scholarly journals Is Structured Exercise Performed with Supplemental Oxygen a Promising Method of Personalized Medicine in the Therapy of Chronic Diseases?

2020 ◽  
Vol 10 (3) ◽  
pp. 135 ◽  
Author(s):  
Nils Freitag ◽  
Kenji Doma ◽  
Daniel Neunhaeuserer ◽  
Sulin Cheng ◽  
Wilhelm Bloch ◽  
...  
Keyword(s):  
Personalized Medicine ◽  
Physical Fitness ◽  
Chronic Diseases ◽  
Well Being ◽  
Supplemental Oxygen ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Eligibility Criteria ◽  
Supervised Exercise ◽  
Patient Reported

Aim: This systematic review aimed to explore the literature to identify in which types of chronic diseases exercise with supplemental oxygen has previously been utilized and whether this type of personalized therapy leads to superior effects in physical fitness and well-being. Methods: Databases (PubMed/MEDLINE, CINHAL, EMBASE, Web of knowledge and Cochrane Library) were searched in accordance with PRISMA. Eligibility criteria included adult patients diagnosed with any type of chronic diseases engaging in supervised exercise training with supplemental oxygen compared to normoxia. A random-effects model was used to pool effect sizes by standardized mean differences (SMD). Results: Out of the identified 4038 studies, 12 articles were eligible. Eleven studies were conducted in chronic obstructive pulmonary disease (COPD), while one study included coronary artery disease (CAD) patients. No statistical differences were observed for markers of physical fitness and patient-reported outcomes on well-being between the two training conditions (SMD −0.10; 95% CI −0.27, 0.08; p = 0.26). Conclusions: We found that chronic exercise with supplemental oxygen has mainly been utilized for COPD patients. Moreover, no superior long-term adaptations on physical fitness, functional capacity or patient-reported well-being were found, questioning the role of this method as a personalized medicine approach. Prospero registration: CRD42018104649.

scholarly journals Home-based pulmonary rehabilitation for people with COPD: A qualitative study reporting the patient perspective

2017 ◽  
Vol 15 (2) ◽  
pp. 123-130 ◽  
Author(s):  
Aroub Lahham ◽  
Christine F McDonald ◽  
Ajay Mahal ◽  
Annemarie L Lee ◽  
Catherine J Hill ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Physical Fitness ◽  
Pulmonary Rehabilitation ◽  
Positive Impact ◽  
Chronic Obstructive ◽  
Structured Interviews ◽  
Obstructive Pulmonary Disease ◽  
Home Setting ◽  
Supervised Exercise ◽  
Home Based

This study aimed to document the perspective of patients with chronic obstructive pulmonary disease (COPD) who underwent home-based pulmonary rehabilitation (HBPR) in a clinical trial. In this qualitative study, open-ended questions explored participants’ views regarding HBPR. Thirteen semi-structured interviews were analysed using a thematic analysis approach. Major themes from interviews included the positive impact of HBPR on physical fitness, breathing and mood. Participants valued the flexibility and convenience of the programme. Participants also highlighted the importance of social support received, both from the physiotherapist over the phone and from family and friends who encouraged their participation. Reported challenges were difficulties in initiating exercise, lack of variety in training and physical incapability. While most participants supported the home setting, one participant would have preferred receiving supervised exercise training at the hospital. Participants also reported that HBPR had helped establish an exercise routine and improved their disease management. This study suggests that people with COPD valued the convenience of HBPR, experienced positive impacts on physical fitness and symptoms and felt supported by their community and programme staff. This highly structured HBPR model may be acceptable to some people with COPD as an alternative to centre-based pulmonary rehabilitation.

