scholarly journals Factors Associated with Persistence with Teriparatide Therapy: Results from the DANCE Observational Study

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Deborah T. Gold ◽  
David L. Weinstein ◽  
Gerhardt Pohl ◽  
Kelly D. Krohn ◽  
Yi Chen ◽  
...  
Keyword(s):  
Side Effects ◽  
Observational Study ◽  
Trend Test ◽  
Factors Associated ◽  
Treatment Side Effects ◽  
Patient Reported ◽  
Proper Training ◽  
Improper Use ◽  
Armitage Trend Test

Purpose. Determine patient-reported reasons for discontinuation with teriparatide.Methods. Patients taking teriparatide in a multicenter, prospective, and observational study were given three questionnaires: baseline, follow-up questionnaire 1 (QF1, 2 to 6 months), and follow-up questionnaire 2 (QF2, 12 months). Discontinuation reported at QF1 and QF2 was defined as “early” and “late,” respectively, and remaining patients were considered persistent. Cochran-Armitage trend test was used to identify factors associated with discontinuation.Results. Side effects, concern about improper use, injection difficulties, and several patient-perceived physician issues were associated with early discontinuation. Low patient-perceived importance of continuing treatment, side effects, difficulty paying, and low patient-perceived physician knowledge were associated with late discontinuation. The most common specific reasons selected for discontinuing treatment were “concerns about treatment outweighing the benefits” (n=53) and “difficulty paying” (n=47).Conclusions. Persistence with teriparatide is dependent on managing side effects, addressing financial challenges, proper training, and obtaining support from the healthcare provider.

EFFICACY OF TENOFOVIR IN PATIENTS OF HBV-RELATED CIRRHOSIS

2016 ◽  
pp. 25-29
Author(s):  
Van Huy Tran ◽  
Thi Huyen Thuong Nguyen
Keyword(s):  
Side Effects ◽  
Serum Creatinine ◽  
Key Words ◽  
Tenofovir Disoproxil Fumarate ◽  
Hbv Dna ◽  
Treatment Side Effects ◽  
Background Data ◽  
Key Words Cirrhosis

Background: Data about efficacy of Tenofovir in patients of HBV –related cirrhosis in Vietnam was still limited. This study is aimed at: - evaluating the clinical, biochemical, virological and Child-Pugh score responses 3,6,9 months after Tenofovir therapy; - assessing possible side effects of tenofovir. Patients and methods: 40 patients with HBV-related cirrhosis were enrolled. All has received Tenofovir disoproxil fumarate 300mg/day. Follow-up after 3,6 and 9 months. Results: Anorexia, oedema and ascites were significantly improved after treatment. HBV DNA became undetectable in 92.5%, 94.55 and 100% after 3,6 and 9 months, respectively. Child- Pugh score was improved after treatment (5.94±0.22 after treatment vs 7.47±0.28 before treatment). Side effects were minors (nausea, vomiting). No case of increase in serum creatinine was found. Conclusion: Tenofovir showed effective and safe in patients of HBV-related cirrhosis. Key words: Cirrhosis, tenofovir, HBV. Key words: cirrhosis, tenofovir, HBV

scholarly journals Assessing post-radiotherapy handover notes from a family physician perspective

2018 ◽  
Vol 25 (1) ◽  
pp. 49
Author(s):  
A. Dang ◽  
S. Miller ◽  
D. Horvat ◽  
T. Klassen-Ross ◽  
M. Graveline ◽  
...  
Keyword(s):  
Side Effects ◽  
Family Physicians ◽  
Essential Information ◽  
Treatment Side Effects ◽  
Counselling Services ◽  
Contact Information ◽  
Score Improvement ◽  
Information Treatment ◽  
Treatment Intent

