Terms Of Patient Acceptability Research Articles

Energy demand supply of small-scale medical centers in epidemic conditions of Covid-19 with hybrid renewable resources

The energy supply of healthcare facilities is of great importance under different circumstances. In this study, supplying the energy of a clinic using maximum renewable resources under normal and crisis conditions is examined. This paper is novel in that it designs an energy system specifically for times of crisis. The proposed clinic is located in two different regions in Iran. This paper considers a solar panel, wind turbine, battery, inverter, and controller for electricity generation from renewable resources, a steam boiler for heating needs, and a diesel generator as a backup system. Scenarios, including changes in the type of controller and the price of different parts, were examined. In the optimal scenario, where the clinic is in normal conditions in terms of patient acceptance, the net present cost and cost of energy were estimated to be $2.57 million and 0.0606 $/kWh for Rasht, and $3.09 million and 0.0732 $/kWh for Shiraz, respectively. In a new scenario, in a critical time of the COVID-19 outbreak, the net present cost and cost of energy were calculated to be $4.29 million and 0.0608$/kWh for Rasht, and $5.31 million and 0.0755 $/kWh for Shiraz, respectively. Also the clinic will generate an annual income of $0.12 million by selling excess energy produced in this scenario during normal conditions.

Anxiety perception among children following two different restorative modalities – A noninferiority randomized clinical trial

Background: Anxiety perception among children plays a significant part in providing oral health care since both are interlinked. Perception refers to the ways or means by which anything is perceived or interpreted. Perception is awareness of the elements of the environment through physical sensation. As part of oral health-care initiation, the present study aimed to compare the anxiety perception among children following two different restorative modalities of atraumatic restorative treatment versus chemomechanical caries removal (CMCR). Methodology: A nonrandomized clinical trial was conducted over 2 months between February 20, 2021 and April 22, 2021, to compare the anxiety perception among children. Children below 14 years were selected for the study purpose. Results: Poisson regression analysis was used to evaluate the association between outcome and the variables. The results showed that the majority of children had dental anxiety issues, who were willing to improve their cooperative levels during dental treatment appointments. No statistically significant association was seen between the two different restorative modalities. Lower heart rate was observed when CMCR was used (P = 0.013). Conclusion: Anxiety perception among children plays a significant part in providing oral health care. The effectiveness of implementation was appropriate with regard to choosing the right treatment modalities among clinicians. Both the techniques showed minimal or lesser anxiety levels, but on a comparative note, CMCR was better, both in terms of patient acceptance and ease of performance.

SCALPEL VERSUS DIODE LASER FOR GINGIVAL DEPIGMENTATION: A CASE REPORT

Gingival hyperpigmentation is believed to be a genetic trait in populations and is more appropriately termed physiologic or racial gingival pigmentation a condition, which affects all races differently. Gingival depigmentation is most frequently performed as an esthetic periodontal plastic surgical procedure. There are various procedures like scalpel, laser. Cryosurgery, diamond burs and chemical methods have been used in this procedure. This case report compares the efficacy of two techniques. Maxillary anterior region was treated with scalpel technique and the mandibular anterior region was treated using Diode Laser. Both the treatment modalities were effective in terms of patient acceptance. Scalpel depigmentation resulted in uneventful healing of the treated site. Laser depigmentation showed some beneficial effects like bloodless field during surgical procedure which healed uneventfully. Patient discomfort was more in laser treated site during the initial healing period as compared to scalpel.

A pilot clinical study of an add-on Ayurvedic formulation containing Tinospora cordifolia and Piper longum in mild to moderate COVID-19

