scholarly journals Breathing exercises for asthma

Breathe ◽  
2014 ◽  
Vol 10 (4) ◽  
pp. 312-322 ◽  
Author(s):  
Mike Thomas ◽  
Anne Bruton
Keyword(s):  
Quality Of Life ◽  
Real Life ◽  
Psychological State ◽  
Current Evidence ◽  
List Type ◽  
Breathing Control ◽  
Breathing Exercises ◽  
Breathing Training ◽  
Patient Reported

Educational aimsTo summarise the evidence of the role of breathing control approaches in the management of asthmaTo provide information on the content of evidence-based breathing exercises programmesSummaryAsthma is a complex, multi-dimensional condition that affects patients in many ways. Having asthma is inherently stressful and psychological problems are common and associated with poor asthma outcomes. Although most patients in clinical trials can achieve high levels of control with optimised pharmacotherapy, in “real-life” practice, poor control is common, with over-reliance on rescue bronchodilator medication and ongoing symptoms and quality-of-life impairment. Many patients are interested in non-pharmacological treatments to improve asthma control, particularly breathing control exercises but, until recently, the evidence base has been inadequate. The place of breathing exercises has been controversial, partly because some proponents have made exaggerated, implausible claims of effectiveness. Recent evidence, however, has resulted in endorsement of breathing exercises as add-on treatment in asthma in systematic reviews and guidelines.This review summarises the current evidence of effectiveness of breathing exercises programmes as an adjuvant treatment to pharmacological strategies for people with asthma. The types of breathing training programmes used and the content of effective programmes are discussed. We conclude that patients whose asthma continues to cause symptoms and quality-of-life impairment, despite adequate pharmacological treatment, or who have high bronchodilator use, should be offered access to an effective breathing training programme as a part of holistic, integrated asthma care.Key pointsAsthma is frequently poorly controlled despite effective modern medicationPsychological factors can be as important as physiological ones in affecting symptom perception and disease impactBreathing exercises can improve patient-reported outcomes and psychological stateBreathing exercises should be offered to all asthma patients with symptoms or impaired quality of life despite standard treatment

scholarly journals Patient-Reported Outcomes, Health-Related Quality of Life, and Clinical Outcomes for Urothelial Cancer Patients Receiving Chemo- or Immunotherapy: A Real-Life Experience

2021 ◽  
Vol 10 (9) ◽  
pp. 1852
Author(s):  
Gry Assam Taarnhøj ◽  
Henriette Lindberg ◽  
Christoffer Johansen ◽  
Helle Pappot
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Patient Reported Outcomes ◽  
Life Experience ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Real Life ◽  
Oncological Treatment ◽  
Patient Reported

Patients with urothelial cell carcinoma (UCC) often have comorbidities, which cause trouble for the completion of oncological treatment, and little is known about their quality of life (QoL). The aim of the present study was to obtain and describe patient-reported outcomes (PRO) and QoL data from UCC patients in the treatment for locally advanced muscle-invasive or metastatic UCC. A total of 79 patients with UCC completed four questionnaires (EORTC QLQ-C30, QLQ-BLM30, HADS, and select PRO-CTCAE™ questions) once weekly during their treatment. From those, 26 patients (33%) underwent neoadjuvant treatment for local disease while 53 patients (67%) were treated for metastatic disease. Of all patients, 54% did not complete the planned treatment due to progression, nephrotoxicity, death, or intolerable symptoms during treatment. The five most prevalent PRO-CTCAE grade ≥ 2 symptoms were frequent urination (37%), fatigue (35%), pain (31%), dry mouth (23%), and swelling of the arms or legs (23%). The baseline mean overall QoL was 61 (±SD 24) for all patients (neoadjuvant (73, ±SD 19) and metastatic (54, ±SD 24)) and remained stable over the course of treatment for both groups. A stable overall QoL was observed for the patients in this study. More than half of the patients did not, however, complete the planned treatment. Further supportive care is warranted for bladder cancer patients.

