Treatment Compliance Rate Research Articles

Pre-operative partial breast irradiation: revolutionizing radiation treatment for women with early stage breast cancer.

Partial breast irradiation (PBI) has been increasingly accepted as a suitable component of breast conservation in the management of patients with early stage breast cancer, however the majority of existing studies have focused on the use of adjuvant or intra-operative techniques. Several early stage studies have more recently shown that PBI can be safely used in the pre-operative setting. Early data show similar local control without evidence of increased toxicity or worsening cosmesis, as compared to postoperative PBI or standard whole breast irradiation. While long term data are still maturing, pre-operative accelerated PBI (PAPBI) offers a number of possible clinical advantages including reducing the treatment field and increasing the number of patients eligible for PBI, identifying biomarkers of response to radiation, and improving the rates of breast conservation and treatment compliance. This review discusses key concepts and controversies surrounding PBI as it has increasingly been adopted in the US, Canada, and Europe, and introduces the concepts and early studies of PAPBI. In addition, we summarize ongoing clinical trials investigating PAPBI, review clinical benefits and challenges associated with PAPBI versus postoperative PBI, and discuss ongoing limitations as well as next generation technologies important to the implementation of PAPBI in the management of patients with early-stage localized breast cancer.

An Orthopaedic Surgeon Led Osteoporosis (OSLO) Model of Care reduces early recurrent fracture rates and improves treatment compliance in patients treated for osteoporotic fractures.

This study aims to evaluate the efficacy of an Orthopaedic Surgeon Led Osteoporosis Model of Care (OSLO-MoC) as compared to a Case Manager Led Osteoporosis Model of Care (CMLO-MoC) in reducing early osteoporotic re-fracture rates and treatment compliance in patients. This was a single centre, retrospective, comparative cohort study of all patients screened and treated for secondary osteoporotic fracture prevention from the 2008 to 2018 at an orthopaedic surgical unit. From the 2008 to 2013, patients were recruited under the CMLO-MoC and from 2014 to 2018, under the OSLO-MOC. Logistics regression analysis was used to identify significant predictors such as OSLO-MOC implementation, gender, ethnicity, marital status and education level for patient recruitment, treatment compliance and secondary fracture rates at 12-month follow-up. Over a 10-year period, 7388 patients were screened of which 2855 patients were eligible for analysis. A total of 1234 patients were recruited under CMLO-MoC and 1621 patients under OSLO-MOC. Implementation of the OSLO-MOC was associated with greater patient recruitment, OR 1.26 (95%CI 1.06-1.49, P = 0.007). Of the 2855 patients recruited, OSLO-MOC implementation, OR 2.61 (95%CI 2.03-3.36, P < 0.001), and a higher level of education, OR 1.428 (95%CI 1.02-1.43, P = 0.037), were associated with improved compliance to medication at 12months. OSLO-MOC implementation was the only factor associated with reduced risk of secondary fractures at 12months, OR 0.14 (95%CI 0.03-0.66, P = 0.013). The OSLO-MOC has shown to be effective in reducing the rate of re-fracture and osteoporotic medication initiation and compliance of patients. IV.

Influence of Continuous Nursing Intervention on Treatment Compliance of Patients with Depression.

Objective This study mainly discusses the influence of the continuous nursing intervention on the treatment compliance of patients with depression. Methods The clinical data of 120 patients with depression admitted to our hospital were collected by retrospective analysis. According to the different implementation of nursing methods, patients were subordinated to the conventional group (n = 48, conventional nursing) and the continuous group (n = 72, continuous nursing). The treatment compliance, depression degree, quality of life, nursing satisfaction, Insight and Treatment Attitude Questionnaire (ITAQ), and recurrence rate of patients in the two groups were compared. Results The continuous group had a higher treatment compliance rate, slighter depression, higher physiological function, psychological function, social function, environmental adaptability, total quality of life, nursing satisfaction, and ITAQ score, and lower recurrence rate, with statistically significant differences (P < 0.05). Conclusion The implementation of continuous nursing intervention for patients with depression could enhance their treatment compliance and relieve depressive symptoms; improve the quality of life and self-awareness; reduce the risk of relapse; and improve nursing satisfaction.

Analysis on Value of Continuous Nursing Based on WeChat in Improving Healthy Quality of Life and Self-Management Behavior of Patients with Diabetic Nephropathy.

