scholarly journals Effects of the Interactive Web-Based Video “Mon Coeur, Mon BASIC” on Drug Adherence of Patients with Myocardial Infarction: A Randomized Study (Preprint)

2020 ◽  
Author(s):  
Christel Bruggmann ◽  
Julien Adjedj ◽  
Sylvain Sardy ◽  
Olivier Muller ◽  
Pierre Voirol ◽  
...  
Keyword(s):  
Emergency Room ◽  
Interactive Video ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Drug Adherence ◽  
Emergency Room Visits ◽  
Web Based ◽  
The Difference ◽  
The Impact

BACKGROUND Secondary prevention strategies after acute coronary syndrome (ACS) presentation with the use of drug combinations are essential to reduce the recurrence of cardiovascular events. However, the lack of drug adherence is known to be common in this population, and to be related to treatment failure. To improve drug adherence, we developed the “Mon Coeur, Mon BASIC” web-based interactive video to inform patients about ACS and their drug treatments. OBJECTIVE To assess the impact of the web-based video on drug adherence. METHODS This randomized study was conducted with consecutive patients admitted to Lausanne University Hospital for ACS. We randomized patients to an intervention group, which had access to the video, and a control group receiving usual care. The primary outcome was the difference in drug adherence, assessed with the Adherence to Refills and Medication Scale [ARMS; nine multiple-choice questions, scores ranging from 12 (perfect adherence) to 48 (lack of adherence)], between groups at 1, 3, and 6 months. We assessed the difference in ARMS score between both groups with Wilcoxon rank sum test. Secondary outcomes were differences in knowledge and readmissions and emergency room visits between groups, and patients’ satisfaction with the video. RESULTS Sixty patients were included at baseline. The median age of the participants was 59 (IQR 49–69) and 85% were male. At 1 month, 51 patients participated in the follow up, 50 patients participated at 3 months, and 47 patients participated at 6 months. The mean ARMS scores at 1 and 6 months did not differ between the intervention and control groups (13.24 and 13.15, 13.52 and 13.68, respectively). At 3 months, this score was significantly lower in the intervention group than in the control group (12.54 vs. 13.75, P = .034). We observed significant increases in knowledge from baseline to 1 and 3 months, but not to 6 months, in the intervention group. Readmissions and emergency room visits have been very rare and the proportion was not different among groups. Patients in the intervention group were highly satisfied with the video. CONCLUSIONS The “Mon Coeur, Mon BASIC” web-based interactive video improved patients’ knowledge and seemed to have an impact on drug adherence. These results are encouraging, and the video will be offered to all patients admitted to our hospital with ACS. CLINICALTRIAL ClinicalTrials.gov NCT03949608; https://clinicaltrials.gov/ct2/show/NCT03949608

A Randomized Study to Assess the Impact of Pharmacist Counseling of Employer-Based Health Plan Beneficiaries With Diabetes

2011 ◽  
Vol 25 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Dale F. Kraemer ◽  
Wayne A. Kradjan ◽  
Theresa M. Bianco ◽  
Judi A. Low
Keyword(s):  
Diabetes Management ◽  
Statistical Significance ◽  
Glycosylated Hemoglobin ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Counseling Intervention ◽  
Care Plans ◽  
Pharmacist Counseling ◽  
The Impact

Objective: To assess the impact of pharmacist counseling on empowering people with diabetes to better self-care. Introduction: Community-based pharmacists can play a key role in educating and empowering people in such programs. Methods: A randomized trial compared the effects of pharmacist counseling (intervention group) with printed materials (control group) in diabetic beneficiaries of several employer-based health care plans. All participants also received waiver of out-of-pocket expenses for diabetic-related medications and supplies. Clinical, humanistic, and claim outcomes were evaluated at baseline and at 1 year follow-up. Results: Sixty-seven beneficiaries participated in this study. The 0.50% decrease from baseline in glycosylated hemoglobin (A1c) was statistically significant ( P = .0008) in the intervention group and the difference between the groups approached statistical significance ( P = .076). Beneficiaries in both groups had greater claim costs for diabetic-related medications and supplies during the study year. Both groups also improved in ability to manage their diabetes with the counseling group showing a significantly better understanding of diabetes ( P = .0024). Conclusion: There was a trend toward improvement in A1c in patients counseled by pharmacist with an increased utilization of diabetes-related medications and supplies. Counseling also improved diabetes knowledge and empowered patients to better diabetes management.

