Health technology assessment : HTA
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Health Technol Assess · Mar 2020
Randomized Controlled Trial Clinical TrialAn intervention for parents with severe personality difficulties whose children have mental health problems: a feasibility RCT.
The children of parents with severe personality difficulties have greater risk of significant mental health problems. Existing care is poorly co-ordinated, with limited effectiveness. A specialised parenting intervention may improve child and parenting outcomes, reduce family morbidity and lower the service costs. ⋯ The Helping Families Programme-Modified is an acceptable specialised parenting intervention. Trial methods using non-diagnostic criteria were largely supported. For future work, a definitive efficacy trial should consider site selection, recruitment methods, intervention efficiency and revised comparator condition.
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Health Technol Assess · Mar 2020
Randomized Controlled Trial Multicenter Study Clinical TrialC-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT.
Most patients presenting with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in primary care are prescribed antibiotics, but these may not be beneficial, and they can cause side effects and increase the risk of subsequent resistant infections. Point-of-care tests (POCTs) could safely reduce inappropriate antibiotic prescribing and antimicrobial resistance. ⋯ Implementation studies that also build on our qualitative findings could help determine the effect of this intervention over the longer term.
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Health Technol Assess · Jan 2020
Randomized Controlled Trial Clinical TrialA group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT.
People with advanced dementia who live and die in nursing homes experience variable quality of life, care and dying. There is a need to identify appropriate, cost-effective interventions that facilitate high-quality end-of-life care provision. ⋯ In a full trial, consideration is needed of the appropriate outcome measure that is sensitive to different participant responses, and of clear implementation principles for this person-centred intervention in a nursing home context.
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Health Technol Assess · Jan 2020
Randomized Controlled Trial Multicenter StudyGroup cognitive rehabilitation to reduce the psychological impact of multiple sclerosis on quality of life: the CRAMMS RCT.
People with multiple sclerosis have problems with memory and attention. The effectiveness of cognitive rehabilitation has not been established. ⋯ Future research should evaluate the selection of those who may benefit from cognitive rehabilitation.
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Health Technol Assess · Dec 2019
Randomized Controlled Trial3-month versus 6-month adjuvant chemotherapy for patients with high-risk stage II and III colorectal cancer: 3-year follow-up of the SCOT non-inferiority RCT.
Oxaliplatin and fluoropyrimidine chemotherapy administered over 6 months is the standard adjuvant regimen for patients with high-risk stage II or III colorectal cancer. However, the regimen is associated with cumulative toxicity, characterised by chronic and often irreversible neuropathy. ⋯ The study achieved its primary end point, showing that 3-month oxaliplatin-containing adjuvant chemotherapy is non-inferior to 6 months of the same regimen; 3-month treatment showed a better safety profile and cost less. For future work, further follow-up will refine long-term estimates of the duration effect on disease-free survival and overall survival. The health economic analysis will be updated to include long-term extrapolation for subgroups. We expect these analyses to be available in 2019-20. The Short Course Oncology Therapy (SCOT) study translational samples may allow the identification of patients who would benefit from longer treatment based on the molecular characteristics of their disease.