Objective To explore the value of continuous nursing (CN) based on WeChat in improving healthy quality of life and self-management behavior of patients with diabetic nephropathy (DN). Methods A total of 100 patients with DN who were treated in our hospital from November 2019 to January 2020 were selected. Thereinto, 54 patients who received CN based on WeChat were considered as the research group, and 46 patients who received the routine nursing intervention were considered as the control group. Peripheral blood samples were collected before nursing intervention (T0), 1 month after intervention (T1), and 2 months after intervention (T2) to test blood glucose, blood lipid, and renal function. Exercise of self-care agency (ESCA) scale and general self-efficacy scale (GSES) was conducted to evaluate patients' self-management ability, and a short-form 36-item health survey (SF-36) was conducted to evaluate their quality of life. Finally, the treatment compliance and satisfaction of patients were investigated. Results There was no marked difference in blood glucose, blood lipid, and renal function between groups at T0 (P > 0.05), but the research group was better than the control group at T1 and T2 (P < 0.05). After the nursing intervention, the scores of ESCA, GSES, and SF-36 in the research group were higher (P < 0.05). In addition, the treatment compliance rate and satisfaction of the research group were also higher. Conclusion CN based on WeChat can effectively improve the self-management behavior and quality of life of DN patients, which is extremely suitable for such chronic diseases with extremely long treatment cycles and can provide a more effective guarantee for their recovery.

Study on Nursing Effect of Psychological Intervention on Uremic Hemodialysis Patients.

Aim Patients in the hemodialysis stage are prone to psychological pressure of depression and anxiety and have resistance, which affects the clinical treatment effect. Effective psychological intervention plays a very important role in improving patients' psychological pressure and patients' compliance. The aim of this study is to explore the nursing effect of psychological intervention on uremic hemodialysis patients. Methods There were 126 uremic hemodialysis patients admitted to the hospital from August 2020 to December 2021. The patients were randomly divided into the routine nursing care group (n = 63) and psychological intervention group (n = 63). The routine nursing care group received routine nursing care for uremia hemodialysis patients. The psychological intervention group implemented psychological intervention on uremia hemodialysis patients. The methods of psychological intervention mainly include establishing a good nurse-patient relationship, popularizing hemodialysis knowledge, timely psychological counseling for patients, and organizing patient communication meetings. The treatment compliance, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) of the two groups were compared before and after nursing. SF-36 scale was used to evaluate the quality of life of patients. The incidence of complications and nursing satisfaction were compared between the two groups. Results The treatment compliance rate and nursing satisfaction of hemodialysis uremic patients in the psychological intervention group were significantly higher than the routine nursing care group. The SAS and SDS of hemodialysis uremia patients in the psychological intervention group were significantly lower than the routine nursing care group after psychological intervention, and SF-36 scale was significantly higher than the routine nursing group. The main complications of uremic hemodialysis patients are hypotension, hyperkalemia, internal fistula occlusion, and infection. Compared with the routine nursing care group, the incidence of complications in the psychological intervention group was significantly reduced. Conclusion The implementation of psychological nursing intervention for uremic hemodialysis patients have a very significant effect on reducing the incidence of complications and improving anxiety, depression, treatment compliance, and the quality of life and the nursing satisfaction.

Effect of personalized nursing based on quantitative evaluation strategies on remission of first-episode schizophrenia comparing to usual care: a systematic review and meta-analysis.