scholarly journals The Impact of a Web-Based Mindfulness, Nutrition and Fitness Platform on the Health Status of First-Year University Students: Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Claire F Trottier ◽  
Jessica RL Lieffers ◽  
Steven T Johnson ◽  
João F Mota ◽  
Roshni K Gill ◽  
...  
Keyword(s):  
Physical Activity ◽  
University Students ◽  
Intervention Group ◽  
Mental Wellbeing ◽  
Control Group ◽  
First Year ◽  
Web Based ◽  
Related Quality ◽  
First Year University ◽  
The Impact

BACKGROUND First-year university students are at increased risk for presenting with anxiety, depression, suicidal thoughts and poor nutritional status. Self-care plays an essential role in optimizing mental health and can prevent/treat stress, anxiety and depression. Web-based self-monitoring of diet and physical activity can lead to similar or improved health outcomes compared to conventional methods. Such tools are also popular among university students. OBJECTIVE The primary objective of this 12-week randomized control trial was to assess the impact of a web-based wellness platform on perceived stress among first-year university students. The study’s secondary outcome was to assess the effects of the platform on diet quality and exploratory outcomes were body composition, health related quality of life, mindfulness, mental wellbeing and physical activity. METHODS Ninety-seven first-year undergraduate students were randomized to either the intervention (n=48) or control (n=49) group. The intervention consisted of access to a web-based platform called My Viva Plan® (MVP) which aims to support healthy living on the topics of mindfulness, nutrition, and fitness. The platform is fully automated and is guided by principals of cognitive behavior theory. Participants in the intervention group were instructed to use MVP as frequently as possible over 12 weeks. The control group did not receive access to MVP. Perceived stress was assessed using the Stress Indicators Questionnaire at baseline, week 6 and week 12. Three day food records were used to analyze dietary intake at baseline and week 12. Health related quality of life, mindfulness, mental wellbeing and physical activity questionnaires were completed at baseline, week 6 and week 12 and body composition was assessed at baseline and week 12. Study assessments were completed in-person at baseline and week 12 and electronically at week 6. RESULTS Study recruitment started in August 2018 with batch enrollment for students registered in the fall (September 2018 to December 2018) and winter (January 2019 to April 2019) academic terms at the University of Alberta, Edmonton, Alberta. Eighty participants completed the 12-week trial (n=35 in the intervention group; n=45 in the control group). All data collection ended in May 2019. CONCLUSIONS This project is the first to explore the impact of an online platform designed to promote health and wellness; it will also shed light into its applicability in first-year university students. If successful, this may become an important health care tool for preventative care in first year university students. CLINICALTRIAL ClinicalTrials.gov NCT03579264

scholarly journals Rational and Design of the SIMULATOR Study: A Multicentre Randomized Study to Assess the Impact of SIMULation-bAsed Training on Transoesophageal echocardiOgraphy leaRning for Cardiology Residents

2021 ◽  
Vol 8 ◽  
Author(s):  
Théo Pezel ◽  
Anne Bernard ◽  
Yoan Lavie Badie ◽  
Julien Dreyfus ◽  
Etienne Audureau ◽  
...  
Keyword(s):  
Randomized Study ◽  
Intervention Group ◽  
Medical Residents ◽  
Control Group ◽  
Traditional Teaching ◽  
Single Center ◽  
Simulation Based ◽  
Simulator Study ◽  
And Performance ◽  
The Impact

Introduction: Simulation-based training in transesophageal echocardiography (TEE) seems promising. However, data are limited to non-randomized or single-center studies. To assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology.Materials and Methods: Nationwide prospective randomized multicenter study involving 43 centers throughout France allowing for the inclusion of >70% of all French cardiology residents. All cardiology residents naive from TEE will be included. Randomization with stratification by center will allocate residents to either a control group receiving theoretical knowledge by e-learning only, or to an intervention group receiving two simulation-based training sessions on a TEE simulator in addition.Results: All residents will undergo both a theoretical test (0–100 points) and a practical test on a TEE simulator (0–100 points) before and 3 months after the training. Satisfaction will be assessed by a 5-points Likert scale. The primary outcomes will be to compare the scores in the final theoretical and practical tests between the two groups, 3 months after the completion of the training.Conclusion: Data regarding simulation-based learning in TEE are limited to non-randomized or single-center studies. The randomized multicenter SIMULATOR study will assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology, and whether such an educational program should be proposed in first line for TEE teaching.

scholarly journals Improving surgical patient’s knowledge about safe use of opioids: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Helen R Doherty ◽  
Enoch Lam ◽  
Maria Garstka ◽  
Junior Chuang ◽  
David Tai Wong ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Knowledge Score ◽  
Controlled Study ◽  
Control Group ◽  
Routine Practice ◽  
Opioid Use ◽  
Randomized Controlled ◽  
The Difference ◽  
The Impact

