scholarly journals Short and long-term outcomes of video observed treatment in tuberculosis patients, the Republic of Moldova

2021 ◽  
Vol 15 (09.1) ◽  
pp. 17S-24S
Author(s):  
Svetlana Doltu ◽  
Ana Ciobanu ◽  
Yuliia Sereda ◽  
Ruth Persian ◽  
Luke Ravenscroft ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Strategy ◽  
Term Outcome ◽  
Operational Conditions ◽  
Republic Of Moldova ◽  
Tb Treatment ◽  
Long Term Treatment ◽  
Short And Long Term ◽  
The Republic

Introduction: The Republic of Moldova is among the 18 high priority countries for tuberculosis (TB) in Europe. This study compared adherence and short and long-term TB treatment outcomes for TB patients who experienced asynchronous Video Observed Treatment (aVOT) during three months of outpatient treatment versus Directly Observed Treatment (DOT) in operational conditions in 2016-2017 in Chisinau. Methodology: We used secondary data from the 2016-2017 Randomized Clinical Trial (RCT) that piloted the aVOT Strategy in Chisinau and data from the national TB register. Relative risk was selected as a measure of association in analysis of treatment strategies (aVOT and DOT under operational conditions) and short and long-term treatment outcomes. Results: From 647 TB patients included in the study, 169 followed the treatment strategy in the RCT (83 in aVOT and 86 in DOT) and 478 were on DOT in operational conditions. Those in aVOT were more likely to have favourable short-term outcome than patients with DOT in operational conditions (RR 0.07; p < 0.001). TB recurrence as an indicator for the long-term outcome, was observed in group with DOT in operational conditions (40 cases, p = 0.006). Conclusions: This study demonstrated that the aVOT treatment strategy was associated with better adherence and both short and long-term TB treatment favourable outcomes. aVOT as a new patient-centred approach supporting TB patients on improving treatment adherence and outcomes might be recommended as an alternative to DOT strategy in the Republic of Moldova.

scholarly journals Collaborative Care Management Associated With Improved Depression Outcomes in Patients With Personality Disorders, Compared to Usual Primary Care

2018 ◽  
Vol 9 ◽  
pp. 215013271877326 ◽  
Author(s):  
Jeremy J. Solberg ◽  
Mark E. Deyo-Svendsen ◽  
Kelsey R. Nylander ◽  
Elliot J. Bruhl ◽  
Dagoberto Heredia ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
Collaborative Care ◽  
Care Management ◽  
Term Treatment ◽  
Study Cohort ◽  
Long Term Treatment ◽  
Patient Health ◽  
Short And Long Term

Background: The use of a collaborative care management (CCM) model can dramatically improve short- and long-term treatment outcomes for patients with major depressive disorder (MDD). Patients with comorbid personality disorder (PD) may experience poorer treatment outcomes for MDD. Our study seeks to examine the differences in MDD treatment outcomes for patients with comorbid PD when using a CCM approach rather than usual care (UC). Methods: In our retrospective cohort study, we reviewed the records of 9614 adult patients enrolled in our depression registry with the clinical diagnosis MDD and the diagnosis of PD (Yes/No). Clinical outcomes for depression were measured with Patient Health Questionnaire–9 (PHQ-9) scores at 6 months. Results: In our study cohort, 59.4% of patients (7.1% of which had comorbid PD) were treated with CCM, as compared with 40.6% (6.8% with PD) treated with UC. We found that the presence of a PD adversely affected clinical outcomes of remission within both groups, however, at 6 months patients with PD had significantly lower MDD remission rates when treated with UC as compared with those treated with CCM (11.5% vs 25.2%, P = .002). Patients with PD in the UC group were also noted to have an increased rate of persistent depressive symptoms (PHQ-9 score ≥10) at 6 months as compared with those in the CCM group (67.7% vs 51.7%, P = .004). Conclusions: In patients with comorbid MDD and PD, clinical outcomes at 6 months were significantly improved when treated with CCM compared with UC. This finding is encouraging and supports the idea that CCM is an effective model for caring for patients with behavioral concerns, and it may be of even greater benefit for those patients being treated for comorbid behavioral health conditions.

