ASSESSING THE IMPACT OF A CONSENSUS CONFERENCE ON LONG-TERM THERAPY FOR 
SCHIZOPHRENIA

Objective: Our aim was to assess the impact of six recommendations regarding drug prescription on the clinical practices of French psychiatrists. The recommendations were part of the conclusions of a consensus conference entitled “Long-term therapy of schizophrenia” (Paris, January 1994).Methods: The impact of the conference was assessed on the basis of awareness of the existence of the conference, knowledge of its conclusions, and actual changes in clinical practice. We performed: a) a survey of a representative sample of 396 psychiatrists 2 years after the conference; and b) an analysis of changes in drug prescriptions in a cohort of 2,407 patients with schizophrenia under treatment at the time of the conference.Results: Overall, 78% of interviewed psychiatrists were aware of the existence of the conference and 70% of its conclusions. Declared prescription practices conformed with conference conclusions about 60% (10%–95%) of the time. No difference in practices was noted between psychiatrists who were aware of the recommendations and those who were not. Single neuroleptic prescriptions increased in the cohort study in line with the main conference recommendation. The increase was small, but significant from 51.1% to 56.4%, and mainly concerned patients recently put on treatment. Contrary to recommendations, prescriptions of anticholinergics plus neuroleptics inexplicably rose from 48.2% to 54.3%.Conclusion: Small changes in prescription habits occurred in the wake of the consensus conference, but we cannot really ascribe them to a direct impact of the conference. Despite the great pains we took in disseminating the conclusions of the conference as widely as possible, it is clear that a more forceful action plan (e.g., including continuous medical education) is required.

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What is the impact of methotrexate on liver in patients with juvenile idiopathic arthritis? Results of liver SWE performed in a single centre

Modern Rheumatology ◽

10.1093/mr/roab064 ◽

2021 ◽

Author(s):

Vildan Güngörer ◽

Mehmet Öztürk ◽

Mustafa Yasir Özlü ◽

Şükrü Arslan

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Shear Wave Elastography ◽

Term Therapy ◽

Control Group ◽

Significant Difference ◽

Group 2 ◽

Long Term Therapy ◽

And Control ◽

The Impact

ABSTRACT Objectives Long-term therapy with low-dose methotrexate (MTX) is widely used in treatment of rheumatic diseases, in children. The purpose of this study was to evaluate liver elasticity in patients with juvenile idiopathic arthritis (JIA) who received MTX and compare the results with control group. Methods Liver elasticity was evaluated with shear wave elastography (SWE) technique in 25 patients aged 3–17 years who were followed up with JIA and received MTX and compared with 25 healthy controls of the same age and weight. Factors that had an effect on liver elasticity were examined. Results The mean SWE value of patients was 2.64 ± 2.13 m/s and 24.10 ± 18.50 kPa, whereas 1.83 ± 0.16 m/s and 10.09 ± 1.83 kPa in control group. There was a significant difference in liver elasticity in the patient and control groups. When the patients were evaluated as Group 1 (< 1000 mg) and Group 2 (≥ 1000 mg) according to the cumulative MTX dose, no significant difference was obtained. There was positive correlation between liver elasticity and weekly MTX dose and age. Conclusions Our study revealed that liver elasticity significantly decreased in patients who received MTX when compared with the control group. The elastography technique will be understood better over time and used safely in many areas.

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Central, peripheral, and renal hemodynamics in patients with hypertensive disease during long-term monotherapy with enalapril alone and in combination with hydrochlorothiazide (according to the data of RU-003 study)

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2004-10-1-19-22 ◽

2004 ◽

Vol 10 (1) ◽

pp. 19-22

Author(s):

A. O. Konradi ◽

R. Kh. Afaunov ◽

O. V. Mamontov ◽

A. A. Pushkarev ◽

A. N. Krutikov ◽

...

