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Temporomandibular joint osteoarthritis (TMJOA) is a commonly encountered degenerative joint disease in oral and maxillofacial surgery. Recent studies have shown that the excessive unbalanced activation of Wnt/β‐catenin signaling is connected with the pathogenesis of TMJOA and due to the inability to inhibit the over‐activated Wnt pathway, while Wnt16‐deficient mice has a more severe Knee OA. However, the efficacy of direct intra‐TMJ injection of Wnt16 for the relief of TMJOA is still not directly confirmed. Moreover, small‐molecule drugs such as Wnt16 usually exhibit short‐lived efficacy and poor treatment adherence. Therefore, in order to obtain a stable release of Wnt16 both in the short and long term, this study fabricates a double‐layer slow‐release Wnt16 carrier based on mesoporous silica nanospheres (MSNs) encased within hyaluronic acid (HA) hydrogels. The biofunctional hydrogel HA/Wnt16@MSN is analyzed both in vitro and in vivo to evaluate the treatment of TMJOA. As a result, it shows superior pro‐cartilage matrix restoration and inhibition of osteoclastogenesis ability, and effectively inhibits the over‐activation of the Wnt/β‐catenin pathway. Taken together, biofunctional hydrogel HA/Wnt16@MSN is a promising candidate for the treatment of TMJOA. [ABSTRACT FROM AUTHOR]

The systematic review and meta-analysis examined cardiovascular events in patients with psoriasis and psoriatic arthritis treated with JAK/TYK inhibitors. The study found no significant differences in major cardiovascular events, stroke, atrial fibrillation, venous thromboembolism, new-onset hypertension, or deaths between the JAK/TYK inhibitor and placebo groups. The research highlights the need for further studies with longer follow-up periods and larger sample sizes to improve the assessment of cardiovascular safety in this population. [Extracted from the article]

ABSTRACT Objectives Methods Results Conclusions Appropriate insulin injection technique can help to enhance positive clinical outcomes in insulin‐treated patients. This cross‐sectional survey was undertaken to assess the present state of injection technique practices of patients administering insulin and the incidence of local complications associated with insulin injection.This cross‐sectional study was conducted at 11 tertiary hospitals in Xi'an City. A total of 1370 patients with diabetes were enroled in the survey. Each patient was asked questions on the Injection Technique questionnaire, demonstrated insulin injection on an injection training pad and had their injection sites inspected by a nurse.About 98% of participants were type 2 diabetic patients. The 5 mm length needles were used by 640 (46.71%) patients. Around 1286 participants reused pen needles. Only one‐third of patients rotate the injection sites. Around 901 patients had ecchymosis at injection sites, 43 participants suffered rash and or pruritus and 661 patients had lipohypertrophy. About 2.99% of patients reported having infection at the injection sites. Most patients (72.55%) occasionally felt pain when injecting insulin. The results of the multivariable logistict analysis showed that gender (male), needle length, priming the pen before injections and correct site rotation were negatively associated with the incidence of injection site ecchymosis. Lower incidence of lipohypertrophy was associated with needle length 4 mm, needle length 6 mm, single use of pen needles, priming the pen before injections and correct site rotation. Higher incidence of injection site infection was related to not disinfecting injection sites before each injection.Despite some improvements detected in some aspects of patients' insulin injection practice in recent years, a large gap still exists between insulin injection guidelines and patients' actual injection behaviour. Injection‐related complications at injection sites are still considerably common among our study population. Patients' education regarding insulin injection technique should be conducted repeatedly and regularly to make sure patients' compliance to injection guidelines. [ABSTRACT FROM AUTHOR]

The article discusses the comparison between surgery and biologics for treating nasal polyposis in patients with chronic rhinosinusitis. Biologics like dupilumab, mepolizumab, and omalizumab have emerged as effective treatments, with dupilumab showing strong performance in various endpoints compared to surgery. While surgery may improve certain symptoms like nasal congestion and polyp size, biologics offer benefits in terms of symptom relief and objective outcomes. Cost-effectiveness and long-term safety considerations suggest that surgery may still play a crucial role in treating nasal polyposis, with individual patient needs guiding treatment decisions. [Extracted from the article]

ABSTRACT Background Purpose Methods Results Conclusions Trial Registration Hypertension (HT) is a global health problem. Although there are effective treatment protocols, patients have difficulty in adapting to regular use of drugs, diet, and lifestyle changes. Mobile apps can be a potential alternative for managing HT and improving self‐care behavior.This study aimed to determine the effect of mobile application follow‐up on treatment compliance and self‐care management in patients with HT.This randomized controlled trial was conducted in November 2021 and March 2022 with 40 experimental and 40 control group patients with HT. Research data were collected using a patient information form, “Hill‐Bone Hypertension Treatment Compliance Scale (HBHTTCS),” “Hypertension Self‐Care Profile‐Motivation Scale (HTSPMS),” a mobile application program (daily blood pressure, pulse, medication, diet, exercise tracking) uploaded to the mobile phones of the patients, and individual motivational messages.The mean total score of the HBHTTCS at Week 6 was 14.57 ± 1.89 and the mean total score of the HTSPMS was 78.15 ± 2.05. There was a statistically significant difference in mean total HTSPMS (p = 0.000) and HBHTTCS (p = 0.000) scores and mean scores on medical (p = 0.002) and nutrition (p = 0.002) subscales of HBHTTCS between the first interview (1st‐week follow‐up) and the last interview (6th‐week follow‐up) of patients in the intervention group.This study showed that mobile application follow‐up increased motivation levels and treatment compliance in patients with HT and resulted in better self‐care. These positive findings indicate importance of integrating mobile applications in the disease management of HT patients.ClinicalTrials.gov ID: NCT05334446, https://clinicaltrials.gov/ct2/show/NCT05334446. [ABSTRACT FROM AUTHOR]

Background: Effective interventions for the management of alcohol‐related liver disease (ARLD) remain a gap in clinical practice, and patients' engagement with alcohol services is suboptimal. Based upon the principles of operant conditioning, contingency management (CM) is a psychosocial intervention th at involves gradual, increasing incentives upon completion of treatment‐related goals such as treatment attendance. Methods: A pilot feasibility trial was conducted with 30 adult patients recruited from an inpatient clinical setting. Consecutive sampling was used to recruit patients presenting comorbid alcohol use disorder (AUD) and ARLD. Participants were randomized to integrated liver care (ILC), receiving hepatology and AUD care, or ILC with a voucher‐based CM intervention (intervention arm). A longitudinal qualitative approach was adopted to explore anticipated (Stage 1) and experienced acceptability (Stage 2). The Theoretical Framework of Acceptability (TFA) guided semi‐structured in‐depth interviews and deductive analysis. Results: Thirty participants were enrolled in the pilot trial, and interviews were conducted with 24 participants at Stage 1 and seven at Stage 2. Over half of the cohort (54.2%, n = 13) presented decompensated liver disease, and an average of 179 units of alcohol were consumed per week. Overall positive views toward voucher‐based CM were noted, and explanatory data emerged across five TFA domains (intervention coherence, ethicality, self‐efficacy, perceived effectiveness, and affective attitude). The core aspects of the voucher‐based CM intervention matched participants' preferences and needs. Participants regarded CM as having a symbolic value and strengthening the therapeutic alliance with healthcare providers. Conclusion: The data support the scope of voucher‐based CM intervention to promote engagement with treatment services, and its potential to address the gaps in the care continuum in ARLD. The findings are of practical significance for developing person‐centered, tailored interventions for this clinical population. The outcomes of this investigation can inform decision‐making among stakeholders and healthcare providers and improve health outcomes for this clinical population. [ABSTRACT FROM AUTHOR]

Background: Clinicians and patients often face a decision to continue or discontinue statins. We examined the impact of discontinuation of statins compared with continuation on clinical outcomes (all‐cause mortality, cardiovascular [CV] mortality, CV events, and quality of life). Methods: We conducted a systematic review. Randomized controlled trials (RCTs), cohort studies, case–control studies, and quasi‐randomized studies among people ≥18 years were eligible. We searched MEDLINE, Embase, and Cochrane Central Registry (inception to August 2023). Two independent reviewers performed screening and extracted data. Quality assessment was performed by one author and verified by another. We summarized results narratively, performed meta‐analysis for a subset of studies, and used GRADE to assess certainty of evidence. We summarized findings in the subgroup of persons ≥75 years. Results: We retrieved 8369 titles/abstracts; 37 reports from 36 studies were eligible. This comprised 35 non‐randomized studies (n = 1,708,684) and 1 RCT (n = 381). The 1 RCT was conducted among persons with life expectancy <1 year and showed there is probably no difference in 60‐day mortality (risk difference = 3.5%, 90% CI −3.5 to 10.5) for statin discontinuation compared with continuation. Non‐randomized studies varied in terms of population and setting, but consistently suggested that statin discontinuation might be associated with a relative increased risk of mortality (hazard ratio (HR) 1.92, 95% CI 1.52 to 2.44, nine studies), CV mortality (HR 1.63, 95% CI 1.27 to 2.10, five reports), and CV events (HR 1.31, 95% CI 1.23 to 1.39, eight reports). Findings in people ≥75 years were consistent with main results. There was a high degree of uncertainty in findings from non‐randomized studies due to methodological limitations. Conclusions: Statin discontinuation does not appear to affect short‐term mortality near end‐of‐life based on one RCT. Outside of this population, findings from non‐randomized studies consistently suggested statin discontinuation may be associated with worse outcomes, though this is uncertain. See related Editorial by Odden and Dave. [ABSTRACT FROM AUTHOR]

