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Background: Evaluating the effectiveness and survival rates of space maintainers is crucial for optimal pediatric dental care. The present study's goal is to evaluate the survival rate of different types of space maintainers—removable, fixed with a metal base, or fixed with a resin base—indicated for children as a consequence of premature loss of primary teeth. Methods: A systematic review was conducted in accordance with PRISMA recommendations and was previously registered in PROSPERO under registration number: CRD42024534183. The search was performed in five different databases PubMed, EMBASE, Scopus, Cochrane, and Web of Science. This was supplemented by a manual database search. From the initial electronic search of the five databases, 72 articles were identified after removing duplicates. After reading the titles and abstracts, 46 articles were excluded, leaving a total of 26 studies. Upon reading the full texts, 15 were excluded for not meeting the inclusion criteria, resulting in a total of 11 articles included in the systematic review. Results: The total number of patients treated in the studies was 479, with four observational studies and seven randomized clinical trials. Fixed space maintainers, such as band and loop (BL) or lingual arch (LA), are preferred due to their long-term stability and lower risk of loss. In contrast, removable maintainers, such as Hawley plates, are suitable temporarily but require more patient cooperation and may be less tolerated. Conclusions: Space maintainers help prevent the migration of adjacent teeth and the need for more invasive orthodontic treatments in the future. Additionally, they contribute to adequate masticatory function and speech development. [ABSTRACT FROM AUTHOR]

Dentist–patient communication is at the core of providing quality dental care. This study aims to review the importance, challenges, strategies, and training of dentist–patient communication. The World Dental Federation (FDI) emphasizes the importance of effective communication between oral healthcare providers and patients as a critical component of high-quality care. Effective dentist–patient communication allows dentists to accurately and effectively pass on essential medical information to patients. It improves the dentist's efficiency, boosts self-confidence, reduces occupational stress, and minimizes the risks of complaint or litigation. Moreover, it alleviates dental anxiety and fear, helps build trust between dentists and patients, addresses patients' needs and preferences, increases patients' adherence to improved treatment outcomes, and ultimately leads to enhanced patient satisfaction. Nonetheless, it has been widely acknowledged that dentists universally encounter the repercussions arising from suboptimal communication strategies. Time constraints, difficulties in establishing rapport, the oral-health illiteracy of the patients, the poor communication skills of the dentists, dentists' perceptions, and language barriers often hinder dentist–patient communication. Dentists should take the patient-centered approach as a premise and acquire verbal and non-verbal communication skills to overcome these communication barriers. The patient-centered approach comprises the understanding of patients' illness, shared decision-making, and intervention with mindfulness of the patient's own pace. Simple, succinct, and jargon-free language should be used in verbal communication. Proper body postures and gestures are fundamental for showing positive attitudes towards patients. Communication training for dental students should involve a structured pedagogical approach that includes didactic instruction, role-playing exercises, patient interviewing, and ongoing assessments. Key components of effective communication skills training in dental education include motivational interviewing, open-ended questioning, affirmations, reflective listening, and summaries to enhance patient engagement and adherence to treatment plans. [ABSTRACT FROM AUTHOR]

The article discusses the use of neural network models to predict the primary completion date (PCD) of clinical trials, focusing on oncology drug development. The model, trained on historical cancer trials and key clinical trial parameters, outperforms sponsors' predictions, reducing the average deviation from the actual PCD by 179 days. By leveraging historical data analysis and predictive modeling, sponsors can design more efficient trials, mitigate delays, and optimize outcomes, ultimately reducing costs and improving drug development processes. The study highlights the importance of accurate PCD predictions in streamlining timelines and enhancing the efficiency of clinical trials. [Extracted from the article]

Background/Objectives: Citrulline, an amino acid produced by small bowel enterocytes, has been proposed as a potential marker of intestinal absorptive capacity. The aim of this study is to evaluate whether measuring citrulline levels could be useful for celiac disease (CD) patients, both at the time of diagnosis and during follow-up. Methods: A multicenter prospective study was conducted. Citrulline levels were measured and compared in 93 pediatric patients classified into three groups. Group A: 28 patients with newly diagnosed CD. In this group, an additional measurement was performed after 3–6 months on a gluten-free diet (GFD). Group B: 32 patients with a prior CD diagnosis and on a GFD for at least 6 months. Group C: 33 healthy controls. Citrulline levels were correlated with clinical and laboratory variables, including serological markers. Statistical analysis: t-tests for paired groups and independent groups, Pearson and Spearman correlation tests. Results: Newly diagnosed CD patients had lower citrulline levels compared to those on a GFD for more than 6 months (27.13 vs. 32.42 µmol/L; p > 0.05). Citrulline levels were nearly identical between healthy controls and CD patients on a GFD for more than 6 months (32.48 vs. 32.42 µmol/L; p > 0.05). Starting a GFD led to a significant increase in citrulline levels in group A (from 27.13 to 37.43 µmol/L, p < 0.001). Conclusions: Plasma citrulline could serve as a valuable marker for mucosal recovery in the follow-up of diagnosed celiac patients adhering to a GFD. [ABSTRACT FROM AUTHOR]

Introduction: Hyperphosphatemia in advanced CKD often accompanies high PTH and FGF23 levels, impaired bone mineralization, ectopic calcifications, and increased cardiovascular risks. Novel treatments are now available to lower serum phosphorus effectively. However, safety, tolerability, and patient adherence must be evaluated to determine the best therapeutic option for hyperphosphatemia. Areas covered: This review examines available treatment strategies for hyperphosphatemia in CKD patients and new emerging treatments, emphasizing the latest inhibitors of active phosphate absorption. Expert opinion: Despite the numerous compounds available, managing hyperphosphatemia in CKD remains challenging. While many phosphate binders exist, they often have limitations and side effects. Aluminum carries significant toxicity risks. Calcium-based binders are effective but can cause hypercalcemia and vascular calcification. Lanthanum is absorbed in the gut, but its long-term tissue deposition appears clinically irrelevant. Sevelamer reduces vascular calcification but has inconclusive data and gastrointestinal side effects. Iron-based binders are effective but may cause gastrointestinal discomfort and lack long-term outcome data. New inhibitors of intestinal phosphate absorption show promise with low pill burden but need more clinical validation. Although these newer compounds might eventually improve phosphate management in CKD patients, enhancing adherence and reducing pill burden, future studies are required to elucidate the best treatment for hyperphosphatemia. [ABSTRACT FROM AUTHOR]

This study aimed to examine the relationship between medication literacy and the degree to which patients are considered capable of medication self‐management, the factors influencing the strength of this relationship and the factors influencing a patient's capability for medication self‐management. Between January and April 2022, a cross‐sectional survey was conducted on hospitalised patients (65+) with polypharmacy. Medication literacy was evaluated using the MEDication Literacy Assessment of Geriatric patients and informal caregivers (MED‐fLAG). The SelfMED assessment determined a patient's capability for medication self‐management. The relationship between MED‐fLAG and SelfMED was explored with Pearson's r. Moderation analysis was used to explore the factors influencing the strength of the relationship between both. Linear regression explored the factors influencing SelfMED scores. In total, 169 patients participated in the study. Patients considered themselves more capable of in‐hospital medication self‐management (8/10 rating) compared to nurses' and physicians' opinions (6/10 rating). Interactive medication literacy scored higher (mean = 3.0) than functional (mean = 2.9) and critical medication literacy (mean = 2.8). The more medication literacy skills, the more patients were considered able for medication self‐management by healthcare providers (r = 0.630, p < 0.001). Moderation analysis could not reveal any factors that significantly affected the strength of the relationship between both. Age, managing medication independently at home, the number of chronic conditions and medication literacy were significant predictors of a patient's capability for in‐hospital medication self‐management. This study demonstrated a rather strong correlation between the results of the MED‐fLAG and the SelfMED assessment. Hence, SelfMED can be used as a stand‐alone first screening instrument to determine a patient's capability for in‐hospital medication self‐management, without first assessing medication literacy. MED‐fLAG can provide valuable insights into the medication literacy of patients considered less capable of managing their medication, allowing medication information and interventions to be tailored to the patient. [ABSTRACT FROM AUTHOR]

