Articles: treatment.
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Singapore medical journal · Jul 2024
Impact of a codesigned and coproduced patient-centred discharge form on communication and understanding.
Adverse clinical outcomes and patient dissatisfaction with care often have elements of poor communication. Factors such as illness and pharmacotherapy can affect cognition, and overestimation of patients' health literacy may contribute to suboptimal communication with patients regarding their hospitalisation and post-discharge instructions. Improved patient understanding and recall of their diagnoses and treatment is critical for adherence to treatment, follow-up and optimal clinical outcomes. The aim of the study was to assess whether a coproduced and codesigned patient-centred discharge form (PCDF) improves patients' understanding of their discharge diagnosis, in-hospital treatment and post-discharge plan. ⋯ The use of PCDF is associated with improved patient understanding with respect to their hospital management and post-discharge instructions. It is also associated with high levels of satisfaction as assessed by measures of patient experience.
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Randomized Controlled Trial Multicenter Study
Efficacy and Safety of Donidalorsen for Hereditary Angioedema.
Hereditary angioedema is a rare disorder characterized by episodic, potentially life-threatening swelling caused by kallikrein-kinin dysregulation. Long-term prophylaxis can stabilize this system. Donidalorsen, an antisense oligonucleotide, specifically reduces prekallikrein expression. ⋯ Donidalorsen treatment reduced the hereditary angioedema attack rate, a finding that supports potential prophylactic use for hereditary angioedema. (Funded by Ionis Pharmaceuticals; OASIS-HAE ClinicalTrials.gov number, NCT05139810.).
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Randomized Controlled Trial Multicenter Study
Oral Sebetralstat for On-Demand Treatment of Hereditary Angioedema Attacks.
Approved on-demand treatments for hereditary angioedema attacks need to be administered parenterally, a route of administration that is associated with delays in treatment or withholding of therapy. ⋯ Oral sebetralstat provided faster times to the beginning of symptom relief, reduction in attack severity, and complete attack resolution than placebo. (Funded by KalVista Pharmaceuticals; KONFIDENT ClinicalTrials.gov number, NCT05259917; EudraCT number, 2021-001226-21.).
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An Assessment of Clinical Accuracy of Vital Sign-based Triage Tools Among U.S. and Coalition Forces.
Early appropriate allocation of resources for critically injured combat casualties is essential. This is especially important when inundated with an overwhelming number of casualties where limited resources must be efficiently allocated, such as during mass casualty events. There are multiple scoring systems utilized in the prehospital combat setting, including the shock index (SI), modified shock index (MSI), simple triage and rapid treatment (START), revised trauma score (RTS), new trauma score (NTS), Glasgow Coma Scale + age + pressure (GAP), and the mechanism + GAP (MGAP) score. The optimal score for application to the combat trauma population remains unclear. ⋯ This study retrospectively applied seven triage tools to a database of 12,268 cases from the Department of Defense Trauma Registry to evaluate their performance in predicting early death or massive transfusion in combat. All scoring systems performed well with an AUROC >0.8 for both outcomes. Although the SI and MSI performed best for predicting massive transfusion (both had an AUROC of 0.89), they ranked last for assessment of mortality within 24 hours, with the other tools performing well. START, RTS, NTS, MGAP and GAP reliably identified early death and need for massive transfusion, with MGAP and GAP performing the best overall. These findings highlight the importance of assessing triage tools to best manage resources and ultimately preserve lives of traumatically wounded warfighters. Further studies are needed to explain the surprising performance discrepancy of the SI and MSI in predicting early death and massive transfusion.