Which psychosocial interventions improve sex worker well-being? A systematic review of evidence from resource-rich countries

2021 ◽  
pp. bmjsrh-2021-201028
Author(s):  
Kevin Turner ◽  
Jane Meyrick ◽  
Danny Miller ◽  
Laura Stopgate
Keyword(s):  
Sex Workers ◽  
Real Life ◽  
Qualitative Evaluation ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Evidence Base ◽  
Vulnerable Groups ◽  
Cochrane Library ◽  
Evidence Based ◽  
Eligibility Criteria

ObjectiveTo establish the state of the evidence base around psychosocial interventions that support well-being in sex workers in order to inform policy and practice within a resource-rich geographical context.MethodsPublished and unpublished studies were identified through electronic databases (PsychINFO, CINHAL Plus, MEDLINE, EMBASE, The Cochrane Library and Open Grey), hand searching and contacting relevant organisations and experts in the field. Studies were included if they were conducted in high-income settings with sex workers or people engaging in exchange or transactional sex, and evaluated the effect of a psychosocial intervention with validated psychological or well-being measures or through qualitative evaluation.ResultsA total of 19 202 studies were identified of which 10 studies met the eligibility criteria. The heterogeneity found dictated a narrative synthesis across studies. Overall, there was very little evidence of good quality to make clear evidence-based recommendations. Despite methodological limitations, the evidence as it stands suggests that peer health initiatives improve well-being in female street-based sex workers. Use of ecological momentary assessment (EMA), a diary-based method of collecting real-life behavioural data through the use of twice-daily questionnaires via a smartphone, increased self-esteem and behaviour change intentions.ConclusionsWork with sex workers should be based on an evidence-based approach. Limitations to the existing evidence and the constraints of this work with vulnerable groups are recognised and discussed.

scholarly journals Chronic Care Model in Italy: a narrative review of the literature

2021 ◽  
Vol 22 ◽  
Author(s):  
Fabio Petrelli ◽  
Giovanni Cangelosi ◽  
Giulio Nittari ◽  
Paola Pantanetti ◽  
Giulia Debernardi ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Health Management ◽  
Clinical Care ◽  
Cochrane Library ◽  
Care Model ◽  
Chronic Patients ◽  
Eligibility Criteria ◽  
Critical Appraisal Skills

Abstract Aim: To analyze scientific literature on the development and implementation of the Chronic Care Model (CCM) in treating chronic diseases in the Italy context. Besides, to evaluate the effects of the activities carried out by the operators participating in the CCM on clinical care. Background: Italy is the second country globally for longevity, with 21.4% of citizens over 65 and 6.4% over 80. The CCM fits into this context, a care model aimed primarily at patients suffering from chronic diseases, especially in emergencies, as the recent COVID-19 pandemic. Methods: PubMed, Embase, Scopus, Cinahl, and Cochrane Library scientific databases were consulted, and the records selected as relevant by title and abstract by nine independent scholars, and disagreements were resolved through discussion. Finally, the studies included in this review were selected based on the eligibility criteria. Results: Twenty potentially relevant studies were selected, and after applying the eligibility criteria and screening by the Critical Appraisal Skills Program tool, eight included in this review. The studies showed the effectiveness of CCM for managing patients with heart failure in primary care settings and significant improvements in clinical outcomes, the reduction of inappropriate emergency room access for chronic patients, and the improvement of patients’ overall health with diabetes. The CCM organizational model is effective in improving the management of metabolic control and the main cardiovascular risk factors. Furthermore, this modality also allows doctors to dedicate more space to patients in the disease’s acute phase. Conclusion: The CCM, with its fundamental pillars of empowering self-management of care, could represent a valid alternative to health management. The managers of health services, especially territorial ones, could consider the CCM for the improvement of the treatments offered.

scholarly journals Telemedicine for Pre-Employment Medical Examinations and Follow-Up Visits on Board Ships: A Narrative Review on the Feasibility

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 69
Author(s):  
Getu Gamo Sagaro ◽  
Marzio Di Canio ◽  
Emanuele Talevi ◽  
Francesco Amenta
Keyword(s):  
High Speed ◽  
New Technologies ◽  
Medical Personnel ◽  
Medical Examination ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Eligibility Criteria ◽  
Medical Specialties ◽  
Medical Examinations