Background: Based on explainable DenseNet model, the therapeutic effects of optimization nursing on patients with acute left heart failure (ALHF) and its application values were discussed. Method: In this study, 96 patients with ALHF in the emergency department of the Affiliated Hospital of Xuzhou Medical University were selected. According to different nursing methods, they were divided into conventional group and optimization group. Activity of daily living (ADL) scale was used to evaluate ADL of patients 6 months after discharge. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were employed to assess patients' psychological state. 45 min improvement rate, 60 min show efficiency, rescue success rate, and transfer rate were used to assess the effect of first aid. Likert 5-level scoring method was adopted to evaluate nursing satisfaction. Results: The optimization group showed shorter durations for first aid, hospitalization, electrocardiography, vein channel establishment, and blood collection compared to the conventional group. However, their SBP, DBP, and HR were inferior. On the other hand, LVEF and FS were significantly better in the optimization group. After nursing intervention, SAS and SDS scores were lower in the optimization group. Additionally, the optimization group had higher 45-minute improvement rates, 60-minute show efficiency, rescue success, and transfer rates. They also performed better in 6-minute walking distance and ADL scores 6 months post-discharge. The optimization group had better compliance, total effective rates, and satisfaction than the conventional group. Conclusion: It was demonstrated that explainable DenseNet model had application values in the diagnosis of ALHF. Optimization emergency method could effectively shorten the duration of first aid, relieve anxiety, and other adverse emotions, and improve rescue success rate and short-term efficacy. Nursing intervention has a positive impact on the total effective efficiency and patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: This study examined the moderating role of e-health literacy (eHL) and patient-physician communication in the relationship between online diabetes information-seeking behavior (online DISB) and self-care practices. Methods: A total of 1143 individuals with type 2 diabetes mellitus completed a cross-sectional survey assessing sociodemographic characteristics, data relating to diabetes clinical history, online DISB, eHL (eHealth Literacy Scale), aspects of patient-physician communication (IPC survey), patient self-care (Self-Care Inventory-Revised), and medication adherence (measure of adherence to prescribed diabetes medications). The data were analyzed using both bivariate (correlation) and multivariate (multiple linear regression) analyses using maximum likelihood estimation procedures in Mplus. Results: Our results showed online DISB significantly predicted diabetes self-care (p < 0.001) and medication adherence behaviors (p = 0.005). Lower Hurried Communication (p < 0.001, p = 0.03), higher Elicited Concerns (p = 0.005, p = 0.03), higher Explained Results (p = 0.03, p = 0.008), and higher eHL (p = 0.02, p = 0.02) were significantly associated with better self-care and medication adherence. Explained Results and eHL moderated the relationship between online DISB and both self-care and medication adherence. Conclusions: Findings support the role of patient eHL and patient-physician communication in amplifying the positive impact of online DISB on patients' behavioral outcomes in diabetes. [ABSTRACT FROM AUTHOR]

Background: In 2019, 77% of women and 82% of men with hypertension had uncontrolled hypertension worldwide. Uncontrolled hypertension can cause stroke, myocardial infarction, heart failure, renal failure, dementia, blindness, and death. However, most of the studies used the previous seventh joint national committee classification to classify hypertensive patients as either controlled or uncontrolled. This study aimed to assess the prevalence and associated factors of uncontrolled hypertension among adult hypertensive patients at public hospitals in Addis Ababa, Ethiopia. Methods: From April 12 to May 12, 2024, three public hospitals in Addis Ababa employed a hospital-based cross-sectional study design with 408 hypertensive patients. Systematic random sampling was used to select the study participants. We used a structured interview questionnaire and chart review and took physical measurements. Data were entered into Epidata and analyzed using the statistical package for social science version 25. A logistic regression model was used to identify factors associated with uncontrolled hypertension at a P-value < 0.05 with a 95% confidence interval. Results: The prevalence of uncontrolled hypertension among hypertensive patients at public hospitals in Addis Ababa was 66.2% (95% CI: 61.6%, 70.8%). After adjusted analysis, age ≥ 60 years (AOR = 2.88, 95% CI: 1.37, 6.04), the presence of comorbidities (AOR = 2.21, 95% CI: 1.23, 3.96), being overweight (AOR = 2.25, 95% CI: 1.20, 4.24), non-adherence to antihypertensive medication (AOR = 5.21, 95% CI: 2.76, 9.83), non-adherence to a low-salt diet and dietary approaches to stop hypertension (AOR = 2.74, 95% CI: 1.35, 5.53), taking three or more antihypertensive medications (AOR = 3.10, 95% CI: 1.16, 8.25), and non-adherence to physical exercise (AOR = 2.84, 95% CI 1.49, 5.39) were factors associated with uncontrolled hypertension. Conclusions: Uncontrolled hypertension was very high in public hospitals in Addis Ababa, Ethiopia. Key factors for uncontrolled hypertension are non-adherence to antihypertensive medications, use of multiple medications, lack of physical exercise, and low adherence to low salt and dietary approaches to stop hypertension. To address these, enhancing patient education on medication adherence, promoting lifestyle changes, and leveraging digital health tools, like mobile apps, for real-time support and adherence tracking are recommended. [ABSTRACT FROM AUTHOR]

Improvement of post-stroke outcomes relies on patient adherence and appropriate therapy maintenance by physicians. However, comprehensive evaluation of these factors is often overlooked. This study assesses secondary stroke prevention by differentiating patient adherence to antithrombotic treatments (ATT) from physician-initiated interruptions or switches. We analyzed a population-based retrospective cohort (n = 10,343) of post-stroke patients with atrial fibrillation using the VID database (2010–2017). Secondary prevention was evaluated based on patients' primary and secondary adherence to ATT at two years (percentage of days covered—PDC—and persistence/discontinuation) and physician prescription patterns (initiation, interruption, switching, restart). E-prescription and dispensing data were linked. Three ATT strategies were identified: oral anticoagulants (OAC), antiplatelets (APT), or combination therapy (OAC + APT), prescribed to 54%, 23%, and 17% of patients, respectively. Primary adherence was high for all ATTs (≈90%). OAC discontinuation was highest (16%), but frequently restarted (73.4%). APT treatment was interrupted the most (14%) and restarted the least (38.5%) by physicians, followed by OAC (interrupted in 11%, restarted in 65%). Overall, 17% of patients switched treatments, with OAC + APT being switched the most (76%), mainly to OAC (53.8%). Identifying areas for improvement in secondary stroke prevention requires considering both patient adherence and physician prescription patterns (initiation, interruptions, and restarts). [ABSTRACT FROM AUTHOR]

ABSTRACT Aims and Objectives Background Design Methods Results Conclusions Relevance to Clinical Practice Patient or Public Contribution To summarise the currently developed risk prediction models for medication adherence in patients with chronic diseases and evaluate their performance and applicability.Ensuring medication adherence is crucial in effectively managing chronic diseases. Although numerous studies have endeavoured to construct risk prediction models for predicting medication adherence in patients with chronic illnesses, the reliability and practicality of these models remain uncertain.Systematic review.We conducted searches on PubMed, Web of Science, Cochrane, CINAHL, Embase and Medline from inception until 16 July 2023. Two authors independently screened risk prediction models for medication adherence that met the predefined inclusion criteria. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to evaluate both the risk of bias and clinical applicability of the included studies. This systematic review adhered to the 2020 PRISMA checklist.The study included a total of 11 risk prediction models from 11 studies. Medication regimen and age were the most common predictors. The use of PROBAST revealed that some essential methodological details were not thoroughly reported in these models. Due to limitations in methodology, all models were rated as having a high‐risk for bias.According to PROBAST, the current models for predicting medication adherence in patients with chronic diseases exhibit a high risk of bias. Future research should prioritise enhancing the methodological quality of model development and conducting external validations on existing models.Based on the review findings, recommendations have been provided to refine the construction methodology of prediction models with an aim of identifying high‐risk individuals and key factors associated with low medication adherence in chronic diseases.This systematic review was conducted without patient or public participation. [ABSTRACT FROM AUTHOR]

Purpose: Biliary atresia (BA) is a critical pediatric condition requiring timely intervention through Kasai portoenterostomy (KPE), and up to two-thirds of patients need liver transplantation (LT). The outcomes for BA patients still need improvement in low- and middle-income countries. This study aims to assess the socioeconomic and geographical profile of BA patients in India, focusing on their compliance with follow-up care, treatment-seeking behaviour, and acceptability of LT in addition, it provides recommendations to overcome identified challenges. Methods: A retrospective observational study was conducted in a tertiary care centre in India, including 48 patients who underwent KPE between 2018 and 2022. SES was assessed using the modified Kuppuswamy scale, and geographical areas were classified as per the criteria of the Indian Census 2011. Compliance with follow-up, treatment-seeking behaviour, and LT acceptability were evaluated. Results: The majority of patients belonged to rural areas and lower middle SES. Compliance with follow-up decreased over time, with financial and geographical barriers being significant challenges. Only one patient underwent LT due to prohibitive costs and limited accessibility. Conclusion: Socioeconomic and geographical factors significantly impact the clinical outcomes of BA patients in India. Improving education, healthcare infrastructure, and financial support is crucial for enhancing patient compliance and access to necessary treatments. [ABSTRACT FROM AUTHOR]

Background: Spinal muscular atrophy (SMA) is a genetic neuromuscular disease associated with progressive loss of motor function. Risdiplam, a daily oral therapy, was approved in the United States for the treatment of SMA. Risdiplam's effectiveness depends on patient adherence to the treatment regimen. This retrospective claims database analysis assessed real-world treatment adherence and persistence, and all-cause health care costs by adherence status, for patients with SMA receiving risdiplam. Outcomes were summarized by SMA types (1−4) and age groups (0–2, 3–5, 6–17, and ≥ 18 years). Results: 86 patients with ≥ 1 SMA diagnosis, risdiplam treatment, and ≥ 6 months of continuous enrollment after the index date (SMA diagnosis) were identified in the IQVIA PharMetrics® Plus database (01/01/2020−06/30/2022). One patient had SMA type 1 (a 1-year-old boy), 18 had type 2 (mean ± SD age: 7.9 ± 5.7 years; 61% female), 47 had type 3 (17.3 ± 10.2 years; 55% female), and 20 had type 4 (38.2 ± 11.6 years; 55% female). The mean proportion of days covered (PDC) with risdiplam was 0.89 overall, ranging from 0.88 for SMA type 4 to 0.97 for type 1. The majority (83.7%) of patients were adherent to risdiplam (PDC ≥0.80), ranging from 75.0% for type 4 to 100% for type 1. Adherence ranged from 76.5% among 6–12-year-olds to 100% among 0–2-year-olds. Compared with adherent patients, nonadherent patients had higher median total health care costs by $335,049 for type 2, $41,204 for type 3, and $12,223 for type 4. Among adherent patients, patients with PDC between 0.90 and 1.00 had lower costs compared with patients with PDC between 0.80 and 0.90. Conclusions: Nonadherence to risdiplam was observed in the first year of treatment, especially for patients with SMA type 4 and patients aged 6–12 years. Nonadherence was associated with higher all-cause health care costs, with the most pronounced cost difference for SMA type 2. For adherent patients, those who were highly adherent incurred lower health care costs. These findings underscore the importance of treatment adherence and persistence for patients with SMA receiving risdiplam, particularly for younger children and those with greater disease severity. [ABSTRACT FROM AUTHOR]

