Primary Study Research Articles

The Implementation of Case Based Learning in Physics Learning at The Collage: A Systematic Literature Review

Abstract Physics learning at the college level using the Case-Based Learning approach offers an interactive method through the analysis of real cases or situations relevant by integrating theory with practical applications and enhancing a deep understanding of concepts. The objective of this research is to analyze literature studies on Case-Based Learning in physics education at the university level. This study employs the Systematic Literature Review (SLR) method. Data collection was carried out by documenting and reviewing related articles published between 2014-2024. Based on the search results, a total of 80 relevant articles were obtained, which were then filtered based on inclusion criteria to yield 10 articles used as primary studies. Each article was coded, and then analyzed based on the skills developed from the research findings. The results of the systematic literature review indicate that Case-Based Learning in physics education effectively enhances students’ analytical and problem-solving skills. This approach facilitates the integration of theory and practical applications through real-life case studies, enabling students to develop their critical and analytical thinking skills.

Underexplored Areas of Photobiomodulation in Oral Oncology: An Expert Analysis.

Objective: This study aimed to review the current body of literature on underexplored areas of photobiomodulation (PBM) for preventing and/or treating oral adverse events. Background: Recent studies suggest that PBM may offer potential benefits in managing cancer-related toxicities other than oral mucositis. Nevertheless, further research to establish conclusive evidence is still missing. Methods: A panel of specialists conducted a narrative review to evaluate the evidence on PBM therapy for oral mucositis, xerostomia, dysgeusia, dysphagia, and trismus/fibrosis. Each topic was reviewed by two specialists who discussed treatment rationale, summarized current evidence, evaluated risk/benefit ratio, and identified future research directions. Results: The current evidence suggests promising outcomes in nonroutine uses of PBM for xerostomia, dysgeusia, odynophagia, oral mucositis (extraoral PBM and the pediatric population), and trismus/fibrosis. However, the primary studies are often small and may have biases that require further evaluation, particularly regarding treatment safety. Conclusion: Despite the overall positive impression of PBM therapy for oral adverse events of cancer treatment, robust evidence from large multicentered studies is necessary to support its widespread clinical use.

Advancing health equity and the role of digital health technologies: a scoping review protocol

IntroductionHealthcare systems around the world exhibit inherent systemic inequities that disproportionately impact marginalised populations. Digital health technologies (DHTs) hold promising potential to address these inequities and to play a pivotal...

Cost Analysis of Scleral Buckle and Pars Plana Vitrectomy for Retinal Detachment Surgery.

To compare the cost and utility of scleral buckle (SB) and pars plana vitrectomy (PPV) techniques for repairing moderately complex rhegmatogenous retinal detachment (RRD). A cost-utility analysis was conducted using data from the Primary Retinal Detachment Outcomes Study (PRO) and a study conducted by the author. Total costs, patient utility over a lifetime, and cost per quality-adjusted life year (QALY) were calculated for each surgical procedure. The cost of scleral buckle surgery was €287.93, with an estimated lifetime QALY of 7.49. Costs per QALY were €38.44. According to the PRO study and Belin et al, total costs were $5975, with a lifetime QALY of 5.4 and costs per QALY of $1106. The cost of pars plana vitrectomy (PPV) was €1468.26, with an estimated lifetime QALY of 6.84 and costs per QALY of €214.65. Based on the PRO study and Belin et al, total costs were $8125, with a lifetime QALY of 4.7 and costs per QALY of $2196. Repairing moderately complex RRD presents a highly cost-effective profile for both SB and PPV techniques, well below recommended QALY thresholds. SB demonstrated a slightly more favorable profile compared to PPV.

Comprehensive analysis of clinical research profiles and study characteristics of oral potentially malignant disorders: an observational study