The drug control of symptoms is for now the main clinical treatment of schizophrenia, but patients' varying condition and poor compliance can also fluctuate the therapeutic effect. Personalized nursing with a quantitative evaluation strategy (PNQES) may help improve the compliance and symptoms, but there are controversies over the outcomes reported in each specific study; the meta-analysis method aims to resolve the controversies over studies, thus, we conducted this study to pooling the results of controlled clinical studies, and to systematically evaluate the effects of this nursing model. The PubMed, Medline, Embase, China National Knowledge Infrastructure, and Wanfang databases were selected and searched for relevant articles for PNQES comparing to usual care. The inclusion criteria were established according to the Participants, Interventions, Comparisons, Outcomes, and Study (PICOS) framework. The Cochrane risk of bias 2.0 tool was used to evaluate the risk of bias of the included articles. The symptom scores, treatment compliance rate, quality of life, and social function indicators of the patients after nursing were quantitatively analyzed with effect sizes of mean difference (MD) or standard mean difference (SMD). The 11 included articles comprised a total of 1,251 patients with experimental group 625 and control group 626. Of all the 11 articles, only 1 had a "low" risk of bias, while the other articles had "some concern of risk;" none of the articles had a "high" risk of bias. The meta-analysis showed that patients who received PNQES had a significantly lower Positive and Negative Syndrome Scale (PANSS) total score after care than patients who received routine care [MD =-9.95, 95% confidence interval (CI): -14.35, -5.55; P<0.00001]. Further, the treatment compliance rate of patients who received PNQES was significantly higher (odds ratio =4.44, 95% CI: 2.17, 9.09; P<0.0001), as was the quality of life (standard MD =2.40, 95% CI: 1.46, 3.34; P<0.00001). Further, the social function deficit score was significantly lower (MD =-2.25, 95% CI: -3.75, -0.76; P=0.003). Subgroup and regression analyses showed that patient age, initial PANSS score, and the quantitative method of disease severity were not the sources of heterogeneity. Different intervention approaches applied may have been the source of heterogeneity. The application of PNQES is helpful for improving patients' symptoms and disease outcomes, treatment compliance, social function, and quality of life. It is suggested to be generalized in clinical application.

A Comparative Analysis of Nonthumb Metacarpal Fracture Treatments in New York City Civilians and Incarcerated Individuals.

Nonthumb metacarpal (NTMC) fractures are common in the incarcerated and the underinsured civilian populations. However, certain social challenges contribute to high rates of follow-up noncompliance and complications in these unique populations. We conducted a retrospective review of the treatments, outcomes, and complications in the incarcerated and civilian patient population who were treated at a tertiary public hospital for NTMC fractures. Even though incarcerated patients were more likely than their civilian counterparts to undergo operative interventions, both populations showed similar complication profiles as well as low rates of treatment compliance and follow-up. This article affirms that incarcerated individuals do not receive inferior care compared with civilians, and both the incarcerated and underinsured civilians would benefit from careful consideration of treatment algorithms and additional access to hand therapy.

Effect of Continuous Nursing Model Based on WeChat Public Health Education on Self-Management Level and Treatment Compliance of Stroke Patients.

To analyze the effect of continuous nursing model based on WeChat public health education on self-management level and treatment compliance of stroke patients. Overall, 98 stroke patients admitted to the Second Affiliated Hospital of Chongqing Medical University, ChongQing, 400000,China from Feb 2018 to Feb 2019 were enrolled as the research objects. They were randomly and equally divided into experimental group and control group. The control group received routine nursing management model while the experimental group received continuous nursing model based on WeChat public health education to compare the self-management level, treatment compliance, life quality and other indexes between the two groups. The overall self-management level in the experimental group was significantly higher than that in the control group (P<0.05). The life quality scores in both groups after nursing intervention increased, and the scores in the experimental group after nursing intervention were significantly higher than those in the control group (P<0.001). The total treatment compliance rate in the experimental group was higher than that in the control group (P=0.001). After nursing intervention, the readmission rate and complication rate in the experimental group were significantly lower than those in the control group (P<0.05). The implementation of continuous nursing model based on WeChat public health education for stroke patients can significantly enhance the self-management level, improve the cognitive level on stroke related-health knowledge, improve treatment compliance of patients in the nursing process, promote their physical and mental health, improve the life quality and effectively reduce the complication rate and readmission rate.

Utilization of radiation therapy and predictors of noncompliance among Syrian refugees in Turkey

BackgroundAccess to cancer care is a problem that continues to plague refugees displaced from their home countries. The turbulent political crisis in Syria, which has led to millions of refugees seeking asylum in Turkey, merits further attention. We aimed to study the rate of utilization of radiation therapy among Syrian refugees with cancer living in Turkey in an attempt to identify the contributing factors predictive of non-compliance with prescribed RT.MethodsIn this retrospective review of 14 institutional databases, Syrian refugee patients in Turkey with a cancer diagnosis from January 2015 to December 2019 who were treated with RT were identified. The demographic data, treatment compliance rates, and toxicity outcomes in these patients were surveyed. Variable predictors of noncompliance such as age, sex, diagnosis, treatment length, and toxicity were studied. The association between these variables and patient noncompliance was determined.ResultsWe identified 10,537 patients who were diagnosed with cancer during the study period, of whom 1010 (9.6%) patients were treated with RT. Breast cancer (30%) and lung cancer (14%) were the most common diagnoses with up to 68% of patients diagnosed at an advanced stage (Stage III, IV). 20% of the patients were deemed noncompliant. Treatment with concurrent chemoradiotherapy (OR 1.61, 95% CI 1.06–2.46, p = 0.023) and living in a refugee camp (OR 3.62, 95% CI 2.43–5.19, p < 0.001) were associated with noncompliance. Age, sex and treatment length were not significantly associated with noncompliance.ConclusionsNoncompliance with radiotherapy among Syrian refugees in Turkey remains an area of concern with a multitude of factors contributing to these alarming numbers. Further studies to better ascertain the finer nuances of this intricately complex problem and a global combination of efforts can pave the way to providing a solution.