BackgroundAfter declaration of COVID- 19 as pandemic by WHO, countries adopted several measures to contain the spread as well as test and treat the patients. Further, as no effective management protocols to address this pandemic were available, a need was felt to explore the integration of modern and traditional medicines to treat COVID- 19 cases. ObjectiveTo undertake a study with Ayurveda formulation as add on to existing standard of care (SOC) and to compare the outcomes in terms of patient acceptability, the time to clinical recovery, hospital stay as well as any signs of drug-herb interaction between the Ayurveda formulation and the SOC. Material and methodsAn exploratory nonrandomized prospective study has been undertaken for comparing the outcomes of traditional Ayurvedic classical formulation of Tinospora cordifolia (Guduchi) and Piper longum (Pippali) as an add on to standard of care (SOC) using modern medicine with SOC alone. This has been done in mild and moderate COVID- 19 cases, at a tertiary care integrative Medicine hospital in the National Capital Region, Gurgaon, India. The outcomes have been evaluated in terms of the duration of hospital stay, the time to clinical recovery, safety and non- interference/interaction of Ayurvedic and Further, long term impact of COVID- 19 treatment has been evaluated using quality of life questionnaire after 3 months of discharge. ResultsFindings of present study reveals that the Ayurveda add-on formulation of T. cordifolia (Guduchi) and P. longum (Pippali) has reduced the length of hospital stay and improve the recovery time. General feeling of wellbeing and activity levels were better in the 3 month follow-up post discharge in the Ayurveda add-on group. ConclusionAddition of Ayurveda formulation has reduced the time of recovery and duration of hospital stay. However, this formulation needs further investigated to provide more information on effective and safe herbal add-on to SOC for better outcomes to treatment of COVID-19 disease.

Patient acceptability of targeted risk-based detection of non-communicable diseases in a dental and pharmacy setting

BackgroundNon-communicable diseases [NCDs] are the major cause of mortality globally and are increasing in prevalence. Different healthcare professionals’ access different population groups; and engaging allied healthcare professionals in risk-driven early case detection of certain NCDs may be beneficial, especially those who have not been tested for NCDs within the previous 12 months.The objectives of this study were to determine: whether NCD case finding in dental/community pharmacy settings is feasible in terms of patient acceptability, barriers to recruitment, impact on the existing service. Determine time taken to test for: type 2 diabetes risk [T2DM], chronic obstructive pulmonary disease [COPD], hypertension, vitamin D deficiency and chronic kidney disease [CKD]. Determine whether there is added benefit of point of care testing [POCT] to identify diabetes risk compared to a validated screening questionnaire alone.MethodsAn exploratory study was undertaken to explore issues associated with NCD assessment in one dental practice and one community pharmacy within the West-Midlands, UK. Fifty patients > 40 years-of-age were recruited per site. Participants undertook: a questionnaire providing demographic data, any previous NCD diagnosis or positive family history. Validated questionnaires for determining NCD risk [T2DM/COPD]. Chair-side capillary blood [finger-prick] samples for HbA1C, creatinine/eGFR, Vitamin-D.Prior work had been undertaken to measure the agreement between point of care testing [POCT] devices and a central laboratory method, and to gauge the opinions of participants regarding discomfort experienced using venous (antecubital fossa) and capillary (finger-prick) blood collection, via a 10 cm Visual-Analogue-Scale. The POCT devices demonstrated good concordance with laboratory testing and were acceptable methods of blood collection for participants.ResultsRecruitment rates demonstrated that 8 days were needed to recruit 50 participants and 60% of those approached opted to participate. The principal barrier to participation was time, with average time taken to test being 19mins. Utilising dental and pharmacy settings identified potential cases of previously undiagnosed disease.ConclusionsRisk-targeted testing for NCDs in high street dental and community pharmacies is both attractive and acceptable to patients.

Distress and Quality of Life Among Patients with Advanced Genitourinary Cancers

Patients with advanced genitourinary cancers face many challenges throughout their disease trajectory, and many will experience clinically relevant psychosocial distress. Certain groups, including female gender, younger age (and older age for suicide), unmarried status, and non–clear cell histology, remain at a higher risk, and evidence suggests that those with kidney and bladder cancers may be at an increased risk of suicide. Routine psychosocial screening, with brief validated tools, has the ability to identify patients’ unmet needs, assist the health care team in addressing such symptoms, and subsequently improve quality of life, adherence, and clinical outcomes. Effective supportive care modalities are available that address common patient needs in the context of incurable disease (eg, emotional and physical symptoms); however, challenges remain in terms of patient acceptance and access through insurance coverage. As a result, remote home-based interventions have emerged with the potential to mitigate emotional symptom burden and improve disease adjustment. In this study, we highlight studies reporting on the prevalence of psychosocial distress and associated risk factors in advanced genitourinary cancers, and review evidence-based interventions for the management of distress, including distress screening and psychosocial interventions. Patient summaryThis mini-review reports the prevalence of psychosocial distress and associated risk factors among patients with advanced kidney, bladder, or prostate cancer. We found that patients with these types of advanced genitourinary cancers are at a great risk of distress, including suicide, with consequent impairments in quality of life. We recommend that a distress screening program be incorporated as the standard of care and that referrals to appropriate psychosocial interventions be available to assist patients in greatest need.

