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Journal articles on the topic "914.675 04":

1

Kulikova, Nataliya Gennadievna, Zaur Gidovich Zhilokov, Albina Sergeevna Tkachenko, and Tinatin Chkheidze. "On the use of laser therapy in dentistry." Fizioterapevt (Physiotherapist), no. 01 (January 13, 2022): 33–40. http://dx.doi.org/10.33920/med-14-2202-04.

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The aim of the research: to optimize the prevention of dental complications by using electromagnetic low-intensity laser radiation (LILR) techniques on dental and periodontal tissues. Research methods. In 138 dental patients, a clinical and functional assessment of the dental apparatus was carried out, dental indices were studied, the results of vascular endothelial parameters (VEGF-A, sVEGF-R1, sVEGF-R2) and immune parameters (FNF, TNF, IFN-γ, neutrophils) of blood serum (solid-phase enzyme immunoassay with a standard set), as well as VAS pain syndrome parameters were analyzed before/after laser therapy of different wavelength, mode and range (red, infrared). Results. The study made it possible to assess the effectiveness of treatment with LILR with one wavelength and in combination of different lengths of laser radiation as independent factors of preventive exposure in dentistry patients. After applying the techniques of transcanal treatment, dental periapical tissues were treated with laser radiation, including root canals (difficult teeth roots), using the C11 attachment from the «Lazmik-01» device. The study used a modulated red spectrum of LILR in continuous and pulsed mode (l = 635 nm) and an infrared pulsed spectrum (l = 904 nm) in a continuous mode with a sequential exposure to red (l = 635 nm) pulsed and infrared continuous laser radiation (l = 904 nm). Emphasis was placed on pain syndrome, vascular endothelial and immune shifts in dental and periodontal tissues before/after using laser therapy in dental patients. Conclusion. The combination of the red spectrum of LILR in pulsed mode (l = 635 nm) with a sequential exposure to infrared laser radiation (l = 904 nm) in continuous mode provides high vascular endothelial responses in the dental and periodontal tissues of the dental apparatus, and the use of red-spectrum laser radiation in continuous mode (l = 635 nm) in dental patients provides antimicrobial and sanitizing effects, including at the level of the root canals, which is more significant than after the use of infrared laser radiation in pulsed mode, when analgesic results are higher.
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Centkowski, Piotr, Lidia Brydak, Magdalena Machala, Ewa Kalinka, Maria Blasinska-Morawiec, Joanna Wegrzyn, Aleksander Skotnicki, et al. "Good but Variable Humoral Response to Trivalent Influenza Vaccination in Patients with Non-Hodgkin’s Lymphoma - Two Seasons Experience." Blood 106, no. 11 (November 16, 2005): 4685. http://dx.doi.org/10.1182/blood.v106.11.4685.4685.