Abstract Background Currently, it is not routine practice to provide standardized patient education for safe postoperative opioid use. The objective of our study was to evaluate the impact of an educational pamphlet for surgical patients on knowledge about safe use, proper storage, and disposal of opioids.Methods This multi-center randomized controlled study recruited 100 patients in the pre-operative clinic. Inclusion criteria were English-speaking, ≥ 18 years, able to give informed consent, and not on opioids for chronic pain or within the past 30 days. All patients completed a baseline knowledge questionnaire (maximum score 38) on opioid safety. Patients were randomized to intervention: educational pamphlet, or control: standard care (no pamphlet) group. Questionnaires were repeated immediately post-education in the intervention group, and at 15, and 30 days after surgery in both groups. The primary outcome was change in knowledge score post-education in the intervention compared to control group. Secondary outcomes were immediate post-education, 15, and 30-day score, and answering safe storage, and disposal questions correctly.Results Between groups, the post-education score immediately after the intervention was higher in the intervention vs. control group baseline 34.2 [95% CI 33.1–35.3] vs 28.3 [95% CI 26.6–29.9]; P < 0.0001). In the intervention vs control group, mean scores were higher 31.6 (95% CI 30.5–32.7) vs 29.1 (95% CI 27.9–30.2; P = .002) at 15 days, and 32.4 (95%CI 31.4–33.5) vs 30.5 (95% CI 29.2–31.7; P = .017) at 30 days. Within the intervention group, the mean score immediately post-education (34.2 [95% confidence interval (CI) 33.1–35.3]) was higher than baseline (27.8 [95% CI 26.3–29.3]); P < 0.0001. Within the intervention group, the difference in mean score versus baseline was 3.8 (95% CI 2.1–5.5) at 15 days, and 4.6 (95% CI 2.9–6.3) at 30 days, (P < 0.05 for all timepoints). For safe disposal, a correct answer was given (intervention vs control group) by 100% vs 89.7% at 30 days (P = 0.04).Conclusions Within the intervention group, there was a significant improvement in knowledge on safe opioid use immediately post-education, and retention of knowledge at 15 and 30 days postoperatively. The intervention group had better knowledge scores compared to the baseline control group, and 15 and 30 days after surgery.Trial Registration: This study was registered in clinicaltrials.gov: NCT03959787 on May 22, 2019.

scholarly journals The Impact of Endoscopy Sedation Information Sheets on the Level of Concern Regarding Possible Awareness in Patients Undergoing Endoscopy Sedation

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 34
Author(s):  
Zi Ping Tong ◽  
Lincoln Gan Gan Lim ◽  
Alison Pighills ◽  
Matthew Hiskens ◽  
Danny Bartlett
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
Patient Counselling ◽  
Unmet Expectations ◽  
Level Of Concern ◽  
The Difference ◽  
Future Work ◽  
The Impact ◽  
Video Material

Sedation encompasses a continuum from complete unconsciousness to drowsiness and anxiolysis where some awareness might be expected. Most patients undergoing endoscopy sedation expect to be completely unconscious during the procedure and thus have unmet expectations regarding their state of consciousness. This study aimed to evaluate whether endoscopy sedation information sheets reduce the level of concern regarding possible awareness during endoscopy sedation at a major regional hospital. Our findings were that 28.8% of patients who received the endoscopy sedation information sheet (n = 82) were concerned about awareness during the procedure, compared to 36.5% of patients in the control group (n = 105). However, the difference was not statistically significant. We also found that the incidence of awareness was higher (13.9%) in the intervention group compared to 8.8% in the control group but, again, not statistically different. This study allowed us to elucidate the level of concern regarding possible awareness during sedation and the incidence of awareness during endoscopy sedation. This will enable future work investigating the role of endoscopy sedation information methods involving written and video material in assisting pre-procedure patient counselling.

scholarly journals Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis

10.2196/16255 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e16255
Author(s):  
Amika Shah ◽  
Michael Chaiton ◽  
Dolly Baliunas ◽  
Robert Schwartz
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Passive Control ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Intervention Group ◽  
Control Group ◽  
Web Based ◽  
The Impact

Background The increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed. Objective The aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups. Methods Literature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group. Results A total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; P=.58; I2=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; P=.80; I2=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; P=.90; I2=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; P=.26; I2=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (P=.03), 3-month (P<.001), and 6-month (P=.02) follow-ups but not at 12-month follow-up (P=.25). Conclusions The results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.