ObjectiveThe study aims to present an observational study of clinical trials on Oral Potentially Malignant Disorders (OPMDs) and corresponding publications. Study design and settingWe searched the OPMDs-related clinical studies registered in the ClinicalTrials.gov database before March 1, 2024. Subsequently, we investigated the publication status of primary completed studies using PubMed and Google Scholar. ResultsA total of 185 studies were identified for analysis, including 141 interventional studies and 44 observational studies. The most commonly studied disease type was oral lichen planus (OLP), accounting for 113 studies (61.1 %). Interventional studies on OPMDs were predominantly early-phased, blind, randomized, parallel and single-center. The primary purpose of these studies was treatment (106, 75.2 %). Among the treatments, herbal medicine (21, 19.8 %), photodynamic therapy (17, 16.0 %), and glucocorticoids (14, 13.2 %) were of greatest interest. In addition, 58 (63.0 %) of the primarily completed interventional studies were published, with a median time to publication of 33.6 months. Published interventional studies including OLP patients and factorial designs had shorter time to publication. However, these studies were less frequently published in high-impact journals and most primary results were positive. ConclusionsClinical trials on OPMDs predominantly focused on OLP and herbal medicine. The quality of studies is unsatisfactory and publication rate is suboptimal. Improvements are needed in ClinicalTrials.gov registration standards, high-quality study design and more stringent publishing requirements.

Heart failure and major haemorrhage in people with atrial fibrillation

BackgroundHeart failure (HF) is not included in atrial fibrillation (AF) bleeding risk prediction scores, reflecting uncertainty regarding its importance as a risk factor for major haemorrhage. We aimed to report...

Development and validation of a prognostic model to predict relapse in adults with remitted depression in primary care: secondary analysis of pooled individual participant data from multiple studies.

Relapse of depression is common and contributes to the overall associated morbidity and burden. We lack evidence-based tools to estimate an individual's risk of relapse after treatment in primary care, which may help us more effectively target relapse prevention. The objective was to develop and validate a prognostic model to predict risk of relapse of depression in primary care. Multilevel logistic regression models were developed, using individual participant data from seven primary care-based studies (n=1244), to predict relapse of depression. The model was internally validated using bootstrapping, and generalisability was explored using internal-external cross-validation. Residual depressive symptoms (OR: 1.13 (95% CI: 1.07 to 1.20), p<0.001) and baseline depression severity (OR: 1.07 (1.04 to 1.11), p<0.001) were associated with relapse. The validated model had low discrimination (C-statistic 0.60 (0.55-0.65)) and miscalibration concerns (calibration slope 0.81 (0.31-1.31)). On secondary analysis, being in a relationship was associated with reduced risk of relapse (OR: 0.43 (0.28-0.67), p<0.001); this remained statistically significant after correction for multiple significance testing. We could not predict risk of depression relapse with sufficient accuracy in primary care data, using routinely recorded measures. Relationship status warrants further research to explore its role as a prognostic factor for relapse. Until we can accurately stratify patients according to risk of relapse, a universal approach to relapse prevention may be most beneficial, either during acute-phase treatment or post remission. Where possible, this could be guided by the presence or absence of known prognostic factors (eg, residual depressive symptoms) and targeted towards these. NCT04666662.

Exploratory analysis of the variable response to an intensive lifestyle change program for metabolic syndrome

BackgroundSubstantial variability in response to lifestyle interventions has been recognized for many years, and researchers have begun to disentangle sources of error from inherent differences in individual responsiveness. The objective of this secondary analysis of an intensive lifestyle intervention (diet and exercise) for metabolic syndrome (MetS) was to identify potentially important differences among study completers grouped by treatment response as measured by change in a continuous metabolic syndrome score (Gurka/MetS).MethodsAll study completers from a 12-month primary care study were categorized into one of five groups according to change in the Gurka/MetS score. A change of 0.4 in z-score defined clinically relevant change in line with results of previous studies. Repeated measures analysis of variance was used to examine cardiovascular disease risk and individual clinical indicators of MetS over 12 months, looking for differences in response over time by the five groups.ResultsOf 176 participants, 50% (n = 88) had stable scores, 10% (n = 18) had relevant change scores in the first 3 months only and reverted toward baseline, 20% (n = 35) achieved meaningful change over the whole study, 11% (n = 20) had a delayed response at 3–12 months, and 9% (n = 15) demonstrated worsening scores. Significant differential patterns were noted for groups over the duration of the intervention (p < .001). Improvement in diet quality and fitness scores were similar across all groups. Other available variables were tested and did not account for the differences.ConclusionWork is needed to identify key factors that account for differences in responses to lifestyle interventions that can be used to guide treatment decisions for intensive lifestyle interventions for this common condition.Trial RegistrationClinicalTrials.gov Identifier: NCT01616563; first registered June 12, 2012.

Social media influencers in the space of pregnancy and parenting: a scoping review protocol

IntroductionSocial media influencers (SMIs) are popular sources of online information on various topics, including many aspects of health. Recently, there has been an upsurge in SMIs creating content about pregnancy...

