scholarly journals Program Evaluation of GLA:D® Australia: Physiotherapist Training Outcomes and Effectiveness of Implementation for People With Knee Osteoarthritis

2021 ◽  
Author(s):  
Christian Barton ◽  
Joanne Kemp ◽  
Ewa Roos ◽  
Soren Skou ◽  
Karen Dundules ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Exercise Therapy ◽  
Effect Size ◽  
Scale Up ◽  
Qualitative Evaluation ◽  
Effective Implementation ◽  
Small Effect Size ◽  
Patient Reported

Abstract BackgroundThe Good Life with osteoArthritis from Denmark (GLA:D®) program incorporates guideline-based patient education and exercise-therapy for osteoarthritis to implement guidelines into practice. We evaluated the implementation of GLA:D® for knee osteoarthritis within Australian physiotherapy practice using the RE-AIM QuEST (Reach, Effectiveness, Adoption, Implementation, Maintenance Qualitative Evaluation for Systematic Translation) framework.MethodsAustralian physiotherapists were trained and supported to deliver GLA:D® (2017-2019) and completed surveys before and after training to assess practices, beliefs about capabilities and confidence, and barriers and enablers to implementation. Patients participating in GLA:D® completed online baseline, 3-month (immediately post-treatment) and 12-month patient reported outcomes. Effective implementation was defined as within-subject moderate effect size (ES, ≥0.50) for average pain (100mm visual analogue scale) and knee osteoarthritis outcome score quality of life scores (KOOS-QoL), and small effect size (≥0.20) for health-related quality of life (EQ-5D-5L).ResultsReach: 1,064 physiotherapists (73% private) and 1,945 (79% private) from all states and territories consented to participation. Key barriers included out-of-pocket cost to patients, and program suitability for culturally and linguistically diverse communities. Effectiveness: Following training, more physiotherapists discussed treatment goals and the importance of weight management, and prescribed supervised, neuromuscular exercise. Patient outcomes at 3- and 12 months (n = 1,044 [54%] and 927 [48%]) reflected effective implementation, including reduced pain intensity (ES, 95%CI = 0.72, 0.62-0.84; and 0.65, 0.54-0.77), improved KOOS-QoL scores (0.79, 0.69-0.90; and 0.93, 0.81-1.04), and improved EQ-5D-5L scores (0.43, 0.31-0.54; and 0.46, 0.35-0.58). Seventy-three percent of participants reported minimal important changes for at least one of pain severity (≥ 15 mm), KOOS-QoL (≥ 15 points) or EQ-5D-5L (≥ 0.07 points). Adoption: GLA:D® was implemented at 297 sites (264 private, 33 public). Implementation: Most patients completed at least one education (90%), and 10 exercise-therapy (78%) sessions. Adequate staffing to support program delivery was a key enabler. Maintenance: Ninety-nine percent of sites (293/297) continued to offer the program in July 2020.ConclusionsTraining was associated with practice changes and widespread implementation of GLA:D® in Australia. Effective implementation, and clinically meaningful improvements in pain and quality of life for most participant, supports further work to scale up GLA:D® in Australia.

scholarly journals The Effect of Educational Intervention on Anxiety and Quality of Life Among Individuals Referring to Healthcare Centers in the Face of COVID-19

2021 ◽  
Author(s):  
Fariba Zahedifar ◽  
Zahra Nejatifar ◽  
Sima Rafiei ◽  
Fariba Hashemi
Keyword(s):  
Quality Of Life ◽  
Educational Intervention ◽  
Effect Size ◽  
Knowledge Score ◽  
Educational Interventions ◽  
Anxiety Control ◽  
Small Effect Size ◽  
Quasi Experimental ◽  
Most Significant Change

