Can an allied health expanded scope Treatment Access Pathway (TAP) improve health outcomes for people with persistent pain? Study protocol for a pragmatic randomised controlled trial

Abstract Background Persistent pain is a public health crisis. Demand for services frequently exceeds supply and many individuals miss out on timely treatment resulting in longer than recommended wait times. The Interdisciplinary Persistent Pain Centre (IPPC) (Queensland, Australia) implemented a Treatment Access Pathway (TAP), an allied health first point of contact model of care to allow patients access to empirically supported allied health treatment without Pain Specialist assessment. The primary aim of this research project is to understand the clinical and cost effectiveness of TAP in a real-world setting. Method: Participants referred to the IPPC are randomly allocated to treatment or waitlist control groups and self-report and objective physical outcome measures are collected at baseline and 6 months’ time. A total of 196 patients will be recruited for the study (treatment group, n=98 and control group, n=98) to allow a 20% attrition rate to gain 156 participants for the study. Discussion: The results of this study will determine the clinical outcomes and cost effectiveness of the TAP as a model of care to inform future clinical decision making and program development. Ethics approval was provided by the Research Governance Office at Gold Coast Hospital and Health Service (RGOGCHHS) on the 19/10/2016 (HREC/16/QGC/156).

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Virtual geriatric clinics and the COVID-19 catalyst: a rapid review

Age and Ageing ◽

10.1093/ageing/afaa191 ◽

2020 ◽

Vol 49 (6) ◽

pp. 907-914 ◽

Cited By ~ 2

Author(s):

Robert P Murphy ◽

Karen A Dennehy ◽

Maria M Costello ◽

Evelyn P Murphy ◽

Conor S Judge ◽

...

Keyword(s):

Cost Effectiveness ◽

Clinical Benefit ◽

Outpatient Service ◽

Added Value ◽

Rapid Review ◽

Model Of Care ◽

Health Crisis ◽

Acute Hospitalisation ◽

Geriatric Clinic ◽

Clinical Benefits

Abstract Background During the current COVID-19 health crisis virtual geriatric clinics have become increasingly utilised to complete outpatient consultations, although concerns exist about feasibility of such virtual consultations for older people. The aim of this rapid review is to describe the satisfaction, clinic productivity, clinical benefit, and costs associated with the virtual geriatric clinic model of care. Methods A rapid review of PubMed, MEDLINE and CINAHL databases was conducted up to April 2020. Two independent reviewers extracted the information. Four subdomains were focused on: satisfaction with the virtual geriatric clinic, clinic productivity, clinical benefit to patients, costs and any challenges associated with the virtual clinic process. Results Nine studies with 975 patients met our inclusion criteria. All were observational studies. Seven studies reported patients were satisfied with the virtual geriatric clinic model of care. Productivity outcomes included reports of cost-effectiveness, savings on transport, and improved waiting list metrics. Clinical benefits included successful polypharmacy reviews, and reductions in acute hospitalisation rates. Varying challenges were reported for both clinicians and patients in eight of the nine studies. Hearing impairments and difficulty with technology added to anxieties experienced by patients. Physicians missed the added value of a thorough physical examination and had concerns about confidentiality. Conclusion Virtual geriatric clinics demonstrate evidence of productivity, benefit to patients, cost effectiveness and patient satisfaction with the treatment provided. In the current suboptimal pandemic climate, virtual geriatric clinics may allow Geriatricians to continue to provide an outpatient service, despite the encountered inherent challenges.

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Benefit From, Satisfaction With, and Cost-Effectiveness of Three Different Hearing Aid Technologies

American Journal of Audiology ◽

10.1044/1059-0889(1998/021) ◽

1998 ◽

Vol 7 (2) ◽

pp. 115-128 ◽

Cited By ~ 15

Author(s):

Craig W. Newman ◽

Sharon A. Sandridge

Keyword(s):

