Uncontrolled allergic rhinitis during treatment and its impact on quality of life: A cluster randomized trial

2010 ◽  
Vol 126 (3) ◽  
pp. 666-668.e5 ◽  
Author(s):  
Philippe J. Bousquet ◽  
Claus Bachert ◽  
Giorgo W. Canonica ◽  
Thomas B. Casale ◽  
Joaquim Mullol ◽  
...  





JMIR Diabetes ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. e18 ◽  
Author(s):  
Shashivadan P Hirani ◽  
Lorna Rixon ◽  
Martin Cartwright ◽  
Michelle Beynon ◽  
Stanton P Newman ◽  
...  


2020 ◽  
Vol 37 (6) ◽  
pp. 731-737
Author(s):  
Matteo Balestrieri ◽  
Davide Sisti ◽  
Marco Rocchi ◽  
Paola Rucci ◽  
Gregory Simon ◽  
...  

Abstract Background Computerized Clinical Decision Support Systems (CCDSS) are information technology tools, designed to improve clinical decision-making. Telemedicine is a health care service delivery using videoconferencing, telephone or messaging technologies. Objectives Our project aimed at testing the effectiveness of a composite CCDSS and telemedicine approach designed to treat depression in primary care. Methods This cluster randomized trial involved four GP clinics located in Northern Italy. Two clinics were assigned to the experimental protocol, and two served as controls. The study compared the telemedicine group (TG), in which GPs had access to a CCDSS platform, with the control group (CG) in which GPs provided treatment as usual (TAU). Patients scoring ≥11 on Patient Heath Questionnaire and ≥26 on the Inventory of Depressive Symptomatology-Self-Report were eligible for participation. Patients were also administered the World Health Organization Quality of Life-BREF to assess quality of life and Medical Interview Satisfaction Scale 21 to assess satisfaction with the medical interview. Results Overall, 2810 patients were screened and 66 in the experimental group and 32 in the CG passed the screening stages and met inclusion criteria. The percentage of remitters at 6 months was significantly higher in the TG than in the CG group (24.1% versus 3.1%, χ 2 = 6.6, P = 0.01). This difference remained significant after adjusting for baseline confounders. Physical and psychological quality of life improved significantly from baseline in both groups. Patients reported, on average, good satisfaction with the medical interview. Conclusions Our study showed that a combined CCDSS and telemedicine approach may be more effective than the TAU offered by GPs to patients with depression. Trial registration The trial was registered on https://clinicaltrials.gov/ on 5 October 2012 with identifier: NCT01701791. The first participant was enrolled on 5 May 2014 and the study was completed on May 2016.



2001 ◽  
Vol 19 (18) ◽  
pp. 3884-3894 ◽  
Author(s):  
Marit S. Jordhøy ◽  
Peter Fayers ◽  
Jon Håvard Loge ◽  
Marianne Ahlner-Elmqvist ◽  
Stein Kaasa

PURPOSE: To assess the impact of comprehensive palliative care on patients’ quality of life. The intervention was based on cooperation between a palliative medicine unit and the community service and was compared with conventional care. PATIENTS AND METHODS: A cluster randomized trial was carried out, with community health care districts defined as the clusters. Patients from these districts who had malignant disease and survival expectancy between 2 to 9 months were entered onto the trial. The main quality-of-life end points were physical and emotional functioning, pain, and psychologic distress assessed monthly by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) questionnaire and Impact of Event scale (IES). In total, 235 intervention patients and 199 controls were included. RESULTS: During the initial 4 months of follow-up, the compliance was good (72%) and comparable among treatment groups. No significant differences on any of the quality-of-life scores were found. At later assessments and for scores that were made within 3 months before death, there was also no consistent tendency in favor of any treatment group on the main outcomes or other EORTC QLQ-C30 scales/items. CONCLUSION: A general program of palliative care may be important to ensure flexibility and to meet the needs of terminally ill patients. However, to achieve improvements on a group level of the various dimensions of quality of life, specific interventions directed toward specific symptoms or problems may have to be defined, evaluated, and included in the program.



2019 ◽  
Vol 27 (4) ◽  
pp. 187-196
Author(s):  
So Yeon Joyce Kong ◽  
Kyoung Jun Song ◽  
Sang Do Shin ◽  
Young Sun Ro ◽  
Helge Myklebust ◽  
...  

Background: The evidence supporting delivery of quality cardiopulmonary resuscitation is growing and significant attention has been focused on improving bystander cardiopulmonary resuscitation education for laypeople. The aim of this randomized trial was to assess the effectiveness of instructor’s real-time objective feedback during cardiopulmonary resuscitation training compared to conventional feedback in terms of trainee’s cardiopulmonary resuscitation quality. Methods: We performed a cluster-randomized trial of community cardiopulmonary resuscitation training classes at Nowon District Health Community Center in Seoul. Cardiopulmonary resuscitation training classes were randomized into either intervention (instructor’s objective real-time feedback based on the QCPR Classroom device) or control (conventional, instructor’s judgment-based feedback) group. The primary outcome was total cardiopulmonary resuscitation score, which is an overall measure of chest compression quality. Secondary outcomes were individual cardiopulmonary resuscitation performance parameters, including compression rate, depth, and release. Generalized linear mixed models were used to analyze the outcome data, accounting for both random and fixed effects. Results: A total of 149 training sessions (2613 trainees) were randomized into 70 intervention (1262 trainees) and 79 control (1351 trainees) groups. Trainees in the QCPR feedback group significantly increased overall cardiopulmonary resuscitation score performance compared with those in the conventional feedback group (model-based mean Δ increment from baseline to session 5: 11.2 (95% confidence interval 9.2–13.2) and 8.0 (6.0–9.9), respectively; p = 0.02). Individual parameters of compression depth and release also showed higher improvement among trainees in QCPR group with positive trends (p < 0.08 for both). Conclusion: This randomized trial suggests beneficial effect of instructor’s real-time objective feedback on the quality of layperson’s cardiopulmonary resuscitation performance.



2017 ◽  
Vol 75 (3) ◽  
pp. 280-289 ◽  
Author(s):  
Hendramoorthy Maheswaran ◽  
Stavros Petrou ◽  
Peter MacPherson ◽  
Felistas Kumwenda ◽  
David G. Lalloo ◽  
...  


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