score was 67.39 ± 5.14, all of which were higher than those of Group A.ConclusionsFrom the perspective of ideological and political education in the curriculum, the innovative construction of music courses has an effective alleviating effect on graduate students’ mania.AcknowledgementGuangxi academic degree and postgraduate education reform project (No. JGY2021162).

Patient compliance for metabolic evaluation and medical treatment (CoMET) in calcium-oxalate stone patients: prospective study by EULIS eCORE study group.

In this study, we aimed to identify the compliance rates of calcium-oxalate stone patients for metabolic evaluation, diet and medical treatment and also determine the factors that are associated with poor compliance rates. This study was conducted by the EULIS eCORE working group prospectively. In the initial visit, demographic and stone-related characteristics were recorded. Patients were suggested metabolic evaluation, dietary advices and medical treatment. Follow-up visit was performed after 3months and compliance rates were recorded. Logistic regression analysis was performed to determine factors associated with poor compliance to metabolic evaluation, diet and medical treatment. Data of 346 patients from nine centers were analyzed. Compliance rates were 71.7%, 65.3%, and 63.7% for metabolic evaluation, diet, and medical treatment, respectively. In multivariate analysis, level of education (p = 0.003), history of emergency department visit (p = 0.04), number of stone surgeries (p = 0.03), patient care in dedicated stone clinic (p = 0.03), and history of shock wave lithotripsy (p = 0.005) were detected as independent predictors of compliance to metabolic analysis. Level of education (p < 0.001) and history of emergency department visit (p = 0.01) were detected as independent predictors of patient compliance to diet. Number of stone episodes (p = 0.03), family history of stones (p = 0.02), and polypharmacy (p < 0.001) were detected as independent predictors of patient compliance to medical treatment. Patient compliance to metabolic evaluation, diet, and medical therapy is important for successful management of urolithiasis. Dietary advices and medications should be personalized by taking in to account the factors associated with poor compliance.

Prevalence and Visual Consequences of Non-adherent Patients Receiving Anti-vascular Endothelial Growth Factor (VEGF) Injections at King Fahad Specialist Hospital (KFSH), Qassim Region.

Anti-vascular endothelial growth factor (VEGF) injection treatment is a widely utilized therapy for various retinal diseases, including diabetic macular edema (DME). Therefore, the importance of compliance and follow-up should be discussed with the patient. There have been no studies conducted in the Qassim region to estimate the prevalence of patients missing their anti-VEGF appointments. To fulfill this need, we conducted this study to evaluate the compliance rate of patients treated with anti-VEGF injections for DME as well as to determine the visual consequences of the delay in anti-VEGF treatment in the Qassim region. This observational retrospective cohort study was conducted at King Fahad Specialist Hospital (KFSH) in the Qassim region of Saudi Arabia. We extracted all file numbers of patients who were using intravitreal anti-VEGF injections to treat DME. The data were managed and analyzed using the IBM Statistical Package for the Social Sciences (SPSS) software (IBM Corp., Armonk, NY, USA). In the current study, we were able to collect data from 198 patients who received anti-VEGF treatment in the hospital. Among the participants, 57.6% were male, with a mean age of 61.7 years old (standard deviation (SD) = 10.23). Among the patients, we found that the rate of non-adherence to the anti-VEGF injection was 54.5%, and those patients delayed their scheduled doses for more than 56 days. In 47.5% of the patients, delaying or stopping their appointments had no known reason; however, blepharitis was the main reason for delaying or stopping the dose in 27.7% of the patients, followed by endophthalmitis in 18.7% of the patients. There is no significant difference between before and after stopping the treatment, considering visual acuity (VA) or optical coherence tomography (OCT). However, regarding the disease progression, we found that 15 out of the 30 patients had worsened in the OCT after they missed their injections (mean increase in the VA was 6.069 (SD = 97.45), t = -0.278, P = 0.783, and decrease in the OCT was -14.9667 (SD = 133.87, P = 0.454). There is a high rate of patients who missed their appointments for an anti-VEGF injection. This resulted in the worsening of OCT in half of the 30 patients who were enrolled in the visual consequences study, which had a negative impact on treatment and disease progression.