Meta-Analysis of Diagnostic Accuracy Studies With Multiple Thresholds: Comparison of Approaches in a Simulation Study.

The development of methods for the meta-analysis of diagnostic test accuracy (DTA) studies is still an active area of research. While methods for the standard case where each study reports a single pair of sensitivity and specificity are nearly routinely applied nowadays, methods to meta-analyze receiver operating characteristic (ROC) curves are not widely used. This situation is more complex, as each primary DTA study may report on several pairs of sensitivity and specificity, each corresponding to a different threshold. In a case study published earlier, we applied a number of methods for meta-analyzing DTA studies with multiple thresholds to a real-world data example (Zapf etal., Biometrical Journal. 2021; 63(4): 699-711). To date, no simulation study exists that systematically compares different approaches with respect to their performance in various scenarios when the truth is known. In this article, we aim to fill this gap and present the results of a simulation study that compares three frequentist approaches for the meta-analysis of ROC curves. We performed a systematic simulation study, motivated by an example from medical research. In the simulations, all three approaches worked partially well. The approach by Hoyer and colleagues was slightly superior in most scenarios and is recommended in practice.

Therapeutic Doll Interventions for People Living with Dementia in Care Homes: A Scoping Review.

Doll therapy is a psychosocial intervention that has been commonly used within dementia care for many decades. The practice of doll therapy involves supporting people with dementia to engage with a therapeutic doll and this has been associated with positive changes in a person's wellbeing and behavior. While there have been several systematic reviews that have focused on behavioral outcomes, limited reviews have explored the broader psychosocial outcomes associated with doll therapy in care home settings. A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Four electronic databases were searched systematically (CINAHL Plus, Medline, PsycINFO, and PubMed). Twelve primary research studies from the past ten years (2013-2023) were included in this review. Primary data were synthesized using a narrative synthesis methodology. The three main themes from this review relate to a reduction in levels of behavioral and psychological symptoms of dementia (BPSD), increased communication skills, and a reduction in caregiver distress. Doll therapy has the potential to be an effective person-centered intervention that can enhance quality of life for people living with dementia in care home settings.

Quality of life issues in patients with ductal carcinoma in situ: a systematic review.

Ductal carcinoma in situ (DCIS) of the breast is one of the most common pre-invasive cancers diagnosed in women. Quality of life (QoL) is extremely important to assess in studies including these patients due to the favorable prognosis of the disease. The primary objective of this systematic review was to compile a comprehensive list of QoL issues, all existing QoL assessment tools, and patient-reported outcome measures used to assess DCIS. A search was conducted on Ovid MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to August 2023, using keywords such as "ductal carcinoma in-situ", "quality of life", and "patient-reported outcomes." QoL issues and QoL tools in primary research studies were extracted. A total of 67 articles identified issues pertaining to patients with DCIS spanning physical, functional, and psychosocial QoL domains. Physical and functional issues observed in patients included pain, fatigue, and impaired sexual functioning. Psychosocial issues such as anxiety, depression, and confusion about one's disease were also common. QoL tools included those that assessed general QoL, breast cancer-specific tools, and issue-specific questionnaires. The current instruments available to assess QoL in patients with DCIS do not comprehensively capture the issues that are pertinent to patients. Thus, the modification of existing tools or the creation of a DCIS-specific QoL tool is recommended to ensure that future research will be sensitive towards challenges faced by patients with DCIS.

A systematic review and guide for using multi-response statistical models in co-infection research.

The simultaneous infection of organisms with two or more co-occurring pathogens, otherwise known as co-infections, concomitant infections or multiple infections, plays a significant role in the dynamics and consequences of infectious diseases in both humans and animals. To understand co-infections, ecologists and epidemiologists rely on models capable of accommodating multiple response variables. However, given the diversity of available approaches, choosing a model that is suitable for drawing meaningful conclusions from observational data is not a straightforward task. To provide clearer guidance for statistical model use in co-infection research, we conducted a systematic review to (i) understand the breadth of study goals and host-pathogen systems being pursued with multi-response models and (ii) determine the degree of crossover of knowledge among disciplines. In total, we identified 69 peer-reviewed primary studies that jointly measured infection patterns with two or more pathogens of humans or animals in natural environments. We found stark divisions in research objectives and methods among different disciplines, suggesting that cross-disciplinary insights into co-infection patterns and processes for different human and animal contexts are currently limited. Citation network analysis also revealed limited knowledge exchange between ecology and epidemiology. These findings collectively highlight the need for greater interdisciplinary collaboration for improving disease management.