Background Across our province, post-radiotherapy (rt) handover notes are sent to family physicians (fps) after rt. Based on previous fp feedback, we created a revised post-radiotherapy handover note with more information requested by fps. The purpose of this study was to determine whether the revised handover note improved the note as a communication aid.Methods Potential common and rare treatment side effects, oncologist contact information, and treatment intent were added to the revised handover note. Both versions were sent alongside a questionnaire to fps. Paired t-tests were carried out to compare satisfaction differences.Results There was a response rate of 37% for the questionnaires. Significantly greater clarity in the following categories was observed: responsibility for patient follow-up (mean score improvement of 1.2 on a 7-point Likert scale, p < 0.001), follow-up schedule (1.1, p < 0.001) as well as how and when to contact the oncologist (1.4, p = 0.001). Family physicians were also more content with how the institute transitioned care back to them (1.5, p = 0.012). Overall, fps were generally satisfied with the content of the revised post-rt handover note and noted improvement over the previous version. The frequency of investigations and institute supports initiated such as counselling services were suggested further additions.Conclusions The inclusion of potential treatment side effects, oncologist contact information, treatment intent and a well-laid out follow-up schedule were essential information needed by fps for an effective post-rt completion note. With these additions, the revised post-rt handover note showed significant improvement.

scholarly journals A prospective study to evaluate the acceptance, efficacy, side effects and expulsion rates of post-placental intrauterine device

2017 ◽  
Vol 6 (11) ◽  
pp. 4821
Author(s):  
Richa S. Sankhe ◽  
Meenal T. Kamble
Keyword(s):  
Side Effects ◽  
Intrauterine Device ◽  
Excessive Bleeding ◽  
Factors Associated ◽  
Insertion Techniques ◽  
Insertion Efficacy ◽  
Post Placental ◽  
A Prospective Study ◽  
Lost To Follow Up

Background: This study was conducted to know the factors associated with acceptability of immediate post placental IUCD insertion in women and to know the level of safety, efficacy and expulsion of post placental insertion of IUCD.Methods: This study was conducted in Obstetrics and Gynecology Department of Kasturba General Hospital, Mumbai over a period of 1 year. Women admitted and delivered at KGH were informed and counselled regarding intrauterine devices regarding its insertion, efficacy and side effects. Cu T 380A was inserted within 15 minutes of delivery of placenta and membranes in women who gave consent and had no contraindications for IUD insertion. All these women were followed for 6 months in the post insertion period.Results: Total number of women counselled was 400 over the period of six months from August 2015 to January 2016. Out of these only 250 women gave consent for PPIUCD insertion. 50 were lost to follow up.  200 women were followed, out of which 15 women had expulsion, 15 women had excessive bleeding, 20 women complained of pelvic pain, bleeding and abdominal pain together was found in 25 women. 160 out of 200 continued with the method   while the rest discontinued.Conclusions: Based on present study it may be concluded that post placental intrauterine device is an effective method of contraception. Proper counselling and insertion techniques would further improve the acceptability and reduce the expulsion rates.

Efficacy and toxicity according to hormone therapy used in the CHHiP trial.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 316-316 ◽  
Author(s):  
Alison Tree ◽  
Clare Griffin ◽  
Emma Hall ◽  
David P. Dearnaley ◽  
Keyword(s):  
Erectile Function ◽  
Cox Regression ◽  
Controlled Trial ◽  
Similar Efficacy ◽  
Trend Test ◽  
Chi Square ◽  
Patient Reported ◽  
Toxicity Analysis ◽  
Randomised Controlled