Summary The aim was to summarize the characteristics of exercise interventions based on the adherence of adults with obesity. Studies were identified through a systematic review of the literature conducted in databases in June 2022. The articles selected were from clinical trials involving adults with obesity. The total number of prescribed sessions and the mean or percentage of sessions attended by participants who completed the intervention were identified, along with details of the exercise prescription, including duration, attendance, and intensity control. A total of 21 studies were included in the synthesis. The adherence percentage ranged from 18% to 99% of the prescribed exercise sessions. Interventions that provided only guidance meetings for physical activities without supervising the training—allowing participants to choose the modality and loads—resulted in adherence to less than half of the prescribed sessions. The session duration and weekly attendance varied between 30–60 min and 2–3 times per week across the studies synthesized. These variables did not appear to significantly affect adherence percentages in this population. It was possible to conclude that supervised interventions, with combined training, which include moderate to high‐intensity physical exercises and/or interval training and with some social support, resulted in greater adherence to sessions in adults with obesity. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Materials and Methods Results Conclusions An increased rate of gastrointestinal (GI) symptoms is reported in patients with type 2 diabetes receiving imeglimin plus metformin vs monotherapy or in combination with other antidiabetic drugs. This post‐hoc analysis explored GI symptom incidence, risk factors for their occurrence, and the impact on therapeutic efficacy during imeglimin and metformin combination therapy.Data were derived from the 52‐week, open‐label, phase 3 TIMES‐2 trial in Japanese type 2 diabetes patients. Patients in the imeglimin plus metformin group were divided into two subgroups based on the presence of GI symptoms and diarrhea, with efficacy and safety assessed. Factors associated with their occurrence were explored using multivariate logistic regression analysis.Of 64 patients analyzed, GI symptoms and diarrhea occurred in 40.6% (n = 26) and 17.2% (n = 11) of patients, respectively. Metformin dose and patient age did not significantly affect their incidence. Events occurred more frequently within the first 4 months of treatment. Approximately half resolved within 1 week, and most were mild. Type 2 diabetes duration <5 years was significantly associated with diarrhea (odds ratio = 5.979; P = 0.039). Significant hypoglycemic effects were observed from baseline, irrespective of GI symptoms or diarrhea. However, the degree of HbA1c improvement tended to be greater in patients with GI symptoms and diarrhea.Increased awareness regarding the potential for GI symptoms, including diarrhea, during imeglimin plus metformin combination therapy is warranted. This data will provide clinicians with useful information regarding symptomatic treatment when it occurs and help determine whether to continue treatment administration and is expected to improve patient adherence. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influencing factors of the number of physical diseases in elderly hospitalized psychiatric patients. Methods: A total of 332 hospitalized elderly patients with mental illness were enrolled in this study. The number of combined physical diseases was divided into three groups, which were 0, 1 ~ 2, and ≥ 3. Data collected included sociodemographic characteristics, depressive symptoms, anxiety symptoms, delirium status, social support, medication adherence, social functioning, ability to perform daily living, and swallowing function. Results: The sample included 64.2% of female patients, mainly concentrated in 60 ~ 69 years old (48.2%). The length of hospital stay of patients was mainly 15 ~ 30 days (55.7%), and the course of disease was mainly 2 ~ 10 years (38.3%). After adjusting for confounding factors such as gender, poor lifestyle habits, course of disease, length of hospital stay, psychiatric symptoms, depressive symptoms, anxiety symptoms, delirium, social functioning, social support, and drug therapy compliance, we found that the number of physical disorders in elderly patients with mental illness was related to age, ability of daily living, and swallowing function. The increase of age, the decrease of the ability of daily living, and poor swallowing function contribute to a higher number of comorbid medical disorders in elderly patients with mental illness (P < 0.05). Conclusion: According to the results, age, ability of daily living and swallowing function were the main influencing factors in the number of complicated physical diseases in elderly patients with mental illness. Future research should focus on improving the daily living ability and swallowing function of elderly patients with mental illness, in order to reduce the prevalence of other physical diseases in elderly patients with mental illness. [ABSTRACT FROM AUTHOR]

Interventions designed to improve medication adherence, and blood pressure control have not been effective globally. There is limited comprehensive understanding regarding the level of drug adherence to antihypertensive medications in Ethiopia, particularly in the study area. This study aimed to assess adherence to antihypertensive medication and associated factors among patients with hypertension on follow-up at public health facilities of Adama town, Oromia, Ethiopia. A multicenter cross-sectional study was conducted among 402 patients with hypertension from January 1 to February 30, 2022. The objectives of the study were explained to participants in the local language and written informed consent was obtained. The level of adherence was measured by Morisky Medication Adherence Scale. Data were entered into Epidata and exported to Statistical Package for the Social Science for analysis. Bivariable and multivariable logistic regression analyses were conducted to determine associations between independent variables and medication adherence. Adjusted Odds ratios with 95% confidence interval were estimated to assess the strength of associations. Statistical significance was declared at a P-value < 0.05. The proportion of adherence to antihypertensive medication was 63.4% (95% CI: 59.1–66.9). Respondents under the age of 49 years ((AOR = 2.3, 95% CI: 1.009–5.459), ages 49–59 years (AOR = 3.2, 95% CI: 1.452–7.396), and ages 60–71 years (AOR = 2.7,95% CI: 1.207–6.066), who were married (AOR = 2.1, 95% CI: 1.056–4.19), urban residents (AOR = 3.9, 95% CI: 1.486–10.949), and patients with a monthly income between 5500 and 8249 Ethiopian Birr (AOR = 4.150, CI: 1.083–15.097) were more likely to be adherent to antihypertensive medications. : The adherence to the antihypertensive drug in this study was lower compared to the expected index, 80%. Education and counseling should focus on older age, rural residents, single, and patients with higher monthly incomes. [ABSTRACT FROM AUTHOR]

The article discusses the application of the 'touch-and-go' concept to mineralocorticoid receptor antagonists in the management of heart failure with reduced ejection fraction. It highlights the challenges of discontinuation and reinitiation of MRAs, emphasizing the importance of addressing barriers such as worsening renal function and hyperkalaemia. The study reveals that early reinitiation of MRAs after resolving these issues can optimize therapy and improve outcomes for patients with heart failure. The 'touch-and-go' approach, focusing on intermittent discontinuation and reinitiation of MRAs, shows promise in enhancing adherence and supporting better long-term results. [Extracted from the article]

Mild cognitive impairment, dementia and osteoporosis are common diseases of ageing and, with the increasingly ageing global population, are increasing in prevalence. These conditions are closely associated, with shared risk factors, common underlying biological mechanisms and potential direct causal pathways. In this review, the epidemiological and mechanistic links between mild cognitive impairment, dementia and skeletal health are explored. Discussion will focus on how changes in brain and bone signalling can underly associations between these conditions, and will consider the molecular and cellular drivers in the context of inflammation and the gut microbiome. There is a complex interplay between nutritional changes, which may precede or follow the onset of mild cognitive impairment (MCI) or dementia, and bone health. Polypharmacy is common in patients with MCI or dementia, and there are difficult prescribing decisions to be made due to the elevated risk of falls associated with many drugs used for associated problems, which can consequently increase fracture risk. Some medications prescribed for cognitive impairment may directly impact bone health. In addition, patients may have difficulty remembering medication without assistance, meaning that osteoporosis drugs may be prescribed but not taken. Cognitive impairment may be improved or delayed by physical activity and exercise, and there is evidence for the additional benefits of physical activity on falls and fractures. Research gaps and priorities with the aim of reducing the burden of osteoporosis and fractures in people with MCI or dementia will also be discussed. [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusions Medical imaging plays a pivotal role in the real‐time monitoring of patients during the diagnostic and therapeutic processes. However, in clinical scenarios, the acquisition of multi‐modal imaging protocols is often impeded by a number of factors, including time and economic costs, the cooperation willingness of patients, imaging quality, and even safety concerns.We proposed a learning‐based medical image synthesis method to simplify the acquisition of multi‐contrast MRI.We redesigned the basic structure of the Mamba block and explored different integration patterns between Mamba layers and Transformer layers to make it more suitable for medical image synthesis tasks. Experiments were conducted on the IXI (a total of 575 samples, training set: 450 samples; validation set: 25 samples; test set: 100 samples) and BRATS (a total of 494 samples, training set: 350 samples; validation set: 44 samples; test set: 100 samples) datasets to assess the synthesis performance of our proposed method in comparison to some state‐of‐the‐art models on the task of multi‐contrast MRI synthesis.Our proposed model outperformed other state‐of‐the‐art models in some multi‐contrast MRI synthesis tasks. In the synthesis task from T1 to PD, our proposed method achieved the peak signal‐to‐noise ratio (PSNR) of 33.70 dB (95% CI, 33.61, 33.79) and the structural similarity index (SSIM) of 0.966 (95% CI, 0.964, 0.968). In the synthesis task from T2 to PD, the model achieved a PSNR of 33.90 dB (95% CI, 33.82, 33.98) and SSMI of 0.971 (95% CI, 0.969, 0.973). In the synthesis task from FLAIR to T2, the model achieved PSNR of 30.43 dB (95% CI, 30.29, 30.57) and SSIM of 0.938 (95% CI, 0.935, 0.941).Our proposed method could effectively model not only the high‐dimensional, nonlinear mapping relationships between the magnetic signals of the hydrogen nucleus in tissues and the proton density signals in tissues, but also of the recovery process of suppressed liquid signals in FLAIR. The model proposed in our work employed distinct mechanisms in the synthesis of images belonging to normal and lesion samples, which demonstrated that our model had a profound comprehension of the input data. We also proved that in a hierarchical network, only the deeper self‐attention layers were responsible for directing more attention on lesion areas. [ABSTRACT FROM AUTHOR]

