scholarly journals Using long-term predicted Quality of Life in ICU clinical practice to prepare patients for life post-ICU: A feasibility study

2022 ◽  
Vol 68 ◽  
pp. 121-128
Author(s):  
Nina Wubben ◽  
Marieke Zegers ◽  
Laurens L.A. Bisschops ◽  
Tim Frenzel ◽  
Johannes G. van der Hoeven ◽  
...  
2014 ◽  
Vol 16 (2) ◽  
pp. 185-195 ◽  

The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words "quality of life" and "schizophrenia" and in a cross-reference search for articles that were particularly relevant. A total of n=432 studies used 35 different standardized generic and specific QoL scales in patients with schizophrenia. Affective symptoms were major obstacles for QoL improvement in patients with schizophrenia. Though positive symptoms, negative symptoms, and cognitive functioning may be seen as largely independent parameters from subjective QoL, especially in cross-sectional trials, long-term studies confirmed a critical impact of early QoL improvement on long-term symptomatic and functional remission, as well as of early symptomatic response on long-term QoL. Results of the present review suggest that QoL is a valid and useful outcome criterion in patients with schizophrenia. As such, it should be consistently applied in clinical trials. Understanding the relationship between symptoms and functioning with QoL is important because interventions that focus on symptoms of psychosis or functioning alone may fail to improve subjective QoL to the same level. However, the lack of consensus on QoL scales hampers research on its predictive validity. Future research needs to find a consensus on the concept and measures of QoL and to test whether QoL predicts better outcomes with respect to remission and recovery under consideration of different treatment approaches in patients with schizophrenia.


2020 ◽  
pp. 44-56
Author(s):  
A. A. Markovich ◽  
M. V. Kalugin ◽  
O. О. Gordeeva ◽  
M. Zh. Yakoobova

Luminal metastatic HER2-negative breast cancer remains one of the most common cancers in oncological practice. This disease still remains incurable. Endocrine therapy remained the standard therapy of choice for disseminated patients for a long time. The search for new effective drugs, development of strategies that can overcome primary and secondary resistance to endocrinotherapy has shown that the CDK4/6-inhibitors group can improve not only the short-term treatment outcomes, but also affect the overall survival of patients, which has been demonstrated in a number of phase III studies. Along with that, the use of CDK4/6 inhibitors maintains a good quality of life, allows patients to maintain professional and social activities, which is of great importance for long-term prospects. Given that the endocrine therapy combined with CDK4/6-inhibitors today is the new standard of therapy in patients with luminal HER2- negative breast cancer, knowing how to use this therapy in daily clinical practice is crucial. Know and apply innovative drugs in clinical practice and the management of regimen toxicity always my work demands close application. This article provides an overview of the data on the efficacy of ribociclib based on phase III registration studies. It also presents its own clinical experience demonstrating the feasibility of using a new group of drugs in patients both in pre- and postmenopausal women. The authors discussed the issues related to the modification of the regimen due to the toxicity of therapy, in particular, neutropenia and hepatotoxicity. They also showed the possibility of managing adverse events with the preservation of a long-term effect with no loss in quality of life.


2021 ◽  
Author(s):  
◽  
Elizabeth Bolwell

<p>This exegesis presents findings which emerged from secondary review of clinical practice data collected during a music therapy placement. The setting for this research is a long-term residential care facility for people with a variety of physical and neurological conditions, including cerebral palsy, traumatic brain injury, stroke and multiple sclerosis, aged 18 to 65. The aim of the facility is to maximise the quality of life for people with physical disabilities and those with terminal illnesses. The research aim was to develop theory about how music therapy can provide support to people with long term neurological conditions. Thematic analysis was employed to develop core themes about the support that music therapy has provided. These findings are presented under the following six themes: building relationships, collaborative practices, fostering community, acknowledging diversity, emotional support and musical engagement. These themes all focus on relatedness, and the quality of life of individuals, groups and the community. They also indicate the value of a flexible community-centred approach for delivering music therapy. A vignette from clinical practice is included to illustrate important points made in the exegesis. The study complements other music therapy research situated within a health-care perspective and could offer particular significance for new music therapy practitioners looking to understand and work with people with neuro-disabilities in long term care facilities.</p>


2021 ◽  
Author(s):  
◽  
Elizabeth Bolwell

<p>This exegesis presents findings which emerged from secondary review of clinical practice data collected during a music therapy placement. The setting for this research is a long-term residential care facility for people with a variety of physical and neurological conditions, including cerebral palsy, traumatic brain injury, stroke and multiple sclerosis, aged 18 to 65. The aim of the facility is to maximise the quality of life for people with physical disabilities and those with terminal illnesses. The research aim was to develop theory about how music therapy can provide support to people with long term neurological conditions. Thematic analysis was employed to develop core themes about the support that music therapy has provided. These findings are presented under the following six themes: building relationships, collaborative practices, fostering community, acknowledging diversity, emotional support and musical engagement. These themes all focus on relatedness, and the quality of life of individuals, groups and the community. They also indicate the value of a flexible community-centred approach for delivering music therapy. A vignette from clinical practice is included to illustrate important points made in the exegesis. The study complements other music therapy research situated within a health-care perspective and could offer particular significance for new music therapy practitioners looking to understand and work with people with neuro-disabilities in long term care facilities.</p>


