Naltrexone implants after in-patient treatment for opioid
                        dependence: randomised controlled trial

BackgroundNaltrexone has considerable potential in helping to prevent relapse in heroin dependency. A longer-lasting formulation for naltrexone treatment is desirable to further reduce non-adherence and relapse during treatment of opiate dependence.AimsTo evaluate the safety and effectiveness of a 6-month naltrexone implant in reducing opioid use after in-patient treatment.MethodA group of 56 abstinence-oriented patients who completed in-patient treatment for opioid dependence were randomly and openly assigned to receive either a 6-month naltrexone implant or their usual aftercare. Drug use and other outcomes were assessed at 6-month follow-up.ResultsPatients receiving naltrexone had on average 45 days less heroin use and 60 days less opioid use than controls in the 180-day period (both P<0.05). Blood tests showed naltrexone levels above 1 ng/ml for the duration of 6 months. Two patients died, neither of whom had received an implant.ConclusionsNaltrexone implant treatment safely and significantly reduces opioid use in a motivated population of patients.

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DHA supplementation in infants born preterm and the effect on attention at 18 months’ corrected age: follow-up of a subset of the N3RO randomised controlled trial

British Journal Of Nutrition ◽

10.1017/s0007114520002500 ◽

2020 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Erandi Hewawasam ◽

Carmel T. Collins ◽

Beverly S. Muhlhausler ◽

Lisa N. Yelland ◽

Lisa G. Smithers ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Primary Outcome ◽

Controlled Trial ◽

High Dose ◽

Peak Period ◽

Soya Oil ◽

Randomised Controlled ◽

To Receive ◽

The Brain

Abstract Infants born preterm miss out on the peak period of in utero DHA accretion to the brain during the last trimester of pregnancy which is hypothesised to contribute to the increased prevalence of neurodevelopmental deficits in this population. This study aimed to determine whether DHA supplementation in infants born preterm improves attention at 18 months’ corrected age. This is a follow-up of a subset of infants who participated in the N3RO randomised controlled trial. Infants were randomised to receive an enteral emulsion of high-dose DHA (60 mg/kg per d) or no DHA (soya oil – control) from within the first days of birth until 36 weeks’ post-menstrual age. The assessment of attention involved three tasks requiring the child to maintain attention on toy/s in either the presence or absence of competition or a distractor. The primary outcome was the child’s latency of distractibility when attention was focused on a toy. The primary outcome was available for seventy-three of the 120 infants that were eligible to participate. There was no evidence of a difference between groups in the latency of distractibility (adjusted mean difference: 0·08 s, 95 % CI –0·81, 0·97; P = 0·86). Enteral DHA supplementation did not result in improved attention in infants born preterm at 18 months’ corrected age.

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Adherence therapy for people with schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.019489 ◽

2006 ◽

Vol 189 (6) ◽

pp. 508-514 ◽

Cited By ~ 108

Author(s):

Richard Gray ◽

Morven Leese ◽

Jonathan Bindman ◽

Thomas Becker ◽

Lorenzo Burti ◽

...

Keyword(s):

Quality Of Life ◽

Health Education ◽

Controlled Trial ◽

Clinical Settings ◽

Clinical Instability ◽

Randomised Controlled ◽

To Receive ◽

Adherence Therapy

BackgroundThere is equivocal evidence of the effectiveness of adherence therapy in improving treatment adherence and clinical outcomes for people with schizophrenia.AimsTo evaluate the effectiveness of adherence therapy in improving quality of life for people with schizophrenia.MethodA 52-week, single-blind, multicentre randomised controlled trial of the effectiveness of adherence therapy. Participants were individually randomised to receive eight sessions of adherence therapy or health education. Assessments were undertaken at baseline and at 52-week follow-up.ResultsAdherence therapy was no more effective than health education in improving quality of life.ConclusionsThis effectiveness trial provides evidence for the lack of effect of adherence therapy in people with schizophrenia with recent clinical instability, treated in ordinary clinical settings.

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Ureteric bupivicaine infusion for loin pain haematuria syndrome

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12628812458338 ◽

2010 ◽

Vol 92 (2) ◽

pp. 139-141 ◽

Cited By ~ 5

Author(s):

P Ahmed ◽

P Acher ◽

AM Deane

Keyword(s):

Randomised Controlled Trial ◽

Adverse Effects ◽

Controlled Trial ◽

Opiate Dependence ◽

Ureteric Catheter ◽

Loin Pain ◽

Loin Pain Haematuria Syndrome ◽

Randomised Controlled ◽

Trial Setting

INTRODUCTION Loin pain haematuria syndrome is a common problem with complications including opiate dependence. Morbidity treatments include intra-ureteric capsaicin infusion, nephrectomy, autotransplantation and nephrolysis. We explored the use of flexible cystoscopic infusion of intra-ureteric bupivicaine. PATIENTS AND METHODS Patients presenting with chronic loin pain underwent urological and nephrological evaluation. Bupivicaine (0.5%, 20 ml) was infused via an intra-ureteric catheter under flexible cystoscopic guidance. Repeat infusions were offered if indicated. RESULTS Sixteen of 17 patients with 1-year follow-up responded and were satisfied. Twelve of these required repeat infusions (mean, 2.9 infusions). The procedures were well tolerated by all patients without adverse effects. CONCLUSIONS Intra-ureteric bupivicaine infusion has a place in the management of patients with chronic renal pain. It offers a minimally invasive alternative to other treatments. This procedure warrants further investigation within a randomised, controlled trial setting.

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Virtual outpatient clinic as an alternative to an actual clinic visit after surgical discharge: a randomised controlled trial

BMJ Quality & Safety ◽

10.1136/bmjqs-2018-008171 ◽

2018 ◽

Vol 28 (1) ◽

pp. 24-31 ◽

Cited By ~ 17

Author(s):

Paul Healy ◽

Liam McCrone ◽

Roisin Tully ◽

Emer Flannery ◽

Aoife Flynn ◽

...