scholarly journals Patient Reported Outcome (PRO) in Patients Receiving High and Moderate Emetogenic Chemotherapy (Ctx) - Results of a German Prospective Non-Interventional Study with Netupitant/Palonosetron Fixed Dose Combination (NEPA)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4844-4844 ◽  
Author(s):  
Meinolf Karthaus ◽  
P Klare ◽  
N Gazawi ◽  
MO Zahn ◽  
B Reimann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Real Life ◽  
Fixed Dose Combination ◽  
Moderate Intensity ◽  
Fixed Dose ◽  
Interventional Study ◽  
Patient Reported ◽  
Dose Combination ◽  
Good For

Abstract Introduction:NEPA is a fixed dose combination of the NK1-receptor antagonist (RA) netupitant and 5-HT3-RA palonosetron approved for prevention of chemotherapy-induced nausea and vomiting (CINV) in pts receiving highly emetogenic (HEC) on cisplatin-basis or moderately emetogenic Ctx (MEC). NEPA demonstrated safety and efficacy in platinum, anthracycline and cyclophosphamid based Ctx, These drugs are frequently used in regimens for hematology pts. A German non-interventional study investigated NEPA's efficacy and impact on quality of life in adult cancer pts by patient-related outcomes (PRO) and physicians' personal assessment under real life conditions. Primary objective was the evaluation of quality of life (QoL) in adults receiving NEPA for CINV prevention. Secondary endpoints were efficacy and safety of NEPA. Methods: Open label, non-interventional, prospective, national, multicenter study that evaluates CINV prevention and patients' QoL receiving NEPA in pts with either HEC or MEC on up to 2 consecutive Ctx days for at least consecutive 3 cycles. QoL was evaluated by the validated FLIE questionnaires at the end of each Ctx cycle. Efficacy was documented by the treating physicians and via patient diaries for 3 Ctx cycles within 24 hrs and on 4 additional d after Ctx. Safety, additional medication and physicians' overall satisfaction was reported via eCRF. Results: Between June 2015 and Sept 2017 a total of 2429 pts were enrolled with 1997 pts being eligible for the 2nd interim analysis. 1901 pts were included in the efficacy analysis in the 1st, 1808 pts in the 2nd and 1734 pts in the 3rd cycle. Median age was 58 (range of 28-89). A total of 630 evaluable pts received MEC (53% carboplatin based) and 1185 pts received HEC (88% anthracycline/ cyclophosphamide based), PRO with complete response (CR=no nausea, no vomiting, no rescue medication) was analyzed based on patient diaries. Diaries for PRO in MEC-pts (n=401) reported CR in 94% in cycle 1, 85% in cycle 2 and 86% in cycle 3. Efficacy, assessed by physicians (n=630 pts) on a 4-point scale, was rated very good/good for 91%, 93%, and 94% in cycle 1, 2 and 3, respectively. PRO of 896 pts with HEC reported 81% CR in cycle 1, 82% in cycle 2 and 83% in cycle 3. Efficacy, assessed by physicians (1185 HEC pts), was rated very good/good for 88%, 89%, and 90% in cycle 1, 2 and 3, respectively. A high percentage of patients receiving HEC or MEC did not suffer from any emesis (93%, 93% and 94% in cycle 1-3, respectively). Over 85%of pts reported no impact on daily QoL due to vomiting in all 3 cycles with HEC or MEC.The most common treatment emergent adverse events were constipation and insomnia of mild-moderate intensity. Conclusions: NEPA prevented CINV highly effective in the acute and delayed phase of HEC and MEC with no impact on daily life due to vomiting in >85% of pts. Physicians evaluation was concordant to PRO.Safety profile was good. Disclosures Karthaus: Riemser: Consultancy. Schilling:Riemser: Honoraria.

