scholarly journals Elderly Medication Adherence Intervention Using the My Interventional Drug-Eluting Stent Educational App: Multisite Randomized Feasibility Trial (Preprint)

2019 ◽  
Author(s):  
Andrew Dallas Boyd ◽  
Chioma Iheanyi Ndukwe ◽  
Anandu Dileep ◽  
Olivia Frances Everin ◽  
Yingwei Yao ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Short Form ◽  
Controlled Trial ◽  
Depression Scale ◽  
Cook County ◽  
Feasibility Trial ◽  
Cook County Hospital ◽  
Drug Eluting Stent ◽  
Significant Difference ◽  
Drug Eluting

BACKGROUND A lifesaving treatment for myocardial infarction is the placement of a stent in a closed or obstructed coronary artery. The largest modifiable risk factor after receiving a stent is medication adherence to Dual AntiPlatelet Therapy, a combination of P2Y12 inhibitors and aspirin. OBJECTIVE This study aimed to determine the acceptability of a protocol and an intervention using the My Interventional Drug-Eluting Stent Educational App (MyIDEA) and to evaluate medication adherence using the proportion of days covered (PDC) and platelet activation tests in a multisite randomized controlled trial. METHODS Potential participants who received a post percutaneous coronary intervention (PCI) procedure with a drug-eluting stent were approached. All patients older than 50 years and who spoke English were recruited. Participants were recruited, baseline demographics were collected, and the Hospital Anxiety and Depression Scale (HADS), Rapid Estimate of Adult Literacy in Medicine-Short Form, Burden-Benefit questionnaire, 36-Item Short Form Health Survey, and PCI knowledge questionnaire were administered. Block randomization was used to randomize participants to either usual care or MyIDEA supplementation. MyIDEA is a personalized educational intervention based on the Kolb experiential learning theory using patient narratives for education. During the visits, participants’ blood was collected to measure platelet suppression from medication. During the second and third encounters, the Morisky medication adherence score and cardiology outcomes were measured. The study was conducted at the University of Illinois Hospital and John H Stroger Jr Cook County Hospital with appropriate ethical approvals. Platelet suppression was measured through aspirin reactive units and P2Y12 reactive units. Medication adherence was measured using the PDC. The analysis team was blinded to the participants’ group membership. The primary outcome was a feasibility analysis of recruitment and retention. RESULTS The mean age of participants was 60.4 years (SD 7.1); the majority of patients were black and non-Hispanic. The majority of patients’ reading levels were seventh grade or above, and they were not very familiar with other electronic devices for information and communication. The number of control subjects was 21, and the number of participants in the interventional arm was 24. The interventional group was able to use MyIDEA in both the hospital and outpatient setting. However, there was no significant difference in platelet suppression or medication adherence between groups. There were also differences between the groups in terms of depression and anxiety, initially, as measured by HADS. No documented adverse event associated with the intervention was found. CONCLUSIONS Elderly patients are willing to use tablet devices to be educated about health conditions. Additional studies are required to measure the effectiveness and determine the most suitable timing and location for patient education.

scholarly journals Elderly Medication Adherence Intervention Using the My Interventional Drug-Eluting Stent Educational App: Multisite Randomized Feasibility Trial

10.2196/15900 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e15900
Author(s):  
Andrew Dallas Boyd ◽  
Chioma Iheanyi Ndukwe ◽  
Anandu Dileep ◽  
Olivia Frances Everin ◽  
Yingwei Yao ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Short Form ◽  
Controlled Trial ◽  
Depression Scale ◽  
Cook County ◽  
Feasibility Trial ◽  
Cook County Hospital ◽  
Drug Eluting Stent ◽  
Significant Difference ◽  
Drug Eluting