Cost Effectiveness ◽

Clinical Decision Making ◽

Hearing Aid ◽

Present Report ◽

Digital Signal ◽

Clinical Decision ◽

The Elderly ◽

Self Report ◽

Effectiveness Model ◽

Hearing Aid Benefit

Clinical decision-making has become more complex as newer, more costly, hearing aid (HA) technologies become available. The expanding array of more expensive HAs demands that clinical researchers continue to justify the value of these instruments relative to the substantial increase in cost to both the provider and consumer. In the present report, 25 current conventional HA users with adult onset of sensorineural hearing loss were fitted with: (a) a one-channel linear HA; (b) a two-channel, nonlinear HA; and (c) a seven-band, two-channel digital signal processing (DSP) HA. All instruments were mini behind-the-ear units with identifying information removed from the cases. Subjects wore each HA for at least a 1-month period. A set of laboratory (Speech Perception in Noise [SPIN] test; audibility index calculated from real-ear measurements) and self-report (Abbreviated Profile of Hearing Aid Benefit; Hearing Handicap Inventory for the Elderly/Adults; Knowles Hearing Aid Satisfaction Survey; preference ratings) outcome measures were used to evaluate the benefit from, satisfaction with, and cost-effectiveness of each test HA. As expected, there were statistically significant differences between unaided and aided conditions across HAs. Although the DSP instrument yielded significantly higher word recognition scores on the SPIN test, no differences were observed among the test HAs for the standardized self-report measures. In contrast, however, more than 75% of the subjects preferred the “higher end” instruments. Yet, 33% of the subjects changed their preference for the “higher end” instruments after being informed of costs. A cost-effectiveness model for evaluating the relationship between HA retail purchase price and improvements in performance/benefit is presented.

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Effectiveness and cost-effectiveness of brief Mindfulness-Based Cognitive Therapy for the improvement of productivity in the workplace: Study protocol for a randomized controlled trial (Preprint)

10.2196/preprints.36012 ◽

2021 ◽

Author(s):

Mitsuhiro Sado ◽

Masashi Yamada ◽

Akira Ninomiya ◽

Maki Nagaoka ◽

Naho Goto ◽

...

Keyword(s):

Cost Effectiveness ◽

Cognitive Therapy ◽

Work Performance ◽

Controlled Trial ◽

Self Report ◽

World Health ◽

Control Group ◽

Work Related ◽

Health Organization ◽

The Impact

BACKGROUND Numerous studies have demonstrated the effectiveness of Mindfulness Based Programs’ (MBPs) among both clinical and non-clinical populations. These data document positive impacts in the workplace, including reducing perceived stress and burnout and increasing wellbeing. However, the effectiveness for productivity, which is of most interest to managers and administrators, is still unclear. In addition, MBPs in the workplace tend to be modified by reducing the number of the program sessions or delivering content online to improve accessibility. To date, however, the impact on productivity of MBPs in the workplace that feature these modifications has not been investigated. OBJECTIVE The study aimed to investigate the effectiveness and cost-effectiveness of the online-delivered brief Mindfulness Based Cognitive Therapy (bMBCT) for improving productivity and other work related outcomes. METHODS We conduct a four-week RCT with a six-month follow-up. Employees are included in the study if they 1) are between the ages of 20-65 and 2) work longer than 30 hours weekly. Employees were randomly allocated to either the bMBCT group or wait-list control group. The primary outcome of the study is the mean difference of productivity measured by World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) between the groups at 4, 16, 28 weeks. Secondary outcomes include several clinical outcomes and health economics evaluation. RESULTS Recruitment began in August 2021. 104 participants have been enrolled in the study as of October 2021. The intervention is ongoing and scheduled to be completed in December 2023. Data collection will be completed by March 2024. CONCLUSIONS The novelty of the study is that 1) it will investigate the bMBCTs’ effectiveness on productivity, which is still unclear, 2) samples are recruited from three companies in different industries, etc. The limitations of the study are 1) all measures assessed are self-report format, 2) we lack an active control group. This study has the potential to provide new data on the relationship between MBPs and occupational health and productivity. CLINICALTRIAL UMIN Clinical Trials Registry: UMIN000044721

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The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction

American Journal of Audiology ◽

10.1044/2018_aja-18-0130 ◽

2019 ◽

Vol 28 (2) ◽

pp. 274-284 ◽

Cited By ~ 6

Author(s):

Elizabeth Convery ◽

Gitte Keidser ◽

Louise Hickson ◽

Carly Meyer

Keyword(s):

Decision Making ◽

Hearing Loss ◽

Hearing Aids ◽

Clinical Decision Making ◽

Hearing Aid ◽

Well Being ◽

Self Report ◽

Self Management ◽

Hearing Aid Benefit ◽

The Relationship

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.