Keyword(s):

Time Course ◽

Combined Therapy ◽

Blood Flow Rate ◽

Renal Hemodynamics ◽

Term Therapy ◽

Hypertensive Disease ◽

The Status ◽

Long Term Therapy ◽

The Impact

The study was undertaken to examine the impact of long-term therapy with enapril alone and in its fixed combination with hydrochlorothiazide (renitec/co-renitec, MSD) on the time course of changes in central, peripheral, and renal hemodynamic parameters and on the status of cardiopulmonary reflex in patients with hypertensive disease. The study included 35 patients with Stages I-II arterial hypertension. Therapy with renitec/co-renitec was performed for 6 months, starting with its dose of 10 mg, followed by titration up to 40 mg and switching to a combined therapy. A decrease in blood pressure in the groups of patients receiving therapy with enalapril alone and in combination with hydrochlorothiazide was found to be associa ted mainly with diminished peripheral vascular resistance, which was followed by a higher volume blood flow rate in the forearm-and a better sensitivity of the cardiopulmonary baroreflex. Moreover, long-term use of enalapril both alone and in combination with thiazide diuretic was attended by improved renal hemodynamics.

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THE IMPACT OF LONG-TERM THERAPY BY A MULTIDISCIPLINARY TEAM ON THE EDUCATION, OCCUPATION AND MARITAL STATUS OF GROWTH HORMONE DEFICIENT PATIENTS AFTER TERMINATION OF THERAPY

Clinical Endocrinology ◽

10.1111/j.1365-2265.1987.tb01144.x ◽

1987 ◽

Vol 27 (2) ◽

pp. 191-196 ◽

Cited By ~ 27

Author(s):

A. GALATZER ◽

O. ARAN ◽

N. BEIT-HALACHMI ◽

E. NOFAR ◽

J. RUBITCHEK ◽

...

Keyword(s):

Growth Hormone ◽

Marital Status ◽

Multidisciplinary Team ◽

Term Therapy ◽

Long Term Therapy ◽

The Impact

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Anticholinergic use in children: Persistence and patterns of therapy

Canadian Urological Association Journal ◽

10.5489/cuaj.3527 ◽

2016 ◽

Vol 10 (3-4) ◽

pp. 137 ◽

Cited By ~ 9

Author(s):

Anne-Sophie Blais ◽

Michelle Bergeron ◽

Geneviève Nadeau ◽

Sophie Ramsay ◽

Stéphane Bolduc

Keyword(s):

Drug Prescription ◽

Median Number ◽

Term Therapy ◽

Public And Private ◽

First Line Therapy ◽

Discontinuation Of Treatment ◽

Persistence Rates ◽

Long Term Therapy ◽

Antimuscarinic Therapy

Introduction: Overactive bladder (OAB) symptoms are complex and generally require long-term therapy. Nevertheless, it has been demonstrated that persistence rates of antimuscarinic drug use are low in adults. Better understanding of the treatment patterns of children treated with antimuscarinics could help to improve drug management. Our objective was to evaluate persistence rates of patients under 20 years of age on antimuscarinic therapy over a four-year period.Methods: Patients having received a first-ever antimuscarinic drug prescription between April 2007 and March 2008 were identified using IMS Brogan’s Public and Private Drug Plans database. Canadian drug claims data from Private Drug Plans, Régie de l’Assurance Maladie du Québec, and Ontario Public Drug Plans were analyzed retrospectively. Patients were followed for four years to assess the prescribed drugs, the lines of treatment, and the duration of each treatment.Results: Data were available for 374 patients. The most prescribed drug as a first-line therapy was oxybutynin (87.2%), followed by tolterodine LA (5.9%). Patients refilled their index prescriptions for an average of 429 days. Solifenacin had the highest mean duration of index therapy (765 days). The median number of antimuscarinics prescribed was one. At the end of the followup, 44 patients were still on therapy. Reasons for discontinuation of treatment were not available.Conclusions: Overall discontinuation rate of antimuscarinic therapy in children is comparable to what has been reported in adult patients with OAB. However, children seem to persist on the medication for a longer duration before adherence rates start declining. The low rate of persistence highlights the need to identify the reasons for discontinuation of therapy in children in order to obtain better persistence rates.