Background A lifesaving treatment for myocardial infarction is the placement of a stent in a closed or obstructed coronary artery. The largest modifiable risk factor after receiving a stent is medication adherence to Dual AntiPlatelet Therapy, a combination of P2Y12 inhibitors and aspirin. Objective This study aimed to determine the acceptability of a protocol and an intervention using the My Interventional Drug-Eluting Stent Educational App (MyIDEA) and to evaluate medication adherence using the proportion of days covered (PDC) and platelet activation tests in a multisite randomized controlled trial. Methods Potential participants who received a post percutaneous coronary intervention (PCI) procedure with a drug-eluting stent were approached. All patients older than 50 years and who spoke English were recruited. Participants were recruited, baseline demographics were collected, and the Hospital Anxiety and Depression Scale (HADS), Rapid Estimate of Adult Literacy in Medicine-Short Form, Burden-Benefit questionnaire, 36-Item Short Form Health Survey, and PCI knowledge questionnaire were administered. Block randomization was used to randomize participants to either usual care or MyIDEA supplementation. MyIDEA is a personalized educational intervention based on the Kolb experiential learning theory using patient narratives for education. During the visits, participants’ blood was collected to measure platelet suppression from medication. During the second and third encounters, the Morisky medication adherence score and cardiology outcomes were measured. The study was conducted at the University of Illinois Hospital and John H Stroger Jr Cook County Hospital with appropriate ethical approvals. Platelet suppression was measured through aspirin reactive units and P2Y12 reactive units. Medication adherence was measured using the PDC. The analysis team was blinded to the participants’ group membership. The primary outcome was a feasibility analysis of recruitment and retention. Results The mean age of participants was 60.4 years (SD 7.1); the majority of patients were black and non-Hispanic. The majority of patients’ reading levels were seventh grade or above, and they were not very familiar with other electronic devices for information and communication. The number of control subjects was 21, and the number of participants in the interventional arm was 24. The interventional group was able to use MyIDEA in both the hospital and outpatient setting. However, there was no significant difference in platelet suppression or medication adherence between groups. There were also differences between the groups in terms of depression and anxiety, initially, as measured by HADS. No documented adverse event associated with the intervention was found. Conclusions Elderly patients are willing to use tablet devices to be educated about health conditions. Additional studies are required to measure the effectiveness and determine the most suitable timing and location for patient education. Trial Registration ClinicalTrials.gov NCT04439864; https://clinicaltrials.gov/ct2/show/NCT04439864

The Effects of Kinesiological Taping and Aerobic Exercise in Women with Primary Dysmenorrhea: A Randomized Single-Blind Controlled Trial

2021 ◽  
Author(s):  
Simge Temizkan ◽  
Miray BUDAK
Keyword(s):  
Quality Of Life ◽  
Menstrual Cycle ◽  
Short Form ◽  
Controlled Trial ◽  
Depression Scale ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Sf 36 ◽  
Significant Difference

Abstract Purpose: The purpose of this study was to investigate the effects of KT and AE on pain, attitude, depression, and quality of life in women with dysmenorrhoea. Methods: Forty-five women with dysmenorrhoea were randomly divided into three groups as KT group(n=15), AE group(n=15) and control group(n=15). In KT Group, 6 sessions of KT were applied, starting on the 14th day of the menstrual cycle and 2 times a week for 3 weeks until the cycle ended. In the AE group, walking and climbing stairs were given during the menstrual cycle, 3 days a week, 45 minutes. No application was made to the control group. All groups were evaluated with Beck Depression Scale(BDS), Mcgill Pain Questionnaire(MPQ), Menstrual Attitude Scale(MAS), and Short Form-36(SF-36) before and after treatment. Results: A significant difference was found in MAS and SF-36 mental and physical in the KT group(p<0.05). There was a significant decrease in the MPQ in the AE group(p<0.05). No significant result was found in the control group. There were significant differences in MPQ and MAS Time*Group interaction(p<0.05). There was no significant difference between the KT and AE Group in post-hoc tests(p<0.05). Conclusion: In conclusion, KT and AE may decrease pain and improve attitude and quality of life in women with dysmenorrhoea. “retrospectively registered” Trial registration number (NCT04856280), date of registration (20.04.2021).

scholarly journals Effects of Personal Low-Frequency Stimulation Device on Myalgia: A Randomized Controlled Trial

2022 ◽  
Vol 19 (2) ◽  
pp. 735
Author(s):  
Yong-Soon Yoon ◽  
Myoung-Hwan Ko ◽  
Il-Young Cho ◽  
Cheol-Su Kim ◽  
Johny Bajgai ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Short Form ◽  
Therapy Group ◽  
Controlled Trial ◽  
Low Frequency ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Low Frequency Stimulation ◽  
Significant Difference ◽  
Frequency Stimulation