The safety and effects of high- and low-volume polyethylene glycol bowel preparation methods before colonoscopy on bowel cleanliness: a systematic review and meta-analysis.

Although both high- and low-volume polyethylene glycol (PEG) are widely used in intestinal preparation before colonoscopy, there is still controversy over the superiority of their cleaning effects. This meta-analysis sought to explore the safety and effects of high-volume PEG solution and low-volume PEG mixed solution on intestinal cleanliness before colonoscopy. The PubMed, EMBASE, and Cochrane Library databases were searched to retrieve relevant articles on the effects of high- and low-volume PEG mixture solutions on intestinal cleanliness from the inception of the databases to October 15, 2022. Two independent researchers screened the literature according to the predetermined inclusion and exclusion criteria, and extracted the required data separately. A bias risk assessment was conducted for each study using the relevant tools in the Cochrane Handbook. The included data were subjected to a meta-analysis using R 4.2.1 software. This article includes a total of 15 studies involving a total of 5,847 patients. There was no difference in the cleanliness score, qualified rate of intestinal cleanliness and patient compliance between the high- and low-volume group. The patients in the low-volume PEG mixed solution group had a higher repeat willingness bowel cleansing rate than those in the high-volume PEG group [risk ratio (RR) =0.71, 95% confidence interval (CI): 0.62-0.82, P<0.01]. Compared with the low-volume group, the incidence of adverse reactions such as nausea, vomiting, and abdominal pain increased in the high-volume group (RR =1.38, 95% CI: 1.22-1.56, P<0.01; RR =1.79, 95% CI: 1.41-2.27, P<0.01; RR =1.05, 95% CI: 1.01-1.08, P<0.01). In the pre-colonoscopy preparation method for patients, although the high-volume PEG and low-volume PEG mixed regimen have similar effects on intestinal cleanliness, the low-volume mixed regimen has a higher willingness to repeat and a lower incidence of adverse reactions. In clinical practice, considering patient compliance and safety, a low-volume mixed regimen may be a more optimal option.

Optimal cancer care pathways - the ideal versus reality for patient-centric cancer care during COVID-19.

Objectives To assess whether compliance with the nationally endorsed Optimal Care Pathways is evident in 75% of patients treated with curative intent treatment and if this compliance was impacted by the COVID-19 pandemic (hereinafter COVID-19). Methods This retrospective study included patients undergoing curative treatment with radiotherapy in head and neck (HN), breast, lung and gastrointestinal malignancies between January 2019 and June 2021 in a single NSW outer metropolitan cancer service. For care delivered within the remit of cancer services, the primary outcome measure was the proportion of patients whose treatment complied with the Optimal Care Pathways recommended time frame. Secondary outcome measures included evaluating the effect of COVID-19 on the proportion of patients being treated within the recommended time frame. Results There were n = 733 eligible patients across the five tumour streams with the majority being breast cancer patients comprising 65% (n = 479) of the cohort, followed by HN cancer patients (n = 125, 17%). None of the tumour subsites abided by the 75% compliance rate. Oesophageal cancer patients had the lowest compliance rate of 4% (P < 0.001), with a similarly low compliance rate for rectal cancer patients at 33% (P = 0.002). None of the hypothesis tests to assess for detriment in treatment time during COVID-19 were statistically significant (P > 0.05). Conclusion Despite the availability of best practice guidelines, there is limited compliance throughout all cancer subtypes, which has not been negatively influenced by COVID-19. Improved awareness of the Optimal Care Pathways, and implementation of the associated infrastructure and systems, are required to support compliance.

Evaluation of the Impact of ABCDEF Bundle Compliance Rates on Postintensive Care Syndrome: A Secondary Analysis Study.