Objective: To apply the 2019 joint American Academy of Neurology (AAN) and American Headache Society (AHS) quality measures for headache management to a cohort of neurology resident physicians and then assess outcomes related to guideline adherence. Background: The optimization of headache management is essential to reduce both the individual and systemic impact of these disorders. In 2014, the AAN developed 10 quality measures for evidence‐based management of patients with headache. A workgroup updated and condensed its headache quality measures in 2019, narrowing the set to six measurements, four of which would primarily focus on the management of migraine and two of which would address the management of cluster headache. Methods: This quality improvement study was conducted using a pretest‐posttest study design. A pre‐intervention survey based on retrospective analysis of five clinic notes for adherence to the measures was designed and distributed to all neurology residents (n = 32) at a large, academic tertiary referral center. The intervention included the creation of an electronic medical record template to aid residents in following the measures during clinical encounters, as well as the provision of direct feedback based on pre‐intervention results. Finally, a post‐intervention survey was distributed for completion based on notes written during the intervention period. Analysis was limited to migraine, given the low percentage of cluster headache seen in clinic. Results: An increase in adherence was seen in three of the four migraine‐related quality measures, with the Use of Abortive Medications for Migraine and Documentation of Counseling on Modifiable Lifestyle and Chronification Factors demonstrating statistically significant improvements (75.8% to 88.0% [p = 0.013] and 83.9% to 94.0% [p = 0.029] adherence, respectively). For secondary outcomes, the increase in the utilization of appropriate diagnostic criteria (82.6% to 93.2%, p = 0.018) was significant, and the self‐assessed confidence rating for adherence to guidelines was significant (p < 0.001). Conclusions: This study provides evidence that the quality improvement intervention led to increased adherence to the AAN and AHS migraine‐related measures. It is anticipated that increased adherence may lead to improved patient outcomes. Plain Language Summary: In 2019, the American Academy of Neurology and the American Headache Society worked together to create a set of quality measures to guide clinicians in the care of patients with headache; however, we do not know if these guidelines are being followed. This study aimed to see if resident neurologists at a large academic medical center would better follow these guidelines if they were part of a standardized electronic medical record template. Overall, this study showed that applying the headache quality measures in a real clinical setting is feasible and can improve best‐care practices. [ABSTRACT FROM AUTHOR]

Objective: The efficacy of psychological interventions for bipolar disorder (BD) is well established, but much remains unknown about how change occurs. The primary objective of this exploratory study was to audit what is known about active components and mechanisms of action of psychological interventions for BD. Method: We conducted a systematic review (PROSPERO CRD42022323276). Two independent reviewers screened references from four databases and extracted data from eligible studies. Results: We included four component studies, six studies with mediation analyses and 26 studies presenting subjective experiences of how psychological interventions bring change. Ten mediators were examined across six studies, with only one putative mediator, medication adherence, tested in more than one study. Some initial support for mediation of varied outcomes by control over thoughts, positive non‐verbal behaviour, self‐esteem, post‐trauma growth and medication adherence. Some preliminary support was found in two components, human support and IPT. Studies exploring participant experiences of therapeutic change enumerated a range of potential active components, mechanisms of action and contextual factors potentially warranting investigation in future research. However, the evidence base for active components and mechanisms of action in psychological interventions for BD is unsatisfactory. Findings were inconsistent, studies homogenous with significant methodological limitations and statistical approaches failed to meet quality criteria. Conclusions: Preliminary identification of potential components and mechanisms via qualitative analyses and the insights emerging from this review will inform future research aimed at investigating how psychological interventions work in BD. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to determine the effects of the training and medication reminder wristwatch on treatment adherence in geriatric patients diagnosed with hypertension. Methods: In this study, which was conducted as a randomized clinical trial with a pretest‐posttest design, 90 patients were randomly divided into the training and medication reminder wristwatch (W) group (n = 30) group, the training (T) group (n = 30), and the control (C) group (n = 30). All patients answered the data collection forms before and after the interventions. Results: By the end of the 12th week, the mean knowledge scores of the groups significantly differed from each other (t = −13.207, P < 0.001). The mean Hypertension Compliance Assessment Scale score of the W group was found to be significantly lower (t = 22.732, P < 0.001). The highest mean Medication Adherence Self‐Efficacy Scale–Short Form score was found in the W group (t = −13.560, P < 0.001). In the posttest, the mean systolic blood pressure values of the patients were 142.7 ± 11.1 in the C group, 126.0 ± 13.0 mm Hg in the T group, and 120.0 ± 9.5 mm Hg in the W group (Kruskal–Wallis test = 38.065, P < 0.05). Conclusions: This study demonstrates that 12 weeks of a training program and the use of medication reminder wristwatches were effective in adherence to treatment. Geriatr Gerontol Int 2024; 24: 1189–1195. [ABSTRACT FROM AUTHOR]

Objectives: Although treatments of patients with borderline personality disorder (BPD) were historically associated with relatively high dropout rates, dropout rates in contemporary evidence‐based treatments for BPD are typically substantially lower. However, only a few studies have investigated dropout rates in mentalization‐based treatment (MBT), and even fewer have investigated predictors of dropout in this type of treatment. In this study, we investigated dropout rates in two types of MBT (day hospital MBT [MBT‐DH] and intensive outpatient MBT [MBT‐IOP]) using data from a recent multicenter randomized clinical trial. Given the central importance of attachment considerations in MBT, we also investigated the relationship between dropout in these two treatments and attachment dimensions. Design: Within a multicenter randomized clinical trial, 114 BPD patients were randomized to MBT‐DH (n = 70) or MBT‐IOP (n = 44). Methods: Dropout in both types of MBT was investigated using descriptive analyses, and its association with attachment anxiety and attachment avoidance, as measured by the Experiences in Close Relationships questionnaire at baseline, was investigated using regression analyses. Results: Dropout rates were relatively low (10.5% across both types of MBT) and did not significantly differ between groups (11.4% in MBT‐DH, 9.1% in MBT‐IOP). Attachment avoidance and attachment anxiety did not impact dropout, nor did their interaction or the interaction with the type of MBT. Conclusions: Low dropout rates in both types of MBT indicate a high level of engagement of patients in both programmes. Attachment dimensions were not associated with dropout, consistent with the principle that MBT is tailored to each individual's needs. More research is needed, however, to investigate to what extent attachment is a dynamic context‐bound adaptive process rather than a static personality feature. [ABSTRACT FROM AUTHOR]

This study evaluated patient‐reported outcomes (PROs) of Medicine Access Programmes (MAPs) for Australian metastatic breast cancer patients on ribociclib. Limited patient awareness of MAP enrolment was identified, emphasising the need for improved education and consent processes. Most patients expressed gratitude for accessing non‐funded medications and perceived enhanced medication adherence as a key benefit. Integrating PRO data with real‐world registry data provides comprehensive insight for future MAP development. [ABSTRACT FROM AUTHOR]

Apixaban is a widely used direct oral anticoagulant that is recommended over warfarin therapy for many clinical indications. In patients with atrial fibrillation, dose reductions are recommended for patients with advanced age (≥80 years), low weight (≤60 kg) or elevated serum creatinine (≥1.5 mg/dL), but there is no routine laboratory monitoring necessary for long term‐use. Furthermore, apixaban dose reductions due to renal dysfunction are not recommended when treating acute venous thromboembolism. Apixaban‐calibrated anti‐Xa assays are readily available at some medical centres, and they may be of clinical utility in certain circumstances such as in patients with renal insufficiency, medication adherence assessment, periprocedural planning, extremes in body weight and advanced age. Here, we describe the case of an elderly patient with chronic kidney disease taking apixaban for acute pulmonary embolism. The patient had an unanticipated prolonged apixaban half‐life, with detectable apixaban‐calibrated anti‐Xa levels for >10 days after the last administered dose, which delayed a necessary surgical intervention by >1 week. This case is an example of appropriately using apixaban‐calibrated anti‐Xa levels to guide therapeutic decision making in perioperative planning. [ABSTRACT FROM AUTHOR]