Electrotherapy is commonly used for myalgia alleviation. Low-frequency stimulation (LFS) is primarily used for controlling acute and chronic pain and is a non-invasive therapy that can be easily performed with electric stimulation applied on the skin. However, little evidence exists regarding the pain alleviation effects of personal low-frequency stimulation device for home use. Moreover, no studies have compared myalgia alleviation effects between personal low-frequency stimulation (PLS) and physical therapy (PT), which are most commonly used for patients with myalgia in hospitals and clinics. Therefore, we aimed to investigate the pain alleviation effects of PLS in patients with myalgia and compare these effects with those of conventional PT (transcutaneous electrical nerve stimulation + ultrasound). In total, 39 patients with myalgia in the neck, shoulder, back, and waist areas were randomly assigned to the personal low-frequency stimulation group (PLSG: n = 20) and physical therapy group (PTG: n = 19). Both groups were treated for 3 weeks (20 min per session and 5 sessions per week). Patients were assessed for pain intensity by surface electromyography (sEMG), visual analogue scale (VAS) and a short-form McGill pain questionnaire (SF-MPQ) before and after the intervention period. Our results showed that PLSG showed a tendency of muscle relaxation with a significant decrease in sEMG in the neck (p = 0.0425), shoulder (p = 0.0425), and back (p = 0.0046) areas compared to the control group. However, there was no significant difference in waist area. Additionally, VAS scores significantly decreased between pre- and post-treatment in both PTG (p = 0.0098), and PLSG (p = 0.0304) groups, but there was no significance difference between the groups. With respect to SF-MPQ, the PLSG showed greater pain alleviation (5.23 ± 0.25) effects than the PTG (6.23 ± 0.25). Accordingly, our results suggest that PLS treatment using a home device might offer positive assistance in pain alleviation for patients with myalgia that is as equally effective as conventional PT treatment. However, further detailed studies are required considering larger samples to fully claim the effectiveness of this device.

P2806A novel sirolimus drug eluting stent for Small-Vessel Disease: results from en-ABL e-registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Testa ◽  
S Dani ◽  
D Desai ◽  
R Pandya ◽  
P Parekh ◽  
...  
Keyword(s):  
Stent Thrombosis ◽  
Small Vessel Disease ◽  
Large Vessel ◽  
Small Vessel ◽  
Drug Eluting Stent ◽  
Vessel Disease ◽  
Significant Difference ◽  
Myocardial Infraction ◽  
Drug Eluting

Abstract Objective The aim of the study was to assess the clinical outcome of Abluminus DES in patients with small vessels. Background Percutaneous coronary intervention (PCI) of small coronary vessel (≤2.75 mm) associated with more chances of restenosis and repeat revascularization even when drug eluting stent employed. Methods A total of 2,500 patients enrolled in en-ABL e-registry which is a prospective, multicentre observational post market registry. Out of 2,500 patients, 1,253 patients had small vessel (SV, ≤2.75 mm) while 1,247 had large vessel (LV, >3mm) disease. The primary endpoint was major adverse cardiac events (MACE) which is composite of cardiac death, target vessel myocardial infraction (TV-MI) and target lesion/vessel revascularization (TLR) at 1 year follow up. The secondary endpoint were stent thrombosis and MACE up to 2 years. Results Baseline characteristics were well matched in both groups. In the SV group had higher prevalence of diabetes as compared to large vessel 43.0% vs 25.7%. Total 1,400 lesions treated with 1,612 Abluminus DES and 1,569 lesions treated with 1,675 Abluminus DES in SV and LV groups respectively. The mean diameter of stent was 2.61±0.23 and 3.3±0.3 mm in SV and LV groups respectively. There was a significant difference in MACE in treatment groups (3.7% vs. 1.4%, p=0.004 respectively) at 1 year. No significant differences were observed between SV and LV groups in terms of death/myocardial infarction or stent thrombosis. There were increment of only one TLR and no stent thrombosis reported at 2-year follow-up. Conclusion This result suggests the efficacy and safety of novel Abluminus DES in small vessel disease.

Novel drug eluting stent system for customised treatment of coronary lesions: CUSTOM I feasibility trial 24 month results

2008 ◽  
Vol 4 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Eberhard Grube ◽  
Horst Sievert ◽  
Karl-Eugen Hauptmann ◽  
Ralf Mueller ◽  
Ulrich Gerckens ◽  
...  
Keyword(s):  
Feasibility Trial ◽  
Drug Eluting Stent ◽  
Stent System ◽  
Drug Eluting ◽  
Coronary Lesions ◽  
Novel Drug

scholarly journals The incidence of in-stent restenosis after drug-eluting stent implantation in patients on chronic hemodialysis

