scholarly journals Real‐world effectiveness of anti‐resorptive treatment in patients with incident fragility fractures – The STORM cohort – A Swedish retrospective observational study

Author(s):  
Bo Freyschuss ◽  
Maria K Svensson ◽  
Thomas Cars ◽  
Lars Lindhagen ◽  
Helena Johansson ◽  
...  
2021 ◽  
Author(s):  
S Meheli ◽  
Chaitali Sinha ◽  
Madhura Kabada

BACKGROUND Digital health interventions can bridge barriers in access to treatment of care for individuals with chronic pain. OBJECTIVE This study aimed to evaluate the perceived needs, engagement and the effectiveness of the mental health app Wysa on mental health outcomes among real-world users who reported chronic pain and engaged with the app for support. METHODS Real-world data from users (N = 2,194) who reported chronic pain and associated health conditions in their conversations with a mental health app was analyzed using a mixed-method retrospective observational study. An inductive thematic analysis was used to analyse conversational data of users with chronic pain to assess perceived needs, along with comparative macro-analyses of conversational flows to capture engagement within the app. Additionally, the scores from a subset of users who completed a set of pre-post assessment questionnaires, namely PHQ-9 (N=69) and GAD-7 (N=57), were examined to evaluate the effectiveness of Wysa in providing support for mental health concerns for those managing chronic pain. RESULTS The themes emerging from the conversations of users with chronic pain included Health Concerns, Socioeconomic Concerns, and Pain Management Concerns. Findings from the quantitative analysis indicated that users with chronic pain showed significantly greater app engagement (p value <2.2e-16) than users without chronic pain, with a large effect size (Vargha and Delaney’s A- 0.76 -0.8). Furthermore, the sample of users with pre-post assessments during the study period were found to have significant improvements in group means on both PHQ-9 and GAD-7 symptom scores, with medium effect size (Cohens’d, 0.6-0.61), respectively. CONCLUSIONS The findings indicate that users look for tools that can help them address their concerns related to mental health, pain management, and sleep issues. The study findings also indicate the breadth of needs for users with chronic pain and the lack of support structures, and suggests that Wysa can provide effective support to bridge the gap.


PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0205924 ◽  
Author(s):  
Eric Gluck ◽  
H. Bryant Nguyen ◽  
Kishore Yalamanchili ◽  
Margaret McCusker ◽  
Jaya Madala ◽  
...  

2018 ◽  
Vol 7 (6) ◽  
pp. 129 ◽  
Author(s):  
Craig Reynolds ◽  
Elizabeth Masters ◽  
Jenny Black-Shinn ◽  
Marley Boyd ◽  
Jack Mardekian ◽  
...  

2021 ◽  
Vol 8 (1) ◽  
pp. e000782
Author(s):  
William Alexander Wright ◽  
Louise E Crowley ◽  
Dhruv Parekh ◽  
Anjali Crawshaw ◽  
Davinder P Dosanjh ◽  
...  

BackgroundPirfenidone and nintedanib are the only disease-modifying treatments available for idiopathic pulmonary fibrosis (IPF). Our aim was to test their effectiveness and safety in clinical practice.MethodsThis is a single-centre retrospective observational study undertaken at a specialised interstitial lung disease centre in England. Data including progression-free survival (PFS), mortality and drug tolerability were compared between patients with IPF on antifibrotic therapies and an untreated control group who had a forced vital capacity percentage (FVC %) predicted within the licensed antifibrotic treatment range.Results104 patients received antifibrotic therapies and 64 control patients were identified. PFS at 6 months was significantly greater in the antifibrotic group (75.0%) compared with the control group (56.3%) (p=0.012). PFS was not significant at 12 or 18 months when comparing the antifibrotic group with the control group. The 12-month post-treatment mean decline in FVC % predicted (−4.6±6.2%) was significantly less than the 12-month pretreatment decline (−10.4±11.8%) (p=0.039). The 12-month mortality rate was not significantly different between the antifibrotic group (25.3%) and the control group (35.5%) (p=0.132). Baseline Body Mass Index of≤25, baseline diffusion capacity for carbon monoxide percentage predicted of ≤35 and antifibrotic discontinuation within 3 months were independent predictors of 12-month mortality. Antifibrotic discontinuation was significantly higher by 3 and 6 months for patients on pirfenidone than those on nintedanib (p=0.006 and p=0.044, respectively). Discontinuation at 12 months was not significantly different (p=0.381).ConclusionsThis real-world study revealed that antifibrotics are having promising effects on PFS, lung function and mortality. These findings may favour commencement of nintedanib as first-line antifibrotic therapy, given the lower rates of early treatment discontinuation, although further studies are required to investigate this.


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