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Promoting the Community's Ability to Detect and Respond to Suicide Risk Through an Online Bystander Intervention Model-Informed Tool

Crisis ◽

10.1027/0227-5910/a000708 ◽

2020 ◽

pp. 1-7

Author(s):

Karien Hill ◽

Shawn Somerset ◽

Ralf Schwarzer ◽

Carina Chan

Keyword(s):

Suicide Prevention ◽

Suicide Risk ◽

Controlled Trial ◽

Intervention Group ◽

Bystander Intervention ◽

Self Report ◽

Innovative Technology ◽

Control Group ◽

Intervention Model ◽

Standard Material

Abstract. Background: The public health sector has advocated for more innovative, technology-based, suicide prevention education for the community, to improve their ability to detect and respond to suicide risk. Emerging evidence suggests addressing the bystander effect through the Bystander Intervention Model (BIM) in education material may have potential for suicide prevention. Aims: The current study aimed to assess whether BIM-informed tools can lead to improved readiness, confidence and intent in the community to detect and respond to suicide risk in others. Method: A sample of 281 adults recruited from the community participated in a randomized controlled trial comprising a factsheet designed according to the BIM (intervention group) and a standard factsheet about suicide and mental health (control group). Participants' self-reported detecting and responding to suicide risk readiness, confidence, and intent when presented with a suicidal peer was tested pre- and postintervention and compared across time and between groups. Results: The intervention group had significantly higher levels of detecting and responding to suicide risk readiness, confidence, and intent than the control group at postintervention (all p < .001) with moderate-to-large effect sizes. Limitations: The study was limited by a homogenous sample, too low numbers at follow-up to report, and self-report data only. Conclusion: This study demonstrates BIM-informed suicide prevention training may enhance the community's intervention readiness, confidence, and intent better than current standard material. Further testing in this area is recommended. While results were statistically significant, clinical significance requires further exploration.

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Efektivitas Short Message Service Reminderterhadap Kepatuhan Konsumsi Tablet Besi pada Wanita Hamil

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v2i3.87 ◽

1970 ◽

Vol 2 (3) ◽

Author(s):

Ermiati E ◽

Imas Rafiyah ◽

Devi Kusnanti

Keyword(s):

Short Message Service ◽

Self Report ◽

Control Group ◽

Short Message ◽

Control Groups ◽

Chi Square ◽

Purposive Sampling ◽

Message Service ◽

Sms Reminder ◽

Expectant Mothers

Anemia merupakan salah satu penyebab terjadinya perdarahan dan bisa mengakibatkan kematian pada ibu hamil. Suplementasi besi merupakan program pemerintah dalam mengatasi anemia pada wanita hamil dan beberapa wanita hamil masih ada yang belum patuh dalam mengkonsumsi tablet besi. Oleh karena itu, diperlukan sebuah metode yang bisa meningkatkan kepatuhan wanita hamil dalam mengonsumsi tablet besi yaitu dengan short message service (SMS) reminder. Penelitian ini bertujuan untuk mengidentifikasi efektivitas SMS reminderterhadap kepatuhan konsumsi tablet besi pada ibu hamil di (unit pelayanan terpadu) UPT Puskesmas Cibuntu Kota Bandung. Rancangan penelitian quasi experimentaldengan desain posttest-only with control group designdengan teknik pengambilan sampel yang digunakan adalah purposive sampling. Penelitian ini dilaksanakan dari bulan April–Mei tahun 2014 di Puskesmas X Kota Bandung. Sampel berjumlah 40 orang wanita hamil yang tidak patuh dalam mengonsumsi tablet besi yang dibagi menjadi 20 kelompok intervensi dan 20 kelompok kontrol. Data diperoleh melalui kuesioner dalam bentuk self report.Analisis data yang digunakan adalah analisis deskriptif dan uji chi square. Hasil penelitian menunjukkan sebagian besar kelompok intervensi 17 orang (85%) patuh dan sebagian besar kelompok kontrol 16 orang (80%) tidak patuh. Hasil analisis dengan menggunakan chi squaredidapatkan p(0.000) dengan taraf signifikan <0.05 sehingga dapat disimpulkan bahwa SMS reminder efektif terhadap kepatuhan konsumsi tablet besi pada wanita hamil dan bisa dijadikan bahan pertimbangan bagi pihak Puskesmas untuk menjalin kerjasama dengan pihak provideratau mengajukan dana ke Dinas Kesehatan untuk mengaktifkan SMS reminderdi Puskesmas.Kata kunci: Kepatuhan, SMS reminder,tablet besi, wanita hamil AbstractAnemia is one of the leading causes of hemorrhage during pregnancy, and it can cause death to expectant mothers. Iron supplementation is a government program to overcome anemia among expectant mothers, and some of the expectant mothers still do not obediently consume iron tablets. Therefore, to increase the obedience of the expectant mothers on consuming the iron tablets, SMS reminder is the appropriate method needed. This research aims to identify the effectiveness of SMS reminder to the obedience of iron tablets consumption among expectant mothers at UPT Puskesmas Cibuntu , Bandung. The research employed quasi-experimental design with posttest-only control group design using purposive sampling technique. The research was held on April–May 2014 at UPT Puskesmas Cibuntu, Bandung. Forty expectant mothers consuming iron tablets disobediently divided into 20 intervention groups and 20 control groups were taken as the samples. Questionnaire in form of self report was used to obtain data. In addition, descriptive analysis and chi square test were applied to analyze the data. The result of the research showed that 17 persons (85%) of intervention groups were mostly obedient, and 16 persons (80%) of control groups were mostly disobedient. From the analysis using chi square, it was found the difference of the obedience of iron tablets consumption after SMS reminder (p=0.00) had been delivered with significant level <0.05. Based on the result of this research, SMS reminder had an effective impact toward the obedience of iron tablets consumption among the expectant mothers. The result will be a good consideration for Puskesmas to cooperate with provider or proposed some funds to Dinas Kesehatan to activate SMS reminder.Key words:Expectant mothers, obedience, SMS reminder, iron tablets