316 Background: CHHiP (CRUK/06/016) is a multicentre randomised controlled trial which investigated the use of moderately hypofractionated radiotherapy (RT) dose schedules for treatment of localised prostate cancer. 97% of participants (pts) had concurrent androgen deprivation therapy (ADT). Luteinising Hormone Releasing Hormone analogues (LHRHa) and bicalutamide 150mg (BIC) daily were permitted. This exploratory analysis investigates whether both ADT regimens show similar efficacy and whether BIC has the propensity to preserve erectile function. Methods: In CHHiP, 2700 pts received LHRH and 403 BIC, median duration 5.6 months. The primary endpoint was biochemical or clinical failure (BCF). ADT groups were compared with Cox regression adjusted forage, NCCN risk group, Gleason score,T-stage and stratified by RT dose. A key secondary endpoint was erectile function assessed by clinicians (LENTSOM subjective erectile function for vaginal penetration score) and pts (single items within UCLA-PCI and EPIC-50 questionnaires) at 2 years. 195/875 (22%) pts were excluded from this toxicity analysis as they had erectile dysfunction pre-ADT (grade (G) 3/4 LENTSOM). A chi square trend test compared ADT regimens. Results: Baseline demographics were similar except BIC pts were significantly younger (median 67 years BIC, 69 years LHRHa). With a median follow-up of 9.2 years, there was no evidence of a difference in BCF with an adjusted hazard ratio 0.95 (95% CI 0.75-1.20), p = 0.657. Eight year BCF rates were 80.7% (95%CI 79.0-82.2) and 80.3% (95%CI 75.8-84.0) for LHRHa and BIC pts respectively. At two years, LENTSOM erectile function was significantly worse (p < 0.0001) for LHRHa pts with 93/585 (16%), 95/585 (16%) and 125/585 (21%) G2, G3 and G4, compared to 3/68 (4%), 5/68 (7%) and 9/68 (13%) in BIC. At 2 years, the ability to have an erection, as reported by pts, was graded poor and very poor in 73/278 (26%) and 57/278 (21%) LHRHa pts and 5/23 (22%) and 4/23 (17%) in BIC pts (p = 0.584). Conclusions: There was no evidence of a difference in efficacy according to ADT received. BIC preserved clinician assessed (LENTSOM) erectile function at 2 years but patient reported outcomes did not show statistically significant differences with type of ADT. Clinical trial information: 97182923.

scholarly journals Long-term follow-up of the use of maintenance antibiotic therapy for chronic antibiotic-dependent pouchitis

2018 ◽  
Vol 9 (2) ◽  
pp. 154-158 ◽  
Author(s):  
Jonathan P Segal ◽  
Stephanie X Poo ◽  
Simon D McLaughlin ◽  
Omar D Faiz ◽  
Susan K Clark ◽  
...  
Keyword(s):  
Side Effects ◽  
Antibiotic Therapy ◽  
Antibiotic Use ◽  
Safety And Efficacy ◽  
Pouch Failure ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
Term Maintenance

ObjectiveRestorative proctolectomy is considered the procedure of choice in patients with ulcerative colitis who have failed medical therapy. Chronic pouchitis occurs in 10%–15% of patients, which often require long-term antibiotics to alleviate symptoms. Safety and efficacy of long-term maintenance antibiotics for chronic pouchitis has yet to be established. We aimed to assess the long-term safety and efficacy of maintenance antibiotic therapy for chronic pouchitis.DesignThis was an observational study. We followed up patients who were diagnosed with chronic antibiotic-dependent pouchitis.SettingData were collected from our single specialist pouch centre.PatientsPatients with chronic antibiotic-dependent pouchitis who had been maintained on antibiotics continuously for at least 1 year with a least one follow-up visit.Main outcome measureDevelopment of pouch failure defined by the need for an ileostomy, patient-reported side effects of antibiotics and development of antibiotic resistance found on stool coliform testing.ResultsLong-term use of antibiotics achieve remission in 21% of patients over a median follow-up of 102 (range 9–125). Pouch failure in association with chronic pouchitis after a median follow-up of 8.5 years occurred in 18%. Side effects of long-term antibiotic use occurred in 28% of patients, with resistance to antibiotics from at least one stool sample occurring in 78% patients.ConclusionsAlthough the use of antibiotics in chronic pouchitis may be justified, the use of long-term antibiotics must be weighed against potential complications associated with pouchitis and antibiotics.

scholarly journals Follow-Up of Cancer Patients Receiving Anti-PD-(L)1 Therapy Using an Electronic Patient-Reported Outcomes Tool (KISS): Prospective Feasibility Cohort Study (Preprint)

2020 ◽  
Author(s):  
Sanna Iivanainen ◽  
Tuomo Alanko ◽  
Pia Vihinen ◽  
Teemu Konkola ◽  
Jussi Ekstrom ◽  
...  
Keyword(s):  
Side Effects ◽  
Cancer Patients ◽  
Prediction Models ◽  
Checkpoint Inhibitors ◽  
Patient Reported Outcome ◽  
Treatment Benefit ◽  
Wide Range ◽  
Patient Reported ◽  
Loss Of Appetite