The use of amniotic membrane injection as an adjunct in endoscopic urethral stricture management

ABSTRACT Introduction: Endoscopic urethral stricture treatment has high recurrence rates. Due to research supporting amniotic membrane’s (AMs) anti-inflammatory and anti-fibrotic properties reducing scar tissue formation, AM has generated interest in reconstructive urethral surgery. To the best of our knowledge, we performed the first investigation of the success rate of urethral dilation when combined with micronized AM injection for the treatment of urethral stricture. Methods: Eligible patients were adult males with anterior strictures meeting strict criteria for diameter, length, International Prostate Symptom Score (IPSS), and flow rate. Micronized AM was injected in the stricture region during urethral dilation. The primary study endpoint was an anatomical success (≥14Fr) at 6 months. Secondary endpoints were evaluated with the IPSS, urethral stricture surgery – patient-related outcome measure, International Index of Erectile Function, flow rate, and postvoid residual. Outcomes were assessed at baseline and multiple points postinjection. Injection safety was analyzed. Results: Ten men with a mean age of 52 years were included in the study. At 6 months, 7 of 10 patients demonstrated recurrence of the urethral stricture on cystoscopy. Improvements in secondary endpoints were noted in 10 of 10 patients at 3 months and 3 of 10 patients at 6 months. No adverse events were observed. Conclusions: To the best of our knowledge, this is the first study evaluating micronized AM injection as an adjunct treatment at the time of urethral dilation. The urethral stricture recurrence rate did not improve with the injection of AM despite the hypothesized benefits of anti-fibrotic and anti-inflammatory properties.

Effects of dyadic interventions on psychological outcomes among cancer patients with non-active treatment: a systematic review and meta-analysis.

Cancer and its treatment can generate substantial psychological distress (depression and anxiety). The objective of this systematic review and meta-analysis is to explore the effectiveness of dyadic interventions on psychological outcomes in cancer patients with non-active treatment and to test subgroup analyses to explore the source of heterogeneity affecting effect sizes. Systematic searching across eight databases identified studies related to dyadic interventions for psychological outcomes of cancer patients published between 2007 and 2022. Rigorous inclusion and exclusion criteria were utilized. Random-effects models were used to compute effect sizes with Hedge's g, forest plot, and Q and I2 statistics to measure heterogeneity. Moderator analyses were examined. Eleven primary studies were identified (938 patients with cancer, 56.14 ± 7.29years old). Overall, dyadic interventions significantly improved depression (g = .36, 95% confidence interval .026 to .68, I2 = 76%) and anxiety (g = .29, 95% confidence interval 0.14 to .45, I2 = 0%) compared to controls. With subgroup analyses, fidelity of dyadic interventions, number of weeks across intervention, and number of days after intervention measured were moderators affecting effect sizes. Dyadic interventions appear to be effective among adults with cancer with non-active treatment. Additional research is needed to explore the efficacy of dyadic interventions among more diverse samples and to examine routes for integrating dyadic interventions into practice. IMPLICATIONS FORCANCER SURVIVORS: Adult with cancer might participate in the dyadic intervention for improving psychological outcomes.

Surat’s sustainable future: analyzing compact urban development and population density trends

Rapid urbanization is a challenge for the cities of developing countries like India. The share of an urban area is rapidly increasing in dynamically growing cities. Due to this, the land use is altered, causing sprawl and unplanned development. The consumption of resources is greater, and the impact on the surroundings is negative. The compact city concept is always more efficient and cost effective compared to unplanned organic growth. The compact city optimizes available land resources with its maximum possible capacity in accordance with other available natural resources. The primary study objective is to assess the growth trend of Surat city using satellite images, geographic information system techniques, and census data for the last few years. The analysis considers population density for different city wards from 1991 to 2020. Based on the land use land cover change carried out using the maximum likelihood method from the satellite images, the rate of spreading out, its direction, and causes are also found. In this study, population density is a crucial attribute of the compact city concept. The study shows that wardwise density is increasing in a specific direction and making that portion of the city a dense, compact development. This is observed in ward numbers 48, 42, and 35 in the east, north, and southeast directions from Central Business District, respectively. The average population density in persons per sq. km is continuously increasing from 5006 to 20329 at city level which also shows the compact city development for Surat. The governing authorities must incorporate the compact city concept into the planning policy for sustainable urban development. By this, policymakers can understand housing needs to promote affordable housing, invest in infrastructure development and public services, and identify areas where sustainable transportation options, such as public transit, walking, or cycling, need improvement.