Background: To eliminate malaria by 2035, Brazil must address Plasmodium vivax. Previously, first-line treatment was chloroquine plus 7-day primaquine (PQ) without glucose-6-phosphate dehydrogenase (G6PD) deficiency testing. In 2021, point-of-care quantitative G6PD testing and single-dose tafenoquine (TQ) were piloted in two municipalities. This study evaluated healthcare professional (HCP) and patient perceptions of TQ implementation. Methods: This qualitative observational study in Manaus and Porto Velho municipalities evaluated the pilot implementation of the new P. vivax malaria treatment algorithm in high/medium-complexity healthcare units (phase one), then low-complexity units (phase two). Qualitative data collection began 30 days after the first TQ treatment in each phase, i.e., October 2021 and March 2022. Perceptions of TQ were assessed using semi-structured in-depth interviews and field notes until saturation. Data were analysed through debriefing sessions, and systematic organization in Excel and MAXQDA, with themes derived by inductive and deductive analysis. Results: The study included 55 patients who received TQ and 94 HCPs. HCPs viewed the TQ single-dose regimen as a significant advancement over 7-day PQ, enhancing adherence. Patients appreciated the shorter duration of treatment and perceived a rapid clinical recovery and fewer side effects. HCPs also noted that TQ resulted in fewer recurrences of P. vivax. The single-dose administration of TQ facilitated complete supervision of the treatment, reduced HCP workload and ensured that patients received the necessary care and did not share the medication with family members. TQ packaging instilled patient trust, though HCPs working in the community found the packaging too bulky. Prescription insecurities among HCPs after initial training prompted requests for additional training. While some patients initially doubted single-dose efficacy, confidence grew with experience. TQ implementation increased awareness of pharmacovigilance and enhanced patient communication, with HCPs adhering to protocols for monitoring haemolysis symptoms. Conclusion: Single-dose TQ for P. vivax malaria in Brazil's Amazon region was positively received by HCPs and patients. Positive perceptions of the medication may aid in improving patient adherence to malaria treatment, thereby reducing malaria recurrences. The findings underscore the importance of adaptive training to optimize P. vivax radical cure implementation. [ABSTRACT FROM AUTHOR]

Background: Early initiation of breastfeeding is defined as giving breast milk to the newborn within one hour of birth. It strengthens the link between mother and child, promotes cognitive development, and lowers the chance of obesity and non-communicable diseases during the prime years of life. Nowadays, only 50% of newborns worldwide receive breast milk within their first hour of life. This study examined the prevalence and individual- and community-level factors associated with early initiation of breastfeeding using the Demographic and Health Survey data and offers suggestions that can enhance the practice in Mozambique. Methods: Data from the nationally representative Mozambique Demographic and Health Survey were used in this cross-sectional analysis. The study included a weighted sample of 3,548 children born in the two years prior to the survey. Software for statistical analysis, STATA/SE version 14.0, was used to clean, recode, and analyze the data. Utilizing multilevel logistic regression, the factors associated with the outcome variable were identified. Statistical significance was attained by variables having a p-value less than 0.05. Results: The prevalence of early initiation of breastfeeding in Mozambique was 75.03% (95% CI: 73.58%, 76.43%). Factors like non-working [AOR = 0.62; 95% CI (0.50, 0.78)], wanted last pregnancy [AOR = 1.68; 95% CI (1.33, 2.12)], antenatal care attendance [AOR = 0.63; 95% CI (0.43, 0.93)], vaginal birth [AOR = 2.30; 95% CI (1.58, 3.36)], size of the child at birth [AOR = 1.77; 95% CI (1.26, 2.48)], urban residence [AOR = 2.99; 95% CI (1.90, 4.72)], community-level antenatal care utilization [AOR = 0.52; 95% CI (0.35, 0.77)], and community poverty level [AOR = 0.34; 95% CI (0.20, 0.58)] were significantly associated with early initiation of breastfeeding. Conclusions: About three out of four newborn babies in Mozambique have an early initiation of breastfeeding. It is critical to concentrate on developing policies that support the early initiation of breastfeeding, particularly for mothers who have small children, unplanned pregnancies, non-vaginal deliveries, and reside in rural areas. [ABSTRACT FROM AUTHOR]

Hypertension management continues to be a significant global health challenge, with patient non-compliance to prescribed therapies serving as a major obstacle to achieving effective blood pressure control. Hydrochlorothiazide (HCTZ), a widely used thiazide diuretic, effectively lowers blood pressure but often faces adherence problems, particularly because its conventional tablet form can be difficult for some patients to swallow. Oral disintegrating tablets (ODTs) have emerged as a potential solution, offering the advantage of rapid dissolution in the mouth without the need for water, making them especially suitable for patients who have difficulty swallowing pills. Furthermore, fast-release formulations of HCTZ can improve its bioavailability by promoting quicker dissolution and absorption, leading to a more rapid onset of action and enhanced blood pressure control. Additionally, solubility-enhancing technologies such as solid dispersions or nanoparticles can address the drug's poor solubility, improving its dissolution rate and ensuring more effective therapeutic outcomes. These advanced drug delivery systems not only enhance HCTZ's pharmacokinetic properties but also help to improve patient adherence and clinical outcomes in hypertension therapy, highlighting the importance of patient-centered formulation innovations in modern medicine. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) patients on the National Tuberculosis Elimination Program (NTEP) treatment protocol receive daily doses without health professional-supervised drug intake as during the previous directly observed treatment short-course (DOTS) regimen. The aim of this study is to determine the socio-demographic and clinical characteristics, treatment outcomes, and factors associated with unsuccessful treatment outcomes of patients who received anti-tubercular drugs under NTEP. METHODS: In this prospective study, 150 TB patients taking anti-tubercular therapy were enrolled using a pre-designed structured pro forma. Socio-demographic characteristics, risk factors, the outcome of treatment, and factors that affected the compliance of patients were recorded. Treatment outcome indicators like cured, treatment completed, treatment failed, loss to followup, treatment success, not evaluated, died, or transferred out should be monitored in each patient. Results: The treatment success rate of new sputum-positive patients was 83.2% in this study. Among outcomes, 59% were cured, 27% completed treatment, 3.4% were lost to follow-up, 5.3% were not evaluated, 4% died, and 1.3% were treatment failures. Type of family, family history of TB, and presence of HIV were significantly associated with the final outcome of treatment. (P<0.05). The main reasons for nonadherence were not feeling well (60%), being unaware of the importance of a full-length course of treatment (80%), time strain problems/loss of wages (60%), feeling side effects of multiple drugs (40%), and some other reason (2%). Conclusion: The present study concludes that the most common causes of noncompliance amongst tuberculosis patients are the side effects of drugs, unawareness regarding the course of treatment, and loss of wages. The immense need for continuous and effective health education improves ATT adherence and strengthens the NTEP. [ABSTRACT FROM AUTHOR]

Background: Idiopathic congenital talipes equinovarus (CTEV), or clubfoot, is a common congenital deformity affecting approximately 3.25 per 1,000 live births in India. The Ponseti method, a gold standard for CTEV management, offers high efficacy through sequential manipulation and casting, with the standard protocol involving weekly cast changes. The accelerated Ponseti method, reducing casting intervals to 3-5 days, has been proposed as a timeefficient alternative, particularly for resource-limited settings. Patients and Methods: This prospective, comparative study evaluated the efficacy of standard versus accelerated Ponseti methods using the Pirani scoring system. Ninety children with idiopathic CTEV were randomized into standard (weekly casting) or accelerated (biweekly casting) groups. Results: Both treatment methods demonstrated equivalent improvements in Pirani scores and similar rates of Achilles tenotomy and relapse over one year. However, the accelerated Ponseti methods significantly reduced treatment duration (p < 0.0001), addressing logistical and economic challenges while maintaining comparable clinical outcomes. Conclusion: These findings affirm the accelerated Ponseti method as an effective alternative, particularly for low-resource settings, by enhancing treatment accessibility and adherence without compromising correction quality. Future research with larger cohorts and extended follow-ups is warranted to validate long-term benefits. [ABSTRACT FROM AUTHOR]

Introduction: Although the Government of Nepal has developed strategies to integrate contraceptive services with abortion care to better meet the contraceptive needs of women, data indicate that significant gaps in services remain. This paper assessed post-abortion contraceptive use, trends over 36 -months, and factors influencing usage. Methods: Data from this paper came from an ongoing cohort study of 1831 women who sought an abortion from one of the sampled 22 government-approved health facilities across Nepal. Women were interviewed eight times over 36 months between April 2019 to Dec 2023. Bivariate and multivariate analysis were used to analyze the data. Results: Results show that after abortion, 59% of women used modern contraception, with injection being the most prevalent method, followed by condoms, pills, implants, and IUD. The hazard model showed that discontinuation of modern contraception was significantly higher among women desiring additional children (aHR 0.62) and lower among literate (aHR − 0.15) and those with existing children (aHR − 0.30). Women's age, ethnicity, cohabitation with husband, household's income and autonomy were not associated with continuation. Conclusion: After having an abortion, we found that just slightly more than half of women used modern methods of contraception; this percentage did not increase significantly over the course of three years. [ABSTRACT FROM AUTHOR]