2020 ◽  
Author(s):  
Masayuki Motohiro ◽  
Hiroshi Sugita ◽  
Hiroki Shibutani ◽  
Syun Morishita ◽  
Masami Tanaka ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Second Generation ◽  
Chronic Hemodialysis ◽  
Rotational Atherectomy ◽  
Drug Eluting Stents ◽  
Drug Eluting Stent ◽  
Stent Restenosis ◽  
Significant Difference ◽  
Drug Eluting ◽  
In Stent Restenosis

Abstract Background: Recently, drug-eluting stents have been widely adopted rather than bare-metal stents in patients on chronic hemodialysis (HD) based on the extrapolation of data from patients on non-HD. However, whether DES implantation is associated with a reduced rate of in-stent restenosis (ISR) is unclear. We investigated the incidence of ISR and its predictors in patients on HD after drug-eluting stent implantation.Methods and Results: We analyzed 194 consecutive patients (331 lesions) on HD who underwent follow-up angiography after drug-eluting stent implantation. ISR was observed in 74 lesions (22.4%). Angiographically, the relative incidence of AHA/ACC type C lesion was increased (47% vs. 32%; P=0.043), the minimal lumen diameter (MLD) before DES implantation was smaller (0.82±0.49 vs. 0.97±0.45mm; P<0.01) and the lesion length (LL) was increased (30.2±16.1 vs. 24.4±12.1mm; P=0.023) in lesions with ISR compared to those without ISR. The rate of rotational atherectomy use was also increased in lesions with ISR compared to those without ISR (50% vs. 25%; P<0.01). In a multivariate analysis, the MLD before drug-eluting stent implantation (odds ratio [OR] =0.50, 95% confidence interval [CI] 0.27-0.91, P=0.024), LL (OR=1.02, 95% CI 1.00-1.04, P=0.030) and the use of rotational atherectomy (OR=2.71, 95% CI 1.55-4.72, P<0.01) were independent predictors of ISR. The incidence of ISR was similar between lesions treated with the first-generation (25.8%) and the second-generation DESs (20.4%).Conclusion: ISR was observed in 74 lesions (22.4%). A small MLD, long LL and the use of rotational atherectomy were independent predictors of ISR after drug-eluting stent implantation in patients on HD. There was no significant difference in ISR rate between the first- and the second-generation drug-eluting stents.

scholarly journals Clinical outcomes after the endovascular treatments of pulmonary vein stenosis in patients with congenital heart disease

2019 ◽  
Vol 29 (8) ◽  
pp. 1057-1065 ◽  
Author(s):  
Yoshihiko Kurita ◽  
Kenji Baba ◽  
Maiko Kondo ◽  
Takahiro Eitoku ◽  
Shingo Kasahara ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Stent Implantation ◽  
Bare Metal Stent ◽  
Pulmonary Vein Stenosis ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Metal Stent ◽  
Significant Difference ◽  
Drug Eluting ◽  
Vein Stenosis

AbstractBackground:Pulmonary vein stenosis (PVS) is a condition with challenging treatment and leads to severe cardiac failure and pulmonary hypertension. Despite aggressive surgical or catheter-based intervention, the prognosis of PVS is unsatisfactory. This study aimed to assess the prognosis and to establish appropriate treatment strategies.Methods:We retrospectively reviewed endovascular treatments for PVS (2001–2017) from the clinical database at the Okayama University Hospital.Results:A total of 24 patients underwent PVS associated with total anomalous pulmonary venous connection and 7 patients underwent isolated congenital PVS. In total, 53 stenotic pulmonary veins were subjected to endovascular treatments; 40 of them were stented by hybrid (29) and percutaneous procedures (11) (bare-metal stent, n = 34; drug-eluting stent, n = 9). Stent size of hybrid stenting was larger than percutaneous stenting. Median follow-up duration from the onset of PVS was 24 months (4–134 months). Survival rate was 71 and 49% at 1 and 5 years, respectively. There was no statistically significant difference between stent placement and survival; however, patients who underwent bare-metal stent implantation had statistically better survival than those who underwent drug-eluting stent implantation or balloon angioplasty. Early onset of stenosis, timing of stenting, and small vessel diameter of pulmonary vein before stenting were considered as risk factors for in-stent restenosis. Freedom from re-intervention was 50 and 26% at 1 and 2 years.Conclusions:To improve survival and stent patency, implantation of large stent is important. However, re-intervention after stenting is also significant to obtain good outcome.