Interactive remote patient monitoring devices for managing chronic health conditions: systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Donato Giuseppe Leo ◽  
Benjamin J.R. Buckley ◽  
Mahin Chowdhury ◽  
Stephanie L. Harrison ◽  
Masoud Isanejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Usual Care ◽  
Current Evidence ◽  
Long Term Conditions ◽  
Increased Risk ◽  
Patient Reported ◽  
Meta Analyses

BACKGROUND Telemedicine is an expanding and feasible approach to improve medical care for patients with long-term conditions. However, there is a poor understanding of patients’ acceptability of this intervention and their rate of uptake. OBJECTIVE To systematically review the current evidence on telehealth in the management of patients with long-term conditions, and to evaluate the patients’ uptake and acceptability of this technology. METHODS MEDLINE, SCOPUS, and CENTRAL were searched from date of inception to 5 February 2021, with no language restrictions. Studies were eligible for inclusion if they reported any of the following outcomes: (i) intervention uptake and adherence; (ii) study retention; (iii) patient acceptability, satisfaction and experience using intervention: (iv) changes in physiological values; (v) all-cause and cardiovascular related hospitalization; (vi) all-cause and disease specific mortality; (vii) patient-reported outcome measures; (viii) quality of life. Two reviewers independently assessed articles for eligibility. This systematic review was registered on PROSPERO (CRD42021236291). RESULTS Ninety-six studies were included and fifty-eight were pooled for meta-analyses. Meta-analyses showed reduction in mortality (RR= 0.71, 95% CI 0.56 to 0.89, P=0.003, I2=0%); and improvements in BP (MD -3.85 mmHg, 95% CI -7.03 to -0.68, P<.02, I2= 100%) and HbA1c (MD -0.33, 95% CI -0.57 to -0.09, P=.008, I2= 99%); but no significant improvements in quality of life (MD 1.45, 95% CI -0.10 to 3, P=.07, I2=80%); and increased risk of hospitalization (RR 1.02, 95% CI 0.85 to 1.23, P=.81, I2=79%) with telehealth compared to usual care. CONCLUSIONS Telehealth is a valid alternative to usual care, reducing mortality and improving self-management of the disease, with patients reporting good satisfaction and adherence. Further studies are required to address some potential concerns regarding higher hospitalisation rates and a lack of a positive impact on patients’ quality of life.

Baseline Characteristics of a National French E-Cohort of Hidradenitis Suppurativa in ComPaRe and Comparison with Other Large Hidradenitis Suppurativa Cohorts

Dermatology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Morgane Condamina ◽  
Laetitia Penso ◽  
Viet-Thi Tran ◽  
Claire Hotz ◽  
Philippe Guillem ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hidradenitis Suppurativa ◽  
Real Life ◽  
Epidemiological Studies ◽  
Scientific Data ◽  
Disease Stage ◽  
Treatment History ◽  
Patient Reported ◽  
History Of