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The role of diuretics in the treatment of hypertension: a focus on chlorthalidone (lecture)

HYPERTENSION ◽

10.22141/2224-1485.14.2.2021.231853 ◽

2021 ◽

Vol 14 (2) ◽

pp. 12-29

Author(s):

Yu.M. Sirenko

Keyword(s):

Cardiovascular Complications ◽

Term Therapy ◽

Thiazide Diuretics ◽

Cerebrovascular Complications ◽

Hypertension Therapy ◽

Long Term Therapy ◽

The Impact ◽

Therapy Of Hypertension

The lecture discusses the role of thiazide and thiazide-like diuretics, in particular chlorthalidone, in the modern treatment of arterial hypertension. The modern concepts about the mechanism of action of thiazide diuretics and chlorthalidone are presented. Differences in the degree of antihypertensive effect of hydrochlorothiazide and chlorthalidone are discussed. The results of large randomized trials SHEP, MRFIT, ALLHAT were analyzed, in which chlorthalidone therapy significantly reduced the risk of developing cardiovascular and cerebrovascular complications of hypertension. The effect of thiazide diuretics on glucose metabolism and the impact of carbohydrate metabolism disorders during treatment with chlorthalidone on the risk of cardiovascular complications was considered. The lecture also discusses the effect of chlorthalidone therapy on kidney function, the possibility of its use in chronic kidney disease. The data are presented on the prevention of resistant hypertension and chro-nic heart failure during long-term therapy of hypertension with chlorthalidone. The frequency and terms of the development of side effects of hypertension therapy with thiazide-like diuretics were also analyzed.

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Efficacy of Crisis Intervention

Crisis ◽

10.1027//0227-5910.20.2.78 ◽

1999 ◽

Vol 20 (2) ◽

pp. 78-85 ◽

Cited By ~ 6

Author(s):

Thomas Reisch ◽

Petra Schlatter ◽

Wolfgang Tschacher

Keyword(s):

Crisis Intervention ◽

Intervention Program ◽

Suicide Ideation ◽

Indirect Evidence ◽

Well Being ◽

Term Therapy ◽

Contributing Factors ◽

Step Therapy ◽

Long Term Therapy ◽

The Impact

This study assesses the efficacy of the treatment approach implemented in the Bern Crisis Intervention Program, where particular emphasis is placed on the remediation of suicide ideation and suicidal behavior, and depression, fear, and phobia are generally considered to be contributing factors. Four questionnaires addressing psychopathology, emotional well-being, social anxiety, and personality were administered prior to and after the treatment of 51 patients over a period of 2 to 3 weeks. The reduction of symptoms contributing to suicidal ideation and behavior was interpreted as indirect evidence of an antisuicidal effect of the program. Significant improvements were found in the psychopathology ratings, with depression and anxiety showing the largest reductions. The impact on personality and social phobia, however, was only moderate, and on average patients still exhibited symptoms after attending the program. This residual symptomatology points to the necessity of introducing a two-step therapy approach of intensive intervention targeted at the precipitating causes of the crisis, augmented by long-term therapy to treat underlying problems.

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Antithrombotic Therapy for DVT/PE

Hämostaseologie ◽

10.1055/s-0038-1659983 ◽

1997 ◽

Vol 17 (03) ◽

pp. 161-162

Author(s):

Thomas Hyers

Keyword(s):

Molecular Weight ◽

Low Molecular Weight Heparin ◽

Oral Anticoagulants ◽

Cost Effective ◽

Therapeutic Agents ◽

Great Promise ◽

Term Therapy ◽

Low Molecular Weight ◽

Long Term Therapy

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.

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