BACKGROUND Immune checkpoint inhibitors (ICIs) have become a standard of care for various tumor types. Their unique spectrum of side effects demands continuous and long-lasting assessment of symptoms. Electronic patient-reported outcome (ePRO) follow-up has been shown to improve survival and quality of life of cancer patients treated with chemotherapy. OBJECTIVE This study aimed to investigate whether ePRO follow-up of cancer patients treated with ICIs is feasible. The study analyzed (1) the variety of patient reported symptoms, (2) etiology of alerts, (3) symptom correlations, and (4) patient compliance. METHODS In this prospective, one-arm, multi-institutional study, we recruited adult cancer patients whose advanced cancer was treated with anti-programmed cell death protein 1 (PD)- ligand (L)1 agents in outpatient settings. The ePRO tool consisted of a weekly questionnaire evaluating the presence of typical side effects, with an algorithm assessing the severity of the symptom according to National Cancer Institute Common Terminology Criteria for Adverse Events and an urgency algorithm sending alerts to the care team. A patient experience survey was conducted monthly. The patients were followed up to 6 months or until disease progression. RESULTS A total of 889 symptom questionnaires was completed by 37 patients (lung cancer, n=15; melanoma, n=9; genitourinary cancer, n=9; head and neck cancer, n=4). Patients showed good adherence to ePRO follow-up. The most common grade 1 symptoms were fatigue (28%) and itching (13%), grade 2 symptoms were loss of appetite (12%) and nausea (12%), and grade 3-4 symptoms were cough (6%) and loss of appetite (4%). The most common reasons for alerts were loss of appetite and shortness of breath. In the treatment benefit analysis, positive correlations were seen between clinical benefit and itching as well as progressive disease and chest pain. CONCLUSIONS According to the results, ePRO follow-up of cancer patients receiving ICIs is feasible. ePROs capture a wide range of symptoms. Some symptoms correlate to treatment benefit, suggesting that individual prediction models could be generated. CLINICALTRIAL Clinical Trials Register, NCT3928938; https://clinicaltrials.gov/ct2/show/NCT03928938

scholarly journals A Novel Digital Patient-Reported Outcome Platform for Head and Neck Oncology Patients–-A Pilot Study

2016 ◽  
Vol 9 ◽  
pp. CMENT.S40219 ◽  
Author(s):  
Maria K. Peltola ◽  
Joel S. Lehikoinen ◽  
Lauri T. Sippola ◽  
Kauko Saarilahti ◽  
Antti A. Mäkitie
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Head And Neck ◽  
Cancer Patients ◽  
Early Stage ◽  
Patient Reported Outcome ◽  
Patient Reported

Introduction The patient's role in toxicity reporting is increasingly acknowledged. There is also a need for developing modern communication methods between the patient and the medical personnel. Furthermore, the increasing number of head and neck cancer (HNC) patients is reflected in the volume of treatment follow-up visits, which remains a challenge for the health care. Electronic patient-reported outcome (ePRO) measures may provide a cost-efficient way to organize follow-up for cancer patients. Materials and Methods We tested a novel ePRO application called Kaiku®, which enables real-time, online collection of patient-reported outcomes, such as side effects caused by treatment and quality of life. We conducted a pilot study to assess the suitability of Kaiku® for HNC patients at the Department of Oncology, Helsinki University Hospital, Helsinki, Finland. Patients used Kaiku® during and one month after radiotherapy to report treatment-related side effects and quality of life. Two physicians and a nurse performed the practical electronic communication part of the study. Results Five of the nine patients agreed to participate in the study: three of them had local early-stage larynx cancer (T2N0, T1aN0, and T2N0) and the remaining two patients had early-stage base of tongue cancer (T2N0 and T1N2b). The degree of side effects reported by the patients via Kaiku® ranged from mild to life threatening. The number of outcome data points on patients' progress was significantly increased, which resulted in a better follow-up and improved communication between the patient and the care team. Conclusions Kaiku® seems to be a suitable tool to monitor side effects and quality of life during and after radiotherapy among HNC patients. Kaiku® and similar tools could be useful in organizing a cost-effective follow-up process for HNC patients. We recommend conducting a larger study to further assess the impact of an ePRO solution in routine clinical practice. • ePRO solutions may aid in the follow-up for cancer patients. • They seem suitable to monitor, for example, side effects and quality of life. • These systems ensure fast patient-driven reporting.