<b><i>Background:</i></b> Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition substantially impacting patients’ quality of life; the pathogenesis remains unclear, and treatment is complex and not yet standardized. Observational data are increasingly being used to evaluate therapeutics in “real-life” interventions, and the development of e-cohorts is offering new tools for epidemiological studies at the population level. <b><i>Objective:</i></b> The aim of this study was to describe the clinical characteristics and treatment history of HS participants in the Community of Patients for Research (ComPaRe) cohort and to compare these to other cohorts. <b><i>Methods:</i></b> We performed a cross-sectional study of the baseline data of HS participants in ComPaRe, an e-cohort of patients with chronic diseases. Data were collected using patient-reported questionnaires about clinical-dem­ographic aspects, quality of life, and treatment history. <b><i>Results:</i></b> A total of 396 participants (339 females, 57 males) were included (mean age 38 years); 83 (21%) had a family history of HS, 227 (57.3%) were current smokers, and 241 (60.9%) were overweight or obese. Most of the participants declared a Hurley stage II (<i>n</i> = 263, 66.4%) or III (<i>n</i> = 76, 20.3%). The breast was more frequently affected in women than men (37.5 vs. 5.3%, <i>p</i> &#x3c; 0.0001), whereas the dorsal region was more frequently affected in men (39.5 vs. 10.9%, <i>p</i> &#x3c; 0.0001). Increased disease stage was associated with obesity (25.9 vs. 33.8 vs. 51.3%, <i>p</i> = 0.02) and some HS localizations (genital [<i>p</i> &#x3c; 0.005], pubis [<i>p</i> &#x3c; 0.007], gluteal fold [<i>p</i> = 0.02], and groin [<i>p</i> &#x3c; 0.0001]). The most frequently prescribed treatments were oral antibiotics (<i>n</i> = 362, 91.4%), especially amoxicillin-clavulanic acid and cyclins. Less than 10% of participants received biologics. Most of these results were consistent with previously published cohorts. <b><i>Conclusion:</i></b> Recruitment of participants by such a web platform can be a faster way to get relevant scientific data for a wide variety of patients that could be used for epidemiological studies and to evaluate therapeutics in “real-life” interventions.

scholarly journals The use of real-world effectiveness measurements in clinical settings at Helsinki University Hospital: a systematic literature review

2020 ◽  
Vol 9 (5) ◽  
pp. 321-326
Author(s):  
Kati Koskinen ◽  
Maija Hytönen ◽  
Pirjo Räsänen
Keyword(s):  
Quality Of Life ◽  
Real World ◽  
Real Life ◽  
University Hospital ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
Quality Of Life Instruments

Aim: Patient reported outcomes collected alongside clinical trials do not reflect real-world effectiveness (RWE). This review assessed the use of RWE measurements in routine clinical treatment and the instruments applied to collect that data. Materials & methods: The RWE articles published from HUS (Helsinki University Hospital) were extracted from several databases. Results: Out of 170 eligible articles, generic health-related quality of life instruments were used in 87 (51.2%) and disease-specific health-related quality of life instruments in 58 (34.1%) articles as a primary measurement. Most of the articles pertained to surgery, gynecology and pediatric surgery. Conclusion: The number of articles assessing RWE is very limited compared with all the articles published from HUS. Thus, we still have limited information about the effectiveness of the treatment in real life.

scholarly journals A new indicator to measure discordance between patient reported outcomes and traditional disease activity holds promise to advance care trajectories improve care in patients with early Rheumatoid Arthritis

2021 ◽  
Author(s):  
Sofia Pazmino ◽  
Anikó Lovik ◽  
Annelies Boonen ◽  
Diederik De Cock ◽  
Veerle Stouten ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Disease Control ◽  
Patient Reported Outcomes ◽  
Sustained Remission ◽  
List Type ◽  
Factor Scores ◽  
Patient Reported ◽  
Disease Impact