AbstractObjective: Older adults with cognitive impairment are at risk of medication-taking errors. This study assessed the impact of providing medication adherence feedback to cognitively impaired older adults. Methods: Forty participants with mild cognitive impairment or mild dementia had their medication adherence electronically monitored for 8 weeks. They were provided with verbal and visual feedback about their adherence results. Initial participant reactions were elicited using a Motivational Interviewing approach, and self-reported behavior changes were assessed during a follow-up interview. Quantitative analyses assessed relationships among electronically monitored and self-rated adherence, initial reactions to adherence feedback, and subsequently reported medication self-management changes. Thematic analysis determined facilitators and barriers to making self-management changes. Results: Although self-rated adherence was high, electronic monitoring revealed that 20% of the sample had suboptimal adherence (took the recommended dose on <80% of monitored days). Fifty-three percent of the sample reported feeling surprised by their adherence results, and 45% endorsed initial motivation to change self-management behaviors. Motivated participants demonstrated worse electronically monitored adherence than unmotivated peers, and those who were surprised by their medication-taking errors expressed greater initial motivation to change. At follow-up, 50% reported having made changes, and 82.4% of them indicated that this study played a role. Facilitators of making changes included awareness of medication-taking errors and cognitive impairment, whereas barriers included lack of perceived difficulty/need. Conclusions: Adherence monitoring with feedback is feasible and impactful in cognitively impaired older adults. Increasing awareness of medication-taking errors fosters motivation to improve medication self-management and results in participant-reported behavior change. [ABSTRACT FROM AUTHOR]

Background: The caries severity in childhood may predict caries conditions in the future and even in adulthood in caries risk models. Nevertheless, the rate of recurrent caries after treatment of severe early childhood caries is high and correlated with behavioural factors, rather than clinical indicators. Compliance with the caries control programme has been demonstrated to prevent root caries development in head and neck cancer patients, suggesting that compliance with treatment protocols is a more important key to bringing about successful outcomes than treatment protocols themselves. However, only few studies defined the triggers of compliance in patients with long-term successful treatment outcomes, especially in children. Furthermore, driven forces of compliant behaviours from patients' aspects have not been described in the dental literature before. Regarding the need to improve current caries control interventions for children, in this study, behavioural determinants that shaped compliance of resilient children were investigated with a qualitative study design, for its advantage in revealing what an individual really feels which incorporates their experience without restriction from previous literature. Resilience was defined as improvement in caries conditions between primary and mixed or permanent dentitions. Methods: Interviews were performed with the patient group, including eight resilient children (M/F = 5/3) and their ten caregivers (M/F = 2/8), and the dentist group, including ten paediatric dentists (M/F = 6/4; clinical experience mean = 26.9 years, minimum = 16 years). Thematic analysis was used to identify main themes. Results: Four themes were identified: (1) dental things/teeth are their priority, (2) normalising, (3) tiger parenting/conscientiousness, and (4) trust. These determinants were identically described by both the patient and dentist groups. Dentists' suggestions were the priority, providing the norms in daily life of resilient patients and their caregivers. These patients found no excuses for failing to take dentists' advice, not only because they trusted their dentists, but also because they and their caregivers were conscientious about putting dentists' orders into practice. Conclusions: It is implementing suggested oral health behaviours daily, but not merely agreeing with professional advice, that alters the fate of teeth in these resilient patients. [ABSTRACT FROM AUTHOR]

Between 2000 and 2019, malaria cases witnessed a global decline. Recent WHO data indicates a reversal of these gains, threatening the goal to eliminate malaria by 2030. In Guyana, malaria is concentrated in remote regions and among itinerant gold miners who have limited access to malaria health services and will thus often self-medicate or delay care. The government implemented a volunteer malaria tester (VMT) program to increase access to malaria testing and treatment in mining communities. Social and behavior change (SBC) interventions targeting psychosocial determinants of malaria-related behaviors complement this program. The "Lil Mosquito, Big Problem" (LMBP) campaign promotes malaria prevention, testing, and treatment behaviors among miners. This campaign, designed and implemented through a participatory human-centered design process, used the ideation model as its conceptual framework to address knowledge, attitudes, beliefs, and social norms to influence malaria-related behaviors. Surveys conducted in 2019 and 2022 among gold miners in regions 7 and 8 showed increased knowledge and improved psychosocial determinants associated with malaria prevention and treatment. Exposure to the combined VMT and LMBP interventions was associated with significantly higher levels of prompt care-seeking. Interventions should consider attitudes and perceptions and address descriptive norms and the benefits of prompt care-seeking and treatment adherence. Changes in the mining population and economic hardships impact these results. Theory-driven programs systematically designed and implemented through stakeholder involvement and engagement are practical and applicable to similar settings and SBC interventions on other global health issues. [ABSTRACT FROM AUTHOR]

Background: Surgical resection is the preferred treatment for localised non-small cell lung cancer (NSCLC). Rehabilitation is central in the management of the associated impaired quality of life, high symptom burden, deconditioning, and social-existential vulnerability. Yet, optimal content and delivery of rehabilitation are not yet defined. Therefore, we aimed to investigate the current rehabilitation offers, attendance rate, and perceived relevance related to content or delivery. Moreover, we investigated the current symptom burden in the patients. Methods: We conducted an observational cohort study in patients who had undergone surgical resection for NSCLC 4–6 months earlier at Odense University Hospital, Denmark. We retrieved demographic data from patient registries, and interviewed patients via telephone concerning availability, uptake, and attendance rate of any rehabilitation offer in their local primary care setting; content and delivery; benefits of attending, experienced relevance and "symptom burden generally" (specially developed questions); and "symptom burden here and now" [Edmonton Symptom Assessment Scale (ESAS)]. Results: We approached 128 patients, reached 115, and interviewed the 100 (87%) patients who consented. In total, 88% (88/100) had received a rehabilitation offer, and 75% (66/88) had participated in programmes that either targeted NSCLC (23%) or were general cancer rehabilitation (33%), pulmonary rehabilitation (12%), online (1%), or other (33%). Disease-specific rehabilitation was significantly related to the highest attendance rate and perception of relevance. High attendance (≥75%) was, moreover, significantly related to the offer being delivered by a physiotherapist and having a focus on physical exercise. General symptoms were physically oriented [dyspnoea (65%), pain (47%), fatigue (78%)] and "mild" in ESAS scoring. No differences were observed in any baseline characteristics. Conclusions: Rehabilitation after surgical resection for localised NSCLC is delivered heterogeneously in Denmark. Disease-specific rehabilitation was positively related to attendance rate and to the perceived relevance of the offer. [ABSTRACT FROM AUTHOR]

Metabolic diseases have gradually become one of the most significant global medical burdens. Diseases such as obesity, diabetes, and metabolic syndrome, along with their complications, are clinically categorized as metabolic diseases. Long-term oral medication significantly reduces patient compliance and quality of life. Therefore, alternative therapies that intervene at the cellular level or target the root causes of metabolic diseases might help change this predicament. Research has found that extracellular vesicles derived from adipose macrophages can effectively regulate metabolic diseases by influencing the disease's development. This regulation is likely related to the role of these extracellular vesicles as important mediators in modulating adipose tissue function and insulin sensitivity, and their involvement in the crosstalk between adipocytes and macrophages. This review aims to describe the regulation of metabolic diseases mediated by adipose macrophage-derived extracellular vesicles, with a focus on their involvement in adipocyte crosstalk, the regulation of metabolism-related autoimmunity, and their potential as therapeutic agents for metabolic diseases, providing new avenues for diagnosis and treatment. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction and Aim Method Results Implications for Practice This study aimed to assess the relationship between treatment adherence, internalised stigma, recovery and the mediating effect of internalised stigma on these relations in individuals diagnosed with schizophrenia.This study was conducted using a cross‐sectional design. A purposive sample of 107 individuals diagnosed with schizophrenia receiving psychiatric outpatient care at outpatient clinics and community mental health services (CMHC) affiliated with SBU Van research and education hospital was recruited for this study. The data were collected by the following tools: sociodemographic data questionnaire, the internalised stigma in mental illnesses scale, the medication adherence rating scale and recovery assessment scale.The study participants reported low levels of treatment adherence, high levels of internalised stigma and moderate levels of recovery. Furthermore, we found a weak negative correlation between internalised stigma and treatment adherence. There was a moderate negative correlation between internalised stigma and recovery. Additionally, it was found that internalised stigma has fully mediating effect on the relation between treatment adherence and recovery.The results of this study can guide mental health nurses in developing tailored interventions and support programmes to improve this population's treatment adherence, recovery and overall mental health outcomes. [ABSTRACT FROM AUTHOR]