scholarly journals Effect of Interval between Human Chorionic Gonadotropin Priming and Ovum Pick-up on the Euploid Probabilities of Blastocyst

2020 ◽  
Vol 9 (6) ◽  
pp. 1685
Author(s):  
Chun-I Lee ◽  
Hsiu-Hui Chen ◽  
Chun-Chia Huang ◽  
Chien-Hong Chen ◽  
En-Hui Cheng ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Generalized Estimating Equations ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Trend Test ◽  
Factors Associated ◽  
Armitage Trend Test ◽  
Euploidy Rate ◽  
Significant Factors

This retrospective study attempts to elucidate the relevance of the interval between human chorionic gonadotropin priming and oocyte pick-up (hCG-OPU) to the euploidy probability of biopsied blastocysts in preimplantation genetic tests for aneuploidy (PGT-A) cycles. A total of 1889 blastocysts from 511 patients undergoing PGT- A cycles were used. An analysis of generalized estimating equations (GEE) was used to identify whether the hCG–OPU interval is associated with euploidy probabilities of blastocysts. Accordingly, maternal age (OR: 0.925, 95% CI: 0.903–0.948, p < 0.001) and the hCG–OPU interval (OR: 1.138, 95% CI: 1.028–1.260, p = 0.013) were the two significant factors associated with the euploidy probabilities. The Cochran-Armitage trend test demonstrated that the blastocyst euploidy percentage increased progressively with the increasing hCG-OPU interval in normal responders (p = 0.006) and advanced maternal age (age ≥38 years; p = 0.020) groups. In normal responders, the euploidy rate was highest in the 38–39 h interval (43.1%, 47/109). In contrast, the euploidy rate was lowest in the 34–35 h interval (28.7%, 29/105). In conclusion, the present study demonstrated that at an hCG-OPU interval between 34–39 h, the longer the hCG-OPU interval, the higher the probability of euploidy for blastocysts.

Symptom Burden in Extensive Disease Small Cell Lung Cancer (ED-SCLC): A prospective, observational study in U.S. community practices.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 196-196
Author(s):  
Donald A. Richards ◽  
Maen A. Hussein ◽  
Steven L. McCune ◽  
Brian Kent Ulrich ◽  
Mark D. Danese ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Status ◽  
Observational Study ◽  
Repeated Measures ◽  
Prospective Observational Study ◽  
Symptom Burden ◽  
Patient Reported ◽  
Lung Cancer Symptom Scale ◽  
Line Of Therapy

196 Background: There is a paucity of data describing the effect of treatment on symptom burden and health status for patients with ED-SCLC receiving care in US community oncology centers. This study explores ED-SCLC patient-reported outcomes independently for either first-line (1L), second-line (2L) or third-line (3L) therapy. Methods: CA209-118 is a prospective observational study of adult patients with lung cancer, including patients with ED-SCLC, in 70 US community practices enrolled between 2014-2017. Participants completed the Lung Cancer Symptom Scale (LCSS) and Euro-QoL 5-D (EQ-5D) utility index and visual analog scale (VAS) at the start of 1L, 2L, or 3L treatment and at follow-up visits. The LCSS is summarized in 3 scales: LCSS total scale which ranges from 0 – 100, average symptom burden scale (ASBI) ranging from 0 – 100, and a three-item global scale (3-IGI) ranging from 0 – 300 (lower scores reflect reduced burden). The EQ-5D scale is a preference based measure of health status with higher scores reflecting better quality and ranges from 0 to 1.0 (index) or 0 – 100 (VAS). LCSS and EQ-5D values at 60 days were predicted in a repeated measures model for patients having a score at baseline and at least 1 follow-up. Results: The mean LCSS and EQ-5D scores at the start of each line of therapy and predicted 60 day change are presented in the table . 60-day improvement was observed only for appetite and cough in 1L. A slight declining trend was seen in 2L and 3L. Conclusions: Patients with ED-SCLC treated in the community reported a high symptom burden at the start of each line of therapy which did not diminish throughout 60 days of treatment. [Table: see text]

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