P971Impact of treatment strategy on 1-year outcome for Left Main trifurcation lesions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Tani ◽  
S Mitomo ◽  
K Tanaka ◽  
S Tahara ◽  
S Nakamura
Keyword(s):  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Restenosis Rate ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Significant Difference ◽  
Drug Eluting

Abstract Background/Introduction Limited data exist regarding procedural strategy and clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (LM) trifurcation lesion. Purpose The aim of this study is to evaluate 1-year clinical outcomes after LM trifurcation PCI comparing different strategies in kissing balloon inflation (KBI). Methods From 1, January, 2011 to 31, March, 2017, patients who underwent LM trifurcation PCI with second generation drug-eluting stent in our center were retrospectively analyzed. They were categorized into single-stent KBT group (KBT in left anterior descending artery [LAD] and left circumflex artery [LCX], or LAD and high lateral branch [HL]) and no-KBT group. Primary endpoint is restenosis in the lesions. Results Among 1301 patients who underwent LM PCI during the study period, 163 patients (12.5%) had a trifurcation lesion. Regarding the number of stents used for the lesions, 1, 2 and 3 stents were used in 75.4%, 22.0% and 2.5%, respectively. Median follow-up period of LM trifurcation patients was 265 days (interquartile range: 81–564). In the no-KBT group (64 patients), 19 patients experienced restenosis of HL and LCX (HL: 8 patients, LCX: 0 patient, and both: 11 patients). In the KBT-group, KBT for LAD and LCX was performed in 47 patients, and of them, 19 patients experienced restenosis of LM-LAD, HL and LCX (HL: 12 patients, LCX: 6 patients and all: 1 patient). On the other hand, in 9 patients with KBT for LAD and HL, there were no restenosis cases at 1-year follow-up. There was no statistically significant difference in restenosis rate between the no-KBI and KBT group (29.6% vs. 40.4%, p=0.69). Restenosis rates in each segments Conclusion After LM trifurcation PCI, restenosis rate at 1-year follow-up was high, and no difference between no-KBT and KBT group overall. However, there was no restenosis case in patients with KBT for LAD and HL.

P2696Clinical characteristics of late catch-up phenomenon after implantation of 2nd generation drug eluting stent

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Saigusa ◽  
T Miura ◽  
M Taki ◽  
M Kobayashi ◽  
M Kanai ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Drug Eluting Stent ◽  
Multicenter Cohort Study ◽  
Cox Regression Analysis ◽  
2Nd Generation ◽  
Significant Difference ◽  
Drug Eluting ◽  
Catch Up

Abstract Introduction Late catch-up phenomenon (LCU) of 1st generation drug eluting stent (DES) has been increasing yearly despite the rate of restenosis in 1 year has reduced compared with bare metal stent (BMS). 2nd generation DES was more improved than 1st generation DES and suggested more benefits about clinical outcome. Purpose To investigate the incidence and predictor of LCU after implantation of 2nd generation DES and to evaluate the association between LCU phenomenon and adverse events. Methods Between August 2012 and July 2013, a total of 1665 consecutive patients (1956 lesions with elective/urgent PCI) were enrolled in SHINANO 5 years Registry (a prospective observational multicenter cohort study) from 13 institutions in Nagano, Japan. 711 patients that were treated with 2nd generation DES and 576 patients with BMS were selected. Exclusion criterias were cases of 1st DES, only POBA, only aspiration and chronic total occulusion. Results There were significant difference about patients background between BMS and 2nd generation DES groups. Those groups were matched with propensity score. After matching, 822 patients (BMS group 411 patients, 2nd generation group 411 patients) were analyzed. The rates of 2nd DES and BMS restenosis 5 years after initial PCI were 9.2% and 8.5% (p=0.572), those of LCU were 2.6% and 5.6% (p=0.043) by 1 year landmark analysis. Cox proportional hazards analysis revealed that the DES in-stent restenosis (ISR) lesion and higher HbA1c were independent predictors for LCU from 1year to 5year (HR 5.304, p=0.009, HR 1.254, p=0.015), but 2nd generation DES was not. Kaplan Meier curve showed no association between LCU phenomenon and all cause death (p=0.446). Cox regression analysis showed LCU was not independent predictor for all cause death (p=0.414). Conclusions Implantation to DES-ISR lesion with 2nd generation DES was associated with higher LCU. Despite of more complex lesions with 2nd generation DES, there were no differences of LCU incidence between 2nd generation DES and BMS. Acknowledgement/Funding None

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