MO524CALCIMIMETIC ADHERENCE AND PREFERENCE IN THE MANAGEMENT OF SECONDARY HYPERPARATHYROIDISM IN EUROPE: A PILOT STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Karly Louie ◽  
Chidozie Nduka ◽  
Jo Taylor ◽  
Matthew Hall ◽  
Filippo Aucella ◽  
...  
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Lower Risk ◽  
Patient Adherence ◽  
Gi Symptoms ◽  
High Adherence ◽  
Patient Questionnaires ◽  
Dialysis Nurses ◽  
Patient Burden

Abstract Background and Aims Oral cinacalcet (CIN) and IV-administered etelcalcetide (ETEL) are calcimimetics available for the management of secondary hyperparathyroidism (SHPT) in hemodialysis (HD) patients. This pilot study assessed patient adherence to calcimimetic therapy and calcimimetic preference of nephrologists and nurses based on adapted questionnaires. Method A cross-sectional survey was conducted with HD patients currently using a calcimimetic, and nephrologists and dialysis nurses who prescribed/administered calcimimetic in 7 European countries (Belgium, France, Germany, Italy, Spain, Sweden and the United Kingdom). Patient questionnaires were adapted from the Medication Adherence Report Scale (MARS), the Beliefs about Medicines Questionnaire (BMQ-specific Necessity and Concern), and Treatment Intrusiveness Scale (TIS) to understand patterns of adherence and perceptions of medications; questions about gastrointestinal (GI) symptoms were included. Questionnaires for nephrologists and nurses were adapted from the Treatment Rating Scale (TRS), Health Professional Preference Scale (HPPS), and Prescribing Comparator Scale (PCS) to understand calcimimetic preference. Questionnaires were translated and administered in the local language. Results Sixty HD patients (33 CIN and 27 ETEL), 16 nephrologists and 18 dialysis nurses participated in the survey. ETEL patients were younger than CIN patients (mean age: 57 vs. 59 yrs). ETEL patients also had a lower pill burden (mean no. of pills: 6 vs. 11) and had numerically fewer hospitalizations in the last 6 months (mean no. of days: 1.5 vs 3.9) than CIN patients. Self-reported adherence to CIN was high (mean MARS: 4.7±0.7). ETEL and CIN patients did not perceive medications (excluding dialysis, diet and dietary restrictions) as interfering with their life (mean TIS: 1.5±0.5 vs. 1.6±1.6) and neither calcimimetic group had a specific belief in medicines in terms of necessity (mean BMQ CIN: 2.4±0.6 and ETEL: 2.3±0.4) or concerns about potential side-effects (mean BMQ CIN: 3.1±0.6 and ETEL: 3.5±0.7). ETEL patients were less likely than CIN patients to experience GI symptoms in the prior month: nausea (11% vs. 49%), vomiting (11% vs. 24%), and diarrhea (15% vs. 33%). Overall, the adapted patient questionnaires showed good internal consistency for MARS (Cronbach’s α=0.99) and BMQ-Necessity and BMQ-Concerns scales (CIN: α=0.74 and ETEL: α=0.81) but lower consistency for TIS (α=0.3 for both CIN and ETEL). Nephrologists and nurses had been practicing for a mean of 17 yrs. Nephrologists and nurses viewed ETEL to have more efficacy, lower risk of side effects, lower risk of non-adherence, lower burden for patients compared to CIN according to the TRS. According to HPPS, the top 3 treatment attributes for ETEL preference vs. CIN among nephrologists were encouraging patient adherence (93%; n=14/15), minimizing patient burden (87%; n=13/15) and having fewer side effects (80%; 12/15). Similar for nurses, encouraging patient adherence (88%; n=15/17) and minimizing patient burden (94%; n=16/17) were top attributes for ETEL preference as well as improving patient quality of life (82%; 14/17). Based on PCS, the majority of nephrologists agreed that compared to CIN, ETEL will ensure high adherence (100%), achieve better PTH control (93%; 14/15), reduce treatment burden for patients (87%; 13/15), improve patient’s quality of life (80%; 12/15), and improve effectiveness without increasing side-effects (80%; 12/15); they also agreed that ETEL created more work for nursing staff (80%; 12/15). Two thirds of nephrologists (n=10/15) agreed that ETEL would be more efficacious than CIN. Conclusion In this pilot study, CIN patients self-reported high adherence and both calcimimetic groups did not perceive medications to be concerning or intrusive. Nephrologists and nurses showed preference for ETEL than CIN. The questionnaires were validated and will be administered in a large study.