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Abstract We assessed humoral response to influenza vaccination (vacc) in two consecutive seasons 2003/2004 and 2004/2005 in 123 NHL patients. In season 03/04 50 patients (29 previously treated with chemotherapy - group A03/04 and 21 not treated - group B03/04) and 73 patients in season 04/05: 34 treated - A04/05, 39 not treated - B04/05 were vaccinated with trivalent subunit influenza vaccine. Antibody responses to influenza hemagglutinin (HI) and neuraminidase (NI) were determined in sera collected before vacc, after 1 month and after 6 months. One month after vacc geometric mean antibody titers (GMTs) of antiHI antibodies significantly increased (p<0.05) and mean fold increases (MFIs) ranged from 10.4 to 24.3 in A03/04, 10.9–11.7 in A04/05, 6.5–31.6 in B03/04 and 14.8–21 in B04/05, than fell after 6 months to 3.6–7.8 in A03/04, 3.7–4.4 in A04/05, 1.7–11.2 in B03/04 and 7.8–8.5 in B04/05. Prevacc protection rate, i.e. the number of subjects with the protective HI antibody titers >1:40, ranged from 3.4 to 10.3% in A03/04, 2.9-8.8% in A04/05, 0–4.6% in B03/04 and 0–5.1% in B04/05. After 1 month protection rates ranged from 78.1 to 87.5% in A03/04, 61.8–70.6% in A04/05, 73.3–93.3% in B03/04 and 66.7–74.4% in B04/05 and decreased after 6 months to 24.1–37.9% in A03/04, 32.4–35.3% in A04/05, 19–47.6% in B03/04 and 17.9–35.9% in B04/05. Response rates, i.e. the number of subjects with at least a 4-fold increase of antiHI antibody titers after vacc, ranged from 58.6–75.9% in A03/04, 50–67.6% in A04/05, 57.1–81% in B03/04 and 61.5–71.8% in B04/05. Six months after vacc it decreased to 17.2–34.5% in A03/04, 20.6–29.4% in A04/05, 19–38.1% in B03/04 and 15.4–33.3% in B04/05. In all patients’ groups, post-vacc antiNI GMTs were significantly higher (p<0.05) than pre-vacc. MFIs of antiNI antibodies 1 month after vacc ranged from 11 to 17.5 in A03/04, 4.1–9.4 in A04/05, 5.1–9.9 in B03/04 and 6.3–9.9 in B04/05, then fell to 2.9–6.9 in A03/04, 1.3–5.1 in A04/05, 3.4–4.9 in B03/04 and 2.8–3.6 in B04/05. In season 03/04 only hemagglutinin H1 antibody titers were significantly higher in CTR than in patients in contrast of season 04/05 when in patients the titers of H1, H3 and N1, N2, NB were significantly lower. We conclude that the response to influenza vaccine is similar in patients previously treated and not-treated with chemoterapy. It is highly immunogenic in NHL patients, but the level of specific antibodies is variable and may depend on immunogenecity of vaccine for actual season. After 6 months the antibody titers rapidly decline, thus the NHL patients may need the second dose of vaccine to maintain good protective level.
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Franceschi, Danilo Santana Alessio, Luiza Tamie Tsuneto, Priscila Saamara Mazini, William Sergio do Sacramento, Pâmela Guimarães Reis, Cristiane Conceição Chagas Rudnick, Samaia Laface Clementino, Ana Maria Sell, and Jeane Eliete Laguila Visentainer. "Class-I human leukocyte alleles in leprosy patients from Southern Brazil." Revista da Sociedade Brasileira de Medicina Tropical 44, no. 5 (October 2011): 616–20. http://dx.doi.org/10.1590/s0037-86822011000500018.

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INTRODUCTION: The present study was designed to investigate a possible role of HLA (histocompatibility leucocyte antigen) class-I alleles (HLA-A, -B, and -C) in leprosy patients from Southern Brazil. METHODS: Two hundred and twenty-five patients with leprosy and 450 individuals for the control group were involved in this research. HLA genotyping was performed through PCR-SSO protocols (One Lambda, USA); the frequency of these alleles was calculated in each group by direct counting, and the frequencies were then compared. RESULTS: There was an association between HLA-A*11 (6.9% vs 4.1%, p=0.0345, OR=1.72, 95% CI=1.05-2.81), HLA-B*38 (2.7% vs. 1.1%, p=0.0402, OR=2.44, 95% CI=1.05-5.69), HLA-C*12 (9.4% vs. 5.4%, p=0.01, OR=1.82, 95% CI=1.17-2.82), and HLA-C*16 (3.1% vs. 6.5%, p=0.0124, OR=0.47, 95% CI=0.26-0.85) and leprosy per se. In addition, HLA-B*35, HLA-C*04, and HLA-C*07 frequencies were different between lepromatous (LL) and tuberculoid (TT) patients. However, after adjusting for the number of alleles compared, Pc values became nonsignificant. CONCLUSIONS: Although our results do not support the previous findings that HLA class-I alleles play a role in leprosy pathogenesis, we suggest new studies because of the importance of the association between the HLA and KIR in the innate immune response to leprosy.
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Zhogaleva, O. S., A. Yu Myshastaya, O. S. Pavlenko, N. N. Vozhzhova, and E. V. Ionova. "Изучение коллекционного материала озимой твердой пшеницы на наличие гена устойчивости к септориозу Stb2." Grain Economy of Russia, no. 6 (December 22, 2020): 51–55. http://dx.doi.org/10.31367/2079-8725-2020-72-6-51-55.