Conditions such as stroke, dementia and neurodegeneration are major contributors to the incidence of acquired communication disorders in Europe. Pharmacological interventions play a central role in the management and treatment of these conditions, though many patients with an acquired communication disorder may be at a higher risk of medication non‐adherence than their peers. The objectives of the current review were to identify, in the context of people with acquired communication disorders: factors that influence medication adherence; current interventions targeting medication adherence; and current measures of medication adherence. This study was conducted and reported in accordance with both PRISMA and SWiM guidelines. Two authors independently screened the results of a literature search, assessed risk of bias and extracted relevant data. Eight studies were identified for inclusion. The results of this review indicate that patient‐related factors are most indicative of medication non‐adherence in a population with acquired communication disorders, followed by socioeconomic factors and medication‐related factors. Despite the recognized importance of medication adherence, no gold standard of assessment or intervention currently exists for this population. Half of the included studies replaced patients with communication difficulties with caregiver proxies, thus reducing opportunities for patients to have agency over their own healthcare. The term "acquired communication disorders" encompasses a range of conditions with diverse aetiologies, presentations and needs, and future research should be tailored to specific patient groups most at risk of medication non‐adherence, namely those with aphasia and cognitive‐communication impairments. Patients should be empowered to participate in future research to ensure the literature accurately represents their lived experience. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The study aim was to investigate sulfonylurea prescription patterns in elderly patients (age ≥65 years) with type 2 diabetes mellitus in Japan. Sulfonylurea use among older adults has been insufficiently examined, despite the associated risks of hypoglycemia. Materials and Methods: This retrospective cross‐sectional survey entailed analysis of Japanese pharmacy data, extracted from the Musubi database, for patients (age 20–100 years) prescribed sulfonylureas between November 2022 and October 2023. Dose distribution, adherence to the Diabetes Treatment Guidelines for the Elderly 2023 and coprescription of other diabetes medications were investigated. Results: Of the total 91,229 patients, 80.1% were prescribed glimepiride, 16.3% gliclazide and 3.6% glibenclamide. In patients aged ≥65 years, exceeding the recommended dose (>1 mg/day for glimepiride, >40 mg/day for gliclazide) was numerically higher for glimepiride (25.0%) than for gliclazide (7.8%). The most common prescribing patterns were quadruple therapy with a sulfonylurea, a dipeptidyl peptidase‐4 inhibitor, an sodium–glucose transporter 2 inhibitor and a biguanide in patients aged 65 to <75 years, and dual therapy with a sulfonylurea and a dipeptidyl peptidase‐4 inhibitor in patients aged ≥75 years. Unfortunately, glinide was coprescribed for 338 (0.5%) of elderly patients. Insulin was coprescribed for 3,682 (5.6%) of elderly patients. Conclusions: Analysis of real‐world sulfonylurea prescription data found guideline non‐adherence, namely, excessive prescription of glimepiride, use of glibenclamide in elderly patients, and common coprescription with dipeptidyl peptidase‐4 inhibitors. These findings might provide an opportunity to reconsider the treatment of patients with type 2 diabetes mellitus who are over‐prescribed sulfonylureas to reduce residual risks, such as hypoglycemia. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of type 2 diabetes requires multidimensional management, with medication adherence a crucial aspect of diabetes control. However, recent rigorous estimates of adherence to oral antidiabetic drugs (OAD) are lacking. The objective of this study is to determine the prevalence of adherence to OAD in type 2 diabetes patients. Methods: A systematic search was performed in PubMed, EMBASE, PsycINFO, and CINAHL from July 2013 to April 2023. Cross‐sectional studies published in English were included if they met the following criteria: (1) reported the adherence to OAD using a validated measure; and (2) had a sample size of at least 385 patients with type 2 diabetes. The Joanna Briggs Institute critical appraisal for studies reporting prevalence data was used to assess the quality of the included studies. Pooled estimates of the prevalence of adherence to OAD were calculated as a percentage together with 95% confidence interval (95% CI) using a random‐effect model. All analyses were conducted using STATA 17.0; PROSPERO (CRD42023414264). Results: Twenty‐six studies involving a total of 69,366 patients met the selection criteria and were included in the meta‐analysis. The overall estimated prevalence of adherence to OAD was 55.53% (95%CI: 44.22%–66.85%). Among the included studies, nine were deemed to be of high quality. A sensitivity analysis conducted using only the high‐quality studies revealed a prevalence of adherence to OAD at 52.24% (95% CI: 39.63%–64.85%). Conclusions: The overall prevalence of adherence to OAD was remarkably low among type 2 diabetes patients worldwide. Healthcare practitioners and policy makers should employ appropriate approaches to improve adherence to OAD. [ABSTRACT FROM AUTHOR]

Adherence and treatment continuation rates of the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) semaglutide for both oral (O‐SEMA) and subcutaneous injection (SEMA‐SC) remain unknown in real‐world clinical practice. This retrospective observational study compared the 12 month adherence and treatment discontinuation of O‐SEMA and once‐weekly SEMA‐SC in patients with type 2 diabetes using a real‐world claims database. SEMA‐SC initiators were 1:1 propensity score‐matched to O‐SEMA initiators. Non‐adherence was defined as <0.8 of the proportion of days covered. SEMA‐SC had a significantly higher odds ratio (OR) for non‐adherence than O‐SEMA (OR: 1.39). The hazard ratio for treatment discontinuation, using O‐SEMA as the reference, was 1.45 for SEMA‐SC, although the discontinuation rate of O‐SEMA was higher during the early stage. O‐SEMA initiators showed significantly higher adherence and greater persistence in therapy than SEMA‐SC initiators at 12 months, which could lead to earlier initiation of GLP‐1RA treatment. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the association between adolescents' adherence to attention‐deficit/hyperactivity disorder (ADHD) medication and their risk of committing minor offenses. Methods: Using two Dutch databases, Statistics Netherlands (CBS) and the Foundation for Pharmaceutical Statistics (SFK), we aimed to investigate the association between adherence to ADHD medication and registered minor offenses between 2005 and 2019 of 18,234 adolescents (12–18 years). We used Cox regression analyses to compare the rate of committing minor offenses of adolescents during periods of high ADHD medication adherence compared to periods of low adherence (i.e., periods with or without sufficient amounts of dispensed medication). We additionally tested associations with adherence to selective serotonin reuptake inhibitors (SSRIs) as control medication and analyzed potential reverse causation. Results: High ADHD medication adherence was associated with a reduced risk of committing a minor offense of between 33% and 38% compared to low adherence periods of ≥3 months (hazard ratio [HR] 0.67, confidence interval [CI] 0.64–0.71) or ≥6 months (HR 0.62, CI 0.59–0.65). The reduction in risk can likely be attributed to ADHD medication, given the absence of effects of SSRIs and no reverse causation. The reduction rate remained between 16% and 55% per sex, stimulant versus non‐stimulant medication, different offense categories and further sensitivity analyses. Conclusions: Among adolescents using ADHD medication, rates of criminality were lower during periods of high medication adherence, suggesting that adherence to ADHD medication may contribute to prevention of minor offenses in adolescents. [ABSTRACT FROM AUTHOR]

This systematic review assesses the evidence concerning laser treatments for nail psoriasis (NP), a prevalent condition among individuals with cutaneous psoriasis that notably affects their quality of life. Traditional treatments have limitations in terms of drug delivery and poor patient adherence, leading to interest in laser therapies for their targeted approach, extended treatment intervals, and the potential to enhance topical medication effectiveness. The MEDLINE, Embase, Web of Science, and Cochrane Library databases were searched. English‐language randomized and non‐randomized controlled trials with full‐text availability were included. Data on the laser type, treatment protocol, Nail Psoriasis Severity Index (NAPSI) outcomes, and adverse events were extracted, and nail bed and matrix features and patient satisfaction were assessed. The primary effect measure was a percentage reduction in NAPSI scores from baseline. Nineteen studies involving the pulse dye laser (PDL), long‐pulsed neodymium:yttrium aluminum garnet (Nd:YAG) laser and fractional carbon dioxide laser (FCL) were identified. Lasers, particularly those used in conjunction with topical agents, have shown favorable results. PDL effectively lowered NAPSI scores, and the Nd:YAG laser had comparable effectiveness but more discomfort. FCL also shows promise, particularly for topical drug delivery. PDL and Nd:YAG laser treatment were more effective at reducing nail bed features, whereas FCL was effective at reducing both nail bed and matrix features. Overall, lasers are promising treatment alternatives for NP, with similar NAPSI outcomes to topical therapies and intralesional injections. [ABSTRACT FROM AUTHOR]

