Impact of a Pharmacist-Driven Protocol to Improve Drug Allergy Documentation at a University Hospital

Background An internal evaluation of the inpatient pharmacy order entry database ( WORx) at a university hospital revealed that the nature of the reaction was documented for only 47% of patients with reported drug allergies/intolerance. Insufficient documentation of drug allergy/intolerance may result in administration of drugs that should not be prescribed. Similarly, valuable agents that should be used may not be prescribed due to an unnecessary fear of adverse drug reaction. More complete description of drug allergy/intolerance may result in more correct prescribing of medications. Objective Evaluate the impact of a pharmacist-driven protocol on the quality of drug allergy/intolerance documentation. Methods Four pre-intervention evaluations were conducted every 2 weeks documenting the completeness of drug allergy/intolerance information in the pharmacy order entry database. One week following the implementation of a pharmacist-driven protocol intended to improve the completeness of drug allergy/intolerance information, a series of 4 postintervention evaluations was repeated. Proportional analysis of pre- and postinterventional data was performed to evaluate the effectiveness of the intervention. Results A total of 1,686 allergies from 2,174 patients were reviewed pre and post intervention. The frequency of complete drug allergy/intolerance documentation pre intervention was 52% to 62%. Following implementation of the hospitalwide, pharmacist-driven protocol, this rate increased to 60% to 76%. Pediatric services demonstrated the most substantial improvement, increasing from 53% to 79% to 67% to 93%. Blank reaction fields decreased by 10% in both age groups. Conclusion A pharmacy-driven initiative intended to improve the completeness of drug allergy/intolerance documentation was associated with modest success. Other mechanisms, including electronic health record systems with computerized physician order entry and decision support, are needed to improve the completeness of drug allergy/intolerance information.

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The impact of a computerized physician order entry system implementation on 20 different criteria of medication documentation—a before-and-after study

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01607-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Viktoria Jungreithmayr ◽

Andreas D. Meid ◽

Janina Bittmann ◽

Markus Fabian ◽

Ulrike Klein ◽

...

Keyword(s):

Tertiary Care ◽

Multivariable Analysis ◽

Computerized Physician Order Entry ◽

Care Hospital ◽

Order Entry ◽

Significant Difference ◽

Before And After ◽

Physician Order Entry ◽

The Impact

Abstract Background The medication process is complex and error-prone. To avoid medication errors, a medication order should fulfil certain criteria, such as good readability and comprehensiveness. In this context, a computerized physician order entry (CPOE) system can be helpful. This study aims to investigate the distinct effects on the quality of prescription documentation of a CPOE system implemented on general wards in a large tertiary care hospital. Methods In a retrospective analysis, the prescriptions of two groups of 160 patients each were evaluated, with data collected before and after the introduction of a CPOE system. According to nationally available recommendations on prescription documentation, it was assessed whether each prescription fulfilled the established 20 criteria for a safe, complete, and actionable prescription. The resulting fulfilment scores (prescription-Fscores) were compared between the pre-implementation and the post-implementation group and a multivariable analysis was performed to identify the effects of further covariates, i.e., the prescription category, the ward, and the number of concurrently prescribed drugs. Additionally, the fulfilment of the 20 criteria was assessed at an individual criterion-level (denoted criteria-Fscores). Results The overall mean prescription-Fscore increased from 57.4% ± 12.0% (n = 1850 prescriptions) before to 89.8% ± 7.2% (n = 1592 prescriptions) after the implementation (p < 0.001). At the level of individual criteria, criteria-Fscores significantly improved in most criteria (n = 14), with 6 criteria reaching a total score of 100% after CPOE implementation. Four criteria showed no statistically significant difference and in two criteria, criteria-Fscores deteriorated significantly. A multivariable analysis confirmed the large impact of the CPOE implementation on prescription-Fscores which was consistent when adjusting for the confounding potential of further covariates. Conclusions While the quality of prescription documentation generally increases with implementation of a CPOE system, certain criteria are difficult to fulfil even with the help of a CPOE system. This highlights the need to accompany a CPOE implementation with a thorough evaluation that can provide important information on possible improvements of the software, training needs of prescribers, or the necessity of modifying the underlying clinical processes.

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Oral Health Related Quality of Life and Prosthetic Status among Institutionalized Elderly from the Bucharest Area: A Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126663 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6663

Author(s):

Laura Iosif ◽

Cristina Teodora Preoteasa ◽

Elena Preoteasa ◽

Ana Ispas ◽

Radu Ilinca ◽

...