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In order to obtain high yields of winter durum wheat, it is necessary not only to use advanced agricultural technologies, but also to sow varieties resistant to major diseases. One of these diseases that cause great harm to grain crops is Septoria leaf blotch. The current paper has presented the study results of collection material of Russian and foreign winter durum wheat according to the efficiency of the Septoria leaf blotch resistance gene Stb2 in the North Caucasus region. The purpose of the current study was to identify the Septoria leaf blotch resistance gene Stb2 in the collection material of winter durum wheat. The study was carried out in 2017–2018 in the laboratory of marker breeding of the FSBSI “ARC “Donskoy” in Zernograd. In the course of the study there have been applied such methods as the isolation of genomic DNA by the CTAB-method, PCR-analysis with the molecular SSR marker WMS533, electrophoresis on 2% agarose gel, analysis of electrophoresis gels in the Bio-Rad Image Lab 6.0 software, general data analysis by Microsoft Excel. The study has shown that 29 samples out of 185 analyzed ones had the Septoria leaf blotch resistance gene Stb2, they are the lines L3557 h42, L3182 h7, L3335 h29, L3336 h43, L3408 h218 (Russia, FSBSI “Research Center of Plants named after P. P. Lukyanenko”), K-61620 (Russia), K-54455, DF 917 (Romania), K-61924, K-59179, K-51863, K-61869 (Moldova), K-63871 (Turkey), Kharkovskaya 909 (Ukraine), MVTD-15-99 (Hungary), 2196-1/04, 922/93, 589/13, 655/13, 683/13, 145/14, 322/14, 484/14, Gordeiform 1424/82 (Russia, FSBSI “ARC “Donskoy”), Beliy Parus (Ukraine), Belgorodskaya Yantarnaya (LLC “Sativa” in Belgorod, Russia), IR named after V. Ya. Yuriev (Kharkov, Ukraine)), Zhivitsa (Russia, Prikumskaya OSS), Pandur (Romania) and Elidur (Romania). There have been recommended using the identified samples of winter durum wheat with the Septoria leaf blotch resistance gene Stb2 in breeding programs.
5

Walker, S., J. Franciose, P. G. Vashi, C. Lammersfeld, J. F. Grutsch, C. G. Lis, D. Gupta, and S. Williams. "A prospective survey evaluating the use of soy products in breast cancer." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 10562. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.10562.

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10562 Background: Many studies have evaluated the potential role of soy in the prevention of breast cancer. A number of components in soy appear to have anticancer properties, including isoflavones, genistein and daidzein. The use of soy by women with breast cancer is now being questioned because of the estrogen-like effects of isoflavones and possible interactions with tamoxifen. Clinicians providing nutrition counseling to these women are concerned because the availability of soy foods has increased dramatically in the past few years. The goal of this study was to quantify the intake of isoflavones in women with breast cancer to determine if their intake is of clinical significance. Methods: We evaluated a consecutive case series of 100 women with breast cancer treated at Cancer Treatment Centers of America between 09/03 and 02/04. After obtaining informed consent, each patient was asked to complete a soy food frequency questionnaire (FFQ) that was scored by Fred Hutchinson Cancer Research Center, the institute that developed and validated FFQ. Results: Mean age was 50.5 years (std. dev. = 9.4; range 31–70) and mean BMI was 27.3kg/m2 (std. dev. = 6.75; range 17–59). Table 1 shows detailed characteristics of our patients. Genistein and Daidzein consumption was limited to 65 patients with a mean intake of 81.5 mg/week (std. dev. = 153; range 0.02–682) and 52.9 mg/week (std. dev. = 98.8; range 0.02–482) respectively. Soy foods with highest reported consumption were soy sauce (37%), soy milk (23%), soy bars (18%), roasted soy nuts (13%) and tofu (13%). Conclusions: Our study suggests that the isoflavone intake of breast cancer patients at our hospital was quite variable. Thirty-five patients reported no soy intake. The mean daily intake translates into 11.6 mg genistein and 7.4 mg daidzein, which is equivalent of less than ¼ cup of tofu per day. This amount is slightly higher than what has been previously reported in non-Asian American women. [Table: see text] No significant financial relationships to disclose.
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Gera, Kriti, Daniela Martir, Wei Xue, and John R. Wingard. "Survival outcomes of acute erythroid leukemia in the United States: A 20-year population-based study." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): e19031-e19031. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e19031.

