Patient Questionnaire Research Articles

Feasibility of a Pharmabuddy Care Service for patients with Parkinson’s disease

BackgroundPharmaceutical care for patients with Parkinson’s disease (PD) is complex. Specialized pharmaceutical care provided by a dedicated pharmacy team member (pharmabuddy) for these patients may reduce medication-related problems. The feasibility of this service for PD patients is unknown.ObjectiveTo evaluate the feasibility of a Pharmabuddy Care Service (PCS) for PD patients in primary care pharmacies.MethodsPharmabuddies who offered PCS were invited to fill in a questionnaire to evaluate the feasibility of PCS. Patients received a patient questionnaire and were invited for an interview. Patient records provided information on medication-related problems and interventions. Feasibility was evaluated conform four domains of Bowen’s Framework. First, acceptability included patients’ satisfaction ratings and experiences, Pharmabuddy impression on start and continuation of the service. Second, demand included use by patients and provision by pharmabuddies. Third, implementation/practicality: implementation indicators and barriers and facilitators from patient- and pharmabuddy perspective and fourth limited efficacy: effect of the PCS on PD symptoms, medication related problems identified and interventions from patient records.ResultsTwenty-three (59%) patients completed the questionnaire, 9 were interviewed, 12 (67%) pharmabuddies responded. Acceptability was high among patients (mean 9.5 (SD 1.3) out of 10), 6 (50%) pharmacies (still) provided PCS. Demand: 56% of patients had 1–2 contact moments, 28% two or more. Ten pharmacies provided up to 14 patients per pharmacy with PCS, one up to 24. Implementation/practicality: important barriers were time constraints and perception of other healthcare professionals. Positive reactions from patients encouraged pharmabuddies to carry out their PCS-activities. Patients were positive about pharmabuddy’s listening competency while knowledge could be improved. Limited efficacy: from patient records, 89 interventions were made in response to 93 (median 3 per patient (range 1–16)) medication related problems or questions, with 20 (87%) patients reporting a positive effect from their interaction with a pharmabuddy.ConclusionThis study shows PCS is highly appreciated by responding patients and can be feasible for primary care pharmacies. Several implementation issues are still present. Future studies should focus on quantifiable effects of PCS services as well as resource and perception hurdles.

Patients' and clinicians’ perspectives on virtual phone consultation in vascular surgery

IntroductionThe pandemic limited our capacity for face-to-face (F2F) outpatient clinics and therefore we set up virtual phone consultation clinics (VPC). Our study evaluated patients' and clinicians’ perspectives on our VPC...

Psychometric Properties of the Chinese Version of Aberdeen Varicose Veins Questionnaire (AVVQ) in Patients With Varicose Veins of Lower Extremity: A Cross-Sectional Study.

Varicose veins in the lower extremities significantly impairs patients' quality of life, highlighting the importance of targeted quality of life assessments for specific diseases. The Aberdeen Varicose Vein Questionnaire (AVVQ) was specifically designed to assess the impact of lower extremity varicose veins on quality of life. This study comprised two phases: in the first phase, the AVVQ was translated and culturally adapted, and the second phase was an evaluation of the psychometric characteristics of the Chinese version of AVVQ in 328 patients with varicose veins of lower extremities. Confirmatory factor analysis revealed that the Chinese AVVQ comprises 13 items distributed across four dimensions, accounting for a total variance of 61.74%, with a Cronbach's α of 0.745 and a content validity index of 0.908. Furthermore, there was a negative correlation between the AVVQ scores and the SF-36. In addition, the difference in AVVQ scores by CEAP classification was statistically significant. These findings affirmed the Chinese version of the AVVQ as both reliable and valid, making it a valid tool for evaluating the quality of life in Chinese patients with varicose veins and applicable across various international contexts and diverse patient populations.

Effects of general magnetic field therapy in comprehensive medical rehabilitation on the quality of life of patients with breast cancer