Background: Telemedicine has already been applied to various medical specialties for diagnosis, treatment, and follow-up visits for the general population. Telemedicine has also proven effective by providing advice, diagnosis, and treatment to seafarers during emergency medical events onboard ships. However, it has not yet been applied for pre-employment medical examinations and follow-up visits on board ships. Objective: This review aimed to assess the possibility of using telemedicine during periodic visits between one pre-employment medical examination and others on board ships, and to recommend necessary medical examination tests with screening intervals for seafarers. Methods: Various databases including PubMed, EMBASE, Scopus, CINAHL, and Cochrane Library were explored using different keywords, titles, and abstracts. Studies published between 1999 and 2019, in English, in peer-reviewed journal articles, and that are conference proceedings were considered. Finally, the studies included in this review were chosen on the basis of the eligibility criteria. Results: Out of a total of 168 studies, 85 studies were kept for further analysis after removing the duplicates. A further independent screening based on the inclusion and exclusion criteria resulted in the withdrawal of 51 studies that were not further considered for our analysis. Finally, 32 studies were left, which were critically reviewed. Out of 32 accepted studies, 10 studies demonstrated the effectiveness of the electrocardiogram (ECG) in monitoring and managing remote patients with heart failure, early diagnosis, and postoperative screening. In 15 studies, telespirometry was found to be effective in diagnosing and ruling out diseases, detecting lung abnormalities, and managing patients with chronic obstructive pulmonary disease (COPD) and asthma. Seven studies reported that telenephrology was effective, precise, accurate, and usable by non-medical personnel and that it reduced sample analysis times and procedures in laboratories. Conclusion: using new technologies such as high-speed internet, video conferencing, and digital examination, personnel are able to make the necessary tests and perform virtual medical examination on board ships with necessary training.

scholarly journals Adherence to Telemonitoring by Electronic Patient-Reported Outcome Measures in Patients with Chronic Diseases: A Systematic Review

2021 ◽  
Vol 18 (19) ◽  
pp. 10161
Author(s):  
Jim Wiegel ◽  
Bart Seppen ◽  
Marike van der Leeden ◽  
Martin van der Esch ◽  
Ralph de Vries ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Chronic Diseases ◽  
Outcome Measures ◽  
Evidence Synthesis ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Factors Associated ◽  
Patient Reported

Background: Effective telemonitoring is possible through repetitive collection of electronic patient-reported outcome measures (ePROMs) in patients with chronic diseases. Low adherence to telemonitoring may have a negative impact on the effectiveness, but it is unknown which factors are associated with adherence to telemonitoring by ePROMs. The objective was to identify factors associated with adherence to telemonitoring by ePROMs in patients with chronic diseases. Methods: A systematic literature search was conducted in PubMed, Embase, PsycINFO and the Cochrane Library up to 8 June 2021. Eligibility criteria were: (1) interventional and cohort studies, (2) patients with a chronic disease, (3) repetitive ePROMs being used for telemonitoring, and (4) the study quantitatively investigating factors associated with adherence to telemonitoring by ePROMs. The Cochrane risk of bias tool and the risk of bias in nonrandomized studies of interventions were used to assess the risk of bias. An evidence synthesis was performed assigning to the results a strong, moderate, weak, inconclusive or an inconsistent level of evidence. Results: Five studies were included, one randomized controlled trial, two prospective uncontrolled studies and two retrospective cohort studies. A total of 15 factors potentially associated with adherence to telemonitoring by ePROMs were identified in the predominate studies of low quality. We found moderate-level evidence that sex is not associated with adherence. Some studies showed associations of the remaining factors with adherence, but the overall results were inconsistent or inconclusive. Conclusion: None of the 15 studied factors had conclusive evidence to be associated with adherence. Sex was, with moderate strength, not associated with adherence. The results were conflicting or indecisive, mainly due to the low number and low quality of studies. To optimize adherence to telemonitoring with ePROMs, mixed-method studies are needed.