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e19031 Background: Acute Erythroid Leukemia (AEL), also known as pure erythroid leukemia, is a rare subtype of Acute Myeloid Leukemia (AML) characterized by proliferation of malignant erythroid precursors. It can occur at any age and portends aggressive course with dismal outcomes. Treatment consists of high-intensity chemotherapy and allogeneic hematopoietic stem cell transplant. Outcome data at a population level is scarce. Methods: We performed a retrospective analysis of the Surveillance Epidemiology and End Results (SEER) database, a U.S. population-based registry maintained by National Cancer Institute. All cases with histologically confirmed diagnosis of Acute erythroid leukemia during the period of 2000-2019 were included in the study. Survival analysis was performed using Kaplan-Meier method. The survival between groups was compared using log-rank test. Results: A total of 968 patients were included in the study. The median age was 68 years (range 0-95). 62% of patients were males. 11% patients were Hispanic and 89% were non-Hispanic (72% white and 7% black). 62.5% (n=605) patients were treated with chemotherapy. Median Overall Survival (OS) for patients with age <18 years (n=50) was 69 months with 1-year OS of 77%. In contrast, median OS for adults with age >18 years (n=918) was only 5 months with 1-year survival of 26.7%. Patients who received chemotherapy had significantly improved OS compared to patients who did not among both adults (Median OS 8 vs 1 months, p<0.0001) and children (Median OS 152 vs 2 months, p=0.004). There were no significant differences in OS based on sex, race, ethnicity and median household income. Median OS for adults diagnosed in 2000-04, 2005-09, 2010-14, 2015-19 was 4, 6, 6 and 3 months respectively with no significant difference in OS between these groups. Conclusions: AEL occurs in all age groups but is most common in elderly. Outcomes are poor with current chemotherapeutic agents, with no improvement in last two decades. This study stresses the urgent need for new investigational agents and treatment strategies. [Table: see text]
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Brunt, Adrian Murray, Joanne S. Haviland, Mark Sydenham, Rajiv K. Agrawal, Hafiz Algurafi, Abdulla Alhasso, Peter Barrett-Lee, et al. "Ten-Year Results of FAST: A Randomized Controlled Trial of 5-Fraction Whole-Breast Radiotherapy for Early Breast Cancer." Journal of Clinical Oncology 38, no. 28 (October 1, 2020): 3261–72. http://dx.doi.org/10.1200/jco.19.02750.

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PURPOSE Previous studies of hypofractionated adjuvant whole-breast radiotherapy for early breast cancer established a 15- or 16-fraction (fr) regimen as standard. The FAST Trial (CRUKE/04/015) evaluated normal tissue effects (NTE) and disease outcomes after 5-fr regimens. Ten-year results are presented. METHODS Women ≥ 50 years of age with low-risk invasive breast carcinoma (pT1-2 pN0) were randomly assigned to 50 Gy/25 fr (5 weeks) or 30 or 28.5 Gy in 5 once-weekly fr of 6.0 or 5.7 Gy. The primary end point was change in photographic breast appearance at 2 and 5 years; secondary end points were physician assessments of NTE and local tumor control. Odds ratios (ORs) from longitudinal analyses compared regimens. RESULTS A total of 915 women were recruited from 18 UK centers (2004-2007). Five-year photographs were available for 615/862 (71%) eligible patients. ORs for change in photographic breast appearance were 1.64 (95% CI, 1.08 to 2.49; P = .019) for 30 Gy and 1.10 (95% CI, 0.70 to 1.71; P = .686) for 28.5 Gy versus 50 Gy. α/β estimate for photographic end point was 2.7 Gy (95% CI, 1.5 to 3.9 Gy), giving a 5-fr schedule of 28 Gy (95% CI, 26 to 30 Gy) estimated to be isoeffective with 50 Gy/25 fr. ORs for any moderate/marked physician-assessed breast NTE (shrinkage, induration, telangiectasia, edema) were 2.12 (95% CI, 1.55 to 2.89; P < .001) for 30 Gy and 1.22 (95% CI, 0.87 to 1.72; P = .248) for 28.5 Gy versus 50 Gy. With 9.9 years median follow-up, 11 ipsilateral breast cancer events (50 Gy: 3; 30 Gy: 4; 28.5 Gy: 4) and 96 deaths (50 Gy: 30; 30 Gy: 33; 28.5 Gy: 33) have occurred. CONCLUSION At 10 years, there was no significant difference in NTE rates after 28.5 Gy/5 fr compared with 50 Gy/25 fr, but NTE were higher after 30 Gy/5 fr. Results confirm the published 3-year findings that a once-weekly 5-fr schedule of whole-breast radiotherapy can be identified that appears to be radiobiologically comparable for NTE to a conventionally fractionated regimen.
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Pilgrim, Katharina, and Sabine Bohnet-Joschko. "Effectiveness of Digital Forced-Choice Nudges for Voluntary Data Donation by Health Self-trackers in Germany: Web-Based Experiment." Journal of Medical Internet Research 24, no. 2 (February 21, 2022): e31363. http://dx.doi.org/10.2196/31363.