Background and aims: Extended‐release naltrexone (XR‐NTX) and sublingual buprenorphine (SL‐BUP) are both approved for opioid use disorder (OUD) treatment in any medical setting. We aimed to compare the real‐world effectiveness of XR‐NTX and SL‐BUP. Design and setting: This was an observational active comparator, new user cohort study of Medicaid claims records for patients in New Jersey and California, USA, 2016–19. Participants/cases: The participants were adult Medicaid patients aged 18–64 years who initiated XR‐NTX or SL‐BUP for maintenance treatment of OUD and did not use medications for OUD in the 90 days before initiation. Our cohort included 1755 XR‐NTX and 9886 SL‐BUP patients. Measurements: We examined two outcomes up to 180 days after medication initiation: (1) composite of medication discontinuation and death and (2) composite of overdose and death. Findings In adjusted analyses, treatment with XR‐NTX was more likely to result in discontinuation or death by the end of follow‐up than treatment with SL‐BUP: cumulative risk 75.9% [95% confidence interval (CI) = 73.9%, 77.9%] versus 62.2% (95% CI = 61.2%, 63.2%), respectively (risk difference = 13.7 percentage points, 95% CI = 11.4, 16.0). There was minimal difference in the cumulative risk of overdose or death by the end of follow‐up: XR‐NTX 3.9% (95% CI = 3.0%, 4.8%) versus SL‐BUP 3.3% (95% CI = 2.9%, 3.7%); risk difference = 0.5 percentage points, 95% CI = –0.4, 1.5. Results were consistent across sensitivity analyses. Conclusions: Medicaid patients in California and New Jersey, USA, receiving treatment for opioid use disorder stayed in treatment longer on sublingual buprenorphine than on extended‐release naltrexone, but the risk of overdose was similar. Most patients in this study discontinued medication within 6 months, regardless of which medication was initiated. [ABSTRACT FROM AUTHOR]

Summary: Background: Opioid analgesic use before total hip or knee arthroplasty has been associated with worse postoperative outcomes. This pilot study aimed to examine the feasibility of a telehealth‐based pharmacist‐partnered opioid tapering intervention before elective primary hip or knee arthroplasty and its potential effectiveness compared with usual care. Methods: This study was conducted at seven hospitals in New South Wales, Australia. Eligible patients were those aged ≥ 18 years, scheduled to undergo primary hip or knee arthroplasty for osteoarthritis and taking opioid analgesics pre‐operatively. The intervention group participated in an opioid tapering telehealth service, a partnership between a pharmacist and general practitioner, for 3 months pre‐operatively up to the day of surgery, while the control group received usual care. The primary outcomes of the study were to investigate the feasibility of the intervention (i.e. adherence to treatment) and potential effectiveness in decreasing baseline daily opioid dose by > 50% before surgery. Results: Between December 2021 and June 2023, 70 patients were recruited and assigned randomly to the intervention group (n = 35) or control group (n = 35). Baseline characteristics were similar between groups. Thirty patients in each group completed their allocated treatment. All patients allocated to the intervention group completed at least one appointment with a pharmacist, with the median (IQR [range]) being 2 (1–4 [1–6]) appointments. The number of patients who successfully decreased their baseline daily opioid dose by ≥ 50% before surgery was 27/30 in the intervention group compared with 5/30 in the usual care group (p < 0.001). Conclusions: The findings of this pilot study support the feasibility of a telehealth‐delivered, pharmacist‐partnered opioid tapering service for patients scheduled for primary hip or knee arthroplasty. A broader multicentre study to examine the effectiveness of this intervention on clinical outcomes is warranted. [ABSTRACT FROM AUTHOR]

One of the most common causes of blindness on a global scale is glaucoma. There is a strong association between glaucoma and increased intraocular pressure (IOP). Because of this, adequate IOP‐lowering is the most important treatment strategy, mostly through topical eyedrops. Well‐functioning meibomian glands are paramount for maintaining a stable tear film, and their dysfunction is the most common cause of dry eye disease. There is a growing concern that both topical glaucoma medications themselves and their added preservatives damage the meibomian glands, and consequently, the ocular surface. Preserved topical glaucoma medications appear to cause dysfunction and atrophy of the meibomian glands. Upon comparison, preserved formulations caused more symptoms of dry eye, tear film instability, inflammatory changes and meibomian gland dropout than the preservative‐free counterpart. However, although seemingly less detrimental, unpreserved alternatives may diminish glandular efficacy, and, depending on the active ingredient, lead to glandular death. This negatively impacts quality of life, adherence to treatment regimens and prognosis. In this review, we explore the available evidence regarding the effects of IOP‐lowering eye drops on the meibomian glands. [ABSTRACT FROM AUTHOR]

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have revolutionized the treatment of type 2 diabetes, chronic kidney disease (CKD), and chronic heart failure. Clinical trials have shown significant benefits in reducing blood glucose levels and improving cardiovascular outcomes. However, despite the growing evidence supporting their effectiveness, there is still a lack of widespread use of these drugs in clinical practice. The article emphasizes the need for better communication between healthcare providers and patients, addressing patient non-adherence and clinical inertia, and further research and education to bridge the gap between scientific knowledge and real-world practice. [Extracted from the article]

Aim: To assess the safety and efficacy of a local skin substitute product in the treatment of chronic diabetic foot ulcers (DFUs). Materials and Methods: Five patients were evaluated over 6 months. Skin substitutes were applied twice at 2‐week intervals. Patients were monitored for any possible adverse effects and wound improvement. Results: The results indicated the overall safety of the skin substitute, with only few adverse effects unrelated to this product. Significant reduction in wound size was observed in four patients during the initial 12‐week treatment phase, with complete closure in two patients at 24 weeks. Conclusions: The application of a bi‐layered allogeneic keratinocyte and fibroblast skin substitute in patients with chronic DFU was safe and associated with favourable wound healing results. Adherence to standard treatment protocols, including optimal offloading, is essential to maximize the likelihood of successful wound healing. [ABSTRACT FROM AUTHOR]

Objectives: Desmopressin is widely used for nocturia in patients with nocturnal polyuria. We investigated the continuation rate and adherence for desmopressin in patients with overactive bladder and nocturia using a claims database and evaluated factors that improved adherence. Methods: Patients with nocturia in a Japanese claims database who started desmopressin between September 2019 and July 2021 were evaluated. Drug persistence was assessed using the Kaplan–Meier method for initial prescription of desmopressin. The proportion of days covered (PDC) was also evaluated among patients with prescription persistence. Multivariate analysis was performed using logistic regression analysis to identify factors predicting adherence to desmopressin. Results: The study included 72,888 patients entered into Japan Medical Data Center (JMDC) database between September 2019 and July 2021. For the 236 patients prescribed desmopressin formulations, mean prescription duration was 114 days. Among the total cases, 90 (38.1%) cases were prescribed only once, mean PDC was 0.60, and the number of high‐adherence patients (PDC ≥ 0.80) was 108 (45.8%). Desmopressin prescription doses were fixed in 216 patients and adjusted in 20 patients. Multivariate analysis identified prescription dose adjustment for desmopressin as significantly associated with high PDC. Conclusion: Desmopressin showed a 38% dropout rate after the first dose. However, high medication continuation and high medication adherence rates (PDC) could be maintained with prescription adjustments. Careful patient monitoring and appropriate adjustment of the desmopressin dosage appear to be important factors in improving nocturia. [ABSTRACT FROM AUTHOR]

Introduction: Urinary incontinence (UI) is defined as any involuntary loss of urine that causes negative impacts on women's lives. Pelvic floor muscle training (PFMT) is considered to be "level A" of scientific evidence in the treatment of UI. Despite its efficacy, it is known that the effect of PFMT may depend on continuous adherence. Therefore, healthcare professionals are looking for alternatives to improve adherence in their patients. Healthcare has been innovating through mobile device apps. Objective: Thus, the objective of this study was to verify the effects of PFMT with the use of a mobile device app in incontinent women. Trial Design: This was a controlled, randomized clinical trial that occurred remotely. Methods: A total of 104 women with stress UI and/or mixed incontinence, over 18 years old, literate, with preserved cognitive capacity, with internet access and a mobile device with the Android system, participated in this study. They were randomly divided into two groups: The App group and the Booklet group, which underwent a PFMT protocol guided by a mobile app and a booklet, respectively. Both groups received daily reminders to perform the exercises. Before and after 12 weeks of intervention, it was evaluated using the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF) and the King's Health Questionnaire (KHQ). Results: Both groups showed improvements in the final ICIQ‐SF score. However, superior results were shown for the Booklet group (App: pre: 11.5 [±3.8], post: 9.8 [±4.5]; Booklet: pre: 12.6 [±4.5], post: 7.4 [±4.3]; p = 0.03). Conclusion: It was concluded that PFMT, with the use of a mobile app, is capable of reducing UI and the impact of UI, but it is not superior to training with the use of booklet instructions. [ABSTRACT FROM AUTHOR]