Feasibility and efficacy of a 12-week supervised exercise intervention for colorectal cancer survivors

2014 ◽  
Vol 39 (6) ◽  
pp. 715-723 ◽  
Author(s):  
Christopher M. Sellar ◽  
Gordon J. Bell ◽  
Robert G. Haennel ◽  
Heather-Jane Au ◽  
Neil Chua ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Exercise Training ◽  
Physical Fitness ◽  
Cancer Survivors ◽  
Exercise Intervention ◽  
Peak Oxygen Uptake ◽  
Supervised Exercise ◽  
Patient Reported ◽  
Health Related

Exercise training improves health-related physical fitness and patient-reported outcomes in cancer survivors, but few interventions have targeted colorectal cancer (CRC) survivors. This investigation aimed to determine the feasibility and efficacy of a 12-week supervised exercise training program for CRC survivors. Feasibility was assessed by tracking participant recruitment, loss to follow-up, assessment completion rates, participant evaluation, and adherence to the intervention. Efficacy was determined by changes in health-related physical fitness. Over a 1-year period, 72 of 351 (21%) CRC survivors screened were eligible for the study and 29 of the 72 (40%) were enrolled. Two participants were lost to follow-up (7%) and the completion rate for all study assessments was ≥93%. Mean adherence to the exercise intervention was 91% (standard deviation = ±18%), with a median of 98%. Participants rated the intervention positively (all items ≥ 6.6/7) and burden of testing low (all tests ≤ 2.4/7). Compared with baseline, CRC survivors showed improvements in peak oxygen uptake (mean change (MC) = +0.24 L·min−1, p < 0.001), upper (MC = +7.0 kg, p < 0.001) and lower (MC = +26.5 kg, p < 0.001) body strength, waist circumference (MC = −2.1 cm, p = 0.005), sum of skinfolds (MC = −7.9 mm, p = 0.006), and trunk forward flexion (MC = +2.5 cm, p = 0.019). Exercise training was found to be feasible and improved many aspects of health-related physical fitness in CRC survivors that may be associated with improved quality of life and survival in these individuals.

scholarly journals P0275SCOPE AND CONSISTENCY OF OUTCOME MEASURES FOR PHYSICAL FITNESS IN TRIALS IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Dev Jegatheesan ◽  
Richard Modderman ◽  
Rathika Krishnasamy ◽  
Allison Tong ◽  
Jeff Coombes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Fitness ◽  
Exercise Capacity ◽  
Outcome Measures ◽  
Cochrane Library ◽  
Randomised Trials ◽  
Increased Risk ◽  
Patient Reported

Abstract Background and Aims Impaired physical fitness is prevalent across the spectrum of kidney disease and is associated with an increased risk of mortality, progression to end-stage kidney disease, falls and hospitalisation. Physical fitness outcomes have been extensively reported in randomised trials involving patients with kidney disease. This study aimed to assess the scope and consistency of physical fitness outcomes and outcome measures reported in kidney disease trials. Method A systematic review of randomised trials reporting physical fitness outcomes in adults with chronic kidney disease not requiring kidney replacement therapy, receiving maintenance haemodialysis or peritoneal dialysis, and kidney transplant recipients was conducted. The scope, frequency and characteristics of physical fitness outcome measures were categorised and analysed. Trials were identified from MEDLINE, Embase and the Cochrane Library from March 2000 to March 2019. Results From 115 relevant trials, 171 outcome measures for 32 outcomes were identified and categorised into five domains of physical fitness: exercise capacity (reported in 83% of trials), physiological-metabolic (57%), neuromuscular fitness (52%), body composition (45%) and cardiorespiratory fitness (19%). Exercise capacity had 53 different outcome measures and at 15 separate time points. The most common outcome measures were the 6-minute walk test (29%), peak oxygen uptake (20%), 1-repetition maximum (19%) and hand-grip strength (11%), with marked inconsistency in the reporting of outcomes between trials. Outcomes were assessed by field-based tests (65%), lab-based tests (31%) and patient-reported measures (4%). Conclusion There is large heterogeneity in the reporting of physical fitness outcomes, with inconsistencies in the use of validated, relevant and patient-important outcome measures.