Treatment of Aggressive Behavior in Dementia With the Anticonvulsant Topiramate: A Retrospective Pilot Study

2003 ◽  
Vol 15 (3) ◽  
pp. 307-309 ◽  
Author(s):  
Benny Fhager ◽  
Inga-Maj Meiri ◽  
Magnus Sjögren ◽  
Åke Edman
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Aggressive Behavior ◽  
Extrapyramidal Side Effects ◽  
Treatment Resistant ◽  
Careful Treatment ◽  
And Training ◽  
Low Dosage

Aggressive behavior in dementia often has a severe impact on the quality of life of the patient and the caregivers, and is therefore important to handle. The strategy of treatment should be broad. Nonpharmacological interventions, including environmental adjustments and supporting and training the caregivers, should always be considered. Pharmacological treatment of aggressive behavior in patients with dementia often includes the use of neuroleptics. The atypical compounds clozapine, risperidone, and olanzapine have been shown to have an effect on aggressive behavior at low dosage with limited extrapyramidal side effects. The anticonvulsants carbamazepine and sodium valproate are further alternatives. In treatment-resistant cases, buspirone or lithium may be tried, although the effect of these substances on aggressive behavior in dementia has not been well established. In the end, however, a considerable degree of aggressive behavior sometimes remains after careful treatment trials, particularly in patients with severe aggressive behavior. In addition, treatment is sometimes limited by side effects.

Gastrointestinal symptoms of pelvic radiation disease (part 1): literature review

2020 ◽  
Vol 18 (2) ◽  
pp. 40-45 ◽  
Author(s):  
Helen Ludlow ◽  
John Green
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Literature Review ◽  
Patient Experience ◽  
Gastrointestinal Symptoms ◽  
Pelvic Radiation ◽  
Gi Symptoms ◽  
Pelvic Cancer ◽  
The Impact

Radiotherapy used to treat cancers in the pelvic region can have lasting side effects, and the persistence of these symptoms for 3 months or more is described as pelvic radiation disease (PRD). The growing number of pelvic cancer patients being diagnosed and successfully treated is increasing the incidence of PRD. This review examines the literature on the gastrointestinal symptoms of PRD. This includes how PRD is defined, how it is identified and how it relates specifically to the three pelvic cancers in which it most commonly manifests (prostate, gynaecological and colorectal). It pays particular attention to the impact of PRD on patient experience and quality of life. This review is the first part in a series on the GI symptoms of PRD.

scholarly journals Ozone therapy can be considered as an integrative therapy in oncology? [abstract]

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Paolo Tordiglione ◽  
Fabio Silvio Mario Araimo ◽  
Carmela Imperiale ◽  
S. Zancla
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
System Quality ◽  
Ozone Therapy ◽  
Integrative Therapy ◽  
Antioxidant Defence System