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Age Groups ◽

Health Related Quality ◽

Institutionalized Elderly ◽

Related Quality ◽

Health Related ◽

Prosthetic Status ◽

The Impact

The aim of the study was to assess the oral health related quality of life (OHRQoL) of elderly in care homes, one of Romania’s most vulnerable social categories, to correlate it to sociodemographic, oral health parameters, and prosthodontic status. Therefore, a cross-sectional study was performed on 58 geriatrics divided into 3 age groups, who were clinically examined and answered the oral health impact profile (OHIP-14) questionnaire. Very high rates of complete edentulism in the oldest-old subgroup (bimaxillary in 64.3%; mandibular in 64.3%; maxillary in 85.7%), and alarming frequencies in the other subgroups (middle-old and youngest-old), statistically significant differences between age groups being determined. The OHIP-14 mean score was 14.5. Although not statistically significant, females had higher OHIP-14 scores, also middle-old with single maxillary arch, single mandibular arch, and bimaxillary complete edentulism, whether they wore dentures or not, but especially those without dental prosthetic treatment in the maxilla. A worse OHRQoL was also observed in wearers of bimaxillary complete dentures, in correlation with periodontal disease-related edentulism, in those with tertiary education degree, and those who came from rural areas. There were no statistically significant correlations of OHRQoL with age, total number of edentulous spaces or edentulous spaces with no prosthetic treatment. In conclusion, despite poor oral health and prosthetic status of the institutionalized elderly around Bucharest, the impact on their wellbeing is comparatively moderate.

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POS0998 SPONDYLOARTHRITIS AND SLEEP DISORDERS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2909 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 767.2-768

Author(s):

S. Lahrichi ◽

K. Nassar ◽

S. Janani

Keyword(s):

Functional Impairment ◽

Sleep Disturbances ◽

Negative Impact ◽

University Hospital ◽

Quality Of Sleep ◽

The Mean ◽

Sleep Deficit ◽

Impaired Sleep ◽

The Impact

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.

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Improving quality and assessment of referrals to the Enfield Crisis Resolution and Home Treatment Team (ECRHTT)

BJPsych Open ◽

10.1192/bjo.2021.541 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S202-S202

Author(s):

Margarita Kousteni ◽

John Cousins ◽

Ajay Mansingh ◽

Maja Elia ◽

Yumnah Ras ◽

...

Keyword(s):

Home Treatment ◽

Absolute Difference ◽

List Type ◽

Treatment Team ◽

Crisis Resolution ◽

Post Intervention ◽

Improvement Project ◽

Consultant Psychiatrist ◽

The Impact

AimsTriaging referrals to crisis resolution and home treatment teams is a significant undertaking requiring experienced and dedicated staff. We observed that the volume of inappropriate referrals to ECRHTT was high, and that staff processing these often felt inexperienced or lacking in confidence to discharge them back to the referrers and signpost them to appropriate services.The aims of this quality improvement project (QIP) were: a)to reduce the number of inappropriate referrals received by the teamb)to reduce the number of inappropriate referrals accepted by the teamThis would significantly improve access and flow to the service and facilitate better patient care.MethodA pilot study was first completed of the quality (appropriateness/ inappropriateness) and source of all referrals to ECRHTT in January 2019 (n = 177).Subsequently, the consultant psychiatrist for ECRHTT based himself within the assessment team. He was able to closely monitor the referrals, at the same time as providing medical input to patients at their first point of contact. To evaluate the impact of this intervention, the percentage of inappropriate referrals accepted pre- and post-change was compared by re-auditing all referrals received in February 2019 (n = 175).Further interventions were instigated to improve referral quality. These included continuation of psychiatric medical input to the assessment team, teaching sessions for GPs and the crisis telephone service, and weekly meetings with psychiatric liaison and community mental health teams (CMHTs). Change was measured by reassessing the quality of all referrals made to ECRHTT in February 2020 (n = 215).Result46.9% of inappropriate referrals to ECRHTT were accepted in January 2019 compared to 16.9% in February 2019 following the addition of medical input to the assessment team. The absolute difference was 30% (95% CI: 14%–44%, p < 0.001).71% of referrals from GPs were inappropriate in January 2019 compared to 36% in February 2020 post-intervention (difference 35%, 95% CI: 8.84%–55.4%, p < 0.05). Inappropriate referrals from CMHTs decreased from 55.5% to 12% (difference 43.5%, 95% CI: 9.5%–70.3%, p < 0.05). Overall, the percentage of inappropriate referrals fell from 38% to 27.4%, a difference of 10.6% (95% CI: 1.3%–19.8%, p < 0.05). The percentage of inappropriate referrals from liaison teams did not change significantly.ConclusionThis piece of work shows that better engagement with referral sources significantly improved the quality of referrals made to ECRHTT. Interventions included medical input at the point of referral, teaching sessions for general practitioners as well as ongoing liaison with referring teams.

