scholarly journals Efficacy and safety of bronchial thermoplasty in clinical practice: a prospective, longitudinal, cohort study using evidence from the UK Severe Asthma Registry

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026742 ◽  
Author(s):  
Julie Burn ◽  
Andrew J Sims ◽  
Hannah Patrick ◽  
Liam G Heaney ◽  
Robert M Niven
Keyword(s):  
Clinical Practice ◽  
Severe Asthma ◽  
Hospital Admissions ◽  
Efficacy And Safety ◽  
Longitudinal Cohort ◽  
Bronchial Thermoplasty ◽  
The Uk ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

ObjectivesUse data from the UK Severe Asthma Registry (UKSAR) to assess the efficacy and safety of bronchial thermoplasty (BT) in routine UK clinical practice and to identify characteristics of ‘responders’.DesignProspective, longitudinal, cohort, multicentre registry study.SettingAll (11) UK centres performing BT.Participants and interventionPatients receiving BT in the UK between 01/06/2011 and 30/09/2016 who had consented to data entry into UKSAR (n=133). Efficacy data were available for 86 patients with a BT baseline and at least one follow-up record. Safety data were available for 131 patients with at least one BT procedure record.Primary and secondary outcome measuresEfficacy: AQLQ, ACQ, EuroQol, HADS anxiety and HADS depression scores, FEV1(% predicted), rescue steroid courses, unscheduled healthcare visits (A&E/Asthma clinic/GP), hospital admissions and days lost from work/school. Safety: peri-procedural events, device problems and any other safety-related findings. Responder analysis: differences in baseline characteristics of ‘responders’ (≥0.5 increase in AQLQ at 12 months) and ‘non-responders’.ResultsFollowing Bonferroni correction for paired comparisons, mean improvement in AQLQ at 12 months follow-up compared with BT baseline was statistically and clinically significant (0.75, n=28, p=0.0003). Median reduction in hospital admissions/year after 24 months follow-up was also significant (−1.0, n=26, p<0.0001). No deterioration in FEV1was observed. From 28 patients with AQLQ data at BTBL and 12-month follow-up, there was some evidence that lower age may predict AQLQ improvement. 18.9% (70/370) of procedures and 44.5% (57/128) of patients were affected by an adverse event; only a minority were considered serious.ConclusionsImprovement in AQLQ is consistent with similar findings from clinical trials. Other efficacy outcomes demonstrated improving trends without reaching statistical significance. Missing follow-up data impacted this study but multiple imputation confirmed observed AQLQ improvement. The safety review suggested BT is being performed safely in the UK.

Actual practice of melanoma follow-up and treatment in Germany: results of a prospective, longitudinal cohort study

2015 ◽  
Vol 172 (6) ◽  
pp. 1646-1650 ◽  
Author(s):  
E. Livingstone ◽  
T.K. Eigentler ◽  
C. Windemuth-Kieselbach ◽  
A. Hauschild ◽  
R. Rompel ◽  
...  
Keyword(s):  
Cohort Study ◽  
Actual Practice ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

Trajectories of glycaemia following acute pancreatitis: a prospective longitudinal cohort study with 24 months follow-up

2020 ◽  
Vol 55 (8) ◽  
pp. 775-788 ◽  
Author(s):  
Sakina Huseni Bharmal ◽  
Jaelim Cho ◽  
Gisselle Charlott Alarcon Ramos ◽  
Juyeon Ko ◽  
Charlotte Elizabeth Stuart ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

Digital rehabilitation for acute ankle sprains: prospective longitudinal cohort study (Preprint)

2021 ◽  
Author(s):  
Fernando D. Correia ◽  
Maria Molinos ◽  
Carlos Neves ◽  
Dora Janela ◽  
Diana Carvalho ◽  
...  
Keyword(s):  
Cohort Study ◽  
Rehabilitation Program ◽  
Longitudinal Cohort Study ◽  
Long Term Results ◽  
Ankle Sprains ◽  
Patient Satisfaction Score ◽  
Longitudinal Cohort ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

BACKGROUND Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, and especially progressive exercise, has proven effective in improving function, while preventing recurrence. OBJECTIVE We aimed to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. METHODS Prospective, longitudinal cohort study of individuals referred for digital rehabilitation therapy for ankle sprain, and eligible for workers’ compensation. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure - activities of daily living (FAAM-ADL) and -sports (FAAM-Sports). Participants were assessed at baseline, end-of-program and 6-months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. RESULTS Ninety-three patients (89.4%) completed the program and seventy-nine were available for follow-up (76.0%). Changes in the primary outcomes between baseline and the 6-months follow-up were both statistically significant (P<.001) and clinically meaningful: mean difference of -2.72 points (95% CI -3-31 to -2.13) in NPRS (49.8% reduction), 21.7 points (95% CI 17.13 to 26.27) in FAAM-ADL (41.1% increase) and 37.8 points (95% CI 30.45 to 45.15) in FAAM-Sports (151.8% increase). Longer waiting periods between accident date and treatment initiation were found to negatively impact functional status at baseline and end-of-program, triggering extended program duration. Total training volume (12.5 h, sd=10.5) was similar to other interventions for ankle sprains, but dosage per week was much higher (2.4 h per week, sd=0.87). Mean patient satisfaction score was 8.8/10 (sd=1.57). Among program completers, 83.9% attained full recovery and were discharged with no residual disability. CONCLUSIONS Being far less demanding in terms of human resources, the digital program presented constitutes a viable, clinically effective and convenient solution for ankle sprains rehabilitation, particularly in pandemic times. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results, comparable to those published for face-to-face interventions. CLINICALTRIAL NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022

scholarly journals Long-term use of CPAP in patients with obstructive sleep apnea: a prospective longitudinal cohort study

2021 ◽  
Author(s):  
Margareta Møkleby ◽  
Britt Øverland
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Sleep Apnea ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Obstructive Sleep ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

AbstractContinuous positive airway pressure (CPAP) is an efficient treatment for obstructive sleep apnea (OSA). Reports of long-term usage vary, as do the factors that predict long-term usage. The aim of this study was to explore long-term CPAP usage and identify potential predictors. This prospective longitudinal cohort study included all patients referred to an outpatient clinic for CPAP treatment during an eight-month period. Clinical data were collected at baseline. Follow-ups were scheduled after one week, three months and two years. Use data were downloaded from the CPAP device at each follow-up. Of 163 included patients, 112 were available for long-term follow-up 2–4 years after starting CPAP, and use data were downloaded for 99 patients. Median duration of CPAP use was 6 h/night (IQR 4.2–7.1). The only significant variable predicting long-term usage was usage at three months. Nearly half (43%) of the patients needed extra consultations beyond the standard treatment plan. Most patients (69%) did not contact the clinic for their recommended two-year follow-up but were instead called into the clinic specifically for the study. There was no significant difference in long-term CPAP usage between patients who initiated contact themselves and those who were called in and would otherwise have been lost for follow-up. Most patients adhere well to CPAP in the long term, although many need extra follow-up. Patients lost for follow-up should not necessarily be considered non-adherent as their reason for not attending could be that they are managing treatment well on their own.

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