BACKGROUND: Our group in Policlinic Umberto I - University Hospital of Sapienza Rome - has decided to further investigate if Ozone therapy can be of support in oncology. In literature it has been reported that ozone applications in oncology or in cancer cells is associated with: high efficiency in preventing chemotherapy complications (nausea, vomiting, opportunistic infections, asthenia) as well as confining or restricting the expansion of tumours.(1-5) PURPOSE: The aim of our study in to evaluate and eventually confirm the validity of ozone treatments in order to consider such procedures as a possible and concrete support therapy for oncology patients undertaking chemotherapy. A statistical significance and clinical evaluation of our work would finally give a scientifically validation, still missing, to officially consider ozone therapy as one of the many possible integrative therapy in oncology. DESIGN: It is a pilot study designed and approved by the Ethical Committee of the University of Rome, La Sapienza (March 2017) to evaluate quality of life and reduction of side effects of adjuvant chemotherapy in 20 breast cancer patients. METHODS: The selected patients will be treated with systemic ozone treatment: Ozonated autohemotherapy will be performed according to the following method: 200 ml venous blood will be exposed an equal amount of O2 /O3 (200 ml) The ozone concentration will be gradually increased as follows: 20-30-40 mcrg/mL with a specific schedule until each patient will receive 15 applications overall. The sessions will be scheduled according to a specific timetable during the administration of adjuvant chemotherapy by means of Epirubicin and Cyclophsphamide (EC) every 3 weeks for 4 cycles followed by Paclitaxel for 12 consecutive weeks. Ozone therapy will not be applied on days of chemotherapy in order to avoid interaction between chemotherapeutics and ozonides. Biochemical blood analysis and stress oxidative blood test will be used as parameters for activity of antioxidant defence system. Quality of life will be evaluated with Fact G Test. It is the first study to have been evaluated and approved by an official university ethical committee and we will be glad to publish our result as soon as possible. On this behalf it would be great if any other centre could be interested in cooperating with us so to transform this pilot study into a multicentre study with larger numbers and therefore, with a greater impact on the international community. Our aim is to give cancer patients a better life quality in general and especially help them overcome all the side effects during the chemotherapy. This could open a new scenario in the alternative complementary treatments in oncology.

scholarly journals A Novel Digital Patient-Reported Outcome Platform for Head and Neck Oncology Patients–-A Pilot Study

2016 ◽  
Vol 9 ◽  
pp. CMENT.S40219 ◽  
Author(s):  
Maria K. Peltola ◽  
Joel S. Lehikoinen ◽  
Lauri T. Sippola ◽  
Kauko Saarilahti ◽  
Antti A. Mäkitie
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Head And Neck ◽  
Cancer Patients ◽  
Early Stage ◽  
Patient Reported Outcome ◽  
Patient Reported

Introduction The patient's role in toxicity reporting is increasingly acknowledged. There is also a need for developing modern communication methods between the patient and the medical personnel. Furthermore, the increasing number of head and neck cancer (HNC) patients is reflected in the volume of treatment follow-up visits, which remains a challenge for the health care. Electronic patient-reported outcome (ePRO) measures may provide a cost-efficient way to organize follow-up for cancer patients. Materials and Methods We tested a novel ePRO application called Kaiku®, which enables real-time, online collection of patient-reported outcomes, such as side effects caused by treatment and quality of life. We conducted a pilot study to assess the suitability of Kaiku® for HNC patients at the Department of Oncology, Helsinki University Hospital, Helsinki, Finland. Patients used Kaiku® during and one month after radiotherapy to report treatment-related side effects and quality of life. Two physicians and a nurse performed the practical electronic communication part of the study. Results Five of the nine patients agreed to participate in the study: three of them had local early-stage larynx cancer (T2N0, T1aN0, and T2N0) and the remaining two patients had early-stage base of tongue cancer (T2N0 and T1N2b). The degree of side effects reported by the patients via Kaiku® ranged from mild to life threatening. The number of outcome data points on patients' progress was significantly increased, which resulted in a better follow-up and improved communication between the patient and the care team. Conclusions Kaiku® seems to be a suitable tool to monitor side effects and quality of life during and after radiotherapy among HNC patients. Kaiku® and similar tools could be useful in organizing a cost-effective follow-up process for HNC patients. We recommend conducting a larger study to further assess the impact of an ePRO solution in routine clinical practice. • ePRO solutions may aid in the follow-up for cancer patients. • They seem suitable to monitor, for example, side effects and quality of life. • These systems ensure fast patient-driven reporting.