New steps in acute coronary syndrome and antihyperlipidemic treatment: Determination of statins and metabolites by liquid chromatography tandem mass spectrometry.

Our aim in this study was to develop a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the measurement of atorvastatin, rosuvastatin and their major metabolites, and furthermore to evaluate patients' adherence to statin therapy and to investigate the effect of statin therapy on various hematological and biochemical parameters. A simple protein precipitation was performed for the extraction of analytes and the extracted samples were injected directly. The levels of drugs and their metabolites were measured by the validated method in a total of 210 patients diagnosed with unstable angina pectoris (USAP), ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). Various biochemical and hematological parameters were measured. The linearity ranges for atorvastatin and rosuvastatin were 1.22-2,500 and 0.97-2000 ng/ml, respectively. The inter-assay coefficient of variation for all analytes was ≤ 6%. In patients diagnosed with USAP, STEMI and NSTEMI, treatment compliance rates were 22.1, 23.5 and 41.2% for atorvastatin and 36.1, 40.2 and 67.1% for rosuvastatin, respectively. An economical, simple and reliable measurement method has been developed. Our findings support the poor patient compliance with statin therapy in the included population. It was observed that 6months of statin treatment caused slight changes in biochemical and hematological parameters.

Sexual rehabilitation with intracavernous alprostadil after radical prostatectomy: Outcomes from a nursing program.

Erectile dysfunction (ED) is a common complication after radical prostatectomy that affects quality of life. There are several therapeutic options, including intracavernous alprostadil injections (IAI). However, no specific recommendations have been made on the optimal rehabilitation strategy. In this study we evaluated a sexual rehabilitation program (SRP) with IAI for patients with ED after radical prostatectomy, assessing the rate of compliance and reasons for dropout. The sexual rehabilitation program (SRP) was offered to all patients who underwent radical prostatectomy from 1 January 2010 to 31 December 2019. The first consultations were performed by a urology specialist nurse, explaining the IAI procedure and possible complications. The program was considered successful when the patients achieved autonomy in the drug preparation with a good injection technique. A medical consultation was performed at 6 months evaluating the IAI usage and adverse events. In case of dropout, a questionnaire about reasons for dropout was performed. The primary endpoint was the rate of compliance and dropout of the program. Secondary endpoints were the reasons for dropout and adverse events. 340 patients underwent radical prostatectomy at our institution, and 123 patients accepted to participate in the rehabilitation program. A total of 96 patients (78%) successfully completed the SRP, and at 6 months 60 (62.5%) still used IAI. Concerning the reasons for dropping out, the most frequent were the need of injectable therapy and pain. Regarding complications, 17 patients (13.8%) reported pain related to the injection and 1 patient (0.8%) had a priapism, managed with conservative treatment. Management of post-radical prostatectomy ED by a nursing program achieved good rates of patients' self-injection accomplishment and treatment compliance. Close monitoring for dose adjustment and management of post-injection penile pain is required during the follow-up.

Magnetic Resonance Imaging (MRI) Based on Machine Learning Algorithms for the Diagnosis in Efficacy of Dexmedetomidine along with Modified Electroconvulsive Therapy Nursing on First Episode Schizophrenia