2009 ◽  
Vol 161 (suppl_1) ◽  
pp. S51-S64 ◽  
Author(s):  
Maria Koltowska-Häggström ◽  
Anders F Mattsson ◽  
Stephen M Shalet

Quality of life (QoL) has emerged as an important construct that has found numerous applications across healthcare-related fields, ranging from research and clinical evaluation of treatment effects to pharmacoeconomic evaluations and global healthcare policy. Impairment of QoL is one of the key clinical characteristics in adult GHD and has been extensively studied in the Pfizer International Metabolic Database (KIMS). We provide summarized evidence on GH treatment effects for both clinical and health economic applications based on the KIMS data. The primary focus is on those aspects of QoL research that cannot be investigated in the traditional clinical trial setting, such as specific patient subgroups, cross-country comparisons and long-term follow-up. First, the impact of age, gender, disease onset, primary aetiology, extent of hypopituitarism, previous radiotherapy and obesity on QoL before and during long-term GH replacement is discussed. Secondly, the studies on QoL in relation to country-specific normative values are reviewed. Finally, health economic data derived from KIMS including both burden of disease and utility assessment are evaluated. We conclude that the wide spectrum of analyses performed on the KIMS data allows for practical application of the results not only to research and clinical practice but also to health policy and global medical decision making.


2018 ◽  
pp. 54-58
Author(s):  
G. L. Ignatova ◽  
E. V. Blinova ◽  
O. L. Minakina

The article presents the results of comprehensive assessment of the efficacy of anti-IgE therapy in adult patients with severe IgE-mediated uncontrolled bronchial asthma in real clinical practice. Omalizumab added to the background anti-inflammatory therapy allowed to reduce the incidence of asthma exacerbations, achieve stable positive dynamics during severe asthma and associated allergic diseases, increase control of the disease, and improve the patients’ quality of life. The drug has a wellcharacterized long-term use safety profile.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S58-S59
Author(s):  
Stephanie Vel En Tial ◽  
Steve Curran ◽  
Adebayo Ikuyajesin

AimsThe current audit aims to assess the compliance with Prescribing Observatory for Mental Health (POMH-UK) guidance on monitoring of metabolic side effects of patients prescribed antipsychotics. Compliance was monitored to ensure that all patients prescribed continuing antipsychotics have their body mass index (BMI), blood pressure, blood glucose and lipids checked within the expected time limits of minimum once per year.BackgroundPatients diagnosed with Schizophrenia rank amongst the worst of chronic medical illnesses in terms of quality of life. This may in part be due to the use of long term antipsychotic medications, in particular the use of atypical antipsychotics which have been increasingly associated with metabolic side effects including hypertension, weight gain, glucose intolerance and dyslipidaemia. These side effects are related to the development of both diabetes mellitus and cardiovascular disease and can lead to increased mortality and morbidity, affecting compliance and engagement to healthcare services. Despite the availability of clinical guidelines, monitoring and screening of metabolic side effects in patients prescribed antipsychotics continues to be suboptimal.MethodThe audit involved a review of electronic records relating to physical health monitoring of patients at two acute inpatient units from January-March 2019. Demographic and clinical variables were collected which included ethnicity, diagnostic grouping as well as current medications. Data were collected on evidence of screening for hypertension, BMI, blood glucose and lipids. Descriptive statistics were applied to study the clinical features of the sample and examine whether performance met clinical practice standard.ResultThe audit overall demonstrated partial compliance with POMH-UK guidelines with a total of 31 patients admitted on long term antipsychotics. Of these patients, 86% were prescribed atypical antipsychotics with 14% prescribed typical antipsychotics. Screening only occurred in 68% of patients for lipid profile with only 71% for BMI and 74% for blood glucose. Blood pressure had the highest compliance rate of 87% of patients being screened.ConclusionEarly identification and monitoring of complications from metabolic syndrome may decrease the risk of more serious health outcomes and improve patients’ quality of life. However in clinical practice, standards are not always met in accordance with best practice recommendations. Requirement of a tailored guideline for physical health monitoring with weekly planned interventions as well as adequate training and awareness of healthcare staff is imperative to drive improvement and increase adherence rates.


Author(s):  
Nina Simmons-Mackie

Abstract Purpose: This article addresses several intervention approaches that aim to improve life for individuals with severe aphasia. Because severe aphasia significantly compromises language, often for the long term, recommended approaches focus on additional domains that affect quality of life. Treatments are discussed that involve increasing participation in personally relevant life situations, enhancing environmental support for communication and participation, and improving communicative confidence. Methods: Interventions that have been suggested in the aphasia literature as particularly appropriate for people with severe aphasia include training in total communication, training of communication partners, and activity specific training. Conclusion: Several intervention approaches can be implemented to enhance life with severe aphasia.


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