Educational interventions are helpful strategies to empower communities encountering the threat of pandemics like Covid-19. This study was carried out to examine the effect of educational intervention on anxiety control and improvement in public quality of life. A quasi-experimental study. The study was conducted among individuals referred to healthcare centers of Qazvin province, Iran, in 2020. Given that Qazvin consists of nine urban healthcare centers, two centers were selected by a simple random selection method. After considering inclusion and exclusion mentioned criteria, 240 individuals were selected to participate in the research and were randomly assigned into two groups of experimental and control. Following the educational intervention, all study variables, including knowledge score, anxiety level, and quality of life, improved significantly in the experimental group compared to the pre-intervention phase (P<0.05). The most significant change was in knowledge score with a nearly large effect size (0.63), presenting an increase of 40.09% from 11.1 to 18.8 exactly after intervention and 12.2 after passing one month from the date of educational intervention; while the quality of life presented a 3.2% increase with a small effect size (0.28). Our findings have implications for the development and implementation of psychological interventions, particularly educational programs. During the outbreak, such strategies can empower the public and diminish the negative emotional effects of the pandemic, helping people to cope with the current situation, and decrease the risk of suffering future psychological disorders.  

scholarly journals 12-Month Cohort Study to Investigate Changes in Patient-Reported Outcomes Pain after Intra-articular Injection of Micro-Fragmented Adipose Tissue for Knee Osteoarthritis

2021 ◽  
Vol 3 (1) ◽  
pp. e19-e28
Author(s):  
Nathan Hogaboom ◽  
Ella D'Amico ◽  
Ken Mautner ◽  
Christopher Rogers ◽  
Gerard Malanga
Keyword(s):  
Quality Of Life ◽  
Adipose Tissue ◽  
Knee Osteoarthritis ◽  
Outcome Measures ◽  
Knee Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Symptomatic Knee ◽  
Patient Reported

BackgroundTo evaluate changes in pain, function, and quality of life after treatment with injected micro-fragmented adipose tissue (MFAT) for knee osteoarthritis in a large cohort of individuals treated at multiple centers. MethodsOne hundred ten individuals were recruited from three private outpatient clinics. Participants had to be diagnosed with symptomatic knee OA (defined by persistent knee pain associated with clinical symptoms of OA and/ or classic imaging findings) and who had not received prior knee surgery or treatment with platelet-rich plasma, cortisone, or hyaluronic acid within the previous 6 weeks. Data from 120 knees were included in the analysis. Outcome measures included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, activities of daily living [ADL], sports and recreation, quality of life [QOL]) and an 11-point Numerical Rating Scale (NRS) for average knee pain over the past week. Outcomes were collected at baseline and 3, 6, and 12 months. ResultsSignificant increases and decreases in KOOS subscale and NRS scores were observed, respectively, in the cohort as a whole (p< .05). Lower BMI was associated with more significant improvements in pain, sports/recreation, and ADL KOOS subscale scores (p< .05). Greater age was associated with more significant improvements in symptoms and QOL subscale scores (p< .05). ConclusionsA single injection of MFAT improved pain, function, and QOL outcome measures up to 12 months in this cohort for more than half of the participants. Greater BMI and lower age negatively influenced outcomes. It is not known whether improvements continue after this timeframe or why many participants reported little-to-no improvement.

The effects of atomoxetine on emotional control in adults with ADHD: An integrated analysis of multicenter studies

2015 ◽  
Vol 30 (4) ◽  
pp. 511-520 ◽  
Author(s):  
P. Asherson ◽  
S. Stes ◽  
M. Nilsson Markhed ◽  
L. Berggren ◽  
P. Svanborg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effect Size ◽  
Adult Adhd ◽  
Self Report ◽  
Integrated Analysis ◽  
Emotional Control ◽  
Adhd Symptoms ◽  
Multicenter Studies ◽  
Small Effect Size

AbstractPurpose:To investigate the effects of atomoxetine on emotional control in adults with ADHD.Methods:We performed an integrated analysis using individual patient data pooled from three Eli Lilly-sponsored studies. An integrated analysis can be viewed as a meta-analysis of individual patient-level data, rather than study-level summary data.Results:Two populations were identified: a large sample of patients with pre-treatment baseline data (the “overall population”; n = 2846); and a subset of these patients with placebo-controlled efficacy data from baseline to 10 or 12 weeks after initiating treatment (the “placebo-controlled population”; n = 829). At baseline, in the overall population, ∼50% of ADHD patients had BRIEF-AS (Behavior Rating Inventory of Executive Function-Adult Version Self-Report) Emotional control subscores between 21 and 30, compared with ∼10% of normative subjects in the BRIEF-A manual. At endpoint, in the placebo-controlled population, atomoxetine led to a small (effect size 0.19) but significant (P = 0.013) treatment effect for emotional control. The effect size was 0.32 in patients with BRIEF-AS Emotional control scores > 20 at baseline. Improvements in emotional control correlated with improvements in the core ADHD symptoms and quality-of-life.Discussion:As deficient emotional control is associated with impaired social, educational and occupational functioning over and above that explained by core ADHD symptoms alone, improvements in emotional control may be clinically relevant.Conclusion:At baseline, adults with ADHD were more likely to have impaired emotional control than normative subjects. In the adult ADHD patients, atomoxetine treatment was associated with improvements in emotional control, as well as in core ADHD symptoms and quality-of-life.