BACKGROUND: The Short Form-36 (SF-36) is one of the most widely used tools to assess quality of life in breast cancer patients. According to MEDLINE, the SF-36 is used in 95.0% of research studies to assess the quality of life in various diseases. Advantages of SF-36 include wide availability, ease of use, and high validity. AIM: The aim of the study was to evaluate the effect of general magnetic field therapy in comprehensive medical rehabilitation on the quality of life parameters using a SF-36 questionnaire in breast cancer patients at 2–4 days and 1.0–1.5 months after surgery. MATERIALS AND METHODS: A randomized, placebo-controlled study was conducted in patients (n=107) after surgery for breast cancer. All patients were divided into three groups balanced by age and clinical and functional parameters, and received a course of medical rehabilitation which included individual postoperative sessions of exercise therapy (posture treatment; movement therapy with breathing, general stimulating, special, and relaxation exercises; sensorimotor training using a biofeedback simulator; individual sessions with a medical psychologist; one session of instrumental physiotherapy). Comprehensive medical rehabilitation included fluctuating current therapy in group 1 (n=35), local magnetic field therapy in group 2 (n=35), and general magnetic field therapy in group 3 (n=37). RESULTS: Analysis of quality of life parameters in the early postoperative period demonstrated effectiveness of the comprehensive physical rehabilitation program using exercise therapy, balance boards, and sessions with a psychologist in combination with one of the physical treatment options. Positive results increase patients’ confidence in the success of their rehabilitation. After providing the general magnetic field therapy in comprehensive medical rehabilitation, most of the SF-36 quality of life parameters improved, which indicates the beneficial effects of the general magnetic field on situational and personal anxiety, asthenic and vegetative manifestations, and sleep, as well as prolongation of these effects. Patients who received fluctuating current therapy as part of medical rehabilitation improved their pain index and physical function, probably due to analgesic and anti-inflammatory effects of this treatment option. CONCLUSION: Comprehensive physical rehabilitation combined with physical therapy increases the patient’s independence in daily living, self-care, and mobility.

Association between accelerometry and physical activity levels measured by questionnaires in patients on hemodialysis

Purpose This study aimed to evaluate association of accelerometry data with physical activity levels (PAL) measured by three questionnaires and to investigate their ability to discriminate physically inactive from active patients on hemodialysis. Materials and methods A cross-sectional study was conducted. PAL were assessed by accelerometry and questionnaires: Human Activity Profile (HAP), International Physical Activity Questionnaire (IPAQ), and 36-Item Short Form Health Survey (SF-36). Results This study included 105 patients (59.2 ± 12.5 years, 60.0% male). Accelerometer data were significantly correlated with all questionnaire scores. Adjusted activity score (AAS) of HAP presented moderate to strong correlation with daily step count (ρ = 0.552, p < 0.001) and time in moderate and vigorous physical activity (ρ = 0.642, p < 0.001). AAS was associated with daily step count (R2 = 0.29, p < 0.001) and time in moderate to vigorous physical activity (R2 = 0.24, p = 0.001). Cutoff values for AAS of HAP, IPAQ, and physical component summary of the SF-36 for discriminating physically inactive from active patients were 63, 1139 and 44 (threshold of 5000 steps/day), respectively, and 55, 773 and 38 (threshold of 4260 steps/day), respectively. Conclusions PAL scores on questionnaires were associated with accelerometer data, mainly the HAP. Furthermore, this study established cutoff points for questionnaire scores to discriminate physically inactive from active patients.

Effectiveness of interventions for convergence insufficiency: an observational study evaluating clinical outcomes and health-related quality of life using AS20.

Convergence insufficiency (CI) is a common condition that can impair visual performance and comfort during close visual work. This observational study evaluated the effectiveness of interventions on clinical outcomes and health-related quality-of-life using the Adult Strabismus-20 (AS20) questionnaire in patients with CI. Data was extracted from a database collected at first consultation from 2015 to 2022. Demographics, interventions and outcomes of 75 patients with CI (mean age 47.2 ± 24.7 years) were analysed. Orthoptic exercises were prescribed to 58% of patients, 28% received prisms and 9% received no treatment. At the latest follow-up review, 24% were recommended to continue exercises, 24% had prisms, 1 underwent bimedial resection and 1 had treatment with Botulinum Toxin A (BTXA). The median follow-up was 5.0 (0-55) months, 100% were discharged with 25% following failure-to-attend and 11% died. At the latest follow-up, the attendance failure rate was higher for exercises (36%) than for prisms (10%). Both near-prism cover test and near-point of convergence improved from a median of 12 (95% CI 10-14) prism dioptres (PD) to 8.5 (95% CI 6-12) PD, and 17.5 (95%CI 15-20) cm to 10.0 (95%CI 8.3-12.0) cm respectively (p < 0.05). Near-prism fusion range also improved from 10(95%CI 8-14) PD to 16(95% CI 12-20) PD (p < 0.05). The median AS20 score at presentation were 100/100 (30-100) and 47.5/100 (0-100), and post-intervention were 100/100 (75-100) and 70/100 (12.5-97.5) for psychosocial and functional components, respectively. This cohort offers valuable insights into the real-life clinical management of CI in a tertiary adult strabismus centre. However, the study also found that long-term compliance with treatment is intrinsically challenging, emphasising the importance of disease education.