This study aimed to examine the association between ABCDEF bundles and long-term postintensive care syndrome (PICS)-related outcomes. Secondary analysis of the J-PICS study. This study was simultaneously conducted in 14 centers and 16 ICUs in Japan between April 1, 2019, and September 30, 2019. Adult ICU patients who were expected to be on a ventilator for at least 48 hours. None. Bundle compliance for the last 24 hours was recorded using a checklist at 8:00 am The bundle compliance rate was defined as the 3-day average of the number of bundles performed each day divided by the total number of bundles. The relationship between the bundle compliance rate and PICS prevalence (defined by the 36-item Short Form Physical Component Scale, Mental Component Scale, and Short Memory Questionnaire) was examined. A total of 191 patients were included in this study. Of these, 33 patients (17.3%) died in-hospital and 48 (25.1%) died within 6 months. Of the 96 patients with 6-month outcome data, 61 patients (63.5%) had PICS and 35 (36.5%) were non-PICS. The total bundle compliance rate was 69.8%; the rate was significantly lower in the 6-month mortality group (66.6% vs 71.6%, p = 0.031). Bundle compliance rates in patients with and without PICS were 71.3% and 69.9%, respectively ( p = 0.61). After adjusting for confounding variables, bundle compliance rates were not significantly different in the context of PICS prevalence ( p = 0.56). A strong negative correlation between the bundle compliance rate and PICS prevalence ( r = -0.84, R 2 = 0.71, p = 0.035) was observed in high-volume centers. The bundle compliance rate was not associated with PICS prevalence. However, 6-month mortality was lower with a higher bundle compliance rate. A trend toward a lower PICS prevalence was associated with higher bundle compliance in high-volume centers.

Assessment of Scheduling Method,Appointment Delay, and No-show Rate in the Ultrasound Unit of a Nigerian Teaching Hospital

Increasing incidence of no-shows has been identified as a major challenge to planning of appointment schedules which imparts negatively on revenue generation and system efficiency. This cross-sectional study analysed the scheduling method in use, appointment delay time, appointment compliance rate and no-show rate of patients in the ultrasound unit of a Nigerian tertiary hospital, using observation, patient records and questionnaires. Information obtained were: The time interval between clinician request and examination appointment schedule, patient load distribution, scheduling method, number of patients scheduled and number that kept to appointment scheduling, and as well staff opinion on reasons for patients’ length of stay for ultrasound investigations. The results showed that the single-block scheduling method was used and patients’ arrival was highest between 7:12 and 9:00 hours with decreasing rate as the day progresses. The time interval between request and appointment was 12–14 days. Appointment compliance rate was observed to be 5.5, while no show rate was 4.5. Poor state of ultrasound machines was observed to be the highest contributing factor to patient delays with Kendall’s coefficient of concordance 0.466. The findings of this work can be utilized in efficient planning of public hospital ultrasound units to enhance patient access.

Understanding patient acceptance and compliance of a blood-based colorectal cancer screening test.