Clinical Outcomes of Ambulatory Acute Exacerbations of Chronic Bronchitis with Older versus Newer Antimicrobials

2002 ◽  
Vol 36 (6) ◽  
pp. 975-980 ◽  
Author(s):  
Karl J Madaras-Kelly ◽  
Stephanie B Magdanz ◽  
Christopher K Johnson ◽  
Sandra G Jue
Keyword(s):  
Chronic Bronchitis ◽  
Term Treatment ◽  
Cure Rate ◽  
Term Outcome ◽  
Long Term Treatment ◽  
Acute Exacerbations ◽  
Short And Long Term ◽  
Traditional Therapies ◽  
Cure Rates

OBJECTIVE: To determine whether the cure rate was similar between traditional and newer antibiotics in the treatment of acute exacerbations of chronic bronchitis (AECB), to determine whether antibiotic selection during the first AECB of the season influences the frequency of subsequent AECB, and to identify variables associated with poor short- and long-term treatment outcome. METHODS: A retrospective analysis of subjects seen for management of their first seasonal AECB was conducted. Subjects were stratified into traditional therapies (n = 95) or newer therapies (n = 101) by antibiotic prescription. RESULTS: There was no difference in initial cure rates between older versus newer antibiotics (93% vs. 95%; p = 0.48). There was no difference in the number of subjects that remained AECB-free for 6 months after initial treatment with older versus newer antibiotic regimens (34% vs. 28%; p = 0.37). Oxygen initiation or increased dose (OR 10.9; 95% CI 1.4 to 84.2; p = 0.02) was the only variable independently associated with lack of AECB resolution. Nonsmoking status trended toward an association with remaining AECB-free at 180 days (OR 0.39; 95% CI 0.15 to 1.01; p = 0.053). CONCLUSIONS: The use of older versus newer antibiotics did not independently predict short-term outcome or future AECB.

Compliance and convenience: do physicians and patients see depot medication differently?

2004 ◽  
Vol 16 (6) ◽  
pp. 314-318 ◽  
Author(s):  
Pierre Chue
Keyword(s):  
Side Effects ◽  
Treatment Outcomes ◽  
Term Treatment ◽  
Crucial Importance ◽  
Collaborative Process ◽  
Long Term Treatment ◽  
Short And Long Term ◽  
The Relationship ◽  
Depot Medication

Physicians' attitudes to depot medication are often focused on improved compliance (adherence), and thus, short- and long-term treatment outcomes. By contrast, patients receiving such formulations tend to have a quite different viewpoint of medication. Factors such as convenience, side-effects and their beliefs about their illness play an important role in determining whether patients will adhere to their prescribed treatment regimen. The relationship between the patient and physician is of crucial importance in determining a patient's attitude to their medication; it is becoming increasingly clear that managing the illness in the long-term and avoiding relapse, while ensuring compliance, should be reframed as a collaborative process between the patient and physician.

Impact of bedaquiline on treatment outcomes of multidrug-resistant tuberculosis in a high-burden country

2020 ◽  
pp. 2002544
Author(s):  
Dumitru Chesov ◽  
Jan Heyckendorf ◽  
Sofia Alexandru ◽  
Ana Donica ◽  
Elena Chesov ◽  
...  
Keyword(s):  
Propensity Score ◽  
Treatment Outcomes ◽  
Multidrug Resistant ◽  
High Burden ◽  
Republic Of Moldova ◽  
Treatment Regimens ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
The Republic

Evaluation of novel anti-tuberculosis (TB) medicines for the treatment of multidrug-resistant (MDR)-TB continues to be of high interest on the TB research agenda. We assessed treatment outcomes in patients with pulmonary MDR-TB who received bedaquiline containing treatment regimens in the Republic of Moldova, a high-burden country of MDR-TB.MethodWe systematically analysed the “SIMETB” national electronic TB database in the Republic of Moldova and performed a retrospective propensity score matched comparison of treatment outcomes in a cohort of patients with MDR-TB who started treatment during 2016–2018 with a bedaquiline-containing regimen (bedaquiline cohort) and a cohort of patients treated without bedaquiline (non-bedaquiline cohort).ResultsFollowing propensity score matching, 114 patients were assigned to each cohort of MDR-TB patients. Patients in the bedaquiline cohort had a higher 6 month sputum culture conversion rate than those in the non-bedaquiline cohort, (66.7% versus 40.3%, p<0.001). Patients under bedaquiline containing regimens had a higher cure rate assessed by both WHO and TBNET definitions (55.3% versus 24.6%, p=0.001 and 43.5% versus 19.6% p=0.004, correspondingly), as well, a lower mortality rate (8.8% versus 20.2%, p<0.001, by WHO and 10.9% versus 25.2%, p=0.01, by TBNET). In patients who previously failed on MDR-TB treatment, more than 40% of patients achieved cure with a bedaquiline-containing regimen.ConclusionsBedaquiline-based MDR-TB treatment regimens result in better disease resolution when compared to bedaquiline-sparing MDR-TB treatment regimens under programmatic conditions in a country with a high-burden of MDR-TB.