A dyadic analysis of family adaptation among breast cancer patients and their spouses based on the framework of family stress coping theory.

The active coping strategies of family members can help breast cancer patients better handle the crisis, and family adaptation is a manifestation of the family's active coping with the crisis. In the study of breast cancer, a disease that predominantly affects women, we explored the influence of spouses on patients' family adaptation. This aspect has not been explored in previous studies. In recent years, with the development of family stress coping theory, cancer coping styles have shifted from an individual focus to a whole-family approach. This shift has the potential to help families of cancer patients adapt to the crisis. This study aimed to explore the correlation between dyadic coping, family adaptation, and benefit finding in couples with breast cancer. Using convenience sampling, the study included 325 pairs consisting of breast cancer patients and their spouses who attended breast surgery, oncology, and chemotherapy sessions between April and November 2023. The survey utilized the General Information Questionnaire for patients and spouses, the Dyadic Coping Scale, the Benefit Finding Scale, and the Family Adaptability and Cohesion Evaluation Scales. Data analysis was conducted using SPSS 25.0 and Amos 24.0 software. In the actor effect of dyadic coping on family adaptation, the benefit finding of patients and their spouses played a mediating role. Regarding the partner effect (B = 0.019, 95% CI = 0.003-0.045, P < 0.05), the dyadic coping of spouses indirectly affected the family adaptation of patients through the benefit findings of patients. The patient's dyadic coping can directly affect the spouse's family adaptation. The spouse's dyadic coping can influence the patient's benefit finding. There is a partial interaction between breast cancer patients and their spouses' dyadic coping, benefit finding, and family adaptation. Therefore, clinical staff should promptly identify patients and spouses with poor coping abilities and provide them with positive psychological interventions to enhance the dyadic coping abilities of both partners and assist them in overcoming the problems encountered during the treatment process, ultimately helping them better cope with family crises.

Nonunion in Foot and Ankle Arthrodesis Surgery: Review of Risk Factors, Identification of High-risk Patients, and a Guide to Perioperative Testing and Optimization.

Foot and ankle arthrodesis surgery is often associated with high rates of nonunion ranging from 8% to 40%. This complication can result in individual patient burden and system burden in the management of these complex patients. Biologic factors contribute greatly to the development of a nonunion, including patient-related modifiable risk factors, metabolic and endocrine factors, systemic disease, previous surgeries, medications, weight loss treatments, and posttraumatic and postsurgical factors. Despite the high nonunion rate, there is a lack of high-level evidence in the identification of high-risk patients, strategies to minimize nonunion, and the management of patients with nonunion. An accepted standard of practice has not been established. This review aims to provide foot and ankle surgeons with (1) a comprehensive review of risk factors for nonunion, (2) a tool to identify high-risk patients using a preoperative patient questionnaire, (3) a clinical practice guide to preoperative and intraoperative testing that aims to improve preoperative counselling and patient optimization, and (4) perioperative strategies to minimize nonunion risk. With the above framework, our goal is to minimize nonunion risk in patients undergoing foot and ankle arthrodesis surgery to improve patient care and outcomes.

Demographics and Disease Characteristics of Patients with Alopecia Areata with Comorbid Atopic Dermatitis, Vitiligo or Anxiety/Depression: TARGET-DERM AA