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The impact of music on health-related quality of life, as quantified by the SF-36: A systematic review and meta-analysis

10.1101/2021.11.30.21267066 ◽

2021 ◽

Author(s):

J. Matt McCrary ◽

Eckart Altenmuller ◽

Clara Kretschmer ◽

Daniel S. Scholz

Keyword(s):

Standard Treatment ◽

Meta Analysis ◽

Music Listening ◽

Health Related Quality ◽

Post Intervention ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

The Impact

Background/Objectives: Increasing evidence supports the ability of music to broadly promote wellbeing and health-related quality of life (HRQOL). However, the magnitude of music effects on HRQOL is still unclear, particularly relative to established interventions, limiting inclusion of music interventions in health policy and care. The SF-36 is the most widely used instrument to evaluate HRQOL, with broad validity in evaluating the effects of a range of interventions. This study aims to synthesize and contextualize the impact of music interventions on HRQOL, as assessed by the SF-36. Methods: MEDLINE; EMBASE; Web of Science; PsycINFO, clinicaltrials.gov, and ICTRP databases were searched on 30 July 2021. Randomized and single-group studies of music interventions which reported SF-36 data at pre- and post-intervention timepoints were included. Observational studies were excluded. The quality and certainty of evidence provided by included articles and meta-analysis results was appraised using GRADE. Inverse variance random effects meta-analyses quantified changes in SF-36 mental and physical component summary scores (respectively, MCS and PCS) pre- to post-intervention and vs. common control groups. Results: Analyses included 764 participants from 25 studies. Music interventions (music listening, 10 studies; music therapy, 7 studies; singing, 7 studies; gospel music, 1 study) significantly improved MCS (Mean difference (MD) [95% confidence interval]=3.0 [1.4, 4.6]; p<.001) and PCS (MD=1.0 [0.1, 2.0; p<.04) scores. In a subgroup (8 studies; music group, N=254; control, N=257) addition of music to standard treatment for a range of conditions significantly improved MCS scores vs. standard treatment alone (MD=3.7 [0.4, 7.1; p<.03). Effects did not vary between music listening, therapy and singing intervention types or doses (p>.12); no evidence of small study or publication biases was present in any analysis (p>.31). Music impact on MCS scores meets SF-36 minimum important difference thresholds (MD>/=3) and is within the range of established interventions. Conclusions: This study provides Moderate quality evidence that music interventions can generally be used to provide clinically meaningful improvements in HRQOL. Further study is needed to determine optimal music interventions and doses for distinct clinical and public health scenarios. Funding: Alexander von Humboldt Foundation Registration: PROSPERO (ID: CRD42021276204)

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Impact of low vision services on the quality of life of low vision patients in Ghana

African Vision and Eye Health ◽

10.4102/aveh.v75i1.19 ◽

2016 ◽

Vol 75 (1) ◽

Author(s):

Godwin O. Ovenseri-Ogbomo ◽

Harriette Osafo-Agyei ◽

Ralph E.U. Akpalaba ◽

James Addy ◽

Elizabeth O. Ovenseri

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Positive Impact ◽

Low Vision ◽

Care Quality ◽

Eastern Region ◽

Post Intervention ◽

Low Vision Clinic ◽

The Impact

Patients’ perspectives on the impact of clinical interventions have been recognised as critical elements in patient care. Quality-of-life instruments are designed to measure these perspectives. We used the National Eye Institute’s 25-item Visual Function Questionnaire (NEI VFQ) to measure the impact of optical low vision devices on the quality of life of 22 low vision patients who obtained and were using low vision devices from a secondary low vision clinic in the Eastern Region, Ghana. The study employed a pre- and post-intervention technique. We found statistically significant improvements in measured visual acuity and NEI VFQ scores in 8 of the 10 domains evaluated. We conclude that optical low vision devices have a positive impact on the quality of life of low vision patients in Ghana.Keywords: low vision; quality of life; visual acuity; visual impairment; Ghana

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Abstract WP266: EMS/Hospital Combined Education Decreased Primary Stroke Center Bypass

Stroke ◽

10.1161/str.48.suppl_1.wp266 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Jason P Stopyra ◽

Myron Waddell ◽

Emily B Parks

Keyword(s):