TPS6654 Background: The Covid-19 pandemic has caused a significant disruption in healthcare utilization. The halt and delay of CRC screening have led to a substantial decline in CRC screening rates. The backlog and the slow resuming of CRC screening will have significant consequences. Although COVID-19 created challenges in CRC screening, it also presents an opportunity for potential innovative approaches that may improve patient compliance and screening rates, such as a blood-based CRC screening test which can be done at the point of care without preparation. Adherence to CRC screening is poor among vulnerable populations even before COVID-19, and these populations disproportionately receive health care in safety-net settings, such as federally qualified health centers (FQHCs). Thus, FQHCs play a significant role in improving CRC-related outcomes and ensuring health equity. This study will examine patient compliance with CRC screening by offering another option, a blood-based screening test, after failing to complete a stool-based screening test or colonoscopy in six months at three FQHCs. Methods: The study will use a stepped wedge cluster trial design and include an initial period of no exposure. Each FQHC will have a cluster of 10 to 17 primary care clinics. After the initial no-exposure period, two FQHCs will implement a blood-based CRC screening test at their primary care clinics. Another FQHC will follow nine months later. Each FQHC will contribute to exposed and unexposed observations and function as its own control. This study will collect quarterly data to capture the impact, feasibility, and acceptability over time. The primary endpoint will be assessed by calculating the number of participants who, otherwise, will not have participated in the CRC screening. In addition, the effectiveness of the implementation strategies will be assessed since transferring innovations into real-world settings is complex, and practical strategies are critical to accelerating future implementation and assisting decision-making. The study will recruit patients who fail to complete a CRC screening after six months and meet the inclusion criteria: between 45-75 years of age, average risk for CRC, capable of and willing to give informed consent, and willing to provide a blood sample. For eligible patients, a blood-based CRC screening test developed by a CLIA-certified laboratory and made commercially available (Guardant Health, CA) will be offered at no cost. An order will be obtained from the participant’s primary care provider before the blood sample is collected. This study plans to enroll up to 2,400 patients over a 3-year period. Patient compliance is a significant barrier to improving CRC screening, and the key to increasing screening participation is patient acceptance of the screening method. A blood-based screening test may offer an alternative for patients who fail to comply with other CRC screening modalities. Clinical trial information: NCT05536713 .

Efficacy of Dienogest in Adolescent Endometriosis: A Narrative Review.

Teenage endometriosis is seen as a chronic condition that can worsen if untreated. Treatment objectives include relief of symptoms, prevention of disease development, and preservation of future fertility. In many regions, dienogest (DNG), an oral progestin, has emerged as a key treatment in suppressing endometriosis. The usage of DNG for endometriosis in adolescents was researched in papers published between 2015 and 2022 using PubMed and Google Scholar. Athorough search of all identified studies' reference lists and previously published literature reviews was carried out. The study's nature and geographic scope were not restricted. After reviewing these publications,the authors decided on which oneswere the most pertinent in light of their personal experiences.The final study consisted of14 studies that satisfied inclusion requirements. The trials showed that taking DNG 2 mg daily efficiently lowers endometriotic lesions, eases painful endometriosis symptoms, and improves quality-of-life indicators. In most of these investigations, DNG was shown to be safe and tolerated, with predictable and moderate side effects, good patient compliance rates, and low withdrawal rates. Although endometrioma did not enlarge while receiving treatment, significant regression was not typical. Overall, the studies found that DNG is safe and effective in reducing symptoms of endometriosis in adolescents.

Abstract WP33: Bedside Insertion Of Implantable Loop Recorders Prior To Hospital Discharge Improves Detection Of Atrial Fibrillation After Cryptogenic Stroke And May Reduce Stroke Recurrence

Atrial fibrillation (AF) is responsible for 15-20% of ischemic strokes. AF can be asymptomatic and remain undetected following acute stroke, initially classifying the event as cryptogenic. Implantable loop recorders (ILRs) provide long-term cardiac monitoring and are superior to traditional methods for detecting AF in patients with cryptogenic stroke. ILR placement is often performed by a cardiologist in an outpatient setting. Our institution identified that some patients were missing or cancelling appointments for device implantation. Failure to detect AF is associated with a greater risk of stroke recurrence. An interdisciplinary inpatient process was developed to place ILRs at the bedside on the stroke unit, prior to discharge. The purpose of the program was to increase patient compliance with ILRs, improve detection of asymptomatic AF, and reduce incidence of stroke recurrence through timely initiation of oral anticoagulants. To evaluate the program and provide recommendations, measures of success included rates of patient compliance with ILR implantation using inpatient vs. outpatient procedure and the percentage of patients who received a diagnosis of AF after ILR placement. Using 18 months of pre-implementation data as a benchmark, the average implant rate increased in the first 12 months following implementation. Of 97 patients who received ILR placement, nine (9%) have received a diagnosis of AF. Since three-year ILR monitoring has shown significantly higher AF detection than 30-day cardiac monitoring after cryptogenic stroke, more patients with AF may yet be identified. This presentation will demonstrate an increase in ILR implant rates and AF detection and highlight positive results using advanced practice professionals to perform the procedure. The program produced financial benefit and mitigated access to care barriers, with no poor outcomes or compromise in quality, and no negative impact on inpatient length of stay. In conclusion, bedside insertion of ILRs prior to discharge after cryptogenic stroke is a safe, efficient, cost-effective process that increases patient compliance when compared to outpatient return visits, improving detection of AF and prompt initiation of oral anticoagulants, and may reduce stroke recurrence.