Introduction Alopecia areata (AA) is a chronic autoimmune disease. Common AA comorbidities include atopic dermatitis (AD), vitiligo, anxiety and depression (AnxDep). TARGET-DERM AA is an ongoing longitudinal, real-world study of United States and Canadian AA patients. The purpose of this analysis is to assess characteristics among AA patients with and without the above comorbidities. Methods At enrollment (December 2021-June 2024), patients reported outcomes (including comorbidities, Patient Global Impression of Severity-AA, and clinician-reported outcome measures: Severity of Alopecia Tool, Measure for Eyebrow/Eyelash Hair Loss). Characteristics were compared across subgroups. Results Of the 267 AA patients with completed patient questionnaires at enrollment, 61.4% were female; 24.4% were aged &lt;12 years, 13.7% 12-17, and 61.7% 18 or older. Overall, 21.0% self-reported an AD diagnosis (19.7% of pediatric, 11.1% of adolescent, and 25.4% of adult AA patients), 7.1% vitiligo (7.0% of pediatric, 3.7% of adolescent, and 8.5% of adult AA patients) and 44.9% AnxDep (21.1% of pediatric, 40.7% of adolescent, and 58.5% of adult AA patients). 42.1% of patients with comorbid vitiligo had severe AA disease (SALT&gt;50) and 27.8% patients without comorbid vitiligo had SALT&gt;50. 28.6% of those with comorbid AD had SALT&gt;50 compared to 28.9% of those not reporting AD, with 30.0% of AnxDep and 27.9% of non-AnxDep having SALT&gt;50, all p&gt;0.2. 42.1% of patients with comorbid vitiligo reported PGIS-AA ‘severe/very severe’ disease, with 41.1% of patients with comorbid AD and 42.5% of patients with comorbid AnxDep reporting severe/very severe AA disease, all numerically higher than patients without comorbid vitiligo (36.3%), AD (35.6%), and AnxDep (31.9%), all p&gt;.07. Among those with and without vitiligo, 42.1% vs 37.9% had eyebrow involvement, 36.8% vs 30.2% eyelash; considering AD, 35.7% vs 38.9% had eyebrow involvement, 28.6% vs 31.3% eyelash; for AnxDep 39.2% vs 37.4% had eyebrow involvement, 30.8% v 30.6% eyelash, all p&gt;0.5. Discussion In this real-world cohort of AA patients, the presence of specific comorbidities was not associated with statistically significant differences in clinician reported AA severity, eyebrow or eyelash involvement. Comorbid AnxDep was associated with increased patient-reported AA disease severity. Additional research characterizing how dermatologic and psychiatric comorbidities impact health-related quality of life and patient burden has the potential to inform management decisions.

Psychometric properties of the Greek simplified medication adherence questionnaire among Iranian hemodialysis patients

Patients suffering from chronic kidney failure ultimately need kidney replacement therapies, such as hemodialysis. Adherence to treatment in these patients can play a central role in improving health levels and feelings of well-being. The aim of this study was to determine the psychometric properties of the Persian version of the modified version of the Greek Simplified Medication Adherence Questionnaire in hemodialysis patients. In a methodological study carried out in 2024, a sample of 411 hemodialysis patients was selected using a convenience sampling method. The GR-SMAQ-HD utilized in the study was translated, and its psychometric properties were evaluated through assessments of construct validity, including exploratory and confirmatory factor analysis, convergent validity, and divergent validity. Furthermore, the study examined the internal consistency of the scale to ensure its reliability. The mean age of the participants was 59.37 (SD = 12.99) years. The results of the tetrachoric correlation matrix with Varimax with Kaiser Normalization rotation using the first random dataset (n = 205) extracted three factors accounting for 74.4% of the variance comprising 8 items. The results of CFA showed that the data fit the model. As for construct reliability, Cronbach’s alpha, CR, AIC, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. In the overall population, the mean score for treatment Adherence was 5.61 (SD = 1.95, 95% CI 5.42, 5.80). Invariance analysis shows that the model has strong measurement invariance between sex ($ΔCFI= − 0.001, ΔRMSEA= − 0.004$). The findings affirm the appropriateness of employing the Persian iteration of the GR-SMAQ-HD as a dependable and valid instrument for assessing adherence to treatment in hemodialysis patients. GR-SMAQ-HD is crucial for ensuring that patients follow their prescribed treatment regimens effectively.

Worse Clinical and Survival Outcomes in Breast Cancer Patients Living in Puerto Rico Compared to Hispanics, Non-Hispanic Blacks, and Non-Hispanic Whites from Florida.

Herein, we report the characterization of four cohorts of breast cancer patients including (1) non-Hispanic Whites in Florida, (2) non-Hispanic Blacks in Florida, (3) Hispanics in Florida, and (4) Hispanics in Puerto Rico. Data from female breast cancer patients were collected from cancer registry (n = 9361) and self-reported patient questionnaires (n = 4324). Several statistical tests were applied to identify significant group differences. Breast cancer patients from Puerto Rico were least frequently employed and had the lowest rates of college education among the groups. They also reported more live births and less breastfeeding. Both Hispanic groups reported a higher fraction experiencing menstruation at age 11 or younger (Floridian Hispanics [38%] and Puerto Ricans [36%]) compared to non-Hispanic Whites (20%) and non-Hispanic Blacks (22%). Non-Hispanic Black and Puerto Rican women were significantly older at breast cancer diagnosis than their non-Hispanic White and Floridian Hispanic counterparts. The Puerto Rican and non-Hispanic Black groups more frequently had pathology stage T2 or higher primary breast tumors at diagnosis (non-Hispanic Whites [29%], non-Hispanic Blacks [39%], Floridian Hispanics [33%], Puerto Ricans [46%]). The Puerto Rican (73%, 95% CI [66, 82]) and non-Hispanic Black (79%, 95% CI [75, 84]) groups demonstrate reduced 5-year survival compared to non-Hispanic Whites (89%, 95% CI [86, 92]) and Floridian Hispanics (89%, 95% CI [86, 90]). These findings demonstrate that Puerto Rican breast cancer patients suffer significant breast cancer health disparities relative to non-Hispanic Whites and Hispanics from Florida similar to the disparities observed for non-Hispanic Blacks. Future work must seek to better understand and address these disparities.