Nurse-led care is preferred over GP-led care of gout and improves gout outcomes: results of Nottingham Gout Treatment Trial follow-up study.

To explore patient satisfaction, gout knowledge, medication adherence and flares among participants receiving nurse-led or general practitioner (GP)-led care of gout in the Nottingham Gout Treatment Trial phase-II (NGTT-II). A total of 438 participants of NGTT-II were sent a questionnaire enquiring about gout knowledge, satisfaction with health-care practitioner, urate-lowering treatment being undertaken, and gout flares ⩾1 year after their final visit. Nurse-led care participants were asked about their preference for receiving gout treatment from either a GP or a nurse. Completed questionnaires were returned by 82% of participants. Participants previously receiving nurse-led care reported greater satisfaction with health-care practitioner (P < 0.001), had better gout knowledge (P = 0.02), were more likely to be taking urate-lowering treatment [adjusted relative risk (95% CI) 1.19 (1.09, 1.30)], and self-reported fewer flares in the previous 12 months [median (inter-quartile range) 0 (0-0) vs 1 (0-3), P < 0.001] than those receiving GP-led care. Of participants receiving nurse-led care, 41-63% indicated preference for receiving gout treatment from a nurse, while only 5-20% indicated preference for receiving treatment from GPs. The results of this study favour nurse-led care, involving individualized patient education and engagement and a treat-to-target strategy, in terms of patient acceptability, long-term adherence, and flares. Further research is required to evaluate the feasibility of implementing such a model of care in clinical practice.

Pure platelet rich plasma injections in the management of knee osteoarthritis

Introduction: Osteoarthritis is a degenerative joint disease. It is a slowly progressive disease that affects individuals from the fourth decade and continues to progress at a variable rate. Knee is the most common joint affected in this condition. Osteoarthritis of the knee is a common problem in India among the population above 40 years of age. Platelets have known roles in coagulation, inflammatory processes, and immunity modulation. Moreover, during degranulation, platelets release various cytokines and growth factors (vascular endothelial growth factor, platelet-derived growth factor, transforming growth factor-B, insulin growth factor-I, and hepatocyte growth factor) which promote angiogenesis, tissue remodelling, and wound healing. In addition, platelets can reduce painful symptoms by an unknown mechanism which is apparently dependent on the release of proteases with analgesic properties. Pure Platelet rich plasma is a rapid and cost effective method which decreases the symptoms of osteoarthritis for a variable period and results in better functional outcome. Materials and Methods: This is a prospective observational study conducted on 100 knees in 75 patients suffering from Osteoarthritis treated from Feb 2017 till Jan 2018, in the Department Of Orthopaedics, Dr D. Y. Patil Hospital, Pimpri, Pune. All the baseline characteristics of the patients, like demographics, symptoms, Kellegren and Lawrence criteria and functional outcome were recorded. The patients were treated at our hospital with Pure Platelet rich plasma and followed up for a minimum period of nine months. The follow-up information included range of motion, scoring, patient satisfaction and overall outcome of the procedure in terms of patient acceptance. The data was analyzed to determine the functional outcome at nine months.Results: There was satisfaction in terms of symptoms of pain and range of movements of the knee. 37% patients showed excellent prognosis, good and fair prognosis was showed by 30% of the patients while only 3% people showed poor prognosis after a follow up of nine months duration.Conclusion: Pure Platelet Rich Plasma was not only associated with excellent functional outcome and short term recovery in terms of patient satisfaction and range of movements of the knee with decrease in pain nine months post-procedure but also was found to be cost effective.

Management of knee osteoarthritis: Knee lavage combined with intra articular injections of methyl prednisolone