This study was aimed to explore the efficacy of dexmedetomidine combined with modified electroconvulsive therapy (MECT) and continuous nursing on first episode schizophrenia (FES), as well as the continuous monitoring effect of magnetic resonance imaging (MRI) on the FES patients under machine learning algorithms. In this study, 48 schizophrenia patients who received the combined treatment of MECT and dexmedetomidine were selected, and they were divided into the routine group (RG) and observation group (OG), with routine nursing and continuous nursing, respectively. Besides, another 30 healthy people were included as the control group (Ctrl group). Based on MRI characteristics, the machine learning algorithm designed for FES patients was used to analyze the changes in the amplitude low-frequency fluctuations (ALFF) of the static state brain MRI; the positive and negative score scale (PANSS) was used to evaluate the mental symptoms of patients. The Schizophrenia Quality of Life Scale (SQLS) score, treatment compliance rate, follow-up rate, and recurrence rate of patients were also compared. The results showed that the image quality of the weakened and enhanced areas of brain MRI was significantly improved under the machine learning algorithm. After treatment, the total score of PANSS and the scores of all dimensions were greatly reduced ( P &lt; 0.05 ). For the FES patients, the ALFF value of the frontal right lower lobe before treatment was higher than that of the Ctrl group ( P &lt; 0.05 ), while the ALFF value of the right insula and right superior frontal gyrus after treatment was lower than that of the Ctrl group ( P &lt; 0.01 ), and the ALFF value of the left inferior frontal gyrus opercular part was lower than that of the Ctrl group ( P &lt; − 0.05 ). The SQLS score, treatment compliance rate, follow-up rate, and recurrence rate of OG after nursing intervention were all much higher than those of the Ctrl group ( P &lt; − 0.05 ). In summary, MRI based on machine learning algorithms could be applied to monitor the effect of dexmedetomidine combined with MECT, and continuous nursing made an effective improvement in SQLS score of FES patients, though which the risk of recurrence was reduced.

Effects of Humanized Nursing on Perioperative Glaucoma Patients under Local Anesthesia and Sleep Quality.

We assessed the effects of humanized nursing on perioperative glaucoma patients under local anesthesia and their sleep quality. Fifty glaucoma patients who underwent surgery under local anesthesia from January 2018 to January 2020 were enrolled and randomly divided into 2 groups (N=25). The control group received routine nursing care whereas the observation group underwent humanized nursing care. We compared negative emotion scores, treatment compliance, incidence of postoperative complications, comfort score, sleep quality score, and nursing satisfaction. After nursing, the observation group had lower SAS and SDS scores than the control group (p < .05). The total treatment compliance rate was higher in the observation group than that in the control group (96.0% vs 72.0%, p < .05). The observation group had a lower incidence rate of postoperative complications than the control group (4.0% vs 24.0%, p < .05). After nursing, the observation group exhibited an increased GCQ score and a decreased PSQI score compared to the control group (p < .05). The total satisfaction rate of nursing was higher in the observation group than that in the control group (96.0% vs 76.0%, p < .05). Humanized nursing for glaucoma patients during the perioperative period under local anesthesia is able to relieve the negative emotion of patients and enhance their treatment compliance, which is conducive to reducing postoperative complications, increasing physical comfort level, and ameliorating sleep quality, thereby improving nursing satisfaction by patients.

Efficacy of Applying Kanglaite Injection under Incentive Nursing Intervention in Treating Patients with Advanced Penile Carcinoma and Its Effect on Treatment Compliance.

Objective To explore the efficacy of applying Kanglaite (KLT) injection under incentive nursing intervention (INI) in treating patients with advanced penile carcinoma and its effect on patient treatment compliance. Methods The clinical data of 120 patients with advanced penile carcinoma treated in the Affiliated Hospital of Southwest Medical University from February 2019 to February 2020 were retrospectively analyzed, and the patients were equally divided into the experimental group (n = 60) and control group (n = 60) according to their admission order. All patients received the KLT injection treatment; those in the control group accepted the conventional nursing; and on this basis, those in the experimental group accepted INI, including psychological nursing intervention, which was conducted concurrently with the treatment, to compare their short-term efficacy, treatment compliance, degree of cancer-related fatigue (Brief Fatigue Inventory), and negative emotion scores (Hospital Anxiety and Depression Scale) between the two groups. Results Compared with the control group, the experimental group presented a significantly higher objective remission rate (58.3%) (P < 0.05), higher rates of excellent and good treatment compliance (P < 0.05), and lower degree of cancer-related fatigue and negative emotion scores (P < 0.001). Conclusion INI can improve the negative emotions in patients with advanced carcinoma of the penis, alleviate their degree of cancer-related fatigue, promote their treatment compliance, and achieve a more significant efficacy of applying the KLT injection treatment, so it should be promoted in practice.

Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: Outcomes of survival, toxicity, sphincter preserving and prognostic factors

BackgroundThis study aimed to compare preoperative chemoradiotherapy (CRT) with postoperative CRT regarding survival, local control, disease control, sphincter preservation, toxicity and also prognostic factors for the treatment of locally advanced rectal cancer. MethodsRecords of 140 patients with locally advanced rectal cancer who received preoperative or postoperative CRT were analyzed retrospectively. We compared the treatment groups (preoperative vs postoperative) according to baseline characteristics (demographic and rectal cancer disease characteristics), and also carried out the survival analyses. ResultsFrom January 2010 to December 2019, 140 patients were included in the analysis, 65 received preoperative treatment and 75 postoperative treatment. There was no difference in survival, recurrence or distant metastasis rate in both treatment groups. The ratios of the failure to complete adjuvant chemotherapy (32% vs 4.6%) and acute grade 3–4 toxicity (32% vs 6.2%) were higher in the postoperative group (p < 0.001). In lower located tumors (≤5 cm from anal verge) the ratio of the sphincter preserving in the preoperative group was 60.7% (n = 17/28), and was 16.6% (n = 3/18) in the postoperative group (Yates χ2 = 5.829, p = 0.005). ConclusionThis study showed no difference in recurrence and survival rate. Preoperative CRT is the preferred treatment for patients with locally advanced rectal cancer, given that it is associated with a superior overall treatment compliance rate, reduced toxicity, and an increased rate of sphincter preservation in low-lying tumors, but not for overall survival.

Effect of Health Education Combined with Dietary Guidance on Nutritional Indicator, Immune Level, and Quality of Life of Patients with Pulmonary Tuberculosis.

Objective To investigate the effects of health education combined with dietary guidance on nutritional indicators, immune level, and quality of life of patients with pulmonary tuberculosis. Method A total of 123 patients with pulmonary tuberculosis who were hospitalized to our hospital between October 2019 and October 2020 were chosen for the study and were separated into 60 control cases and 63 observation cases based on the ward they were assigned to. Patients in the two groups were compared in terms of nutritional risk, nutritional indicator levels in serum, immunological function, treatment compliance, sputum culture conversion rate, and quality of life. Result With the prolongation of patients' illness, the total NRS 2002 score gradually increased in both groups and the total NRS 2002 score of patients in the control group was higher than that of patients in the observation group at the same time point after discharge. The difference between the total NRS 2002 score of patients in both groups was significant at 3 and 6 months after discharge. After the intervention, the Hb, ALB, CD4+, and CD4+/CD8+ levels of patients in both groups were higher than those at the time of admission, and the CD8+ levels were lower than those at the time of admission. At 6 months after discharge, the Hb, ALB, CD4+, and CD4+/CD8+ levels of patients in the observation group were significantly higher than those in the control group, and the CD8+ levels were significantly lower than those in the control group. The treatment compliance rate of patients in the observation group (96.83%) was significantly higher than that of the control group (75%), and the negative sputum culture transfer rate (85.71%) was significantly higher than that in the control group (60%). The overall quality of life scores of patients in the observation group was significantly higher than that in the control group. Conclusion Health education combined with dietary guidance for patients with pulmonary tuberculosis can deepen patients' understanding of disease and nutritional knowledge, improve treatment compliance, improve their nutritional status, enhance their immune function, accelerate sputum bacterial conversion, enhance treatment effect, and improve their quality of life.

Evaluation of the Impact of Personalized Nursing Intervention on Treatment Compliance Rate of Patients with Mania

Evaluation of the Impact of Personalized Nursing Intervention on Treatment Compliance Rate of Patients with Mania

Preoperative analgesic instruction and prescription reduces early home pain after outpatient surgery: a randomized controlled trial.