Repetitive transcranial magnetic stimulation as a therapy for post-stroke dysphagia: An overview of systematic reviews and meta-analysis

Objective Post-stroke dysphagia is a common swallowing disorder that occurs after a stroke, leading to an increased risk of aspiration pneumonia and malnutrition. There is a pressing need for effective and safe interventions for its rehabilitation. This review aims to answer two key scientific questions: (1) What is the efficacy of repetitive transcranial magnetic stimulation in the rehabilitation of post-stroke dysphagia? (2) Is repetitive transcranial magnetic stimulation a safe intervention for post-stroke dysphagia? Data Sources A comprehensive search was conducted across four electronic databases: PubMed, Cochrane Library, Web of Science, and Embase. The search aimed to identify relevant studies concerning our topic of interest and was completed on 28 May 2024. Review methods In accordance with the PRISMA checklist, a comprehensive search of four databases was conducted, which identified 13 relevant systematic reviews. The inclusion criteria were systematic reviews that evaluated the efficacy and safety of repetitive transcranial magnetic stimulation for post-stroke dysphagia. Exclusion criteria were reviews that did not focus on post-stroke dysphagia or did not evaluate repetitive transcranial magnetic stimulation as a therapeutic intervention. The quality, bias, reporting, and overall evidence quality of these reviews were assessed using validated tools, including the AMSTAR 2 tool for assessing the methodological quality of systematic reviews, the ROBIS tool for assessing the risk of bias, and the GRADE approach for evaluating the overall quality of evidence. This rigorous approach ensures that our review provides a comprehensive and reliable overview of the current state of knowledge on the use of repetitive transcranial magnetic stimulation for post-stroke dysphagia. Results The sample sizes for the individual studies included in the systematic reviews/meta-analyses ranged from 66 to 555. The total number of participants across all studies included in the overall analyses was 752. The evidence was limited by the methodological flaws and heterogeneity of the systematic reviews. The quality of the evidence varied from high to low, with most outcomes having moderate quality. Future research should adopt more rigorous, standardized, and comprehensive designs to confirm the efficacy and safety of repetitive transcranial magnetic stimulation for post-stroke dysphagia. The main reason for downgrading the evidence quality was the small sample size and high heterogeneity of the primary studies. Conclusion This overview synthesized research on repetitive transcranial magnetic stimulation for dysphagia, aiming to inform clinical and policy decisions. However, the current evidence does not conclusively establish the safety and efficacy of repetitive transcranial magnetic stimulation for post-stroke dysphagia rehabilitation. The studies reviewed varied in quality, and many were of poor quality. Therefore, while some studies suggest potential benefits of repetitive transcranial magnetic stimulation, these findings should be interpreted with caution. There is a pressing need for more rigorous, high-quality research to validate the use of repetitive transcranial magnetic stimulation for post-stroke dysphagia rehabilitation. The implications of these findings for clinical practice and policy will be clearer once we have more robust, evidence-based recommendations.

The Effect of Omega-3 Supplementation and Fish Oil on Preeclampsia: A Systematic Review and Meta-Analysis

BackgroundPreeclampsia is a type of hypertension disorder characterized by symptoms of damage to other organs. The effect of omega-3 supplementation and fish oil on preeclampsia has been studied several times over the years. Therefore, due to the importance of the subject and the inconsistency of the results of the studies, the present research aimed to estimate the effect of omega-3 supplementation and fish oil on preeclampsia by systematic review and meta-analysis. MethodsThe present systematic review and meta-analysis was performed according to PRISMA guidelines from 1990 to February 2022. A systematic literature review was conducted in MagIran, SID, PubMed, Embase, Scopus, Web of Science (WoS) databases and Google Scholar motor engine using related MeSH/Emtree terms, which were combined with free text word. The heterogeneity of the studies was addressed using I2 index and publication bias was assessed using Egger’s regression intercept. ResultsThe initial systematic literature search retrieved 12095 studies, of which 16 articles with a sample size of 8004 subjects in the intervention group and 8233 in the control group were finally included in the meta-analysis after excluding irrelevant studies. As a result of combining primary studies, the risk ratio of the frequency of total preeclampsia (mild and severe) was obtained (RR: 0.63; 95% CI, 0.41-0.95, P = 0.027) in the intervention group compared to the control group and risk ratio of the frequency of severe preeclampsia was calculated (RR: 0.45; 95% CI, 0.24-0.83, P = 0.011) in the intervention group compared to the control group. ConclusionBased on the results of the present study, the consumption of omega-3 supplementation and fish oil significantly reduces the risk of developing preeclampsia. Therefore, it seems that omega-3 supplementation and fish oil can be considered in preventing preeclampsia.