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The Effectiveness of Using a Mobile Messenger as an Educational Supporting Tool among Nursing Students

Asian Journal of Medicine and Biomedicine ◽

10.37231/ajmb.2020.4.1.333 ◽

2020 ◽

Vol 4 (1) ◽

pp. 67-77

Author(s):

Rohimah Ismail ◽

Chong Mei Chan ◽

Wan Muhammad Azly W. Zulkafli ◽

Hasnah Zani ◽

Zainab Mohd Shafie

Keyword(s):

Nursing Education ◽

Nursing Students ◽

Clinical Decision Making ◽

Intervention Group ◽

Great Influence ◽

Control Group ◽

P Value ◽

Significant Difference ◽

Supporting Tool ◽

Nursing College

The evolution of information technology has exerted great influence on nursing education via new pedagogy of knowledge delivery without time and place restriction. Mobile technology revolutionises nursing education and clinical practice via empowering skills of critical thinking and clinical decision-making through learning. The aim of this study is to evaluate the effectiveness of using mobile messenger (Whatsapp) as an educational supporting tool among nursing students. The study design used is a Cluster Randomized Control Trail. Two nursing colleges were selected. Sample size was 93 participants, 48 from the Kuala Terengganu Nursing College Kuala Terengganu as the intervention group while the control group were recruited among 45 participants from UniSZA Nursing College. There is a significant difference in the level of knowledge between pre and posttest among intervention group (mean difference was -8.70 with a standard deviation 8.42, p-value< 0.001) and 93.8 percent of the respondents perceived the usefulness of using WhatsApp mobile messenger to enhance learning. This demonstrates that learning through mobile messenger (WhatsApp) enhances learning and is well received as a new method of learning by almost all students. Keywords: Mobile learning, WhatsApp messenger, Social Interaction

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Relaksasi Benson Untuk Durasi Tidur Pasien Penyakit Jantung Koroner

Jurnal Endurance ◽

10.22216/jen.v3i3.2788 ◽

2018 ◽

Vol 3 (3) ◽

pp. 556

Author(s):

Mulyanti Roberto Muliantino ◽

Tuti Herawati ◽

Masfuri Masfuri

Keyword(s):

Cardiac Rehabilitation ◽

Sleep Duration ◽

Intervention Group ◽

Self Report ◽

Pharmacological Intervention ◽

Control Group ◽

P Value ◽

Short Sleep Duration ◽

Short Sleep ◽

Coronary Arterial Disease

Coronary Arterial Disease (CAD) is one of cardiovaskular disease that remain leading cause death and disability. Short sleep duration is the major symptoms in patients with CAD, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to increase sleep duration, however few studies related to this technique in planned intervention. This study was to measured the effectiveness of Benson’s relaxation in short sleep duration of CAD patients during cardiac rehabilitation. It was a quasi experimental pretest posttest control group design. This study included 29 respondens in Dr.M.Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). Benson’s relaxation technique was administered for 5 days 2 times a day, each 20 minutes to intervention group. Short sleep duration was measured using sleep diary (self report). The result indicated significant increasing in mean of sleep duration before and after Benson’s relaxation in intervention group (p value < 0,001). The study concluded that Benson’s relaxation technique is an effective non-pharmacological intervention to increase sleep duration in CAD patients. Penyakit jantung koroner menjadi masalah kardiovaskular yang mengakibatkan angka mortalitas yang tinggi. Durasi tidur pendek termasuk salah satu keluhan utama pasien penyakit jantung koroner pada masa recovery setelah serangan dan menjalani rehabilitasi fase 2. Relaksasi Benson merupakan teknik relaksasi sebagai terapi modalitas untuk mengurangi keluhan durasi tidur pendek, namum belum banyak penelitian terkait intervensi ini. Penelitian ini bertujuan untuk mengidentifikasi pengaruh relaksasi Benson terhadap durasi tidur pasien penyakit jantung koroner yang menjalani rehabilitasi fase 2. Penelitian ini menggunakan desain Quasi Eksperimen dengan pendekatan control group pretest posttest design pada 29 responden di RSUP. Dr.M.Djamil Padang yang dibagi dalam dua kelompok (kelompok intervensi dan kelompok kontrol). Hasil penelitian menunjukan ada perbedaan rerata durasi tidur yang signifikan antara sebelum dan setelah dilakukan intervensi relaksasi Benson pada kelompok intervensi (p value < 0,001). Simpulan hasil penelitian ini dapat menjadi salah satu terapi modalitas bagi perawat untuk mengatasi masalah durasi tidur pendek pada pasien penyakit jantung koroner.