Background: Mobile health applications (mHealth apps) offer potential benefits for improving diabetes management, such as better glucose monitoring and patient engagement, but their widespread adoption faces challenges, including privacy concerns and user adherence. This research investigates mHealth app usage among patients living with diabetes in Kinta District, Perak, exploring experiences, challenges and patient perceptions regarding diabetes management using mHealth apps. Methodology: A cross-sectional community survey was conducted in September till November 2020 across nine government health clinics focusing on diabetes mellitus (Type 1 or Type 2) patients, aged 18 years and older, receiving Diabetes Medication Adherence Counseling (DMTAC) services and able to use smart devices. A self-developed questionnaire with four sections was used to gather demographic information, explore mHealth apps usage and understand both users and non-users' experiences and perceptions. The questionnaire was tested through cognitive debriefing, translated into Malay, pre-tested and finalized by the expert committee. The questionnaire was digitally implemented using Google® Form and QR code. After obtaining informed consent, data collection was performed by the trained DMTAC pharmacists. Statistical analyses involved descriptive and inferential analyses. Results: The study analyzed the engagement of 295 patients living with diabetes with mHealth apps. Females (54.9%), of Malay ethnicity (58.3%) and with a mean age of 53.8 years (SD: 12.38) constituted the majority. Diabetes duration had a median of 6 years (IQR: 3.0, 10.0) with prevalent comorbidities like hypertension (58.0%) and dyslipidemia (42.7%). Most patients were employed (44.7%) and their primary source of diabetes management information was through healthcare providers (92.5%). Despite the high app use for social interaction, only 13.6% used mHealth apps for disease management. Users were influenced by social media (65.0%) and favored for wellness apps and disease monitoring. Users perceived the mHealth app as useful (97.5%), yet faced challenges over the app initiation, charges and data security. Non-users cited lack of awareness (70.2%), struggled with app startup (22.4%) and preference for conventional healthcare visits (22.0%). In multivariable analysis, longer diabetes duration reduced mHealth app usage (p = 0.046), while multimorbidity increased the likelihood (p = 0.001). Awareness of the availability of health apps significantly influenced the usage of mHealth apps (p < 0.001). Conclusion: The findings highlight the underutilization of mHealth apps for diabetes management despite their perceived usefulness. Challenges faced by users and non-users underscore the need for more awareness, thus encourage widespread acceptance and usage of mHealth apps in diabetes care. [ABSTRACT FROM AUTHOR]

Background: Chronic Kidney Disease (CKD) is a growing global health issue with a complex symptom phenotype. It negatively impacts patients' health-related quality of life and increases healthcare utilization. While digital health interventions offer promising avenues for improving symptom management in CKD, understanding their development, validation, and effectiveness is crucial for clinical application. Objective: To comprehensively map the existing literature on digital health interventions designed to manage symptoms in patients with Chronic Kidney Disease (CKD), using the UK Medical Research Council's complex intervention framework as a guiding lens. This scoping review aims to: (1) catalogue digital health interventions utilized in CKD symptom management; (2) detail the range of outcome measures assessing intervention effectiveness, including clinical efficacy, patient adherence, and quality of life; (3) examine the methodologies and frameworks employed in the creation of these interventions; (4) assess the pilot testing and effectiveness evaluations; and (5) categorize and analyze the barriers to implementation. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Databases searched included PubMed, Scopus, Embase, and others, covering literature up to December 2023. Studies were selected based on predefined eligibility criteria for digital health interventions for CKD symptom management. Results: The search yielded 31 studies, with a mix of development and validation studies, predominantly from developed countries. The review highlights the potential of digital interventions in enhancing symptom management, quality of life, and patient engagement in CKD care. However, gaps were identified as follows: (1) Iterative refinement cycles involving multidisciplinary stakeholders enhanced intervention acceptability and usability should be guaranteed, (2) Theory-driven and evidence-based approaches were underutilized in current intervention development, (3) Long-term implementation outcomes and process evaluations were rarely assessed. This review maps an evolving landscape where digital health interventions offer patient-centric solutions for CKD symptom management while highlighting opportunities for methodological advancements. Conclusion: Digital health interventions hold promise for improving symptom management in CKD, yet more research is needed to overcome current limitations and fully realize their potential. Future studies should focus on patient-centred designs, comprehensive validation processes, exploring the underlying mechanism using process evaluation and the integration of these technologies into routine clinical practice. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is one of the most common neurologic disorders affecting approximately 51 million people globally and is associated with significant cases of age-standardized DALYs (182.6 per 100 000 people). The quality of health care services offered to people suffering from epilepsy often fails to meet standards in Ethiopia or internationally. This study was designed to assess the quality of care and associated factors among patients with epilepsy at public hospitals in Arba Minch Town, 2024. Method: A facility-based cross-sectional study was conducted among 392 adult epileptic patients attending public hospitals in Arba Minch Town. Data entry was performed via Epi-data 3.1 software, and the data were analyzed via SPSS version 24 software. Binary logistic regression analysis was used to evaluate the associations between quality of care and sociodemographic, disease-related, and treatment-related factors. Multivariate logistic regression analysis was applied to identify factors independently associated with quality of care. Results: Three hundred ninety-two adults with epilepsy participated in this study, for a response rate of 92.7%. More than one-half of the 237 (60.5%) patients were males, with a median age of 31 ± 12 years (interquartile range). Fewer than one-half (44.1%) of the patients adhered to antiepileptic medicines. The overall proportion of patients receiving quality care was 213 (54.3%). The seizure control rate was also low, at 130 (33.2%). Patients aged 18–29 years [AOR = 30.8 (95% CI, 8.22–35.616, p < 0.000)] and aged 30–39 years [AOR = 18.4 (95% CI, 5.016–67.613, p < 0.000)], and a seizure frequency of less than three [AOR = 2.318 (95% CI, 1.028–5.225, p < 0.043)] were positively associated with quality of care. Whereas, having poor knowledge about epilepsy [AOR = 0.107 (95% CI, 0.0.057–0.202, p < 0.000)] was negatively associated with quality care. Conclusion: The quality of care provided to adult epilepsy patients at Arba Minch was low. In addition, patient knowledge, medication adherence, and the seizure control rate were also suboptimal. Therefore, addressing identified factors by involving all relevant stakeholders (health professionals, hospitals, zonal health departments, regional health bureaus, and patients) is critical for improving the quality of care. In addition, researchers willing to study this topic should use strong designs that can determine causal determinants of quality care. [ABSTRACT FROM AUTHOR]

Background: Adolescents living with HIV (ALHIV) in sub-Saharan Africa are affected by poor treatment outcomes, likely a consequence of poor adherence. Objectives: To assess viral suppression rates and evaluate factors associated with achieving viral suppression and maintaining treatment adherence among ALHIV in rural Tanzania. Methods: Cross-sectional analysis of data from the Kilombero and Ulanga Antiretroviral Cohort in Ifakara, Tanzania, including adolescents aged 10–19 years on antiretroviral treatment (ART) ≥6 months at the time point of their first viral load (VL) measurement after implementation of routine VL testing from August 2017 through December 2023. VL ≥1000 copies/ml was considered unsuppressed. We assessed agreement between adherence measures (self-report, pill box return, pill count and visual analogy scale) and viral suppression. Logistic regression was used to determine factors associated with viral suppression. Results: Of 319 included adolescents, 159 (50%) were male, 143 (45%) aged 10–13 years, 213 (74%) had disclosed their HIV status, 72 (23%) lived ≥50 kilometers from the clinic, 161 (55%) had a WHO stage III/IV and 80 (33%) had CD4 cell counts <500 cells/mm3. Overall, 249 (78%) adolescents were virally suppressed. Factors associated with viral suppression were having a CD4 cell count ≥500 cells/mm3 (adjusted Odds Ratio (aOR) 3.48; 95% CI 1.49–8.13) versus those with a CD4 cell count <500 cells/mm3, being on a dolutegravir-based regimen (aOR 12.6; 95% CI 2.50–68.7) versus those on a NNRTI based regimen. Female gender was associated with lower odds of having viral suppression (aOR 0.41; 95%CI 0.18–0.93). There was a weak to moderate agreement between adherence measures and VL suppression. Conclusion: Adolescents in this rural cohort remain far behind the UNAIDS 95% viral suppression target with only 78% being virally suppressed. The weak to moderate associations between adherence assessment and viral suppression. Adolescents' HIV care models need to be strengthened in order to achieve viral suppression goals in this population. [ABSTRACT FROM AUTHOR]

This study assessed the effectiveness of case management compared to that of standard care in improving treatment outcomes for first-time antiretroviral therapy (ART) patients in Liangshan Prefecture, China. First-time ART patients (total n = 828) were divided into the Standard Care Group (SCG, n = 419) and Case Management Group (CMG, n = 409). At week 48, the CMG showed higher retention rates (97.7% vs. 93.6%), better adherence, and more complete virological responses (84.2% vs. 64.0%) compared to the SCG. These findings suggest that case management improves adherence and virological suppression in resource-limited areas, though further research is needed to confirm its broader applicability. [ABSTRACT FROM AUTHOR]

Background: High adherence to behavioral interventions among parents of autistic children contribute to improvement in children's behaviors and parental outcomes. However, most of previous studies focused on the effects of intervention adherence on health-related well-being among parents, which is inadequate to capture the multi-dimensional parental burden of caring for autistic children. The aim of this study is to assess the association between parents' adherence to behavioral intervention and their capability well-being. Methods: A cross-sectional study was conducted among caregivers of autistic children aged 1–17 years with a confirmed diagnosis in China. A total of 213 parents of autistic children who were currently receiving behavioral intervention were considered in this study. Parental adherence to behavioral intervention was evaluated by the 5-item General Adherence subscale of the Medical Outcome Study. Capability well-being was assessed using the Investigating Choice Experiments Capability Measures for Adults (ICECAP-A), including the domains of stability, attachment, autonomy, achievement, and enjoyment. The index scores for each domain were computed based on the preference-based value set in the United Kingdom, ranging from 0 to 1. Multivariate linear regression analyses were conducted to assess the relationship between intervention adherence and parental well-being. Intervention adherence as well as the variables with p < 0.1 in the univariate analyses were included in multivariate linear regression analyses. Results: The mean overall score of ICECAP-A was 0.681 (0.205). In the univariate analyses, intervention adherence was positively associated with stability, autonomy, achievement, and enjoyment (p < 0.05), while the relationship between intervention adherence and attachment was not significant (p = 0.07). After controlling for the confounders in the multivariate linear regression analyses, intervention adherence was positively associated with achievement (β = 0.0004) and enjoyment (β = 0.0004). Conclusions: The overall capability well-being among parents of autistic children was worse than that of the general population and caregivers of adult patients with chronic diseases. Adherence to behavioral interventions was positively associated with parental well-being in terms of achievement and enjoyment. Health professionals should involve parents in behavioral interventions and encourage them to implement therapeutic strategies on a routine basis. Customized interventions are warranted to improve capability well-being targeting at vulnerable groups. [ABSTRACT FROM AUTHOR]