Early Postoperative Pain is Similar after Arthroscopic Rotator Cuff Repair versus Short-Stay Shoulder Arthroplasty: A Prospective Study.

IntroductionOne of the barriers to counseling patients for shoulder arthroplasty (SA) is the anticipated pain after surgery. This can be contrasted with the common perception of arthroscopic rotator cuff repair (RCR) surgery being less painful due to the less invasive nature of the procedure. We conducted a prospective study comparing postoperative pain levels and narcotic consumption after SA compared to those after RCR. MethodsThis prospective study enrolled 102 patients undergoing short-stay SA and RCR at a single hospital. 50 patients underwent RCR and 52 underwent SA. All participants received a multimodal pain regimen consisting of an interscalene block with liposomal bupivacaine and one of two oral pain medication regimens. Patients were provided a daily pain diary to be completed for 14 postoperative days that tracked pain levels, narcotic consumption, and pain location. Patients were excluded for age <40, revision surgery, SA for fracture, history of chronic opioid use, or an inability to adhere to study protocol. Demographics, visual analogue scale (VAS) scores, and pain sensitivity questionnaires (PSQ) were collected preoperatively. Primary study outcomes were daily VAS pain scores and narcotic consumption during the 14 days after surgery. ResultsRCR patients were younger (60.6 vs. 68.9 years; p<0.01) but other demographics, preoperative pain, and PSQ scores were similar between groups. Peak mean VAS pain levels for RCR and SA each occurred on postoperative (POD) 2 and were 4.4 ± 3.1 and 5.1 ± 2.7 respectively (p=0.214). There was no significant difference in VAS pain during the 14-day postoperative period between RCR and SA patients (p>0.05) or between anatomic SA and reverse SA (p>0.05). Narcotic usage was greater for RCR patients at POD 7 (0.5 vs. 0.2 tablets; p=0.039) and 8 (0.5 vs. 0.2 tablets; p=0.015) compared to SA patients. ConclusionsOur study demonstrated that postoperative pain levels do not significantly differ between RCR and short-stay SA, with greater narcotic usage observed for RCR at one week after surgery. These findings support the notion that despite the increased invasiveness of SA, early postoperative pain is comparable with early pain after RCR.

Health-Care Utilisation and Costs of Transition from Paliperidone Palmitate 1-Monthly to 3-Monthly Treatment for Schizophrenia: A Real-World, Retrospective, 24-Month Mirror-Image Study.

Poor adherence to antipsychotics in patients with schizophrenia is a leading cause of relapse and functional deterioration. Long-acting injectable paliperidone may reduce relapse risks, health-care utilisation, and health-care costs in these patients. In this 24-month mirror-image study, we compared health-care utilization and costs before and after the initiation of paliperidone palmitate 3-monthly (PP3M) treatment in patients with schizophrenia spectrum disorders. Before the initiation of PP3M, the patients received paliperidone 1-monthly (PP1M) treatment. The primary study outcomes were changes in health-care utilisation and costs over the study period. This study included 34 patients with schizophrenia spectrum disorders. During the 12-months period after the initiation of PP3M treatment, the mean duration of hospitalisation decreased from 57.7 to 28.5 days (p = 0.03). Moreover, significant reductions were noted in emergency room visits (PP1M vs PP3M: 0.3 vs 0.0, respectively; p = 0.05) and health-care costs (PP1M vs PP3M: 107,328.8 vs 57,848.6, respectively; p = 0.03). PP3M may significantly reduce hospitalisation duration, emergency room visits, and health-care costs in patients with schizophrenia.