Effect of Patient Resilience on Functional Outcomes After Anterior Cruciate Ligament Reconstruction.

Previous studies have examined the relationship between patient resilience and functional outcome scores after anterior cruciate ligament reconstruction (ACLR). However, past studies have failed to explore the longitudinal relationship between preoperative resilience and functional outcomes 2 years after ACLR. To evaluate the relationship between preoperative patient resilience and functional outcomes 2 years after ACLR. Cohort study; Level of evidence, 3. Patients were identified who underwent ACLR for anterior cruciate ligament tears between January and June 2020 at a single institution. Those who completed the Brief Resilience Scale preoperatively as part of routine patient questionnaires were considered for inclusion. Patients were contacted a minimum of 2 years after ACLR to complete the short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-JR), Single Assessment Numeric Evaluation (SANE), International Knee Documentation Committee (IKDC) Subjective Knee Form, and visual analog scale (VAS). Outcomes were compared among patients with low resilience (LR), normal resilience (NR), and high resilience (HR), as defined in a previous study.23. A total of 81 patients were included in the final analysis, with 14 patients in the low preoperative resilience group, 54 in normal, and 13 in high. The mean age of the cohort was 32.0 years, and there were no significant differences in age, sex, race, graft type, or psychiatric comorbidities among the resilience groups. Significantly increased postoperative KOOS-JR scores were observed in patients in the HR group as compared with those in the NR and LR groups (94.8, 86.7, and 79.6, respectively; P = .031). There were also significantly increased postoperative SANE scores in patients in the HR group versus those in the NR and LR groups (92.3, 83.5, and 69.2; P = .012). Patients with high preoperative resilience achieved the IKDC Patient Acceptable Symptom State at significantly higher rates (P = .003). No significant differences were observed in postoperative VAS (P = .364), IKDC (P = .072), or change in IKDC (P = .448) over time among resilience groups. Postoperatively, 30 patients (37.0%) changed resilience groups, with 13 moving down and 17 moving up in category (low, n = 12; normal, n = 55; high, n = 14). Preoperative resilience correlated with KOOS-JR and SANE scores 2 years after ACLR but did not correlate with VAS, IKDC, or change in IKDC over the same period. Resilience was not static, with changes in resilience observed from initial to final evaluations. Resilience is not a strong predictor of postoperative patient-reported outcomes after ACLR.

Completion Rate and Satisfaction With Online Computer-Assisted History Taking Questionnaires in Orthopedics: Multicenter Implementation Report.

Collecting the medical history during a first outpatient consultation plays an important role in making a diagnosis. However, it is a time-consuming process, and time is scarce in today's health care environment. The computer-assisted history taking (CAHT) systems allow patients to share their medical history electronically before their visit. Although multiple advantages of CAHT have been demonstrated, adoption in everyday medical practice remains low, which has been attributed to various barriers. This study aimed to implement a CAHT questionnaire for orthopedic patients in preparation for their first outpatient consultation and analyze its completion rate and added value. A multicenter implementation study was conducted in which all patients who were referred to the orthopedic department were invited to self-complete the CAHT questionnaire. The primary outcome of the study is the completion rate of the questionnaire. Secondary outcomes included patient and physician satisfaction. These were assessed via surveys and semistructured interviews. In total, 5321 patients were invited, and 4932 (92.7%) fully completed the CAHT questionnaire between April 2022 and July 2022. On average, participants (n=224) rated the easiness of completing the questionnaire at 8.0 (SD 1.9; 0-10 scale) and the satisfaction of the consult at 8.0 (SD 1.7; 0-10 scale). Satisfaction with the outpatient consultation was higher in cases where the given answers were used by the orthopedic surgeon during this consultation (median 8.3, IQR 8.0-9.1 vs median 8.0, IQR 7.0-8.5; P<.001). Physicians (n=15) scored the average added value as 7.8 (SD 1.7; 0-10 scale) and unanimously recognized increased efficiency, better patient engagement, and better medical record completeness. Implementing the patient's answers into the electronic health record was deemed necessary. In this study, we have shown that previously recognized barriers to implementing and adapting CAHT can now be effectively overcome. We demonstrated that almost all patients completed the CAHT questionnaire. This results in reported improvements in both the efficiency and personalization of outpatient consultations. Given the pressing need for personalized health care delivery in today's time-constrained medical environment, we recommend implementing CAHT systems in routine medical practice.