Background: Studies investigating notions of a 'good death' tend to focus on specific medical conditions and specific groups of people. Therefore, their results are often poorly comparable, making it difficult to anticipate potential points of conflict in practice. Consequently, the study explores how to achieve a good death from the perspective and experience of physicians, nursing staff, and seniors. The aim of this study is to identify comparable notions of a good death among the participants and to determine factors that may promote or prevent a good death, including those that may lead to futile care. Methods: The study used a qualitative design with a total of 16 focus group discussions, 5 each with physicians and nursing staff, and 6 with seniors at least 75 years old. The group size ranged between 3 and 9 participants. Analysis was carried out using Qualitative Content Analysis. Results: Three major aspects affect the quality of death: (1) good communication and successful cooperation, (2) avoidance of death, and (3) acceptance of death. While successful communication and acceptance of death reinforce each other, successful communication counters avoidance of death and vice versa. Acceptance and avoidance of death are in constant tension. Additionally, the role of family and loved ones has been shown to be crucial in the organization of dying (e.g. communicating the patient's wishes to health care professionals). Conclusions: Communication and cooperation between patients and all involved caretakers determines quality of death. However, communication depends on several individual and organizational factors such as the personal level of acceptance or avoidance of death and the availability of institutionalized communication channels crossing professional and organizational boundaries. Furthermore, treatment cultures and organizational structures in hospitals and nursing homes often default towards life prolongation. This carries significant potential for problems, particularly because physicians emphasized the need to prevent hospital admissions when no further life-sustaining treatment is desired. In contrast, nurses and seniors were less aware that hospitals may not be the most suitable place for end-of-life care. This, along with the ambivalent role of nursing homes as places of death, holds potential for conflict. Trial registration: German Clinical Trials Register: DRKS00027076, 05/11/2021. [ABSTRACT FROM AUTHOR]

Background: Diabetes is one of the most common chronic diseases that severely reduce a patient's quality of life. Effective self-care and management are critical for maintaining blood glucose levels and preventing complications. Aim: This study evaluates the effectiveness of a structured diabetes self-management education program on patients' self-management behaviors, empowerment, and activation levels. Methods: This study employed a quasi-experimental design involving 100 participants aged 30–65 to improve diabetes self-management and empowerment. Over 16 weeks, the program included three phases: a two-week pre-test phase for recruitment and baseline assessments using the Diabetes Self-Management Questionnaire (DSMQ), Diabetes Empowerment Scale (DES), and Patient Activation Measure (PAM); a 12-week intervention phase featuring weekly 90-minute educational sessions on topics such as diet, exercise, medication adherence, stress management, and self-empowerment; and a two-week post-test phase for follow-up assessments using the same tools. Data were analyzed using descriptive statistics, chi-square tests for PAM levels, and paired t-tests for DSMQ and DES scores, with statistical significance set at p < 0.05. Results: The study demonstrated significant improvements in participants' self-management, empowerment, and activation levels after the intervention. DSMQ scores increased from 64.5 to 68.6 (p < 0.001), DES scores rose from 65.4 to 70.0 (p = 0.001), and the number of participants at the highest PAM activation level (Level 4) grew from 30 to 50 (p = 0.016). Positive correlations among DSMQ, DES, and PAM scores suggest these improvements are interrelated. Conclusion: The structured diabetes self-management education programme significantly impacted participants' self-management behaviors, empowerment, and activation levels. The findings underscore healthcare professionals' need to implement targeted interventions that facilitate patient engagement in diabetes care. Recommendation: Future interventions should be designed to address the specific needs of diverse populations, paying attention to those facing socio-economic challenges. It is vital to facilitate greater access to diabetes self-management education to enhance health outcomes for these demographic groups. [ABSTRACT FROM AUTHOR]

Purpose: Explore the use, characteristics, feasibility, and functional outcomes of rehabilitation interventions used for individuals with head and neck cancer (HNC) during treatment. Methods: Searches were conducted in four databases from Jan 2011 to Dec 31, 2022. Included studies had to include adults with HNC undergoing treatment, a rehabilitation intervention, an assessment of functional outcome(s) addressed by the International Classification of Functioning Framework (ICF) and be published in English language. Title and abstract screening, full-text review, and data extraction were completed independently, in duplicate. Descriptive statistics and a qualitative synthesis summarized findings. Results: Twenty-seven studies were included in this review. The majority of studies were randomized controlled trials (70%). Most individuals represented in the included studies were males (92% of all participants) between 50 and 60 years of age. Interventions led by a speech language pathologist (33%) were most commonly described. Sixteen studies (59%) described primary outcomes that fit the ICF "impairment" domain. Conclusions: We identified few studies that explored the use, feasibility, and effectiveness of rehabilitation interventions for individuals with HNC during treatment. Future research should assess the effectiveness of rehabilitation interventions on functional outcomes beyond the ICF body function and structure domain. IMPLICATIONS FOR REHABILITATION: Rehabilitation for individuals with Head and Neck Cancer (HNC) undergoing treatment should not only focus on impairment outcomes but also evaluate activity and participation outcomes as these directly impact overall function. Rehabilitation for individuals with HNC undergoing treatment should include a coordinated team of multidisciplinary rehabilitation professionals to optimize whole-body functioning. Studies on rehabilitation during HNC treatment should report more specifically on intervention adherence, safety, cohort retention, and fidelity. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionTo identify factors that are associated with no-shows and cancellations in a glaucoma clinic.Retrospective observational study of patients seen at a glaucoma clinic over a two-year period (6/2017–5/2019). Demographics and clinic information were recorded from the electronic medical record. A total of 36,810 visits from 7,383 patients were studied. Weather data was collected from the National Centers for Environmental Information. Distance analysis was calculated utilizing Bing Maps application programming interface (API) on Microsoft Excel. Visits were divided into three groups based on appointment status: kept, cancelled, and no-show.Bivariate analysis found a statistically significant difference in various factors amongst patients based on appointment status. Patients <15 miles from clinic had a higher rate of no-show, but a lower rate of cancellations compared to those farther (p < 0.0001) Using multivariable logistic regression, the following factors were associated with the likelihood of patient cancellation: average snowfall (Odds Ratio = 1.37); presence of storm event (OR = 1.12), new visit (OR = 1.82), follow-up appointments (OR = 1.90), and travel distance > 15 miles (OR = 1.11). The following factors were associated with patient no-show: resident clinic (OR = 1.79), new visit (OR = 2.24), follow-up appointments (OR = 2.18), age (OR = 0.99), average snowfall (OR = 1.27), presence of storm event (OR = 1.41), average windspeed (OR = 0.98), and travel distance > 15 miles (OR = 0.67).Patient age, gender, travel distance, appointment type, and weather were all significantly associated with rates of patient cancellations and no-shows. These risk factors could lead to interventions to improve appointment adherence and patient retention. Weather is an under-analyzed factor in patient follow-up rates that warrants further investigation. [ABSTRACT FROM AUTHOR]

Background: Echinococcosis is an infectious parasitic disease that is extremely harmful to human health. Albendazole is provided free of charge to patients requiring medication under the central government finance transfer payment scheme for echinococcosis control and prevention in China. Our aim is to monitor the state of patient medication and its therapeutic impact, which will help improve medication compliance and the therapeutic effect. Methods: Random cluster sampling was used to select 10 echinococcosis-endemic counties in China, and all albendazole-treated patients in these counties were investigated. The chi-square and Kruskal–Wallis tests were used to compare two or more rates or constituent ratios, and multiple logistic regression analysis was used to identify the influencing factors. The records of patients were reviewed to obtain the initial diagnosis results as well as the most recent follow-up results and time, and efficacy was assessed. Results: We examined 899 patient files treated with albendazole in 10 endemic counties. Of the 582 evaluable files, 7.9% did not take albendazole, and 69.2% did not take albendazole regularly. Only 22.9% took albendazole regularly. Of the 536 patients who took albendazole, 242 exhibited adverse reactions. Patients who were Tibetan, herdsmen, received no formal education, used emulsion, and exhibited adverse reactions demonstrated poor compliance. A total of 174 patients with cystic echinococcosis received their most recent imaging follow-up results within one year of the investigation date. Among them, 9 patients met the criteria for cure, accounting for 5.2%; 56 patients showed effectiveness, accounting for 32.2%; 105 patients were deemed ineffective, accounting for 59.8%; 5 patients experienced recurrence, accounting for 2.9%. Conclusions: Albendazole medication compliance in patients with echinococcosis is not ideal. We must prioritize health education and promotion for Tibetans, herdsmen, and those without formal education. Patients who adhered to their medication regimen achieved higher rates of cure and effectiveness. To improve medication compliance and efficacy, it is particularly important to improve communication and medication guidance for patients receiving emulsions and those with adverse reactions after taking albendazole. Simultaneously strengthen patients' attention to follow-up and re-examination. [ABSTRACT FROM AUTHOR]