North Carolina ◽

Quality Improvement ◽

Service Area ◽

Education Intervention ◽

Post Intervention ◽

Intervention Phase ◽

Primary Stroke Center ◽

Stroke Center ◽

The Impact

Introduction: Historically, community hospitals have had few options for meaningful treatment of patients presenting with acute stroke. As expertise grows in the administration of thrombolytics, primary stroke centers (PSC) fulfill an important role in the reduction of morbidity and mortality related to stroke. It is important for the PSC to partner with Emergency Medical Services (EMS) to change historical perceptions of the quality of PSC care. Education may improve teamwork and increase awareness of the PSC, thereby increasing their utilization in EMS disposition decisions. Objective: The objective of this study is to report the impact of an education intervention on PSC bypass decisions. Methods: The electronic patient care record database from a North Carolina county EMS system was queried as a quality improvement analysis from January 1, 2012 to February 28, 2016. This included 19 months prior to the education intervention, the year during the education intervention, and 19 months after the education intervention. All primary patient transports with Stroke/CVA, or suspected TIA as the primary or secondary impression were included. Interfacility transports were excluded. The recorded call location was determined to either be inside or outside the PSC service area. The hospital the patient was transported to was also recorded. Results: During the pre-intervention phase 222 patients were identified, 48 of which originated in the PSC service area. Of those 48 patients, 16 bypassed the PSC (33.3%). In the post-intervention phase, 94 of 269 total patients were in PSC service area. Only 12 bypasses occurred (12.8%) which is a reduction of 61.7% in PSC bypass compared to the pre-intervention phase. Conclusion: The period following a combined hospital/EMS educational intervention showed significant reduction in PSC bypass.

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Impact of epileptic patient's knowledge level on their quality of life

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n2p31 ◽

2018 ◽

Vol 9 (2) ◽

pp. 31

Author(s):

Sahar A. Abd-El Mohsen ◽

Nagwa M. Ahmed

Keyword(s):

Quality Of Life ◽

Management Program ◽

University Hospital ◽

Patient Interview ◽

Knowledge Questionnaire ◽

Hospital Patients ◽

Patients With Epilepsy ◽

Age Range ◽

The Impact

Background and objective: Inadequate epileptic patient’s knowledge regarding their disorder may affect the quality of their life. The aim of the study was to determine the impact of epileptic patient’s knowledge on the quality of their life.Methods: Research design: a descriptive study was conducted in the period from February to April 2017 to determine the impact of epileptic patient's knowledge on the quality of their life. Setting; this study was carried out in the neurology department and neurology outpatient clinic of Assiut Neurology University Hospital. Patients; a sample of sixty epileptic male and female patients, with an age range between 18 to 65 years was included. Two tools were used: Tool I: Structured patient interview questionnaire sheet and it included two parts: Part one: Sociodemographic data about of the studied patients, Part two: knowledge assessment regarding their disorder using Epilepsy Patient Knowledge Questionnaire (EPKQ). Tool II: Quality of Life in Epilepsy (QOLIE 31).Results: The highest percentage of the studied sample was male, married, their mean age was 38.97 ± 11.21, and their duration of epilepsy was 16.82 ± 9.7. 58.3% were having satisfactory level of knowledge regarding their condition.Conclusions and recommendation: The present study concluded that: epileptic patients are lacking knowledge regarding their condition (58.3% vs. 41.7%). There was No significant correlation between total QOL and score of knowledge. Recommendation: A self-management program is needed for patients with epilepsy in order to improve their knowledge regarding their disease.

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Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

BioMed Research International ◽

10.1155/2020/9292163 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Fandresena Arilala Sendrasoa ◽

Naina Harinjara Razanakoto ◽

Volatantely Ratovonjanahary ◽

Onivola Raharolahy ◽

Irina Mamisoa Ranaivo ◽

...

Keyword(s):

Quality Of Life ◽

Negative Impact ◽

Young Patients ◽

The Body ◽

University Hospital ◽

Medical Decision ◽

Cross Sectional ◽

The Difference ◽

The Impact

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

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The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

Otolaryngology ◽

10.1177/0194599819855379 ◽

2019 ◽

Vol 161 (4) ◽

pp. 589-597 ◽

Cited By ~ 1

Author(s):

Jesper Roed Sorensen ◽

Trine Printz ◽

Jenny Iwarsson ◽

Ågot Møller Grøntved ◽

Helle Døssing ◽

...

Keyword(s):

Quality Of Life ◽

Thyroid Disease ◽

Superior Laryngeal Nerve ◽

Laryngeal Nerve ◽

University Hospital ◽

Specific Patient ◽

Perceptual Evaluation ◽

Patient Reported ◽

The Impact

Objective To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design Observational study. Setting University hospital. Subjects and Methods Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI ( P = .002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency ( P < .001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT ( P = .001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point ( P = .02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

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