scholarly journals Do catastrophic costs impact treatment outcomes in people with rifampicin-resistant tuberculosis in the Republic of Moldova?

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Valeriu Plesca ◽  
Ana Ciobanu ◽  
Yuliia Sereda ◽  
Andrei Dadu
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Outcome Variable ◽  
Republic Of Moldova ◽  
Tb Treatment ◽  
The World ◽  
Mdr Tb ◽  
The Republic ◽  
Lost To Follow Up

The Republic of Moldova is among the 30 Rifampicin-Resistant and/or Multidrug-Resistant (RR/MDR) Tuberculosis (TB) high burden countries in the world. Despite free TB diagnostics and treatment, TB patients face substantial economic losses and this may impact overall treatment outcomes. We assessed if there is an association between TB-related catastrophic costs and TB treatment outcomes. We conducted a cohort study using data from patient records and a survey that quantified catastrophic costs among RR/MDR-TB affected households in the Republic of Moldova in 2016. We included adult patients (age ≥18 years) with RR/MDR-TB who had been in inpatient (intensive phase) or outpatient (continuous phase) treatment for at least 2 months. Unfavourable treatment outcome, such as failure, death or lost to follow-up, was the primary outcome variable. The definition of catastrophic TB-related costs followed the World Health Organisation (WHO) guidelines: costs due to TB ≥20% of annual household income. Log-binomial regression was used to assess association between the outcome and catastrophic TB-related costs adjusting for other socio-demographic, behavioural and clinical covariates.  In total 287 RR/MDR-TB patients (78% males, mean age 42 years) were included. Of them, 30% experienced catastrophic TB-related costs. Overall, one in five patients (21%) had unfavourable treatment outcome, such as treatment failure (5%), death (8%) or lost to follow-up (8%). The experience of catastrophic TB-related costs was not associated with unfavourable treatment outcome [adjusted relative risk (aRR)=0.88, 95% CI: 0.50–1.50]. Major factors independently associated with unfavourable TB treatment outcomes were poverty (aRR=2.07; 95% CI: 1.06-4.07), urban residence (aRR=1.99; 95% CI: 1.12-3.52) and positive HIV (Human Immunodeficiency Virus) status (aRR=2.61; 95% CI: 1.31-4.89). As a result, we failed to find an association between catastrophic costs and treatment outcomes of RR/MDR-TB patients in the Republic of Moldova. However, we found that patients from poor households and urban areas were twice more likely to achieve unfavourable TB treatment outcomes disregarding whether they experienced catastrophic costs or not. Also, TB/HIV patients and urban residents were identified as the most vulnerable groups with higher risk of unfavourable treatment outcome and TB-related costs.

Manual circumlaryngeal therapy for functionaldysphonia: An evaluation of short- and long-term treatment outcomes

1997 ◽  
Vol 11 (3) ◽  
pp. 321-331 ◽  
Author(s):  
Nelson Roy ◽  
Diane M. Bless ◽  
Dennis Heisey ◽  
Charles N. Ford
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Short And Long Term

scholarly journals The effect of two predictors’ interaction on short- and long-term treatment outcomes of schizophrenia

2013 ◽  
Vol 47 (5) ◽  
pp. 775-786
Author(s):  
Andrzej Cechnicki ◽  
Anna Bielańska ◽  
Artur Daren ◽  
Konrad Wroński ◽  
Aneta Kalisz ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Short And Long Term
Sign in / Sign up

Export Citation Format

Share Document