scholarly journals Walking-related digital mobility outcomes as clinical trial endpoint measures: protocol for a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038704
Author(s):  
Ashley Marie Polhemus ◽  
Ronny Bergquist ◽  
Magda Bosch de Basea ◽  
Gavin Brittain ◽  
Sara Catherine Buttery ◽  
...  
Keyword(s):  
Real World ◽  
Prognostic Value ◽  
Grey Literature ◽  
Proximal Femoral Fracture ◽  
Sensor Technology ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Eligibility Criteria ◽  
Obstructive Pulmonary Disease ◽  
Scoping Reviews

IntroductionAdvances in wearable sensor technology now enable frequent, objective monitoring of real-world walking. Walking-related digital mobility outcomes (DMOs), such as real-world walking speed, have the potential to be more sensitive to mobility changes than traditional clinical assessments. However, it is not yet clear which DMOs are most suitable for formal validation. In this review, we will explore the evidence on discriminant ability, construct validity, prognostic value and responsiveness of walking-related DMOs in four disease areas: Parkinson’s disease, multiple sclerosis, chronic obstructive pulmonary disease and proximal femoral fracture.Methods and analysisArksey and O’Malley’s methodological framework for scoping reviews will guide study conduct. We will search seven databases (Medline, CINAHL, Scopus, Web of Science, EMBASE, IEEE Digital Library and Cochrane Library) and grey literature for studies which (1) measure differences in DMOs between healthy and pathological walking, (2) assess relationships between DMOs and traditional clinical measures, (3) assess the prognostic value of DMOs and (4) use DMOs as endpoints in interventional clinical trials. Two reviewers will screen each abstract and full-text manuscript according to predefined eligibility criteria. We will then chart extracted data, map the literature, perform a narrative synthesis and identify gaps.Ethics and disseminationAs this review is limited to publicly available materials, it does not require ethical approval. This work is part of Mobilise-D, an Innovative Medicines Initiative Joint Undertaking which aims to deliver, validate and obtain regulatory approval for DMOs. Results will be shared with the scientific community and general public in cooperation with the Mobilise-D communication team.RegistrationStudy materials and updates will be made available through the Center for Open Science’s OSFRegistry (https://osf.io/k7395).

Impact of cancer survivorship care plans (SCPs) on health outcomes and health care delivery: A systematic review.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 2-2 ◽  
Author(s):  
Paul B. Jacobsen ◽  
Antonio P. Derosa ◽  
Tara O. Henderson ◽  
Deborah Mayer ◽  
Chaya S. Moskowitz ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Care Delivery ◽  
Well Being ◽  
Cochrane Library ◽  
Satisfaction With Care ◽  
Survivorship Care ◽  
Care Plans ◽  
Randomized Studies ◽  
Patient Reported ◽  
The Impact

2 Background: In 2006, the Institute of Medicine recommended that patients at or near completion of active treatment be provided with a SCP (treatment summary, relevant health information, and follow-up care plan) to improve care delivery and outcomes in the post-treatment period. We systematically reviewed published research to determine if SCPs have a positive impact on health outcomes and healthcare delivery. Methods: Randomized and nonrandomized studies evaluating patient-reported outcomes, healthcare utilization, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, and Cochrane Library. Data were extracted by independent raters and summarized based on qualitative synthesis. Results: Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer diagnoses, timing of SCP delivery in relation to treatment completion, SCP delivery method and recipients, SCP content, SCP-related counseling, and outcomes assessed. Findings from nonrandomized studies yielded descriptive information only on outcomes such as satisfaction with care and reactions to SCPs. Among randomized studies, findings were near uniformly negative for the impact of SCPs on the most commonly assessed outcomes (physical, functional, and psychological well-being); findings were positive in single studies for other outcomes including amount of information received, satisfaction with care, and physician implementation of recommended survivorship care. Conclusions: Existing research provides minimal evidence that SCPs improve quality of life in cancer survivors. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal health outcomes. Findings are very limited but more positive for proximal outcomes (e.g., information received) and for care delivery, especially when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. In light of current findings, future research should focus to a greater extent on evaluating ways to ensure SCP recommendations are subsequently implemented as part of ongoing care.

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