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- Abrahams, Harriët J. G., et al.
(författare)
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Moderators of the effect of psychosocial interventions on fatigue in women with breast cancer and men with prostate cancer : Individual patient data meta-analyses
- 2020
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 29:11, s. 1772-1785
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Forskningsöversikt (refereegranskat)abstract
- ObjectivePsychosocial interventions can reduce cancer‐related fatigue effectively. However, it is still unclear if intervention effects differ across subgroups of patients. These meta‐analyses aimed at evaluating moderator effects of (a) sociodemographic characteristics, (b) clinical characteristics, (c) baseline levels of fatigue and other symptoms, and (d) intervention‐related characteristics on the effect of psychosocial interventions on cancer‐related fatigue in patients with non‐metastatic breast and prostate cancer.MethodsData were retrieved from the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) consortium. Potential moderators were studied with meta‐analyses of pooled individual patient data from 14 randomized controlled trials through linear mixed‐effects models with interaction tests. The analyses were conducted separately in patients with breast (n = 1091) and prostate cancer (n = 1008).ResultsStatistically significant, small overall effects of psychosocial interventions on fatigue were found (breast cancer: β = −0.19 [95% confidence interval (95%CI) = −0.30; −0.08]; prostate cancer: β = −0.11 [95%CI = −0.21; −0.00]). In both patient groups, intervention effects did not differ significantly by sociodemographic or clinical characteristics, nor by baseline levels of fatigue or pain. For intervention‐related moderators (only tested among women with breast cancer), statistically significant larger effects were found for cognitive behavioral therapy as intervention strategy (β = −0.27 [95%CI = −0.40; −0.15]), fatigue‐specific interventions (β = −0.48 [95%CI = −0.79; −0.18]), and interventions that only targeted patients with clinically relevant fatigue (β = −0.85 [95%CI = −1.40; −0.30]).ConclusionsOur findings did not provide evidence that any selected demographic or clinical characteristic, or baseline levels of fatigue or pain, moderated effects of psychosocial interventions on fatigue. A specific focus on decreasing fatigue seems beneficial for patients with breast cancer with clinically relevant fatigue.
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| 2. |
- Haughney, John, et al.
(författare)
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Achieving asthma control in practice: Understanding the reasons for poor control
- 2008
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 102:12, s. 1681-1693
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Forskningsöversikt (refereegranskat)abstract
- Achieving asthma control remains an elusive goat for the majority of patients worldwide. Ensuring a correct diagnosis of asthma is the first step in assessing poor symptom control; this requires returning to the basics of history taking and physical examination, in conjunction with lung function measurement when appropriate. A number of factors may contribute to suboptimal asthma control. Concomitant rhinitis, a common co-pathology and contributor to poor control, can often be identified by asking a simple question. Smoking too has been identified as a cause of poor asthma control. Practical barriers such as poor inhaler technique must be addressed. An appreciation of patients' views and concerns about maintenance asthma therapy can help guide discussion to address perceptual barriers to taking maintenance therapy (doubts about personal necessity and concerns about potential adverse effects). Further study into, and a greater consideration of, factors and patient characteristics that could predict individual responses to asthma therapies are needed. Finally, more clinical trials that enrol patient populations reflecting the real world diversity of patients seen in clinical. practice, including wide age ranges, presence of comorbidities, current smoking, and differing ethnic origins, will contribute to better individual patient management. (C) 2008 Elsevier Ltd. All rights reserved.
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| 4. |
- Spetz, Kristina, et al.
(författare)
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Using the 5-Item Medication Adherence Report Scale (MARS-5) to Screen for Non-adherence to Vitamin and Mineral Supplementation After Bariatric Surgery
- 2024
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Ingår i: Obesity Surgery. - : Springer. - 0960-8923 .- 1708-0428. ; 34, s. 576-582
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionPoor adherence to recommended vitamin and mineral supplementation after bariatric surgery is common and challenging for healthcare professionals to identify. There are several questionnaires for self-reporting of adherence to chronic medication, but none has so far been evaluated for assessment of adherence to vitamin and mineral supplementation after bariatric surgery. The aim of this study was to assess the accuracy of the 5-item Medication Adherence Report Scale (MARS-5) in measuring adherence to vitamin and mineral supplementation post bariatric surgery (gastric bypass or sleeve gastrectomy).MethodThe psychometric properties of MARS-5 for vitamin and mineral supplementation were validated in two cohorts: one at 1 year post bariatric surgery (n = 120) and the other at 2 years post-surgery (n = 211). MARS-5 was compared to pharmacy refill data for vitamin B12 and combined calcium/vitamin D as reference.ResultsCorrelation analyses demonstrated that the MARS-5 had acceptable validity compared to objectively measured adherence rates from pharmacy refill data (calculated as continuous, multiple-interval measures of medication availability/gaps-coefficient ranged from 0.49 to 0.54). Internal reliability (Cronbach's alpha) was high: 0.81 and 0.95, respectively. There was a clear ceiling effect where one out of three had a maximum score on MARS-5.ConclusionMARS-5 demonstrated acceptable psychometric properties for assessment of adherence to vitamin and mineral supplementation post bariatric surgery.
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| 5. |
- Svensberg, Karin, et al.
(författare)
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Perceived sensitivity to medicines : a study among chronic medicine users in Norway.
- 2019
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Ingår i: International Journal of Clinical Pharmacy. - : Springer Science and Business Media LLC. - 2210-7703 .- 2210-7711. ; 41:3, s. 804-812
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Tidskriftsartikel (refereegranskat)abstract
- Background Little is known about patients' Perceived Sensitivity to Medicines (PSM), "the belief that one is especially sensitive to the actions and side effects of medicines". Objective (i) To explore the extent of and factors associated with high Perceived Sensitivity to Medicines in a Norwegian population of chronic medicine users; (ii) to assess the psychometric characteristics of the tool to measure PSM. Setting Community pharmacies in the Oslo area, Norway. Method A cross-sectional, questionnaire-based study was conducted between October 2015 and January 2016. Patients filling prescriptions for chronic disorders were recruited. Main outcome measure Perceived sensitivity to medicines. Results The study population included 214 patients (response rate 36.7%). In total 20.1% of the patients reported low, 61.7% moderate and 18.2% high perceived sensitivity to medicines. Factors positively associated with high perceived sensitivity were female gender (Adjusted Odds Ratio (aOR) 5.33, 95% CI 1.52 to 18.72, p < 0.001) and having a non-native language (aOR 4.76, 95% CI 1.48 to 15.30, p < 0.001); lower educational level (aOR 0.43, 95% CI 0.17 to 1.07, p < 0.001) and using generic medicines (aOR 0.12, 95% CI 0.03 to 0.57, p < 0.001) were negatively associated with high perceived sensitivity to medicines. There was no association between the perceived sensitivity and the number of prescription medicines taken. The Norwegian version of the Perceived Sensitivity to Medicines tool demonstrated good psychometric characteristics. Conclusion Almost one out of five patients in this study reported high sensitivity to medicines. Female gender, having a non-native language, lower educational level and using generic medicines were important factors related to the perceived sensitivity. Health care providers should be aware of the impact negative expectations about medicines can have on health behaviors and treatment outcomes, and seek to elicit and address patients' beliefs about their personal sensitivity to medicines.
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