Home pain remains the most common complication in outpatient surgery. Optimal management requires good information and early availability of analgesics. The main objective of this randomized controlled trial was to compare the effects of pre- vs postoperative analgesic instruction and prescription on postoperative home pain. Patients were randomized into an anesthesia consultation group (AC group) and a standard postoperative group (POP group). The AC group and the POP group received analgesic prescription and instruction during the anesthesia consultation and after surgery, respectively. The primary outcome was the incidence of home pain on postopertive day one (D1). Home pain was defined by at least one episode with a numeric rating scale score > 3/10 at rest. Treatment compliance and postoperative nausea and vomiting (PONV) were also assessed on D1 and postoperative day 7 (D7). One hundred and eighty-six patients were included between May 2017 and May 2018 at Rouen University Hospital, France. Ninety-four patients were randomized to the AC group and 92 to the POP group. On D1, the incidence of pain was 23/94 (24%) in the AC group and 44/92 (48%) in the POP group (P < 0.001). On D1, the rate of treatment compliance was significantly higher in the AC group than in the POP group (85% vs 69%; P = 0.02). There was no statistically significant difference in the incidence of pain or treatment compliance between groups on D7 or in PONV on D1 and on D7. Preoperative analgesic instruction and prescription during anesthesia consultation reduces the incidence of early postoperative home pain in outpatient surgery. www.clinicaltrialsgov (NCT03205189); registered 2 July 2017.

Outpatient prescribing pattern for acute bronchitis in primary healthcare settings in China

Inappropriate prescribing for acute bronchitis in primary healthcare settings (PHSs) is commonly seen worldwide. Here we describe the prescribing patterns and antibiotic use for acute bronchitis in PHSs across China. We conduct a nationwide cross-sectional survey to collect outpatient prescriptions from PHSs in 2017. Patients diagnosed with acute bronchitis without other infections are eligible for this study. Generalized estimating equations are used for analysis. Overall, 10,678 prescriptions for acute bronchitis from 214 institutions are included. The antibiotic prescription rate is 44.5% for total prescriptions, and differs significantly by region and urban/rural status (p < 0.05). Among all single-antibiotic prescriptions, 91.5% are broad-spectrum. Two-thirds of the prescriptions contain medicines for symptom management. The overall guideline compliance rate of acute bronchitis treatment for adults is 31.0%. Prescribing antibiotics, especially broad-spectrum ones, for acute bronchitis is commonly observed in Chinese PHSs. Targeted interventions are urgently needed for Chinese primary clinicians, especially in western rural areas.

Комплаєнс до лікування левотироксином хворих на гіпотиреоз під час пандемічної ери SARS-CoV-2

Актуальність. Гіпотиреоз потребує замісної терапії левотироксином (L-T4), щоб підтримувати в пацієнтів стан еутиреозу. Кількість госпіталізацій з приводу хронічних захворювань зменшилась протягом ери COVID-19. Мета дослідження— встановити частоту госпіталізацій пацієнтів з гіпотиреозом під час пандемії COVID-19 порівняно з аналогічним періодом часу в 2019 році. Матеріали та методи. Дослідження було проведене серед пацієнтів, які звернулись у відділення внутрішньої медицини університетської лікарні Abant Izzet Baysal та отримували замісну терапію L-T4 внаслідок гіпотиреозу. 108 пацієнтів з гіпотиреозом були включені в дослідження, підписавши інформаційну згоду. Пацієнти були розділені на дві групи відповідно до прихильності до лікування: хворі, які відповідали вимогам лікування, і хворі, які не дотримувались режиму лікування. Результати. Рівень тиреотропного гормона (ТТГ) перед включенням у дослідження у групі осіб, які відповідали вимогам лікування, був вірогідно нижчим, ніж у групі хворих, які не дотримувались режиму лікування (p&lt;0,001). При цьому рівень вільного тироксину (вТ4) серед пацієнтів першої групи був вірогідно вищим, ніж в осіб другої групи (p=0,04). Медіана нерегулярного прийому левотироксину становила 35 (10–90) днів у групі осіб, які не відповідали вимогам лікування, і 0 (0–0) днів у групі осіб, які відповідали вимогам лікування (p&lt;0,001). Кількість днів, коли левотироксин використовувався нерегулярно, вірогідно позитивно корелювала з останнім значенням ТТГ (r=0,564, p&lt;0,001) та негативно— з останнім значенням вT4 (r=–0,492, p&lt;0,001). Середній об’єм еритроцитів (MCV) у хворих першої та другої груп становив 85 (69,1–97,5) та 89 (66–96,6) фл відповідно (p=0,03). Ретроспективний характер та порівняно невелика кількість досліджуваних були двома основними обмеженнями проведеного дослідження. Висновки. Дотримання режиму лікування є дуже важливим для досягнення стану еутиреозу в пацієнтів з гіпотиреозом під час пандемії COVID-19. Підвищений рівень MCV може передбачати невідповідність лікування у хворих на гіпотиреоз.