scholarly journals Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? A systematic review and meta-analysis

2019 ◽  
Vol 54 (5) ◽  
pp. 263-271 ◽  
Author(s):  
Andrew Craig Hislop ◽  
Natalie J Collins ◽  
Kylie Tucker ◽  
Margaret Deasy ◽  
Adam Ivan Semciw
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Patient Reported ◽  
Randomised Controlled ◽  
And Function ◽  
Hip Strengthening

ObjectivesTo determine, in people with knee osteoarthritis (KOA): i) the effectiveness of adding hip strengthening exercises to quadriceps exercises and ii) the type of hip strengthening exercise with the greatest evidence for improving pain, function and quality of life.DesignSystematic review with meta-analysis.Data sourcesMedline, Embase, Cochrane, CINAHL and SportDiscus databases were searched from inception to January 2018.Eligibility criteria for selecting studiesRandomised controlled trials investigating the effect of adding hip exercises to quadriceps exercises in people with KOA on pain, function and/or quality of life were included. Three subgroups of hip exercises were included: resistance, functional neuromuscular or multimodal exercise.ResultsEight studies were included. Pooled data provide evidence that combined hip and quadriceps exercise is significantly more effective than quadriceps exercise alone for improving walking function (standardised mean difference −1.06, 95% CI −2.01 to −0.12), but not for outcomes of pain (−0.09, 95% CI –0.96 to 0.79), patient-reported function (−0.74, 95% CI –1.56 to 0.08) or stair function (−0.7, 95% CI –1.67 to 0.26). Subgroup analyses reveal that hip resistance exercises are more effective than functional neuromuscular exercises for improving pain (p<0.0001) and patient-reported function (p<0.0001). Multimodal exercise is no more effective than quadriceps strengthening alone for pain (0.13, 95% CI –0.31 to 0.56), patient-reported function (−0.15, 95% CI –0.58 to 0.29) or stair function (0.13, 95% CI –0.3 to 0.57).ConclusionWalking improved after the addition of hip strengthening to quadriceps strengthening in people with KOA. The addition of resistance hip exercises to quadriceps resulted in greater improvements in patient-reported pain and function.

scholarly journals Feasibility and acceptability of e-PROMs data capture and feedback among patients receiving haemodialysis in the Symptom monitoring WIth Feedback Trial (SWIFT) pilot: protocol for a qualitative study in Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039014
Author(s):  
Emily Duncanson ◽  
Paul N Bennett ◽  
Andrea Viecelli ◽  
Kathryn Dansie ◽  
William Handke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Qualitative Study ◽  
Symptom Burden ◽  
Qualitative Evaluation ◽  
Patient Reported Outcome Measures ◽  
Data Capture ◽  
Normalisation Process Theory ◽  
Main Trial ◽  
Patient Reported

IntroductionPeople receiving haemodialysis experience a high symptom burden and impaired quality of life. The use of patient-reported outcome measures (PROMs) is increasing in nephrology care, however their acceptability, utility and impacts are not well understood.Methods and analysisWe describe a protocol for a qualitative study to evaluate the feasibility and acceptability of electronic-PROMs (e-PROMs) data capture and feedback in haemodialysis following the pilot Symptom monitoring WIth Feedback Trial (SWIFT). SWIFT involves linkage of e-PROMs data, including symptoms and health-related quality of life, to the Australia and New Zealand Dialysis and Transplant Registry with feedback to patients’ treating nephrologists and nurse unit managers. Focus groups and semistructured interviews will be conducted with nephrologists (n=15), dialysis nurses (n=24) and patients receiving haemodialysis (n=24) from six dialysis units in Australia. Question topics will include the technical and clinical feasibility and acceptability of e-PROMs reporting and feedback (including the barriers and enablers to uptake) and perceived impact on patient care and outcomes. Transcripts will be analysed thematically and guided by Normalisation Process Theory.Ethics and disseminationEthics approval was obtained from the relevant hospital Human Research Ethics Committees (HREC/18/CALHN/481; HREC/MML/54599). The findings from the SWIFT pilot and qualitative evaluation will inform the implementation of the SWIFT main trial, and more broadly, the use of e-PROMs in clinical settings and registries.Trial registration numberANZCTRN12618001976279.