ABSTRACTObjectiveTo unravel disease impact in early RA patients by separately quantifying patient reported (PRF), clinical (CF) and laboratory (LF) factors. We put forward a new indicator, the discordance score (DS), for early identification and prediction of unmet patient outcomes in terms of future achievement of sustained remission and RA-related quality of life (QoL).MethodsWe obtained factor scores via factor analysis in the CareRA trial, then calculated the DS between PRF and the mean of the other scores. We computed the improvement from baseline to week 104 (%) and area-under-the-curve (AUC) across time-points per factor score and compared these between patients achieving or not achieving sustained (week 16 to 104) remission (DAS28CRP<2.6) with ANOVA. Logistic and linear regressions respectively were used to predict SR based on previous factor and discordance scores, and QoL at year 1 and 2 based on DS at week 16.ResultsPRF, CF and LF scores improved rapidly within 8 weeks. In patients achieving SR; PRF improved 57%, CF 90% and LF 27%, compared to 32% PRF (p=0.13), 77% CF (p<0.001) and 9% LF (p=0.36) score improvement in patients not achieving SR. Patients achieving SR had an AUC of 15.7, 3.4 and 4.8 for PRF, CF and LF respectively, compared to 33.2, 10.1, and 7.2 in participants not achieving SR (p<0.001 for all). Early factor and discordance scores were associated with later stage factor scores as well as QoL and PRF scores predicted SR (p<0.005 for PRF and DS).ConclusionsAll factor scores improved rapidly, especially in patients achieving SR. Patient-reported burden improved less extensively. Discordance scores could help in predicting the need for additional non-pharmacological interventions to achieve SR and decrease disease impact.KEY MESSAGESWhat is already known about this subject?Early and intensive RA drug-treatment using disease activity as a target allows rapid disease control and prevents joint destruction.Including pain, fatigue and physical function when assessing patients with early RA broadens the evaluation of disease impact.What does this study add?Leveraging patient reported outcomes (pain, fatigue and physical function) and traditional disease activity measures, we introduce a new indicator (named discordance score) for unraveling disease impact and treatment efficacy.We show how the discordance score stands for current unmet patient reported outcomes and could be used to predict future sustained disease contol and quality of life (1 and 2 years after baseline).We demonstrate this effect both in patients with and without sustained remissionHow might this impact on clinical practice or future developments?The earlier detection of unmet needs despite good disease control could allow to perform timely interdisciplinary interventions other than medication adaptations and could promote psychosocial wellbeing for patients.

scholarly journals Role of Quality of Life as Endpoint for Inflammatory Bowel Disease Treatment

2021 ◽  
Vol 18 (13) ◽  
pp. 7159
Author(s):  
Cristina Calviño-Suárez ◽  
Rocío Ferreiro-Iglesias ◽  
Iria Bastón-Rey ◽  
Manuel Barreiro-de Acosta
Keyword(s):  
Quality Of Life ◽  
Real Life ◽  
Mucosal Healing ◽  
Patient Reported Outcome ◽  
New Drugs ◽  
Physical And Mental Health ◽  
Patient Reported ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel diseases (IBDs) are chronic disabling conditions, characterized by an unpredictable course with flare-ups and periods of remission, that frequently affect young people and require lifelong medical follow-up and treatment. For years, the main endpoints of IBD treatment had been clinical remission and response, followed by biomarker normalization and mucosal healing. In the last decades, different therapies have been proved to be effective to treat IBD and the use of patient reported outcome (PRO) have become more relevant. Therefore, health-related quality of life (HRQoL) that has been defined as the value assigned to the duration of life influenced by physical and mental health, has been suggested as an important endpoint for IBD management since multiple studies have shown that IBD impairs it, both physically and psychologically. Thus, HRQoL has been included as an outcome in numerous studies evaluating different IBD therapies, both clinical trials and real-life studies. It has been assessed by using both generic and specific disease tools, and most treatments used in clinical practice have been demonstrated to improve HRQoL. The relevance of HRQoL as an endpoint for new drugs is going to increase and its management and improvement will also improve the prognosis of IBD patients.

scholarly journals An overview of patient-reported outcome measures to analyze the quality of life after orthognathic surgery

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2266-2271
Author(s):  
Shivangi Gaur ◽  
Subhashini R ◽  
Madhulaxmi M ◽  
Abdul Wahab P U
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Orthognathic Surgery ◽  
Social Impact ◽  
Treatment Plan ◽  
Well Being ◽  
Psychological State ◽  
Patient Reported ◽  
The Impact