Rationale: Knowledge about the clinical importance of patient-reported outcome measures (PROMs) in severe asthma is limited. Objectives: To assess whether and to what extent asthma exacerbations affect changes in PROMS over time and asthma-specific PROMs can predict exacerbations in adult patients with severe asthma in usual care. Methods: Data of 421 patients with severe asthma (62% female; mean age 51.9 ± 13.4 years; mean FEV1 67.5 ± 21.3%pred) from the U-BIOPRED cohort were analyzed. The included PROMs were: Asthma Control Questionnaire (ACQ5); Asthma Quality of Life Questionnaire (AQLQ); Hospital Anxiety and Depression scale (HADS); Epworth Sleepiness Scale (ESS); Medication Adherence Report Scale (MARS); Sino-Nasal Outcomes Test (SNOT20). Participants were assessed at baseline and after 12–18 months of usual care. Results: PROMs showed very weak to weak correlations with clinical characteristics such as age, body mass index, FEV1, FeNO and eosinophilic cell count. Patients presenting no exacerbations during follow-up showed a statistically significant improvement in all PROMs (except for MARS), whereas individuals experiencing > 2 exacerbations showed a deterioration. Baseline ACQ5 was a predictor of exacerbations with an AUC of 0.590 (95%CI 0.514–0.666). Conclusions: The association of PROMs with clinical measures was poor in severe asthmatics. Moreover, PROMs were prone to changes in usual care, with exacerbations playing a key role. PROMs need to be systematically evaluated in severe asthma to improve clinical care based on specific patient's needs. [ABSTRACT FROM AUTHOR]

Background: Electronic patient-reported outcomes (ePROs) have been shown to enhance healthcare quality by improving patient symptom management or quality of life (QoL). However, ePROs data for urothelial cancer (UC) patients receiving systemic therapies are scarce, and the application of ePROs in this patient cohort may need specific setups. This study tested the feasibility of ePROs for UC patients receiving systemic therapies in the outpatient clinic of a tertiary care center. Patients and Methods: From January 2022 to April 2023, 30 UC patients receiving systemic cancer therapies received ePROs based on the Common Terminology Criteria for Adverse Events (CTCAE) and European Organization for Research and Treatment of Cancer Core Quality of Life questionnaires (EORTC QLQ-30) to report their symptoms and QoL during systemic therapy, in total, 125 questions for every therapy cycle. The proportion of patients adherent to the ePROs was assessed to evaluate feasibility, with a preset threshold of 50%. At least half of all treatment cycles with a minimum of two consecutive ePROs (corresponding to two successive therapy cycles) had to be completed to be counted as adherent, and a maximum of six successive therapy cycles was followed by ePROs. Descriptive statistics were calculated for clinical and demographic patient characteristics. T-test and chi-square-test analyses were performed to study the association between ePROs adherence and clinical or demographic factors. The digital process was closely monitored for procedural impediments that could occur. Results: 21 (70%) of the included 30 patients adhered to the provided ePROs, significantly higher than the predetermined threshold of 50%. Adherence remained above 70% until the end of the observation period. A significant negative effect of immigration background on ePROs compliance was observed (p = 0.006). No other variables were significantly associated with ePROs compliance. Conclusions: In this study, ePROs were a feasible method to assess symptoms and QoL during the systemic cancer therapy of UC patients at our center. The compliance of patients with immigration backgrounds was the most significant barrier to using ePROs in this setting. However, the study is limited by the exclusion of patients without email access and the lack of assessment of physician compliance with the ePROs data, which may affect the generalizability and implementation of the findings. [ABSTRACT FROM AUTHOR]

Rationale: One of the critical roles of pharmacists in the field of community and hospitals is to provide medication therapy management (MTM) services and reconciliation. Objectives: This study aimed to assess the perceptions, adherence, and performance of the patients with chronic kidney disease (CKD) to the clinical pharmacist-provided MTM before and after receiving this service. Method: A cross-sectional survey was conducted from June 2023 to January 2024. A validated questionnaire assessed patients' knowledge, attitude, and performance, and the Morisky medication adherence scale evaluated the medical adherence of the patients before and after the clinical pharmacist-provided MTM. Inclusion criteria were patients with CKD according to NKF KDOQI guidelines and GFR < 60 mL/min/1.73 m2. Before and after the MTM service, CKD patients' knowledge, attitude, performance, and adherence to their pharmacotherapy were assessed. Results: A total of 100 patients enrolled in the study and completed the questionnaire. Before and after the MTM service, total knowledge was 3.38 ± 1.82 and 7.59 ± 1.11, respectively. Before and after the MTM service, the attitude score was 54.53 ± 5.05 and 59.24 ± 4.68, respectively. Before and after the MTM service, the mean performance score was 30.15 ± 4.27 and 34.54 ± 2.56, respectively. Adherence score to medications before and after the MTM service was 4.86 ± 1.99 and 6.22 ± 1.39, respectively. In all fields, outcomes significantly improved (P < 0.05). Conclusion: The current study showed the critical role of clinical pharmacists in training patients about medications and improving adherence to their pharmacotherapy. [ABSTRACT FROM AUTHOR]

This study used the Medical Expenditure Panel Survey data (2010-2018) to examine associations between diabetes patients' satisfaction with their provider and ratings of healthcare received, diabetes care self-efficacy, and monitoring adherence among nonpregnant reproductive age women with diabetes. The sample included nonpregnant women of childbearing age (18-45) with diabetes mellitus (n = 767; weighted n = 1.3 million women). The results indicated that patients who reported that their usual care provider always asked/showed respect for medical, traditional, and alternative treatments that the person is happy with had 2.59 times greater odds (95% confidence interval [CI]:1.32-5.10) of giving high ratings of healthcare (8-10) compared to those whose provider did not show respect for treatments. Results also showed that patients who reported they were asked to decide between a choice of treatments had 1.76 greater odds (95% CI:1.03-3.01) of diabetes care monitoring adherence. Findings demonstrate the importance of patient-centered communication experiences in relation to diabetes care monitoring adherence. Implications of the findings for clinical encounters are discussed. [ABSTRACT FROM AUTHOR]

Aim: This study aims at analyze the current status and influencing factors of missing appointments in patients with periodontitis after supragingivgy scaling, and to explore the measures to reduce the rate of missing appointments, so as to provide a reference for the prevention of periodontitis and oral health promotion. Methods: This study adopted convenience sampling method to select 204 patients who made appointments for revisits in Grade III and Grade A stomatological hospitals in Guizhou Province from May 2021 to May 2022 as the study objects, and conducted the investigation by general data questionnaire, patient satisfaction questionnaire and modified Dental Anxiety Scale (MDAS). Results: The rate of missing appointments in patients with periodontitis was 64.48%.Gender, type of medical payments, perceived severity of disease, communication and convenience of medical service are the influencing factors of missing appointments in patients with periodontitis. Conclusion: The situation of missing appointments in patients with periodontitis is not optimistic, and there are many influencing factors. It is suggested that medical staff should increase the popularization of disease knowledge, communication with patients, and improve the convenience of medical services. Relevant departments should improve the medical insurance system. [ABSTRACT FROM AUTHOR]

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Background: Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo. While various techniques and technologies have improved BPPV diagnostics and treatment, optimizing BPPV healthcare pathways requires a comprehensive understanding of the diagnostic modalities across diverse clinical settings. Objective: To compare traditional manual BPPV diagnostics (MD) with diagnostics done with the aid of a mechanical rotation chair (MRC) when using videonystagmography goggles with both modalities. Methods: This prospective, open-label, randomized diagnostic crossover study involved 215 adults with typical BPPV symptoms at a tertiary University Hospital-based outpatient clinic (Aalborg University Hospital, Denmark). Participants referred by general practitioners or otorhinolaryngologist clinics underwent both traditional manual and MRC diagnostics with the aid of videonystagmography goggles. The order of the diagnostic modalities was randomly assigned, and the two modalities were separated by a minimum of 30 min. The primary outcomes included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of traditional MD compared to MRC diagnostics. The secondary outcome was the agreement between the two modalities. Results: The MRC demonstrated a significantly higher sensitivity for BPPV detection in general for all participants (p = 0.00). Compared to MRC diagnostics, traditional MD displayed a sensitivity of 69.5% (95% confidence interval (CI): 59.8–78.1), specificity of 90.9% (95% CI: 83.9–95.6), PPV of 88.0% (95% CI: 83.9–95.6), and NPV of 75.8% (95% CI: 67.5–82.8). The overall inter-modality agreement was 80.5% (95% CI: 75.2–85.8, Cohen's kappa 0.61). While both modalities detected unilateral posterior canal BPPV equally good (p = 0.51), traditional MD underperformed for non-posterior BPPV (significantly) and in subgroups referred by ENTs (trend) or with impaired cooperation during traditional MD (significantly). Conclusion: Traditional manual BPPV diagnostics remains a valuable first-line approach for most patients. However, MRC diagnostics offers advantages for complex BPPV cases, patients with impaired cooperation, patients referred from otorhinolaryngologist clinics, and those with negative traditional MD but an evident BPPV history. MRC may be useful as a second opinion diagnostic tool for treatment-resistant BPPV. Clinical trial registration: ClinicalTrials.gov identifier: NCT05846711. [ABSTRACT FROM AUTHOR]