Quality of Life and Side Effects in Patients with Actinic Keratosis Treated With Ingenol Mebutate: A Pilot Study

2015 ◽  
Vol 106 (8) ◽  
pp. 644-650 ◽  
Author(s):  
E. Jubert-Esteve ◽  
L.J. del Pozo-Hernando ◽  
N. Izquierdo-Herce ◽  
A. Bauzá-Alonso ◽  
A. Martín-Santiago ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Actinic Keratosis ◽  
Ingenol Mebutate

Change‐oriented patient questionnaires ‐ testing a new method at three departments of ophthalmology

1997 ◽  
Vol 10 (7) ◽  
pp. 254-259 ◽  
Author(s):  
Ingemar Eckerlund ◽  
Bengt Jönsson ◽  
Magnus Tambour ◽  
Anders H. Westlund
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Quality Of Health Care ◽  
Survey Methods ◽  
Patient Perspectives ◽  
New Method ◽  
Validity And Reliability ◽  
Patient Questionnaires

The use of patient questionnaires has increased widely in recent years. Their purpose, to incorporate patient perspectives into the orientation and design of health care, is, of course, commendable. However, the survey methods themselves have been less adequate, both in terms of validity and reliability, and with respect to the potential for using the results to improve the quality of health care. Presents a pilot study at three departments of ophthalmology in Sweden, involving a new method which meets reasonable demands for validity and reliability, and is explicitly change‐oriented.

Quality of Life and Side Effects in Patients with Actinic Keratosis Treated With Ingenol Mebutate: A Pilot Study

2015 ◽  
Vol 106 (8) ◽  
pp. 644-650 ◽  
Author(s):  
E. Jubert-Esteve ◽  
L.J. del Pozo-Hernando ◽  
N. Izquierdo-Herce ◽  
A. Bauzá-Alonso ◽  
A. Martín-Santiago ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Actinic Keratosis ◽  
Ingenol Mebutate

“Was it worth it?” A pilot study of advanced cancer patients’ retrospective perceptions of benefit from phase I trial participation

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19670-19670
Author(s):  
J. Y. Bruce ◽  
F. J. Hlubocky ◽  
C. K. Daugherty
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Phase I ◽  
Phase I Trial ◽  
Therapeutic Benefit ◽  
Trial Participation ◽  
Close Monitoring ◽  
Retrospective Perceptions

19670 Background: Subjects who enroll in phase I cancer trials generally are those with advanced and terminal disease. Although all such patients (pts) undergo an informed consent process, there is evidence that these pts may not appreciate the primary aims of a phase I trial and have unrealistic expectations of therapeutic benefit. However, these perceptions of benefit have not been described in pts after trial enrollment. Methods: As a pilot study, pts previously enrolled on Phase I trials were interviewed regarding their retrospective perceptions of benefit. A total of 9 pts have been interviewed to date: median age: 72 yr (range: 59–82 yr); 55% male; 77% Caucasian. The interview included open-ended questions assessing patient experiences with the trial, including reasons for enrollment, impressions of quality of life, costs incurred, and other benefits. Pts’ qualitative responses were recorded and analyzed for content and themes. Results: Reasons for enrollment included hope, prior treatment failure, altruism, and family influence. Described perceptions of anticipated benefit included stabilization of disease and close monitoring of their disease. Unexpected costs involved time spent during clinic visits, financial costs, time taken off work by family members, time spent away from family, and additional trial procedures. Issues of quality of life revolved around side effects from the investigational agent. Many interviewed pts (44%) described improved quality of life off the trial as compared to during trial participation. The majority of interviewed pts (67%) believed that the trial had no effect on their survival. Conclusions: Our data suggest that pts’ perceptions of therapeutic benefit after trial enrollment may be different from pre-enrollment expectations. There would also appear to be potentially significant and otherwise undescribed out-of-pocket expenses incurred by subjects as a result of phase I enrollment. Further research is needed to examine how side effects, unexpected costs, and lack of improved survival contribute to these pts’ perceptions of trial benefit. No significant financial relationships to disclose.