Society imparts great importance to physical appearance in this modern age. The physical and psycho-social impact of a dentofacial deformity on an individual is often impossible to assess with certainty. A facial deformity can profoundly affect the quality of life and thereby entailing lifelong adjustments. Facial aesthetics affect an individual's confidence and their overall acceptance in society, which in turn has an apparent effect on their quality of life. Corrective jaw surgeries are indicated in cases not amenable to produce acceptable post-treatment results with orthodontics alone. Orthognathic surgery aims to produce a more aesthetic facial appearance and strives to improve stomatognathic functions in the process. WHO defines Quality of Life as- An individual's perception of their position in life in the context of the culture and value systems in which they live and concerning their goals, expectations, standards and concerns. It is a broad-ranging concept affected in a complicated way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of their environment. The impact of dentofacial deformities on an individual's holistic emotional, physical and social development has been a focus of research for a long time. Several patients reported outcome scales are employed to assess the quality of life and this review aims to discuss the use of these scales as an indicator of successful surgical treatment. At the same time, these scales may serve as a patient education tool because a holistic health indicator is required which considers the psychological well being of the patient along with regards to functional and aesthetic demands before formulating a surgical treatment plan.

scholarly journals Patient-Reported Outcomes for Quality of Life in SLE: Essential in Clinical Trials and Ready for Routine Care

2021 ◽  
Vol 10 (16) ◽  
pp. 3754
Author(s):  
Matthew H. Nguyen ◽  
Frank F. Huang ◽  
Sean G. O’Neill
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Lupus Erythematosus ◽  
Clinical Care ◽  
Routine Care ◽  
Patient Reported Outcome ◽  
Current Evidence ◽  
Patient Reported ◽  
Pro Tools

Patient-reported outcome (PRO) instruments are widely used to assess quality of life in Systemic Lupus Erythematosus (SLE) research, and there is growing evidence for their use in clinical care. In this review, we evaluate the current evidence for their use in assessing quality of life in SLE in both research and clinical settings and examine the different characteristics of the commonly used PRO tools. There are now several well-validated generic and SLE-specific tools that have demonstrated utility in clinical trials and several tools that complement activity and damage measures in the clinical setting. PRO tools may help overcome physician–patient discordance in SLE and are valuable in the assessment of fibromyalgia and type 2 symptoms such as widespread pain and fatigue. Future work will identify optimal PRO tools for different settings but, despite current limitations, they are ready to be incorporated into patient care.

scholarly journals Associations of Physical Activity and Exercise with Health-related Outcomes in Patients with Melanoma During and After Treatment: A Systematic Review

2021 ◽  
Vol 20 ◽  
pp. 153473542110407
Author(s):  
Brendan J. Crosby ◽  
Pedro Lopez ◽  
Daniel A. Galvão ◽  
Robert U. Newton ◽  
Dennis R. Taaffe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Side Effects ◽  
Patient Reported Outcomes ◽  
Current Evidence ◽  
Patient Reported ◽  
Health Related ◽  
Physical Activity And Exercise ◽  
Objectively Measured

Purpose: Although exercise medicine is recommended to counter treatment-related side-effects and improve health-related outcomes of patients affected by different cancers, no specific recommendations exist for patients with melanoma. As a result, we systematically examined the current evidence regarding the effects of physical activity and exercise on objectively-measured and patient-reported outcomes among patients with melanoma. Methods: Searches were conducted in PubMed, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases. This review included published data involving physical activity or exercise and objectively-measured or patient-reported outcomes of patients with cutaneous melanoma. The quality of included studies was assessed using the McMaster University Critical Appraisal Tool for Quantitative Studies. Results: Six studies including 882 patients with melanoma were included. Studies presented heterogeneity of design with 2 cross-sectional surveys, 2 retrospective analyses, and 2 non-randomized intervention trials. No statistically significant change in quality of life, fatigue, physical function, cardiorespiratory fitness, body composition, psychological distress, cognitive function, or treatment-related side-effects were attributable to physical activity or exercise. Importantly, physical activity or exercise during melanoma treatment or into survivorship did not adversely impact patients/survivors. Conclusion: In summary, physical activity or exercise did not adversely impact quality of life, objectively-measured or patient-reported outcomes in patients with melanoma. In addition, there is a paucity of quality studies examining the effects of physical activity or exercise on patients with melanoma throughout the cancer care continuum.

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