Introduction: Either in conservative or in surgical management of maxillo‐mandibular fractures, intermaxillary fixation (IMF) provides stable occlusion, while offering reduction in the fractured segments. Various techniques have been used for achieving IMF, among which Erich arch bar is the most conventional and routinely used technique. However, it poses a risk of percutaneous injury to the surgical team with every wire used in the technique, causes trauma to the periodontium of the teeth secured by wires and it is not very comfortable for the patient. The few IMF techniques that are recommended without wire require special armamentarium that are not universally available. Materials and Methods: Our novel IMF technique employing multiple looping of orthodontic E chains around IMF screws can provide adequate reduction and stabilization of the fractured segments with good occlusion before plating of the maxillo‐mandibular fractures. It can also be utilized for extended periods for closed reduction or postoperatively for guiding the occlusion. Results: As seen in our clinical experience using this novel technique, there is no risk of percutaneous injury to the surgical team. It provides stable occlusion, optimal reduction in the fractured segments and is accepted well by patients as no wires are used. Conclusion: This novel technique can be used in all patients who require IMF and is particularly useful in patients with periodontally compromised teeth or in those who are partially edentulous where conventional arch bar fixation cannot be performed. This technique will considerably reduce the operative time and aid in better patient compliance. [ABSTRACT FROM AUTHOR]

Background: Post‐treatment surveillance recommendations for oropharyngeal cancer do not vary with p16 status despite the differences in outcomes. The optimal algorithm personalizing follow‐up for these patients remains undefined. Here, we evaluate the feasibility and utility of incorporating electronic patient‐reported outcomes (ePROs) and circulating tumor DNA (ctDNA) into routine surveillance for patients treated for p16+ oropharynx cancer. Methods: A prospective registry was developed in which ePROs and ctDNA were incorporated into routine surveillance among patients with oropharynx cancer. ePROs were emailed monthly for 1 year and blood HPV ctDNA testing was performed every 3–6 months. The primary objective was to assess patient compliance with ePRO‐based surveillance with adequate compliance defined as ≥85% of patients completing monthly ePROs. Sensitivity, specificity, and positive/negative predictive values to detect recurrence were calculated for ePROs, HPV ctDNA, or the combination. Results: Of 122 patients who initially expressed interest, 76 completed the electronic consent process and 44/76 (58%) were compliant with monthly surveys over 1 year; thus adequate compliance was not achieved. Technical difficulties associated with ePRO receipt through email largely limited participation. Provider feedback was significantly associated with heightened ePRO compliance. One hundred and six patients had ctDNA testing with a mean number of three tests per patient. Sensitivity to detect recurrence was 75% for the combination of ePROs and ctDNA. Conclusion: Despite lower than anticipated compliance with ePROs, our findings show promise for incorporation of HPV ctDNA into surveillance paradigms for HPV‐related oropharynx cancer with suggestions of methods to optimize ePRO formats for personalized surveillance. [ABSTRACT FROM AUTHOR]

Background: While preventive swallowing exercises reduce the risk of radiation‐associated dysphagia in patients with head and neck cancer, strategies are needed to improve patient adherence. Methods: Before radiation, all participants were taught preventive swallowing exercises and randomized to either an adherence intervention or enhanced usual care. During radiation, all participants met twice with a speech pathologist for swallowing assessment and reinforcement of exercises. Intervention participants met weekly with a counselor in‐person or by phone. At 6‐week post‐radiation follow‐up, all participants completed a follow‐up assessment of self‐reported adherence, which was then corroborated with medical record documentation. Results: Newly diagnosed pharyngeal and laryngeal cancer patients without distant metastases were randomized (n = 265; 135 to intervention, and 130 to usual care). Intervention participants were more likely to adhere to exercises during radiation compared to the control group (p < 0.0001). Conclusion: The weekly in‐person adherence intervention program significantly increased patient's adherence to preventive swallowing exercises during radiation. [ABSTRACT FROM AUTHOR]

Background: Head and neck cancer treatment often leads to trismus, a condition characterized by limited mouth opening. Exercise‐based therapy is the most common intervention but there are no clear guidelines as to the optimal exercise regimen. Restorabite™ is a portable and force‐regulated trismus device designed to enhance exercise adherence. This study explores the adherence to exercises using Restorabite™ in head and neck cancer patients with trismus and identifies facilitators and barriers to exercise therapy. Materials and methods: Mixed‐methods, prospective cohort study undertaken at a quaternary oncology hospital, in Sydney Australia involving participants diagnosed with head and neck cancer diagnosed with trismus (maximal incisal opening under 35 mm). Patients underwent a 10‐week individualized trismus program using Restorabite™ with weekly speech pathology reviews. Exercise adherence was tracked through categorized descriptors. Data were collected prospectively at baseline, during 10 weeks of therapy with Restorabite™, and at 6‐ and 12‐month post‐trismus exercise. Participants described facilitators of trismus therapy, and barriers to completing the prescribed exercises. Clinical documentation of these responses was then analyzed using content analysis. Results: One‐hundred and thirty‐five participants were recruited. During the intervention 69% (n = 93) exercised as recommended, 24% (n = 32) exercised less, and 7% (n = 10) exercised more than recommended. At 6 months post‐intervention, 55.5% (n = 75) exercised as recommended, 38.5% (n = 52) exercised less, and 4% (n = 6) exercised more. At 12 months, 36% (n = 49) exercised as recommended, 48% (n = 62) exercised less, and 11% (n = 15) exercised more. MIO increased from a mean of 18.6 mm at baseline, to 30.1 mm at the end of the 10‐week intervention. This was maintained at 6 and 12 months (31.7 and 32.1 mm, respectively). Adherence to the exercise program was associated with greater improvement in maximum interincisal opening (p < 0.001). Facilitators of adherence included intrinsic motivation, device portability, perceived functional change, and external support tools. Barriers included cancer treatment toxicities, competing priorities, and health challenges. Positive outcomes included functional improvements, while negative outcomes included increased pain. Conclusions: Seventy‐six percent of patients prescribed Restorabite™ performed trismus exercises at or more than the recommended frequency. Facilitators and barriers identified provide insights into factors influencing adherence. Future research should involve comparative studies that compare the adherence and effectiveness of different exercise programs. [ABSTRACT FROM AUTHOR]

The potential efficacy of psychosocial interventions in the treatment of borderline personality disorder (BPD) is impacted by significant treatment non‐completion (TNC), with meta‐analytic studies reporting rates of attrition of between 25% and 28%. Increasing patient retention could facilitate outcomes and improve resource utilization, given limited healthcare services. A systematic search of PsycINFO, CINAHL, EMBASE, CENTRAL, and Web of Science Core Collection identified 33 articles that met the criteria for inclusion. Although substantial heterogeneity in terms of methodology and quality of analysis limited conclusions that could be drawn in the narrative review, a few consistent patterns of findings were elucidated, such as Cluster B personality disorder comorbidities and lower therapeutic alliance were associated with TNC. Interestingly, the severity of BPD symptoms was not a predictor of TNC. These findings are discussed in terms of their potential theoretical contribution to TNC. Clinically, there may be value in applying mindfulness and motivational interviewing strategies early on in treatment for individuals who present uncertainty about engaging in treatment. Further research to develop this empirical landscape includes focusing on high‐powered replications, examining burgeoning lines of research, and investigating dynamic predictors of TNC. [ABSTRACT FROM AUTHOR]

Quetiapine myristate (QM), an ester‐bonded lipophilic prodrug of quetiapine (QTP), is synthesized and converted into an amphiphilic structure in acidic pH to trigger a novel self‐assembled QM nanosuspension (QMN). Following injection, this QMN rearranges within physiological pH to form nanoaggregates in structure, resulting in enhanced physicochemical properties and in vivo therapeutic performance without an initial burst release. The 200‐nm‐sized QMN exhibits less invasive injection, higher drug content, and better storage stability profile than conventional poly(lactide‐co‐glycolide) (PLGA) nanosuspensions containing QTP or QM. Following a single intramuscular injection to beagle dogs (35 mg kg−1 QTP), QMN undergoes pH‐responsive nanoaggregation to form the lipophilic prodrug, providing esterase‐oriented sustained release for five weeks compared with the two‐week period of PLGA nanosuspensions. Notably, QMN exhibits improved in vivo pharmacokinetic performance with long‐acting delivery while minimizing issues associated with polymeric PLGA formulations, including the initial massive burst release, cellular toxicity, and adverse side effects. These results support the further development of QMN as a novel long‐acting injectable to improve patient compliance and dosing frequency. [ABSTRACT FROM AUTHOR]