Emergency Room Utilization in the First 15 Months of Life: A Randomized Study

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 486-490 ◽  
Author(s):  
Nigel Paneth ◽  
Deborah Bell ◽  
Ruth E.K. Stein
Keyword(s):  
Primary Care ◽  
Emergency Room ◽  
Randomized Study ◽  
Group Analysis ◽  
Care Program ◽  
Pediatric Care ◽  
Control Group ◽  
Municipal Hospital ◽  
Primary Care Program ◽  
The Impact

The impact of a system of primary pediatric care on emergency room use in a municipal hospital was measured by comparing that use in two randomly selected populations. The population that was offered participation in a primary care program consistently used the emergency room less than did the control group. Analysis of the pattern of utilization revealed that the differences were limited to patients who actually participated in the program, and to weekday use of the emergency room. Unusually heavy (greater than ten visits per year) use of the emergency room was virtually eliminated among participants in the primary care program.

scholarly journals Pupillometry pain index decreases intraoperative sufentanyl administration in cardiac surgery: a prospective randomized study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Vivien Berthoud ◽  
Maxime Nguyen ◽  
Anouck Appriou ◽  
Omar Ellouze ◽  
Mohamed Radhouani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cardiac Surgery ◽  
Primary Outcome ◽  
Randomized Study ◽  
Intervention Group ◽  
Prospective Randomized Study ◽  
Control Group ◽  
Standard Group ◽  
Postoperative Course ◽  
The Impact

AbstractPupillometry has proven effective for the monitoring of intraoperative analgesia in non-cardiac surgery. We performed a prospective randomized study to evaluate the impact of an analgesia-guided pupillometry algorithm on the consumption of sufentanyl during cardiac surgery. Fifty patients were included prior to surgery. General anesthesia was standardized with propofol and target-controlled infusions of sufentanyl. The standard group consisted of sufentanyl target infusion left to the discretion of the anesthesiologist. The intervention group consisted of sufentanyl target infusion based on the pupillary pain index. The primary outcome was the total intraoperative sufentanyl dose. The total dose of sufentanyl was lower in the intervention group than in the control group and (55.8 µg [39.7–95.2] vs 83.9 µg [64.1–107.0], p = 0.04). During the postoperative course, the cumulative doses of morphine (mg) were not significantly different between groups (23 mg [15–53] vs 24 mg [17–46]; p = 0.95). We found no significant differences in chronic pain at 3 months between the 2 groups (0 (0%) vs 2 (9.5%) p = 0.49). Overall, the algorithm based on the pupillometry pain index decreased the dose of sufentanyl infused during cardiac surgery.Clinical trial number: NCT03864016.

scholarly journals Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis (Preprint)

2019 ◽  
Author(s):  
Amika Shah ◽  
Michael Chaiton ◽  
Dolly Baliunas ◽  
Robert Schwartz
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Passive Control ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Intervention Group ◽  
Control Group ◽  
Web Based ◽  
The Impact

BACKGROUND The increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed. OBJECTIVE The aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups. METHODS Literature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group. RESULTS A total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; <i>P</i>=.58; <i>I</i><sup>2</sup>=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; <i>P</i>=.80; <i>I</i><sup>2</sup>=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; <i>P</i>=.90; <i>I</i><sup>2</sup>=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; <i>P</i>=.26; <i>I</i><sup>2</sup>=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (<i>P</i>=.03), 3-month (<i>P</i>&lt;.001), and 6-month <i>(P</i>=.02) follow-ups but not at 12-month follow-up (<i>P</i>=.25). CONCLUSIONS The results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.

scholarly journals DAMPAK ALOKASI DANA DESA BAGI PEMBANGUNAN DAERAH DAN KESEJAHTERAAN MASYARAKAT

2019 ◽  
Vol 1 (2) ◽  
pp. 164
Author(s):  
Alfian Mujiwardhani ◽  
Heru Wibowo ◽  
Iman Tri Mulya
Keyword(s):  
Economic Growth ◽  
Intervention Group ◽  
Physical Capital ◽  
Welfare Economic ◽  
Control Group ◽  
Fund Allocation ◽  
Education And Health ◽  
The Difference ◽  
The Impact ◽  
The Village

This study aims to evaluate the impact of the Village Fund allocation on the improvement of regional development, which is measured by improvements in physical capital, human capital, economy, and community welfare (economic growth, poverty, and unemployment). The Difference in Difference (DID) method is applied to estimate the effects of village fund allocation by comparing the changes in outcome between the district that get village fund allocation (intervention group) and the cities that did not (control group). The results of the study show that the Village Fund has an impact on improving the achievement of outputs in infrastructure, education and health services, as well as improving economic performance, but has not been able to improve welfare indicators. The Village Fund is expected to be able to increase economic growth in the short term, but it has not yet affected poverty and unemployment.

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