Introduction: Osteoarthritis is a degenerative joint disease. It is a slowly progressive disease that affects individuals from the fourth decade and continues to progress at a variable rate. Knee is the most common joint affected in this condition. Osteoarthritis of the knee is a common problem in India among the population above 40 years of age. Knee Lavage with intra articular injections of methyl Prednisolone is a rapid and cost effective method which decreases the symptoms of osteoarthritis for a variable period and results in better functional outcome. Materials and Methods: This is a prospective observational study conducted on 100 knees in 75 patients suffering from Osteoarthritis treated from July 1 2016 till Dec 31 2016, in the Department Of Orthopaedics, Dr D.Y. Patil Hospital, Pimpri, Pune. All the baseline characteristics of the patients, like demographics, symptoms, Kellegren and Lawrence criteria and functional outcome were recorded. The patients were treated at our hospital with Knee Lavage combined with intra articular injections of methyl prednisolone and followed up for a minimum period of six months. The follow-up information included range of motion, scoring, patient satisfaction and overall outcome of the procedure in terms of patient acceptance. The data was analyzed to determine the functional outcome at six months. Results: There was satisfaction in terms of symptoms of pain and range of movements of the knee. 37% patients showed excellent prognosis, good and fair prognosis was showed by 30% of the patients while only 3% people showed poor prognosis after a follow up of six months duration. Conclusion: Knee Lavage with intra articular injections of methyl prednisolone was not only associated with excellent functional outcome and short term recovery in terms of patient satisfaction and range of movements of the knee with decrease in pain six months post-procedure but also was found to be cost effective.

Patients’ Perspectives on Treatment with Metacognitive Training for OCD

Abstract. There is much room for improvement in the treatment of obsessive-compulsive disorder (OCD). The current study introduces a newly developed version of Metacognitive Training for OCD (MCT-OCD), inspired by the self-help intervention myMCT as well as by MCT group programs for other disorders. The current study examines the acceptability of the training. Forty-four patients with OCD received four sessions of MCT-OCD in addition to inpatient treatment. At post assessment, patients provided a subjective appraisal of the training. Analyses revealed high acceptability and added value of the MCT-OCD. The current, preliminary version of the MCT-OCD is promising in terms of patient acceptance. Results will be used to improve current shortcomings of the training and to develop a more comprehensive MCT-OCD.

Patients’ perspectives on treatment with Metacognitive Training for Depression (D-MCT): Results on acceptability

BackgroundOur understanding of how patients perceive and evaluate treatment for depression is scarce. Because dropout rates are high among individuals in treatment for depression, it is necessary to expand the focus of research to patients’ perspectives on the treatment they receive. The aim of the two studies presented was to evaluate patient acceptance of Metacognitive Training for Depression (D-MCT), a highly standardized group intervention. MethodsAcceptability was evaluated in an open case series (Study 1, N = 70) and a randomized controlled trial (RCT; Study 2, N = 84). In both studies, participants rated their subjective appraisal on a 15-item questionnaire after administration of eight D-MCT modules. In Study 1, a subsample of patients also evaluated modules individually after each session. In Study 2, ratings were compared to an active control intervention (walking and psychoeducation sessions), and assessment was repeated at 6-months follow-up. ResultsHigh rates of acceptance of the D-MCT were demonstrated in both studies immediately after treatment (post-assessment). In addition, the RCT showed better evaluations for the D-MCT than for the control condition at post-assessment as well as at 6-months follow-up. Weekly session evaluations in Study 1 indicated good acceptance for individual modules. LimitationsEvaluations could only be obtained from completers; blinding of patients and therapists was not possible. ConclusionsResults of the two studies suggest that D-MCT represents a promising group treatment in terms of patient acceptance and provide an example of how patients’ feedback may be used to improve treatment.

Outpatient Percutaneous Release of Trigger Finger: A Cost Effective and Safe Procedure.

IntroductionTrigger finger is a common cause of pain and disability of the hand. Percutaneous release results in earlier functional recovery and patient satisfaction. This is a rapid and cost-effective method which saves a surgical procedure and results in better functional outcome.Materials and MethodsThis is a prospective observational study conducted on fifty-two fingers and thumbs in 52 patients treated from 1st July 2014 till 31st December 2014, in the Orthopaedic Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. All the baseline characteristics of the patients, like demographics, symptoms, Quinell's criteria and functional outcome were recorded. The patients were treated at our hospital with trigger finger, managed with percutaneous release using an 18 gauge needle and followed up for a minimum period of three months. The follow-up information included range of motion scoring, patient satisfaction and overall outcome of the procedure in terms of patient acceptance. The data was analyzed to determine the functional outcome at three months.ResultsThere was complete release of A1 pulleys in 52 out of 52 digits (100%) in the patients undergoing percutaneous release and significant patient satisfaction. No recurrence was observed.ConclusionPercutaneous release of trigger finger with needle was not only associated with excellent functional outcome and recovery in terms of patient satisfaction and range of finger motion three months post-procedure but also was found to be cost effective.

Effect of Diclofenac Mouthwash on Postoperative Pain after Periodontal Surgery.

