International journal of clinical practice
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Int. J. Clin. Pract. · Dec 2020
Randomized Controlled Trial Multicenter StudyEffect of Electroacupuncture in Pre- and Postmenopausal Women with Stress Urinary Incontinence.
To evaluate the effect of electroacupuncture and assess the impact of menopausal status in women with stress urinary incontinence or stress-predominant mixed urinary incontinence. ⋯ This subgroup analysis indicated that electroacupuncture can improve the symptoms of urinary incontinence in women with stress urinary incontinence or stress-predominant mixed urinary incontinence and that menopausal status may not affect the effects of electroacupuncture in subjects.
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Int. J. Clin. Pract. · Nov 2020
Multicenter StudyInter-hospital Variation in Surgical Intensity for Trauma Admissions: A Multicenter Cohort Study.
Guidelines for injury care are increasingly moving away from surgical management towards less invasive procedures but there is a knowledge gap on how these recommendations are influencing practice. We aimed to assess inter-hospital variation in surgical intensity for injury admissions and evaluate the correlation between hospital surgical intensity and mortality/complications. ⋯ Results should be interpreted with caution as they may be a result of residual confounding. However, they may suggest that there are opportunities for quality improvement in surgical care for injury admissions, particularly for orthopaedic injuries. Moving forward, we should aim to prospectively evaluate adherence to guidelines on non-operative management and their impact on mortality and morbidity.
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Int. J. Clin. Pract. · Nov 2020
Multicenter StudyReal-world assessment and characteristics of men with benign prostatic hyperplasia (BPH) in primary care and urology clinics in Spain.
To describe the real-world demographic and clinical characteristics of patients with lower urinary tract symptoms (LUTS) as a result of benign prostatic hyperplasia (BPH) in Spain. ⋯ Demographic and clinical characteristics of patients with BPH in Spain were similar in primary care and urology; however, assessment criteria to evaluate LUTS severity differ and are not completely aligned with clinical guideline recommendations. Increased use of recommended assessments may enhance optimal BPH management.
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Int. J. Clin. Pract. · Apr 2020
Multicenter StudyDiabetes in day case general and vascular surgery: A multicentre regional audit.
People with Diabetes Mellitus (DM) are at increased risk of postoperative complications if their HbA1C readings are not well controlled. In the UK, there are clear national guidelines requiring all people with DM to have HbA1C blood testing within 6months before undergoing surgery and that these readings should be below 69 mmol/mol if this is safe to achieve. The aim of this study was to determine whether hospitals in the region were compliant with the guidelines. ⋯ A significant proportion of people with diabetes undergoing elective day case procedures in our region do not have HbA1C testing within 6 months of their procedure as recommended by the national guidelines. In patients who do have a high HbA1C, the majority still undergo surgery without adequate control of their DM. Greater awareness amongst healthcare workers and robust pathways are required for this vulnerable group of patients if we are to reduce the risk of developing postoperative complication rates.
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Int. J. Clin. Pract. · Feb 2020
Multicenter Study Observational StudyA quantitative evaluation of adherence and inhalation technique among respiratory patients: An observational study using an electronic inhaler assessment device.
Problems related to poor adherence and inhaler technique (IT) are historically reported in the literature. Most common methods used for adherence and IT assessment are reported to be either inaccurate or subjective. Few electronic monitoring devices (EMDs) that provide an objective measure of both adherence and IT while patients use inhalers at home now exist. Therefore, this study aimed to examine adherence level and IT among respiratory patients in community care using such an EMD for the first time in England. ⋯ The current study demonstrates that measures such as dose counter, prescription refill and self-reporting showed a high level of adherence among the observed patients. However, the objective data provided by the EMD showed a significantly lower actual adherence rate, reflecting how adherence remains variable and problematic among patients in the community.