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Background Health self-tracking is an evidence-based approach to optimize health and well-being for personal self-improvement through lifestyle changes. At the same time, user-generated health-related data can be of particular value for (health care) research. As longitudinal data, these data can provide evidence for developing better and new medications, diagnosing rare diseases faster, or treating chronic diseases. Objective This quantitative study aims to investigate the impact of digital forced-choice nudges on the willingness of German health self-trackers to donate self-tracked health-related data for research. This study contributes to the body of knowledge on the effectiveness of nonmonetary incentives. Our study enables a gender-specific statement on influencing factors on the voluntary donation of personal health data and, at the same time, on the effectiveness of digital forced-choice nudges within tracking apps. Methods We implemented a digital experiment using a web-based questionnaire by graphical manipulation of the Runtastic tracking app interface. We asked 5 groups independently to indicate their willingness to donate tracked data for research. We used a digital forced-choice nudge via a pop-up window, which framed the data donation request with 4 different counter values. We generated the counter values according to the specific target group needs identified from the research literature. Results A sample of 919 was generated, of which, 625 (68%) were women and 294 (32%) were men. By dividing the sample into male and female participants, we take into account research on gender differences in privacy tendencies on the web and offline, showing that female participants display higher privacy concerns than male participants. A statistical group comparison shows that with a small effect size (r=0.21), men are significantly more likely (P=.04) to donate their self-tracked data for research if the need to take on social responsibility is addressed (the prosocial counter value in this case—contributing to society) compared with the control group without counter value. Selfish or pseudoprosocial counter values had no significant effect on willingness to donate health data among male or female health self-trackers in Germany when presented as a forced-choice nudge within a tracking app. Conclusions Although surveys regularly reveal an 80% to 95% willingness to donate data on average in the population, our results show that only 41% (377/919) of the health self-trackers would donate their self-collected health data to research. Although selfish motives do not significantly influence willingness to donate, linking data donation to added societal value could significantly increase the likelihood of donating among male self-trackers by 15.5%. Thus, addressing the need to contribute to society promotes the willingness to donate data among male health self-trackers. The implementation of forced-choice framing nudges within tracking apps presented in a pop-up window can add to the accessibility of user-generated health-related data for research.
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Porto, Ana Paula Matos, Icaro Boszczowski, Ann Versporten, Ines Pauwels, Thais THAIS, Evelyne Girão, Patricia Esteves, et al. "Point Prevalence Surveys and Customized Interventions Are Good Strategies to Improve Antimicrobial Use: The Brazilian Experience." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s523. http://dx.doi.org/10.1017/ice.2020.1207.

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Background: Although antimicrobial stewardship is recommended by Brazilian government, data regarding prescription practices in the country are scarce. Objective: To describe the impact of 2 point-prevalence surveys and customized interventions on antimicrobial consumption among 8 hospitals in 3 regions of Brazil. Method: In 2017 and 2018, 8 tertiary-care Brazilian hospitals conducted the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS). All enrolled hospitals were provided the 2017 results. The group discussed intervention strategies by WhatsApp and e-mail. Hospitals customized interventions, including feedback to prescribers, discussion with pharmacists, and antimicrobial use data in accreditation process. A web-based program was used for data entry, validation, and reporting of details on AMC prescriptions. The Global-PPS was developed by the University of Antwerp and was funded by bioMérieux. The 1-day prevalences in 2017 and 2018 are presented as risk ratios. The main outcomes are whole antimicrobial use in hospitals and intensive care units (ICUs). Prevalence of infections caused by multidrug-resistant organisms (MDROs) were reported. Results: Overall, 1,716 patients were evaluated, of whom 420 (52.5%) and 429 (46.8%) were using antimicrobials in 2017 and 2018, respectively (P = .02). In 33 ICUs, 170 patients (61.4%) and 204 patients (56.8%) were on antimicrobials, in 2017 and 2018, respectively (P = .20). Significant decreases of overall use were observed for vancomycin (from 11% to 7%; P =.01), meropenem (from 12% to 9%; P = .04), and linezolid (from 1.5% to 0.33%; P =.01). There was no significant increase in any singular drug or class of drugs. Within ICUs, vancomycin use decreased significantly (from 19% to 11%; P = .005), linezolid use decreased significantly (from 2.9% to 0.3%; P = .01), colistin use decreased significantly (from 4.3% to 1.7%; P = .05), and metronidazole use decreased significantly (from 6.5% to 2.8%; P = .03). We observed a nonsignificant decrease of infections caused by MDROs across the whole hospital (from 8.7% to 6.6%; P = .10) and in the ICUs (from 15.2% to 12.3%; P = .30). The most frequent infectious diagnoses were pneumonia (27%), intra-abdominal sepsis (14%), skin and soft-tissue infection (SSTI) (9.4%), urinary tract infection (9.1%), and sepsis and septic shock with no identified focus (SSNIF) (7.4%). There was a significant increase in SST (from 7.6% to 11.4%; P = .03) and a decrease in SSNIF (from 10.7% to 4.1%; P = .00002). In 2018, there were significantly fewer antimicrobial prescriptions for healthcare-acquired infections (from 52.6% to 43.6%; P = .0007) and more antimicrobial prescriptions for community-acquired infections (from 27.4% to 34.6%; P = .003). We detected no difference for medical or surgical prophylaxis. Conclusions: Feedback of prescription practices might have had an impact on local policies of antimicrobial use, as demonstrated by an overall decrease is antimicrobial use and a decrease in the ICU.Funding: This study was supported by Biomérieux.Disclosures: None
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McCue, Maggie, Christopher Blair, Ben Fehnert, James King, Francesca Cormack, Sara Sarkey, Anna Eramo, Christopher Kabir, Rasha Khatib, and David Kemp. "Mobile App to Enhance Patient Activation and Patient-Provider Communication in Major Depressive Disorder Management: Collaborative, Randomized Controlled Pilot Study." JMIR Formative Research 6, no. 10 (October 27, 2022): e34923. http://dx.doi.org/10.2196/34923.