Background Aim Method Results Conclusion Venous thromboembolism is among the main causes of maternal morbidity and mortality, with caesarean section (CS) delivery carrying greater risk. Outpatient thromboprophylaxis, such as enoxaparin, is administered subcutaneously and prescribed as an outpatient; raising the issue of medication adherence.This study aimed to evaluate women's adherence to enoxaparin administration after CS delivery, explore the reasons for non‐adherence, and assess the factors associated with patients' adherence to enoxaparin.Women after CS delivery, who had been given enoxaparin at discharge were included in the study. Eligible patients were contacted via telephone at the middle and the end of the enoxaparin treatment. Syringe count determined the main outcome of adherence during direct telephone interviews with the patient. Optimal adherence was defined as all the doses of enoxaparin being administered and suboptimal adherence was at least one dose not administered. Ethical approval was granted by the Malaysian Registry Ethics Committee belonging to National Medical Research Registry (Reference no: NMRR ID‐22‐02859‐P41) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants through completion of written consent forms, after an explanation of the study was provided by investigators.Out of 201 women included, the majority (91.5%) were fully adherent to enoxaparin, while 8.5% missed at least one dose. Most patients administering at home missed the dose due to reporting they were unwell (n = 6), busy (n = 4), or forgot to administer (n = 2). Among missed doses in patients administered in a healthcare setting, all participants (n = 5) forgot to bring their medication to the appointment. Only medication knowledge had a significant association with adherence to enoxaparin administration (p = 0.008).The study raised concern about the substantial percentage of patients missing at least one dose of enoxaparin, particularly among patients injecting at home. Initiatives should focus on customised enoxaparin administration counselling and providing educational materials. [ABSTRACT FROM AUTHOR]

Background Objective Method Results Conclusions Preventing errors associated with medication administration is achievable through nurses’ adherence to correct principles.This study aims to investigate the relationship between nurses’ adherence to medication administration principles and their attitudes toward patient safety.This study adopts a descriptive and relationship‐seeking research design. A total of 310 nurses who met the inclusion criteria participated in the study. Data collection tools included the “Nurse Information Form,” “Medication Administration Principles Adherence Form,” and “Patient Safety Attitude Scale”.Among the participating nurses, 32.9% (n = 102) reported experiencing a medication administration error, and 77.7% (n = 241) witnessed such an error. The study revealed a statistically significant positive relationship between nurses’ adherence to medication administration principles and their attitudes toward patient safety (p < 0.001).This study underscores the importance of nurses’ adherence to medication administration principles in ensuring patient safety. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Long‐acting injectable antipsychotics (LAIs) are not routinely offered to patients living with bipolar disorder type I (BP‐I), despite widespread evidence that supports their benefits over oral antipsychotics, particularly in early disease.A round‐table meeting of psychiatrists convened to discuss barriers and opportunities and provide consensus recommendations around the early use of LAIs for BP‐I.LAIs are rarely prescribed to treat BP‐I unless a patient has severe symptoms, sub‐optimal adherence to oral antipsychotics, or has experienced multiple relapses. Beyond country‐specific accessibility issues (e.g., healthcare infrastructure and availability/approval status), primary barriers to the effective use of LAIs were identified as attitudinal and knowledge/experience‐based. Direct discussions between healthcare providers and patients about treatment preferences may not occur due to a preconceived notion that patients prefer oral antipsychotics. Moreover, as LAIs have historically been limited to the treatment of schizophrenia and the most severe cases of BP‐I, healthcare providers might be unaware of the benefits LAIs provide in the overall management of BP‐I. Improved treatment adherence associated with LAIs compared to oral antipsychotics may support improved outcomes for patients (e.g., reduced relapse and hospitalization). Involvement of all stakeholders (healthcare providers, patients, and their supporters) participating in the patient journey is critical in early and shared decision‐making processes. Clinical and database studies could potentially bridge knowledge gaps to facilitate acceptance of LAIs.This review discusses the benefits of LAIs in the management of BP‐I and identifies barriers to use, while providing expert consensus recommendations for potential solutions to support informed treatment decision‐making. [ABSTRACT FROM AUTHOR]

Minocycline is a commonly used drug for adjunctive therapy in periodontal disease. However, the current mainstream local medications primarily rely on intra‐pocket administration, which, while avoiding the side effects of traditional systemic drugs, presents challenges such as inconvenience, discomfort, and the need for professional assistance, thus affecting patient compliance. Herein, we introduce a minocycline‐loaded dissolvable microneedle (Mino‐DMN) patch that allows for local and efficient delivery of minocycline to gingiva for the treatment of periodontitis. A two‐step casting micro‐molding process involving vacuum drying and freeze drying is employed to concentrate minocycline in the microneedle part and limit its diffusion into the patch backing. The resulting Mino‐DMN patch features an array of minocycline‐enriched gelatin MNs with a porous HA patch backing. The microneedles can penetrate into gingiva with enough mechanical strength and quickly release minocycline into the gingival tissue, ensuring prolonged local residence of the drug and minimizing its loss to saliva. In vivo experiments show Mino‐DMN inhibits pro‐inflammatory factors, promotes anti‐inflammatory factors, and stimulates bone formation, surpassing topical application and comparable to the inconvenient and discomfort administration of Periocline®. This proposed Mino‐DMN offers a simple, efficient, user‐friendly strategy for the adjunctive treatment of periodontal disease. [ABSTRACT FROM AUTHOR]

To meet legislative requirements in Australia, the balance of controlled drugs (CDs) must be confirmed after completion of each transaction. This is particularly challenging for liquid CD formulations, and over the years, health organisations have implemented various methods of performing this task, including the use of visual aids or conversion of bulk formulations to individual unit doses. These methods have a number of limitations. Therefore, this study aimed to evaluate the accuracy and feasibility of a weight‐based method for confirming oral liquid CD balances packed in multidose containers. This study was conducted in a palliative care ward of a metropolitan hospital over a 41‐day period. Morphine mixture 5 mg/1 mL transactions and balance checks were confirmed using weight calculations of the product bottle. The weights were then converted to volume using a locally developed electronic application, which was recorded in the relevant CD registers. The acceptable tolerance per transaction (±0.1 mL) was determined prior to commencement based on 80 test transactions. Throughout the trial period, 407 transactions were undertaken, among which there were no CD discrepancies. Nine nurses provided feedback via an anonymous online survey after the trial, mostly reporting that the new method was more accurate. However, participants also reported that it took on average 3 min longer to complete each transaction. In conclusion, utilising a weight‐based method of confirming liquid CD balances may present a feasible method of meeting legislative requirements related to the recording and accountability of CDs. This project was exempt due to the local policy requirements that constitute research by the Eastern Health Office of Research and Ethics (Reference no: QA24‐100‐111698). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) Ethical considerations in quality assurance and evaluation activities and did not directly affect patient care; written consent was not required from participants per local requirements, however staff were provided verbal and written project information and were informed their participation in the survey was voluntary and anonymous. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Sample Measurements Results Conclusions To measure healthy life awareness, blood pressure awareness and insight levels, along with their predisposing factors among adult individuals.A population‐based cross‐sectional study.The population consisted of adult individuals in a rural district of a city in Türkiye. Voluntary individuals who visited the population screening, organized as the May Measurement Month activity, were invited to the study (n = 290).The data were collected by a questionnaire, the Healthy Life Awareness Scale (HeLAS), and the Blood Pressure Awareness and Insight Scale (BASIS). Descriptive statistics, Pearson Correlation, and multiple linear regression were used to analyze the data.The mean scores of the HeLAS and the BASIS were 49.62 ± 8.30 and 2.89 ± 1.43, respectively. Income level, regular physical activity habits, and formerly being diagnosed with hypertension were positively associated with a healthy life awareness level. Former diagnosis of hypertension, regular medication usage, and being unemployed were the significant predisposing factors of blood pressure awareness and insight level.Most adult individuals displayed a moderate level of healthy life awareness and a low level of blood pressure awareness and insight. Nurses could take on the leading role in developing healthy lifestyle habits among individuals, ensure medication treatment adherence, and prevent hypertension prevalence. [ABSTRACT FROM AUTHOR]