PS-C19-6: STUDY ON THE EFFICACY AND SAFETY OF TENG FU JIANGYA TABLET IN THE TREATMENT OF HYPERTENSION

Background: At present, the most important task of cardiovascular disease health management that is to improving the blood pressure compliance rate of Hypertensive Patients. Traditional Chinese medicine (TCM) is an important part of complementary and alternative medicine. Research shows that traditional Chinese medicine has antihypertensive effect from multiple pathways and multiple targets. However, lack of clinical evidence-based medical evidence of TCM in the treatment of hypertension. The purpose of this study was to investigate the efficacy and safety of Teng Fu Jiangya tablet (TJT) in the treatment of hypertension. Methods: A prospective, randomized, single-blind, placebo-controlled clinical trial was conducted in order to evaluating the effectiveness and safety of TJT in the treatment of grade 1 hypertension (N = 130). On this basis, a multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted on the treatment of grade 2 hypertension with TJT combined with valsartan / amlodipine (N = 288). During the experiment, the efficacy index of the subjects were recorded for effectiveness evaluation, and the safety index and adverse reaction events of the subjects were recorded for safety evaluation. Results: 1. After 4 weeks of intervention in patients with grade 1 hypertension, there were significantly difference in the SBP and DBP compared with placebo group. The compliance rate of blood pressure of TJT group is 67.19% and in placebo group is 43.08%. TJT can improve the standard rate of blood pressure. There were also significantly difference in the level of Arachidonic acid, the thromboxaneB2 and the Prostaglandin E2 between the two groups. And there was no serious adverse event reported. 2. After 4 weeks of intervention in patients with grade 2 hypertension, in accordance blood pressure compliance rate, the systolic blood pressure compliance rate of the treatment group was 61.65%, and the placebo group was 37.68%. The treatment group could more effectively reduce the levels of arachidonic acid and thromboxane B2 and increase the level of prostaglandin E2, reduce inflammatory factors, so as to reduce the inflammatory. Conclusion: TJT tablet has good effectiveness and safety in the clinical treatment of hypertension. TJT also can effectively reduce the damage of vascular endothelium in the treatment of hypertension. Therefore, TJT play a key role in reducing blood pressure and protecting target organ damage. This is an innovative method for the treatment of hypertension.

Modern Approaches to &lt;i&gt;H. pylori&lt;/i&gt; Eradication Therapy in Adults (Literature Review and Resolution of Experts Council)

Aim: to analyze current approaches to H. pylori eradication therapy in adults and present the materials of Experts Council held on December 9, 2022 in Moscow.General statements. H. pylori infection is the main etiological factor of gastritis, peptic ulcer, and gastric cancer. Eradication of H. pylori is recognized as a necessary measure to reduce the incidence of these diseases. The approaches to selecting an eradication regimen should be optimized to take into account epidemiological trends and achieve better treatment outcomes. The updated Maastricht VI Consensus Report presents the means to overcome the difficulties in selecting an approach to the treatment of H. pylori infection. However, eradication therapy remains challenging due to adverse events (primarily antibiotic-associated diarrhea), poor treatment tolerance and patient compliance. Eradication therapy can be optimized by supplementing treatment regimens with strain-specific probiotics that reduce adverse events, improve patient compliance and eradication rates, such as Saccharomyces boulardii CNCM I-745 strain with established efficacy.Conclusion. The inclusion of certain probiotics in eradication regimens improves treatment tolerance, reduces the risk of adverse events, improves patient compliance and eradication rates.