Validation of the German version of the SarQoL® questionnaire in sarcopenic and probable sarcopenic patients

BackgroundThe German version of the SarQoL®, a sarcopenia-specific quality of life (QoL) questionnaire, has not been validated hindering its widespread use. This study aimed to evaluate the psychometric properties of the German SarQoL®.MethodsVia a cross-sectional study participants were recruited in two geriatric outpatient facilities and one acute geriatric ward in Munich (Germany). Sarcopenia and probable sarcopenia were diagnosed with the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm. From 185 participants (age 79.8 ± 6.1), 77 had probable sarcopenia, and 51 had sarcopenia. Participants completed the SarQoL® and the European Quality-of-Life 5-Dimension (EQ-5D) questionnaires. The validation included examination of the discriminative power, construct validity, internal consistency, test-retest reliability, and floor/ceiling effects.ResultsLower SarQoL®scores for sarcopenic (p = 0.002) and probable sarcopenic subjects (p < 0.001) compared to controls indicated good discriminative power. Consistent construct validity was found for sarcopenic subjects: moderate to high correlations with domains capturing similar constructs of the EQ-5D: ‘Activities of daily living’ (r = -0.58, p < 0.001), ‘Mobility’ (r = -0.72, p < 0.001) and low correlations with domains related to different constructs like ‘Pain’ (r = -0.32, p < 0.022). Similar correlations were found for probable sarcopenic subjects. The Cronbach’s alpha was 0.8. Test-retest reliability was excellent (intraclass coefficient correlation of = 0.96; 95% CI = 0.91–0.99), and no floor/ceiling effects were observed.ConclusionQoL was similarly reduced in both patient cohorts compared to controls. The German SarQoL® is a valid and reliable instrument for measuring QoL in patients > 65 years of age with sarcopenia and probable sarcopenia and can now be used in epidemiological studies and clinical trials in a German-speaking population.Trial registrationGerman Clinical Trials Register (DRKS)-ID: DRKS00020504 (March 12th, 2021) .

DISP-09. IMPROVING ADHERENCE TO CANCER CARE IN UNDERSERVED PATIENTS WITH CENTRAL NERVOUS SYSTEM TUMORS

Abstract Patients with central nervous system tumors have disease-specific symptoms such as aphasias, motor symptoms, neuropsychiatric symptoms, or seizures that make treatment adherence difficult. This is further exacerbated by the social determinants of health – patients from historically marginalized groups or those with lower socioeconomic status have additional barriers to treatment. The Integrated Cancer Care Access Network (ICCAN) is a multi-institutional patient navigation program assisting patients who express socioeconomic needs during cancer treatment. In this pilot program, we assessed the impact of ICCAN on treatment adherence and quality of life of CNS cancer patients from marginalized backgrounds. 42 participants with primary brain tumors or brain metastases were recruited from inpatient and outpatient services at Memorial Sloan Kettering Cancer Center to enroll in ICCAN-CNS. Patients were eligible if they were 18 years or older, receiving active treatment or under active surveillance, and screened positive for an essential need. Through standardized patient interviews and questionnaires, we evaluated their needs such as food access, housing, and financial needs. The clinical research coordinator interviewed the patients via phone, taking approximately 60 minutes. The interviews comprised an Essential Needs Assessment, Health Related Social Needs Assessment, NCCN Distress Thermometer, and an ICCAN-CNS questionnaire focused on neurology-specific symptoms. Caregivers helped complete the questions for patients with cognitive impairments. Patients were then matched with resources based on their initial needs assessment. The interviewer conducted 2, 4, and 6-month follow-ups to see if new needs emerged for which resources were provided. Response to the program was overwhelmingly positive with many patients expressing gratitude for the resources provided to them. This pilot demonstrates the feasibility of CNS tumor patients participating in the ICCAN intervention and the need for additional patient navigation programs and interventions that focus on the social determinants of health.