Non-Steroidal AntiInflammatory Drugs (NSAIDs) are widely used drugs for the management of pain. Oral administration of NSAIDs has various adverse events like gastrointestinal alterations - nausea, dyspepsia and gastrointestinal bleeding, hepatotoxicity and blood dyscrasias. As orally given NSAIDs are associated with systemic side effects, it is preferred to alleviate pain and inflammation using topical medication. Thus, recently the focus has been on the development of topical administration of NSAIDs in the form of gels, toothpastes and rinses. To determine if diclofenac mouthwash, would be a better alternative to its systemic administration post surgery, in terms of patient acceptance and to minimize the adverse effects of orally administered drug. The study was designed as a single blinded, randomized, controlled clinical trial. Thirty chronic periodontitis patients scheduled for full mouth flap surgeries were randomized to receive either Diclofenac Mouthwash (MW) or Diclofenac Tablets (TB), post surgery. The MW group patients (15) were advised to rinse undiluted 15 ml solution for 30 secs, twice daily for three days. TB group (15) was advised to take 50 mg tablet twice daily for three days. A 10 point Visual Analog Scale (VAS) and Wong Baker Facial Rating Scale (FRS) was recorded to measure the pain perception by the patients. Gingival status was assessed by the Modified Gingival Index (MGI) at Baseline and seventh day. Data pertaining to pain perception were analysed using repeated measures of ANOVA (Analysis of Variance) with post-hoc LSD test. Intra group comparisons showed a significant reduction in pain, post surgery. Inter group comparisons showed a significant reduction only in the MGI scores of MW group, when compared to TB group. Intergroup comparisons showed no significant reduction in pain scores between both the groups, stating that diclofenac mouthwash is as effective as oral administration. Diclofenac mouthwash is a better alternative to the systemic administration post surgery, in terms of patient acceptance and to minimize the adverse effects of orally administrated drug.

Noninvasive Markers to Assess Liver Fibrosis

Chronic liver disease represents a major public health problem, accounting for significant morbidity and mortality worldwide. Their prognosis and management greatly depends on the amount and progression of liver fibrosis with time and the risk of development of cirrhosis. Historically, liver biopsy was considered to be the gold standard for the detection of fibrosis. Nevertheless, liver biopsy is an invasive procedure that has limitations in terms of patient acceptance, risk-benefit ratio, cost-effectiveness, and its availability in various geographic regions. Moreover, it is a questionable gold standard due to significant sampling error and intraobserver and interobserver variability. These limitations have led to the development of noninvasive techniques for assessing the presence and the degree of liver fibrosis. This review aims to revise the most recent data from the literature about noninvasive methods useful in the evaluation of liver fibrosis.

Calcipotriol/betamethasone for the treatment of psoriasis: efficacy, safety, and patient acceptability.

BackgroundOne of the advances in the treatment of plaque-type psoriasis is combined local therapy with calcipotriol and betamethasone. To provide both ingredients in a two-compound product, efforts have been made to unite calcipotriol and betamethasone because they are usually inactivated when present in the same formulation. This aspect was resolved when carefully designed vehicle components were invented (gel and ointment). This article reviews the efficacy, safety, and patient acceptability of calcipotriol/betamethasone dipropionate.MethodsA literature search of all articles published until February 2015 was performed, including the largest medical databases. The search strategy for evaluating the main topics of this review – efficacy, safety, and patient acceptability – was defined before checking the publications.ResultsSeventy references were found and checked for relevance. For efficacy, the proportion of patients whose psoriasis improved was always significantly higher in the two-compound group compared to the group treated with the individual substances. In the context of safety, the fixed combination was generally associated with a lower risk of adverse events. In terms of patient acceptability, the fixed combination led to a significant improvement in quality of life. The two-compound product was more convenient to handle and time saving compared to former treatments.ConclusionCalcipotriol/betamethasone dipropionate in a fixed combination is an effective and well-tolerated medication in mild-to-moderate psoriasis of body and scalp and, in addition, is an evidence-based treatment modality.