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Background Enhanced patient-provider engagement can improve patient health outcomes in chronic conditions, including major depressive disorder (MDD). Objective We evaluated the impact of a digitally enabled care mobile app, Pathway, designed to improve MDD patient-provider engagement. Patients used a mobile interface to assess treatment progress and share this information with primary care providers (PCPs). Methods In this 52-week, real-world effectiveness and feasibility study conducted in primary care clinics, 40 patients with MDD who were recently prescribed antidepressant monotherapy were randomized to use a mobile app with usual care (20/40, 50%) or usual care alone (20/40, 50%). Patients in the app arm engaged with the app daily for 18 weeks; a report was generated at 6-week intervals and shared with the PCPs to facilitate shared treatment decision-making discussions. The patients discontinued the app at week 18 and were followed through year 1. Coprimary outcome measures, assessed via research visits, included change from baseline in the 13-item Patient Activation Measure (PAM-13) and 7-item Patient-Provider Engagement Scale scores at week 18. Additional outcome measures included depression severity (9-item Patient Health Questionnaire [PHQ-9]) and cognitive symptoms (5-item Perceived Deficits Questionnaire–Depression). Results All 37 patients (app arm: n=18, 49%; usual care arm: n=19, 51%) who completed the 18-week follow-up period (n=31, 84% female, mean age 36, SD 11.3 years) had moderate to moderately severe depression. Improvements in PAM-13 and PHQ-9 scores were observed in both arms. Increases in PAM-13 scores from baseline to 18 weeks were numerically greater in the app arm than in the usual care arm (mean 10.5, SD 13.2 vs mean 8.8, SD 9.4; P=.65). At 52 weeks, differences in PAM-13 scores from baseline demonstrated significantly greater improvements in the app arm than in the usual care arm (mean 20.2, SD 17.7 vs mean 1.6, SD 14.2; P=.04). Compared with baseline, PHQ-9 scores decreased in both the app arm and the usual care arm at 18 weeks (mean 7.8, SD 7.2 vs mean 7.0, SD 6.5; P=.73) and 52 weeks (mean 9.5, SD 4.0 vs mean 4.7, SD 6.0; P=.07). Improvements in 7-item Patient-Provider Engagement Scale and WHO-5 scores were observed in both arms at 18 weeks and were sustained through 52 weeks in the app arm. Improvements in WHO-5 scores at 52 weeks were significantly greater in the app arm than in the usual care arm (41.5 vs 20.0; P=.02). Conclusions Patients with MDD will engage with a mobile app designed to track treatment and disease progression. PCPs will use the data generated as part of their assessment to inform clinical care. The study results suggest that an app-enabled clinical care pathway may enhance patient activation and benefit MDD management. Trial Registration ClinicalTrials.gov NCT03242213; https://clinicaltrials.gov/ct2/show/NCT03242213

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