Translation, cross-cultural adaptation and psychometric properties of the Urdu version of the avoidance endurance behavior questionnaire in patients with chronic musculoskeletal pain.

The Avoidance Endurance Questionnaire (AEQ) successfully measures the fear-avoidance and endurance-related responses to chronic pain. The objective of this study was to translate, cross-culturally adapt AEQ into Urdu and assess the reliability and validity of the Urdu version. For the translation and cross-cultural adaptation process, the Beaton Guidelines were followed. A total of 103 participants responded to the Urdu version of the AEQ SF-12, Pain Catastrophizing Scale (PCS) and Numeric Pain Rating Scale (NPRS) at baseline and after 48 hours. The test-retest reliability was assessed using the intraclass correlation coefficient (ICC). Cronbach's alpha was used to measure internal consistency. To measure validity, Pearson's correlation between the subscales of AEQ-Urdu and other outcome measures (SF-12, PCS and NPRS scores) were used (p< 0.05). The mean age of the total 103 participants was 32.7 ± 10.90 among which 45 (43.6%) were male and 58 (56.3%) were female. The pre-final version of the translated AEQ was tested on 40 Urdu speaking participants and no major changes were made. The Cronbach's alpha for all subscales of the AEQ-Urdu ranged from 0.848-0.990. AEQ-U showed an excellent test-retest reliability with the ICC ranging from 0.775-0.996. The majority of the subscales of AEQ showed significant (p< 0.05) positive correlation with pain scales (PCS and NPRS) and negative correlation with the domains of SF-12. The AEQ-U has reliable and valid construct validity, good internal consistency, and test-retest reliability, indicating that it has adequate psychometric features and can be a useful tool for evaluating pain responses in patients with chronic musculoskeletal pain.

Survey of fear and compliance of Insulin Degludec and Insulin Aspart injection in type 2 diabetes mellitus patients and analysis of influencing factors.

This study aims to investigate the fear and compliance of Insulin Degludec and Insulin Aspart (IDegAsp) injection in type 2 diabetes mellitus (T2DM) patients and study the factors influencing patient compliance. A total of 120 patients with T2DM treated from February 2019 to March 2022 were investigated and analyzed for fear and compliance on the Diabetes Fear of Injecting and Self-testing Questionnaire of diabetic patients and were divided into compliance and noncompliance groups according to the results to analyze the factors affecting patient compliance. The study found a high level of fear of IDegAsp injection among the 120 T2DM patients, with an average Diabetes Fear of Injecting and Self-testing Questionnaire score of (39.19 ± 4.59) points. Scores for medication compliance, dietary compliance, blood sugar monitoring, and lifestyle changes were (10.48 ± 1.52) points, (12.18 ± 2.27) points, (0.84 ± 0.12) points, and (9.13 ± 2.21) points, respectively. There was no significant difference between the compliance and noncompliance groups in terms of gender, age, lifestyle, educational level, occupation, current treatment method, family monthly income per capita, and medical payment method (P > .05). However, there were significant differences influenced by disease duration, complications, cognitive level, self-efficacy level, comorbidity count, and living status (P < .05). Multifactorial analysis showed that educational level, disease duration, complications, cognitive level, self-efficacy level, comorbidity count, and living status all affected patient compliance (P < .05). Educational level, disease duration, complications, cognitive level, self-efficacy level, comorbidity count, and living status are important factors affecting the fear and treatment compliance of IDegAsp injection in T2DM patients. These findings have implications for improving patient compliance and alleviating treatment fear.

Effect of Tezepelumab on Sino-Nasal Outcome Test (SNOT)-22 Domain and Symptom-Specific Scores in Patients with Severe, Uncontrolled Asthma and a History of Chronic Rhinosinusitis with Nasal Polyps.