Increasing on-treatment visit compliance for radiation therapy cancer patients.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 175-175
Author(s):  
Voichita Bar-Ad ◽  
Kathleen W. Wilson ◽  
Susan Munro ◽  
Amy Harrison ◽  
Harriet Eldredge ◽  
...  
Keyword(s):  
Side Effects ◽  
Radiation Oncology ◽  
Performance Metrics ◽  
Action Plan ◽  
Clinical Work ◽  
Electronic Data Collection ◽  
Staff Members ◽  
Number Of Patients ◽  
Patient Questionnaires

175 Background: Weekly on-treatment-visits (OTVs) represent standard care in radiation oncology and have significant impact on the quality of patient care. Ensuring that OTVs are completed might decrease the severity of acute treatment-related side effects by facilitating timely treatment of symptoms. This study evaluates factors contributing to missed OTVs and formulates a plan to mitigate this problem. Methods: A multidisciplinary team of radiation oncology staff members reviewed clinical work flow data to determine the number of patients missing their weekly OTVs. These numbers generated benchmarks for the QIP. The team used 30 patient questionnaires and 291 electronic medical records to identify the causative factors for missing the OTVs. After analyzing these results the team generated an action plan for multiple interventions and future audit protocols. Results: On average, 5% of patients miss their weekly OTVs during radiotherapy course. The identified reasons which affected patient compliance with OTVs include: patient inconvenience waiting for the MD, parking concerns, difficulty navigating the clinic to find the exam room, failure of therapist to send the patient for OTVs, changes in MD’s schedule, lack of patient awareness about expected treatment related side effects and importance of immediate treatment of their symptoms. We developed a multidisciplinary plan to minimize patients missing OTVs which includes electronic medical record alerts, communication cues, physical triggers and improved patient education. Additionally, electronic data collection has been implemented for OTV performance metrics and auditing. Conclusions: Patients missing their weekly OTVs during radiotherapy course might be at risk for more severe treatment-related side effects. The details of this multidisciplinary QIP implementation and its impact on quality of care will be presented at the meeting.

Oral chemotherapy follow up on a Brazilian private health care unit.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18311-e18311
Author(s):  
Mauro Zukin ◽  
Marcos Coelho Simões Travassos Soares ◽  
Nathalia Fonseca Gamboa ◽  
Fabiano Hosken Pombo ◽  
Lucyana Carvalho
Keyword(s):  
Side Effects ◽  
Private Health Care ◽  
Adherence Behavior ◽  
Adverse Side Effects ◽  
High Adherence ◽  
Health Care Unit ◽  
Adherence Scale ◽  
Dispensing Errors

e18311 Background: Oral antineoplastic therapy is a growing reality, and ensures greater comfort and better quality of life for patients. However, this modality of treatment requires greater attention of the professionals to avoid dispensing errors and to guarantee adherence to the treatment. The goal of this study is to present a method to follow up cancer patients to reduce percentage of problems related to medication and improve oral antineoplastic adherence. Methods: The study was conducted at a private oncology clinic in Rio de Janeiro during the year 2018. In the first dispensation, patients received verbal and written pharmaceutical advice on posology, proper storage, safe handling requirements and strategies to avoid adverse side effects and food and drugs interactions. There were also given nutrition, sexuality, rights and duties guidelines. To improve adherence and to avoid forgetfulness or duplicity of dosing, patients received a medication calendar. Pharmacist made dispensing, managed adverse side effects and assessed adherence of patient using a model based on Morisky Medication Adherence Scale. Patients that answered "yes" to any questions were considered non-adherents. All information was registered in medical record. Non-compliances were considered: wrong medicine, incorrect dose and delays of any administrative reason. Results: In 2018, on average 1487 dispensings were made and 1053 patients’ adherence behavior were measured. 94.37% were considered adherent. Monthly percentage of non-compliance was 1.5% of dispensings. Conclusions: The present study demonstrates that with education and pharmaceutical follow-up since the first dispensation, it is possible to guarantee a safer and more effective treatment for patients using oral cancer medication. It is imperative to maintain the objective of developing better techniques for dispensing, guiding and guaranteeing high adherence.

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