Keyword(s):

Outpatient Clinic ◽

Controlled Trial ◽

Randomised Trial ◽

Significant Proportion ◽

Clinic Visit ◽

Surgical Service ◽

Randomised Controlled ◽

To Receive ◽

Study Inclusion

BackgroundIt is standard practice to review all patients following discharge at a follow-up clinic but demands on all health services outweigh resources and unnecessary review appointments may delay or deny access to patients with greater needs.AimsThis randomised trial aimed to establish whether a virtual outpatient clinic (VOPC) was an acceptable alternative to an actual outpatient clinic (OPC) attendance for a broad range of general surgical patients following a hospital admission.Patients and methodsAll patients admitted under one general surgical service over the study period were assessed. If eligible for inclusion the rationale, randomisation and follow-up methods were explained, consent was sought and patients randomised to receive either a VOPC or an OPC appointment.ResultsTwo-hundred and nine patients consented to study inclusion, of which 98/107 (91.6%) in the VOPC group and 83/102 (81.4%) in the OPC group were successfully contacted. Only 6 patients in the OPC group and 10 in the VOPC group reported ongoing issues. A further follow-up indicated 78 of 82 (95%) VOPC patients were very happy with their overall experience compared with 34/61 (56%) in the actual OPC group (p<0.001). A significant proportion of both cohorts—68/82 (83%) in VOPC group and 41/61 (67%) in OPC group (p = 0.029)—preferred a VOPC appointment as their future follow-up of choice.ConclusionsThe majority of patients discharged from a surgical service could be better followed up by a virtual clinic with a significant proportion of patients reporting a preference for and a greater satisfaction with such a service.

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A trial protocol for the effectiveness of digital interventions for preventing depression in adolescents: The Future Proofing Study

Trials ◽

10.1186/s13063-019-3901-7 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Aliza Werner-Seidler ◽

Kit Huckvale ◽

Mark E. Larsen ◽

Alison L. Calear ◽

Kate Maston ◽

...

Keyword(s):

Clinical Trial ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Trial Registration ◽

Control Group ◽

School Students ◽

School Based ◽

Randomised Controlled ◽

To Receive

Abstract Background Depression frequently first emerges during adolescence, and one in five young people will experience an episode of depression by the age of 18 years. Despite advances in treatment, there has been limited progress in addressing the burden at a population level. Accordingly, there has been growing interest in prevention approaches as an additional pathway to address depression. Depression can be prevented using evidence-based psychological programmes. However, barriers to implementing and accessing these programmes remain, typically reflecting a requirement for delivery by clinical experts and high associated delivery costs. Digital technologies, specifically smartphones, are now considered a key strategy to overcome the barriers inhibiting access to mental health programmes. The Future Proofing Study is a large-scale school-based trial investigating whether cognitive behaviour therapies (CBT) delivered by smartphone application can prevent depression. Methods A randomised controlled trial targeting up to 10,000 Year 8 Australian secondary school students will be conducted. In Stage I, schools will be randomised at the cluster level either to receive the CBT intervention app (SPARX) or to a non-active control group comparator. The primary outcome will be symptoms of depression, and secondary outcomes include psychological distress, anxiety and insomnia. At the 12-month follow-up, participants in the intervention arm with elevated depressive symptoms will participate in an individual-level randomised controlled trial (Stage II) and be randomised to receive a second CBT app which targets sleep difficulties (Sleep Ninja) or a control condition. Assessments will occur post intervention (both trial stages) and at 6, 12, 24, 36, 48 and 60 months post baseline. Primary analyses will use an intention-to-treat approach and compare changes in symptoms from baseline to follow-up relative to the control group using mixed-effect models. Discussion This is the first trial testing the effectiveness of smartphone apps delivered to school students to prevent depression at scale. Results from this trial will provide much-needed insight into the feasibility of this approach. They stand to inform policy and commission decisions concerning if and how such programmes should be deployed in school-based settings in Australia and beyond. Trial registration Australian and New Zealand Clinical Trial Registry, ACTRN12619000855123. Registered on 31 May 2019. Clinical Trial Notification Scheme (CTN), CT-2019-CTN-02110-1-v1. Registered on 30 June 2019.

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Effect of educational progressive web application on patient’s oral and denture knowledge and hygiene: A randomised controlled trial

Health Informatics Journal ◽

10.1177/14604582211035821 ◽

2021 ◽

Vol 27 (3) ◽

pp. 146045822110358

Author(s):

Jade Yi Ming Ng ◽

Tong Wah Lim ◽

Natasya Tarib ◽

Ting Khee Ho

Keyword(s):

Web Application ◽

Controlled Trial ◽

Knowledge Score ◽

Gingival Index ◽

Feedback Form ◽

Removable Partial Denture ◽

Partial Denture ◽

Randomised Controlled ◽

To Receive

This study aimed to evaluate the effect of a novel progressive web application (PWA) on the patient’s oral and denture knowledge and hygiene. Fifty-two removable partial denture wearers were randomised to receive education using the PWA, or verbal instructions accompanied by demonstration of hygienic procedures. Changes in the participants’ knowledge score, plaque index, gingival index and denture plaque was evaluated during a follow-up period of 3 months. The participants’ acceptance of PWA was explored through usage logs and a feedback form. Both groups showed significant improvement in knowledge scores, oral and denture hygiene indices ( p < 0.001) after education. The PWA group demonstrated significantly lower gingival index score than control ( p = 0.008) at the third month review. In conclusion, there is potential of using mobile application in educating elderly patients and the PWA is a viable option for providing post-denture delivery instructions.

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