Tezepelumab blocks the activity of thymic stromal lymphopoietin, an epithelial cytokine implicated in the pathogenesis of asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). In a previous analysis, tezepelumab improved asthma and rhinosinusitis symptoms compared with placebo in patients with severe, uncontrolled asthma and a history of CRSwNP in the 2years before randomization in the NAVIGATOR study. This post hoc analysis of patients with a CRSwNP diagnosis at any time before randomization in NAVIGATOR enabled domain and symptom-specific analyses of Sino-Nasal Outcome Test (SNOT)-22 outcomes. Patients (aged 12-80years) with severe, uncontrolled asthma were randomized to tezepelumab 210mg or placebo subcutaneously every 4weeks for 52weeks. SNOT-22 total, domain, and item scores were assessed in patients with a history of CRSwNP. Annualized asthma exacerbation rate (primary efficacy outcome), pre-bronchodilator forced expiratory volume in 1s, and Asthma Control Questionnaire-6, Asthma Quality of Life Questionnaire (standardized) for patients 12years and older, and Asthma Symptom Diary scores were also assessed in patients with and without a history of CRSwNP. Of 1059 patients with severe asthma, 165 (15.6%) had a history of CRSwNP. Tezepelumab treatment resulted in sustained improvements versus placebo in SNOT-22 total score throughout the 52-week study period [least-squares mean difference (95% confidence interval) - 11.08 (- 17.80, - 4.35)]. Tezepelumab improved all five SNOT-22 domain scores (sleep, nasal, function, ear/facial, and emotion) and the five SNOT-22 item scores of most clinical interest (decreased sense of smell/taste, nasal blockage, reduced productivity, waking up tired, and cough). Tezepelumab improved asthma-related clinical outcomes in patients with and without a history of CRSwNP. In patients with severe, uncontrolled asthma and a history of CRSwNP, tezepelumab improved rhinosinusitis symptoms across multiple domains, as well as asthma exacerbations, lung function, asthma control, and health-related quality of life. NCT03347279 ( https://classic. gov/ct2/show/NCT03347279 ).

Robotic versus laparoscopic revision to Toupet fundoplication for failed Nissen fundoplication: a single-center experience.

Nissen fundoplication (NF) is a common surgical procedure to treat gastroesophageal reflux disease; however, a subset of patients may continue to experience symptoms or develop symptom recurrence despite a successful procedure. This study aims to compare laparoscopic and robotic approaches for treating failed NF and evaluate the outcomes after converting to Toupet fundoplication (TF). We conducted a retrospective analysis of patients who underwent robotic or laparoscopic revision to TF for failed NF between 2016 and 2023. The data collected included demographics, pre-operative workup, and peri- and post-operative outcomes. Symptom analysis and anti-reflux medication usage were collected using a patient questionnaire. Failed fundoplication was defined as the need for an additional operation due to unresolved GERD symptoms or the emergence of a new issue. Eighty-eight patients (56 laparoscopic, 32 robotic) were included. Mean operative time was 148.71 ± 53.64min for the total cohort and was significantly longer in the robotic group (RG) 167.43min vs 138.01min in the Laparoscopic group (LG) (p value = 0.012). The LG had a length of hospital stay of 2.16 ± 1.69days vs RG 2.21 ± 1.28days (p value = 0.867). The LG had a higher number of early readmissions (5.4%, p value = 0.629) and both the LG and the RG had 1 patient that required an early reintervention. Symptoms of dysphagia and reflux decreased in both groups at last follow-up, but the reduction in PPI use was not significant. Surgical revision to TF for failed NF provides significant symptom improvement with low rates of complications and recurrences. Our study shows that both approaches are safe and feasible and have comparable surgical and symptom outcomes.

Pre-transplant Screening for MMP-9 in Allogeneic HSCT Candidates

Purpose: InflammaDry® (Quidel Eye Health, San Diego, California), an FDA-approved point-of-care commercial test, measures matrix metalloproteinase-9 (MMP-9) levels in the tear film. MMP-9 is an inflammatory biomarker that is elevated in response to ocular surface stress, particularly observed in ocular graft-versus-host disease (oGVHD). The purpose of this study is to assess the prevalence of MMP-9 positivity and a score &gt;4 on the OSDI-6 questionnaire in patients before allogeneic hematopoietic stem cell transplant (HSCT). Methods: A prospective, observational, cross-sectional single center pilot study was conducted among 23 patients (46 eyes) undergoing planned allogenic HSCT. InflammaDry® results, OSDI-6 questionnaire results, and development of oGVHD were collected. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and chi-square test were calculated. Results: InflammaDry® demonstrated high sensitivity (1.0) but low specificity (0.1429) for oGVHD development. The PPV was 0.25, while the NPV was 1.0. No statistical significance was found between InflammaDry® result and development of oGVHD (p-value&gt; 0.05). Conclusion: InflammaDry® is not an effective tool for detecting the onset or predicting the risk of developing oGVHD. A significant percentage of patients exhibited ocular inflammation before allogeneic HSCT, suggesting that initiating prophylactic treatment could be valuable in reducing oGVHD development.