Healthcare professionals encounter many moral challenges in their daily clinical practice. However, there have been few studies on the subject matter in Tanzania. This study aims to provide an account of moral challenges faced by healthcare professionals in Tanzanian hospitals, their understanding of clinical ethics, and the ethics education they have received. Many participants reported receiving some kind of ethics training through formal education and on‐the‐job training. Some participants understood ethics in healthcare settings as adherence to established laws, regulations, guidelines, procedures, norms, and rules essential in clinical practice. Analysis of the data identified four themes of moral challenges. These challenges are related to 1) decision‐making and communication in clinical practice, 2) scarcity of medical resources and prioritization in clinical practice, 3) withdrawal of curative treatment, and 4) conflicts between professional judgment, religious convictions and adherence to alternative treatments. Based on the findings, we suggest a context‐sensitive form of clinical ethics training to prepare healthcare professionals to recognize and address these moral challenges. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion A shared decision‐making (SDM) model‐based intervention programme was implemented for a population at high risk for diabetes to explore its effectiveness in intervening with blood glucose levels in this population.One hundred residents were selected according to the principle of voluntary participation and divided into the intervention group (n = 50) and the control group (n = 50) by using multistage cluster sampling. The control group received only brief diabetes knowledge education through a disease brochure issued by the hospital; the intervention group implemented a SDM model based on large classroom and individualised education for 4 months. Univariate analysis and generalised estimating equation fitting model were used to analyse the effect of intervention on blood glucose parameters in the study subjects.Univariate analysis showed that after 4 months of intervention, fasting blood glucose was lower in the intervention group than in the control group (5.57 ± 0.56 vs. 6.07 ± 0.77, F = 45.721, p < 0.001); glycosylated hemoglobin was lower in the intervention group than in the control group (5.91 ± 0.28 vs. 6.02 ± 0.24, F = 25.998, p < 0.001), decreased by 0.26% in the intervention group and increased by 0.01% in the control group. One‐way analysis of variance (ANOVA) showed that fasting blood glucose and glycosylated hemoglobin in the intervention group decreased to different extents from baseline. The generalised estimation equation was fitted with the intervention programme, gender, hypertension, smoking, alcohol consumption, physical activity, age, waist circumference, body mass index, baseline fasting blood glucose, and baseline glycosylated hemoglobin as independent variables, and fasting blood glucose and baseline glycosylated hemoglobin as dependent variables. Results showed that compared with the control group, fasting blood glucose and glycosylated hemoglobin levels were significantly different between the two groups (p < 0.001).Applying an intervention programme based on SDM model to people at high risk of diabetes can improve patients' adherence to self‐management and establish a good lifestyle, thus contributing to their good glycemic control. [ABSTRACT FROM AUTHOR]

Background Objective Design Participants Measurements Results Conclusion One of the most common problems encountered in transplant patients is nonadherence with immunosuppressive drugs, one of the most important reasons for graft rejection.The study aimed to assess the impact of text message reminders on medication adherence among kidney transplant recipients.A randomized controlled trial.The study was conducted from January to October 2021. This study included a total of 100 patients receiving a kidney transplant, 50 in the intervention group and 50 in the control group.Patients in the intervention group were sent text message reminders four times a day during the 6th–9th months after transplantation. Control patients received no such intervention. Tacrolimus concentrations in the bloodstream were monitored for all participants through measurements taken at Months 7, 8 and 9. Data collection tools included Sociodemographic Form and Immunosuppressive Medication Adherence Scale.Patients were homogeneously distributed among the groups. Sending daily text message reminders to transplant recipients caused an independent positive effect on medication adherence scale scores at the end of the study. Mean pretest medication adherence score of all patients was 45.18 ± 4.22 and posttest score was 47.4 ± 3.6. The intervention group exhibited a significantly higher mean posttest adherence score compared to controls, with values of 48.68 ± 2.58 and 45.62 ± 4.42, respectively (p < 0.001). Findings demonstrated a substantial improvement in the final medication adherence scores of transplant patients when they received daily Short Message Service reminders, acting as an independent factor (β = 0.356, p < 0.001).Sending text message reminders to kidney transplant recipients is a statistically and clinically effective intervention to improve immunosuppressive medication adherence. [ABSTRACT FROM AUTHOR]

The editorial comment in the International Journal of Urology discusses the potential for large language models (LLMs) like GPT-4 to pass specialized medical examinations, specifically the Japanese Urology Board Examinations. The study by Okada et al. shows that GPT-4 achieved high accuracy in handling complex questions, indicating the growing proficiency of LLMs in educational and evaluative settings. While LLMs show promise, challenges such as clinical decision-making and adherence to medical guidelines remain, highlighting the need for further exploration and development of AI tools to support medical professionals. [Extracted from the article]

ABSTRACT Background Methods Results Conclusions Androgen‐deprivation therapy (ADT) remains a cornerstone in treatment for patients with advanced prostate cancer. ADT is associated with several adverse effects, including osteoporosis, metabolic syndrome, and cardiovascular events, leading to guidelines recommending routine testing to monitor for these toxicities. There is a lack of data assessing adherence to these recommendations.The authors conducted a retrospective cohort study using administrative data from Ontario, Canada between 2008 and 2021. They identified all older men (aged 65 years and older) who received ADT for prostate cancer using comprehensive provincial health databases. The primary outcomes were the use of testing for lipids, dysglycemia (glucose), bone health serum, and bone density between 6 weeks before and 1 year after the initiation of ADT.In total, 29,097 patients were examined, of whom 52.8% were prescribed ADT by urologists, 37.9% were prescribed ADT by radiation oncologists, 2.8% were prescribed ADT by medical oncologists, and 2.4% were prescribed ADT by other physicians. Adherence to guidelines was low: only 21.3% of patients received a bone density scan, 41.2% underwent bone health–related serum tests, 51.3% completed a lipid profile, and 65.9% underwent dysglycemia testing within 1 year of diagnosis. Overall, only 11.9% of patients received all of the recommended investigations. Adherence to testing did not appear to improve over time (2008–2021) or with guideline publication. Patient (age) and physician (specialty) factors had important associations with adherence to testing.Most patients receiving ADT for prostate cancer do not receive recommended testing to monitor for treatment‐related toxicity. Further study is required to address barriers to therapeutic monitoring of men on ADT and to reduce treatment‐associated adverse events. [ABSTRACT FROM AUTHOR]

Aim Method Results Conclusion Ileus is characterized by a period of intestinal dysmotility after surgery, leading to vomiting and constipation. In preclinical models, vagus nerve stimulation reduces intestinal inflammation and prevents smooth muscle dysfunction, accelerating the return of gut function. This study explored the feasibility of a definitive trial of non‐invasive vagus nerve stimulation (nVNS) along with an early assessment of efficacy.A multicentre, randomized feasibility trial (IDEAL Stage 2B) of self‐administered nVNS was performed. Patients undergoing colorectal surgery were randomized to nVNS or sham before and after surgery. Feasibility outcomes comprised assessments of recruitment, compliance, blinding and attrition. Clinical outcomes were measures of intestinal function and adverse events. All participants were followed up for 30 days. Interviews with patients and health professionals explored barriers to feasibility and perspectives around implementation.In all, 125 patients were approached about the study and 97 (77.6%) took part. Across all randomized groups, the median compliance to treatment was 19 out of 20 stimulations (interquartile range 17–20). The incidence of adverse events was similar across groups. In this unpowered feasibility study, the time taken for the return of gut function (such as first passage of stool) was similar between nVNS and sham treatments. According to interviews, patients were highly motivated to use the device because it provided them with an opportunity to engage actively in their care. Health professionals were highly driven to tackle the problem of ileus.Powered assessments of clinical efficacy are required to confirm or refute the promise of nVNS, as already demonstrated in preclinical models. This feasibility study concludes that a definitive randomized assessment of the clinical benefits of nVNS is desired and feasible. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Method Results Conclusion New treatments for patients with bleeding disorders (PWB) have emerged, including products with extended half‐life and subcutaneous administration. These less frequent treatments can potentially enhance quality of life (QoL), but adherence becomes critically important.To investigate adherence and QoL among PWB and explore the correlation between treatment adherence and QoL in adult patients with haemophilia A (HA), haemophilia B (HB) and Von Willebrand disease (vWD) in Denmark.This survey used disease‐specific patient‐reported questionnaires: Veritas‐PRO and Veritas‐PRN to measure adherence, and Haemo‐A‐QoL and VWD‐QoL to assess QoL.Responses were obtained from 149 patients with HA, 32 with HB and 118 with vWD. Adherence was reported by 87.1% of patients on prophylaxis and 71.2% of patients treated on demand, according to Veritas‐PRO and Veritas‐PRN cut‐off scores. High QoL was generally reported, decreasing with age in HA and HB, but not in vWD.Danish patients with HA, HB and vWD reported high QoL and high adherence to prescribed treatments. There was no correlation between treatment adherence and QoL among the different patient groups. These findings highlight the need for further research to better understand adherence behaviours and identify opportunities to further improve QoL in PWB. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion Trial Registration Adherence to pediatric atopic dermatitis (AD) treatment regimens can be complex and a major challenge to optimizing treatment outcome. We aimed to review factors associated with nonadherence in pediatric AD and propose interventions to improve adherence.PubMed and EMBASE databases were systematically searched for articles from 2000 to February 2023 related to AD and adherence, with an additional update in December 2023. Non‐human studies, reviews, commentaries, and meta‐analyses were excluded. Articles were sorted into pediatric versus adult study population based on volume. Herein, we examine the results of papers discussing adherence factors related to pediatric patients.A total of 62 studies met inclusion criteria. Thirty‐six studies surveyed patients and caregivers (N = 10,268) to identify barriers to treatment adherence. None of the included studies were specific to systemic medications. Barriers included poor caregiver quality of life, inadequate AD‐related education, topical corticosteroid (TCS) phobia, unclear therapy‐related instructions, and dissatisfaction with physician interaction. Five studies solely measured adherence using medication electronic monitoring systems, Morisky medication adherence scale, or self‐reported adherence to measure adherence to topical medications. Twenty‐one studies described interventions involving nurse‐led or web‐based education programs, text message or email reminders, and TCS education. Adherence was improved with caregiver education programs, daily text‐message reminders, eczema action plans, TCS potency “traffic light” color system, and frequent follow‐up visits.Adherence to pediatric AD treatment poses a multifactorial challenge for caregivers and patients. This study provides an index of strategies to optimize adherence, as it is essential for prevention of long‐term sequela associated with AD in children. As the AD treatment landscape rapidly expands, further studies are vital to assess pediatric adherence to new topical, oral, and injectable medications.PROSPERO: CRD42023488557 [ABSTRACT FROM AUTHOR]