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Enhancing Patient-Provider Communication With the Electronic Self-Report Assessment for Cancer: A Randomized Trial

Journal of Clinical Oncology ◽

10.1200/jco.2010.30.3909 ◽

2011 ◽

Vol 29 (8) ◽

pp. 1029-1035 ◽

Cited By ~ 204

Author(s):

Donna L. Berry ◽

Brent A. Blumenstein ◽

Barbara Halpenny ◽

Seth Wolpin ◽

Jesse R. Fann ◽

...

Keyword(s):

Controlled Trial ◽

Clinic Visit ◽

Self Report ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Control Group ◽

Cancer Symptoms ◽

Patient Reported ◽

Life Issues ◽

Clinic Visits

Purpose Although patient-reported cancer symptoms and quality-of-life issues (SQLIs) have been promoted as essential to a comprehensive assessment, efficient and efficacious methods have not been widely tested in clinical settings. The purpose of this trial was to determine the effect of the Electronic Self-Report Assessment–Cancer (ESRA-C) on the likelihood of SQLIs discussed between clinicians and patients with cancer in ambulatory clinic visits. Secondary objectives included comparison of visit duration between groups and usefulness of the ESRA-C as reported by clinicians. Patients and Methods This randomized controlled trial was conducted in 660 patients with various cancer diagnoses and stages at two institutions of a comprehensive cancer center. Patient-reported SQLIs were automatically displayed on a graphical summary and provided to the clinical team before an on-treatment visit (n = 327); in the control group, no summary was provided (n = 333). SQLIs were scored for level of severity or distress. One on-treatment clinic visit was audio recorded for each participant and then scored for discussion of each SQLI. We hypothesized that problematic SQLIs would be discussed more often when the intervention was delivered to the clinicians. Results The likelihood of SQLIs being discussed differed by randomized group and depended on whether an SQLI was first reported as problematic (P = .032). Clinic visits were similar with regard to duration between groups, and clinicians reported the summary as useful. Conclusion The ESRA-C is the first electronic self-report application to increase discussion of SQLIs in a US randomized clinical trial.

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Solution-Focused Brief Therapy With Substance-Using Individuals

Research on Social Work Practice ◽

10.1177/1049731516650517 ◽

2016 ◽

Vol 28 (4) ◽

pp. 452-462 ◽

Cited By ~ 13

Author(s):

Johnny S. Kim ◽

Jody Brook ◽

Becci A. Akin

Keyword(s):

Substance Use ◽

Linear Models ◽

Brief Therapy ◽

Controlled Trial ◽

Addiction Severity Index ◽

Self Report ◽

Effect Sizes ◽

Control Group ◽

Solution Focused Brief Therapy ◽

Solution Focused

Objective: This study examined the effectiveness of solution-focused brief therapy (SFBT) intervention on substance abuse and trauma-related problems. Methods: A randomized controlled trial design was used to evaluate the effectiveness of SFBT in primary substance use treatment services for child welfare involved parents in outpatient treatment for substance use disorders. Mixed linear models were used to test within- and between-group changes using intent-to-treat analysis ( N = 64). Hedges’s g effect sizes were also calculated to examine magnitude of treatment effects. Results: Both groups decreased on the Addiction Severity Index-Self-Report and the Trauma Symptom Checklist-40. The between group effect sizes were not statistically significant on either measures, thus SFBT produced similar results as the research supported treatments the control group received. Conclusion: Results support the use of SFBT in treating substance use and trauma and provide an alternative approach that is more strengths based and less problem focused.

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