Complete mouth reconstruction with implant-supported fixed partial dental prostheses fabricated with zirconia frameworks: A 4-year clinical follow-up

Few scientific reports regarding the success of complete mouth partial fixed dental prostheses frameworks fabricated with zirconia are available, especially when dental implants serve as the abutments. A complete mouth reconstruction with zirconia frameworks veneered with feldspathic porcelain is reported involving a 65-year-old white woman who presented with partial edentulism and an unrestorable remaining dentition. After examination, 14 implants were planned (8 in the maxillary arch and 6 in the mandibular arch), and implant-supported zirconia framework screw-retained partial fixed dental prostheses (ISZPFDPs) were fabricated and made in sections for easier retrievability and management. No major complications were encountered during follow-up appointments at 6-month intervals for 4 years. However, minor fractures of the veneering ceramic were noted 4 years after placement. The ISZPFDPs were well accepted by the patient and had a favorable outcome in terms of patient acceptability and success, despite some complications.

Needle free parenteral drug delivery: Leveraging active transdermal technologies for pediatric use

Administration of medications via the parenteral route directly to the systemic circulation is an effective way of overcoming the first pass effect, obtaining quicker onset of action, and achieving higher bioavailability. However, needle phobia and the pain perceived during the injection process often make this a less preferred route than oral in terms of patient acceptance and compliance, particularly for pediatrics. Needleless injection technologies that deliver medications via the transdermal interface have been an active area of pharmaceutical research for many years. This review summarizes the various emerging technologies in the area of active transdermal delivery that can be potentially extended to pediatric applications.

PTU-040 Study of Quality and Efficacy of Bowel Preparation for Colonoscopy

IntroductionEffective bowel preparation of ≥90% is a key quality indicator for ensuring good standards of colonoscopy1. Good quality bowel preparation improves polyp detection and caecal intubation rates. Various regimens used...

The evolution of minimally invasive bariatric surgery

BackgroundObesity is a pandemic associated with significant morbidity and mortality. This historical article charts the progress of successful strategies that have been used to tackle weight loss from dietary modifications to the development of surgical interventions that have subsequently evolved. It also provides a précis of the reported outcome data following minimally invasive bariatric procedures. MethodsA literature review was performed. All articles relevant to the progression of bariatric surgery and minimally invasive surgery were assessed, as were those articles that described the ultimate evolution, combination, and establishment of the two techniques. ResultsThis article charts the progression of early weight loss strategies, from early dietary modifications and pharmacologic interventions to initial techniques in small bowel bypass procedures, banding techniques, and sleeve gastrectomies. It also describes the simultaneous developments of endoscopic interventions and laparoscopic procedures. ConclusionsA range of procedures are described, which differ in their success in terms of loss of excess weight and in their complication rates. Weight loss is greatest for biliopancreatic diversion followed by gastric bypass and sleeve gastrectomy and least for adjustable gastric banding. Bariatric surgery is an evolving field, which will continue to expand given current epidemiologic trends. Developments in instrumentation and surgical techniques, including single access and natural orifice approaches, may offer further benefit in terms of patient acceptability.

Review of the safety, efficacy, and side effect profile of asenapine in the treatment of bipolar 1 disorder

Objective:Asenapine is approved for acute manic and mixed states in bipolar disorder. The objective is to review the efficacy of asenapine in bipolar disorder, with a particular focus on acceptability and adherence to treatment.Methods:Five clinical trials were conducted in bipolar disorder manic or mixed states: two 3-week trials (n = 976) comparing asenapine to placebo, a 9-week extension (n = 504), and a 40-week extension (n = 107). One trial was conducted comparing asenapine to placebo (n = 326) as adjunctive therapy for subjects with an incomplete response to lithium or valproate. All trials were conducted in the USA and internationally.Results:Asenapine was found to be efficacious for manic and mixed states in bipolar disorder compared with placebo control, and compares equally well to olanzapine on efficacy measures after 3 weeks of treatment. Asenapine was not found to be efficacious for depression symptoms. Common asenapine side effects in the 40-week extension trial were sedation, insomnia, and dizziness, and 31% reported clinically significant weight gain, compared with 55% reporting clinically significant weight gain with olanzapine. Additionally, 18% had clinically significant changes in fasting blood glucose levels compared to 22% of those on olanzapine. In terms of patient acceptability, one concern may be sublingual administration requiring no liquids or food for 10 minutes after dosing and a twice-daily regimen. Suggestions about addressing barriers to adherence and acceptability are provided.Conclusion:Asenapine is a promising new medication in bipolar disorder. Asenapine in the long-term has a more favorable weight gain profile compared to olanzapine. No benefit was seen for depression symptoms, a major patient-reported concern. Some side effects do not remit after the short-term trials in at least 10% of patients.