scholarly journals Quality of life in elderly ICU survivors before the COVID-19 pandemic: a systematic review and meta-analysis of cohort studies

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045086
Author(s):  
Kevin Ariyo ◽  
Sergio Canestrini ◽  
Anthony S David ◽  
Alex Ruck Keene ◽  
Sebastian Wolfrum ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Decision Making ◽  
Cohort Studies ◽  
Effect Size ◽  
Meta Analysis ◽  
Qualitative Synthesis ◽  
Small Effect Size

ObjectivesThe influence of age on intensive care unit (ICU) decision-making is complex, and it is unclear if it is based on expected subjective or objective patient outcomes. To address recent concerns over age-based ICU decision-making, we explored patient-assessed quality of life (QoL) in ICU survivors before the COVID-19 pandemic.DesignA systematic review and meta-analysis of cohort studies published between January 2000 and April 2020, of elderly patients admitted to ICUs.Primary and secondary outcome measuresWe extracted data on self-reported QoL (EQ-5D composite score), demographic and clinical variables. Using a random-effect meta-analysis, we then compared QoL scores at follow-up to scores either before admission, age-matched population controls or younger ICU survivors. We conducted sensitivity analyses to study heterogeneity and bias and a qualitative synthesis of subscores.ResultsWe identified 2536 studies and included 22 for qualitative synthesis and 18 for meta-analysis (n=2326 elderly survivors). Elderly survivors’ QoL was significantly worse than younger ICU survivors, with a small-to-medium effect size (d=0.35 (−0.53 and −0.16)). Elderly survivors’ QoL was also significantly greater when measured slightly before ICU, compared with follow-up, with a small effect size (d=0.26 (−0.44 and −0.08)). Finally, their QoL was also marginally significantly worse than age-matched community controls, also with a small effect size (d=0.21 (−0.43 and 0.00)). Mortality rates and length of follow-up partly explained heterogeneity. Reductions in QoL seemed primarily due to physical health, rather than mental health items.ConclusionsThe results suggest that the proportionality of age as a determinant of ICU resource allocation should be kept under close review and that subjective QoL outcomes should inform person-centred decision -aking in elderly ICU patients.PROSPERO registration numberCRD42020181181.

Association of Physical Morbidity and Health-Related Quality of Life in a Representative Sample of Older German People

2018 ◽  
Vol 25 (4) ◽  
pp. 140-151
Author(s):  
Markus A. Wirtz ◽  
Matthias Morfeld ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer
Keyword(s):  
Quality Of Life ◽  
Representative Sample ◽  
Short Form ◽  
Physical Symptoms ◽  
German Population ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Abstract. The association between health-related quality of life (HRQoL; Short-Form Health Survey-12; SF-12) and patient-reported morbidity-related symptoms measured by the Patient Health Questionnaire-15 (PHQ-15) is analyzed in a representative sample of older people in the general German population. Data from 1,659 people aged 60 to 85 years were obtained. Latent class analysis identified six classes of patients, which optimally categorize clusters of physical symptoms the participants reported: musculoskeletal impairments (39.8%), healthy (25.7%), musculoskeletal and respiratory/cardiac impairments (12.8%), musculoskeletal and respiratory impairments, along with bowel and digestion problems (12.9%), general impairments (4.9%), and general impairments with no bowel and digestion problems (4.8%). The participants’ SF-12 Physical Health Scores (η2 = .39) and their Mental Health Scores (η2 = .28) are highly associated with these latent classes. These associations remain virtually identical after controlling for age. The results provide evidence that profiles of patient-reported physical impairments correspond strongly with reduced HRQoL independently from aging processes.

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