Background: Breastfeeding provides benefits for both mothers and babies. However, many women experience postpartum weight gain, unfavorable lipid profiles, and other postpartum problems that can adversely impact their overall quality of life (QoL). Objective: To examine the effect of adding aerobic and resistive exercise to faradic stimulation and nutritional counseling on lipid profile and QoL in overweight breastfeeding women. Subjects and Methods: Fifty‐four breastfeeding women were randomly allocated into two equally sized groups. Group A underwent abdominal faradic stimulation along with nutritional counseling for 12 weeks, whereas Group B received identical faradic stimulation and nutritional counseling and engaged in a combined aerobic and resistive exercise program for the same duration. Before and after treatment, the following anthropometric measurements were evaluated: body mass index (BMI), waist‐to‐hip ratio (W/H); lipid profile analysis, such as high‐density lipoprotein (HDL), low‐density lipoprotein (LDL), and triglycerides (TG); and the Short Form 36 Health Survey Questionnaire (SF‐36). Results: All outcome measures demonstrated significant improvements within the two groups (p < 0.05). Group B showed more significant reductions in BMI, W/H ratio, and LDL, along with greater significant increases in the SF‐36 domain scores for physical functioning, physical health problems, bodily pain, general health, energy/fatigue, social activity, mental health, and the total SF‐36 score (p < 0.05) compared to group A post‐treatment. However, there were no significant differences in HDL, TG, and the score of the emotional wellbeing domain of the SF‐36 between the groups after treatment (p > 0.05). Conclusion: 12‐week aerobic and resistive exercise is effective in reducing the BMI, W/H ratio, and LDL levels and enhancing the QoL in overweight breastfeeding women. [ABSTRACT FROM AUTHOR]

Background: Hip osteoarthritis (OA) is a prevalent and burdensome condition that leads to impaired quality of life and a substantial economic burden. Encouraging physical activity, particularly walking, is crucial for OA management, but many individuals with hip OA fail to meet recommended activity levels. Prefabricated contoured foot orthoses have shown promise in improving hip muscle efficiency during walking in laboratory settings, but their real‐world feasibility and efficacy remain uncertain. Objective: The aim of this study was to assess the feasibility of conducting a fully powered randomised controlled trial (RCT) to evaluate the effectiveness of prefabricated contoured foot orthoses, prescribed via telehealth, in people with hip OA. Methods: This feasibility trial randomised 27 participants with hip OA into two groups: prefabricated contoured foot orthoses or flat shoe inserts. Feasibility outcomes were assessed, including recruitment rate, adherence, logbook completion, and dropout rate. Patient‐reported outcomes and accelerometer‐measured physical activity were collected as secondary outcomes. Results: While the recruitment rate was low (0.88 people/week), adherence to the intervention (59%), logbook completion (93%), and dropout rates (7%) met or exceeded our predefined feasibility parameters. Participants found the intervention acceptable, and practicality was demonstrated with minor adverse events. Preliminary efficacy testing indicated that prefabricated contoured foot orthoses positively affected physical activity (adjusted mean difference = 2590 [260 to 4920] steps/day), with comparable outcomes for hip‐related quality of life and pain. Conclusion: This trial supports proceeding to a fully powered RCT to assess the effect of teleheath prescribed prefabricated contoured foot orthoses on physical activity in people with hip OA. Study Registration Number: National Institutes of Health Trial Registry (NCT05138380). [ABSTRACT FROM AUTHOR]

Background: We investigated whether a novel 8‐week personalised health behaviour support programme, focusing on the stability of symptoms and strategies to improve activities of daily living, was feasible and acceptable in adults with post‐COVID syndrome. Methods: In this randomised, controlled, pilot feasibility trial, 32 adults with post‐COVID syndrome (continued symptoms for ≥ 12 weeks) were randomised 1:1 to receive personalised health behaviour support (self‐reported physical activity and symptom diaries, plus seven one‐to‐one remotely delivered personalised self‐management support sessions), once weekly for 8‐weeks, or usual care (referral to online 'your COVID‐19 recovery' programme). The primary outcome was the feasibility of recruiting and randomising adults with post‐COVID syndrome. The secondary outcomes were to assess the acceptability and safety of the intervention and various outcome measures. Results: Of the 48 adults who expressed interest in the study, 32 (67%) were eligible and completed the baseline assessment. All 32 adults were willing to be randomised to either the personalised health behaviour support programme (n = 17) or usual care (n = 15) and 27 (age: 45 ± 12 years) adults completed follow‐up at 9 weeks. The intervention was deemed feasible, with high adherence (92% and 94% completion rates for the physical activity and symptom diaries, respectively) and excellent acceptability rates (94% 'liked the intervention a lot'). The intervention was deemed safe, with no symptom exacerbations reported. Conclusion: An 8‐week personalised health behaviour support programme was feasible for adults with post‐COVID syndrome, with good adherence and acceptability rates. Early pilot data from this small sample also suggests meaningful improvements in physical activity, fatigue and respiratory symptoms. Patient or Public Contribution: People living with post‐COVID syndrome were involved from the outset with the study design, review of study documentation and interpretation of the data following completion. Furthermore, several participants have supported the local dissemination of findings following the completion of the study. [ABSTRACT FROM AUTHOR]

Background: The coexistence of diabetes and hypertension is prevalent due to shared risk factors. Pharmacological treatment has been reported to be effective in managing both conditions. However, treatment effectiveness depends on the extent to which a patient adheres to their treatment. Poor adherence to long‐term treatment for chronic diseases is a growing global problem of significant magnitude. Several interventions have been developed to help improve medication adherence in patients with coexisting diabetes and hypertension. This review aimed to determine the characteristics of these interventions and their impact on medication adherence. Methods: A systematic review of the literature was conducted using the PRISMA guidelines and registered in the PROSPERO International Registry of Systematic Reviews. Studies were searched in the databases CINAHL, Embase and Medline to identify relevant articles published during 2012–2023. The search concepts included 'medication adherence', 'hypertension', 'diabetes' and 'intervention'. Studies were included if they were in English and evaluated the impact of an intervention aimed at promoting adherence to medications for both diabetes and hypertension. Results: Seven studies met the inclusion criteria, with five demonstrating a statistically significant improvement in medication adherence. Of the five studies that improved medication adherence, four were multifaceted and one was a single‐component intervention. All successful interventions addressed at least two factors influencing non‐adherence. Patient education was the foundation of most of the successful interventions, supported by other strategies, such as follow‐ups and reminders. Conclusion: Multifaceted interventions that also included patient education had a positive impact on medication adherence in patients with coexisting diabetes and hypertension. Improving adherence in patients with coexisting diabetes and hypertension requires a multipronged approach that considers the range of factors impacting medication‐taking. Patient or Public Contribution: This systematic review provides comprehensive insights into the benefits of patient‐centred approaches in intervention development and strengthening. Such patient involvement ensures that medication adherence interventions are more relevant, acceptable and effective, ultimately leading to better health outcomes and more meaningful patient engagement in healthcare research. [ABSTRACT FROM AUTHOR]