Effects of Early Initiation of Solid Versus Liquid Diet after Endoscopic Submucosal Dissection on Quality of Life and Postoperative Outcomes: A Prospective Pilot Randomized Controlled Trial

Background: Although homebound older adults are among the highest users of hospital services, the existing health and social services that are provided to them in the community are limited and fragmented. This study attempts to bring this group of older adults to providers’ attention by designing a health-social-oriented self-care mobile Health (mHealth) program and subjecting it to empirical testing. The aim of this study is to shift the current reactive, cure-oriented approach to a preventive and health-promoting model, empowering homebound older adults to take an active role in their health, be responsive to their care needs, and subsequently improve their holistic health. Methods: This is a pilot randomized controlled trial. The study is supported by 5 community centers with an estimated sample size of 68 subjects. The subjects will be randomly assigned to video-based mHealth or control groups when they (1) are aged 60 or over, (2) go outdoors less than once a week in the current 6 months, (3) live within the service areas, and (4) use a smartphone. Subjects in the video-based mHealth group will receive a 3-month program comprising 2 main interventions: nurse case management supported by a social service team and video messages covering self-care topics, delivered via smartphone. The control group will receive usual care. Data will be collected at 2 time points – pre-intervention (T1) and post-intervention (T2). The primary outcome will be self-efficacy, and secondary outcomes will include health outcomes (activities of daily living, instrumental activities of daily living, and medication adherence), perceived well-being outcomes (quality of life and depression), and health service utilization outcomes (outpatient clinic, emergency room, and hospital admission). Discussion: The current study will add to the knowledge gap in using mHealth supported by a health-social team to enhance quality of life and self-care and meet the needs of these particularly vulnerable older adults.

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A Web-Based Telemanagement System for Improving Disease Activity and Quality of Life in Patients With Complex Inflammatory Bowel Disease: Pilot Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/11602 ◽

2018 ◽

Vol 20 (11) ◽

pp. e11602 ◽

Cited By ~ 15

Author(s):

Javier Del Hoyo ◽

Pilar Nos ◽

Raquel Faubel ◽

Diana Muñoz ◽

David Domínguez ◽

...

Keyword(s):

Quality Of Life ◽

Inflammatory Bowel Disease ◽

Randomized Controlled Trial ◽

Bowel Disease ◽

Controlled Trial ◽

Web Based ◽

Randomized Controlled ◽

Inflammatory Bowel ◽

Pilot Randomized Controlled Trial

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Can sedation using a combination of propofol and dexmedetomidine enhance the satisfaction of the endoscopist in endoscopic submucosal dissection?

Endoscopy International Open ◽

10.1055/s-0043-122228 ◽

2018 ◽

Vol 06 (01) ◽

pp. E3-E10 ◽

Cited By ~ 1

Author(s):

Takashi Nonaka ◽

Masahiko Inamori ◽

Tetsuya Miyashita ◽

Yumi Inoh ◽

Kenji Kanoshima ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Endoscopic Submucosal Dissection ◽

Analogue Scale ◽

Controlled Trial ◽

Combination Group ◽

Randomized Controlled ◽

Sedation Protocol ◽

Submucosal Dissection ◽

Group 2 ◽

Pilot Randomized Controlled Trial

Abstract Background and study aims The aim of this pilot randomized controlled trial was to evaluate and compare the satisfaction of the endoscopist along with the effectiveness and safety of sedation between sedation protocol using a combination of propofol (PF) and dexmedetomidine (DEX) (Combination group) and sedation protocol using PF alone (PF group) during gastric endoscopic submucosal dissection (ESD). Patients and methods Fifty-eight patients with gastric neoplasias scheduled for gastric ESD were enrolled and randomly assigned to the two groups. The satisfaction scores of the endoscopists and the parameters for the effectiveness and safety of sedation were evaluated by comparisons between the two groups. Results The satisfaction scores of the endoscopists, which were measured using a visual analogue scale, were significantly higher in the Combination group than in the PF group (88 vs. 69, P = 0.003). The maintenance dose of PF was lower in the Combination group than in the PF group (2 mg/kg/h vs. 5 mg/kg/h, P < 0.001), and the number of rescue PF injections was fewer in the Combination group than in the PF group (2 times vs. 6 times, P < 0.001). The incidence of bradycardia (defined as a pulse rate ≤ 45 bpm) in the Combination group was higher than that in the PF group (37.9 % vs. 10.3 %, P = 0.029). Conclusions This study suggests that gastroenterologist-directed sedation using a combination of PF and DEX during gastric ESD can enhance the satisfaction levels of endoscopists by providing stable sedation with an acceptable safety profile.

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