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Recent genetic studies have revealed that hemimegalencephaly (HME) is a multi-system disorder associated with germline or mosaic variants within the PI3K-mTOR-GATOR1 signaling pathways. Patients with HME typically develop drug-resistant epilepsy necessitating extensive evaluation, hemispherectomy, and long-term management. We describe the role of a multidisciplinary team (MDT) for the diagnosis and management of recent patients with HME at UCLA who underwent hemispherectomy. Genetic evaluation identified nine patients with the following variants: NPRL3 x2 germline, PIK3CA mosaicism x4, MTOR mosaicism x1, AKT3 mosaicism x1, unknown x1. Each patients MDT comprised 4-9 specialties. One child with a MTOR variant had persistent epilepsy after hemispherectomy, but addition of everolimus resulted in an 80% decrease in seizure frequency. Another child with hemihypertrophy and PIK3CA mosaic variant was offered targeted PIK3CA inhibitor treatment, alpelisib, for overgrowth. A third child with germline NPRL3 variant inherited from their unaffected mother resulted in a sibling being diagnosed with the variant who later developed seizures secondary to focal cortical dysplasia. The implementation of a MDT offers essential guidance for families affected by HME, encompassing prognostication, surveillance, and therapeutic strategies. Identifying the etiology of HME can facilitate the development of targeted treatments and enable timely genetic counseling. PLAIN LANGUAGE SUMMARY: Hemimegalencephaly (HME) is a complex brain disorder caused by genetic changes. It often leads to severe epilepsy that doesnt respond to standard treatments and frequently requires surgery. In this case series, nine patients with HME were identified and found to have genetic mutations in key growth-regulating genes. A multidisciplinary team model was developed to facilitate patients care. For example, one patients seizures improved with surgery, another with a new targeted medication, and another received treatment for symptoms of overgrowth. This team approach provides comprehensive care for patients and can lead to efficient care coordination and implementation of novel therapies.

Pain Medicine, a field that was once considered primarily a specialty of opioid medication management, evolved into a multimodal care model with the goal of limiting reliance on pain medications. Now, we see another revolution-the advancement from percutaneous procedures to minimally invasive surgical procedures. Despite these changes, Pain Medicine fellowships have consistently been recognized as a competitive subspecialty with more applicants than the number of available positions - until now. The most recent pain fellowship match suggests an abrupt change to the popularity of the specialty (with over 61 unmatched positions and over 35 unfilled programs) for applicants expected to matriculate in the year 2024 [1]. Unfilled positions have risen from 5% to 15% in the past three years. Similarly, unfilled programs have risen from 10% to 30% in the past three years. Several reasons for this sudden change in popularity have been proposed, including a lucrative general anesthesiology market, increasing difficulties with insurance coverage and reimbursement for procedures, and a dearth of advanced pain procedures performed at academic medicine programs. The field is at a critical juncture, necessitating ongoing discussions and collaboration among stakeholders to ensure that trainees are attracted to this dynamic field and are ultimately equipped to meet the evolving needs of patients.

Supplemental Digital Content is Available in the Text. Implementing an interdisciplinary chronic pain training program significantly enhances biopsychosocial pain knowledge, attitudes, and clinical recommendations in various healthcare professionals regarding chronic pain management. Advancements in clinical science have shown the necessity for a paradigm shift away from a biomedical toward a biopsychosocial approach. Yet, the translation from clinical science into clinical practice is challenging. The aim of this study was to assess the short-term and mid-term changes in pain knowledge and attitudes and guideline-adherent recommendations of healthcare professionals (HCP) by means of an interdisciplinary training program (ITP) about chronic pain. Belgian HCPs, with a priority for medical doctors, physiotherapists, occupational therapists, nurses, psychologists, and pharmacists in primary care, participated in the ITP, which contained 2 e-learning modules and two 7-hour workshops provided in small interdisciplinary groups in 5 cities. The objective of ITP was to improve HCP's competencies for integrating biopsychosocial chronic pain management with a cognitive behavioral approach into clinical practice. Primary outcomes were changes in knowledge and attitudes about pain and guideline-adherent recommendations for continuation of physical activity, sports, and work; avoiding bed rest; and not supporting opioid usage measured through 2 clinical vignettes. They were measured before, immediately after, and 6 months after the ITP. Changes were analyzed using (generalized) linear mixed models. A total of 405 HCPs participated. The knowledge and attitudes about pain scores improved at post-training (Δ = 9.04, 95% confidence interval 7.72-10.36) and at 6-month follow-up (Δ = 7.16, 95% confidence interval 5.73-8.59). After the training program, HCPs provided significantly more recommendations in accordance with clinical guidelines. Thus, an ITP can improve the biopsychosocial perspective of chronic pain management among HCPs in the short-term and mid-term. [ABSTRACT FROM AUTHOR]

Objective: To reflect upon the evolution of global surgical care in lower and middle income countries (LMICs) through the analysis of healthcare delivery models and our senior author's personal experiences to implement an advanced model of effective cleft care in the developing world. Materials and Methods: A thorough literature review was conducted on the need for cleft care in the developing world and how international organizations have responded. We analyzed the types of healthcare delivery models, delineating between those addressing immediate operations versus models emphasizing long-term healthcare investments through local infrastructure and primary care system expansion. We also highlight our senior author's experiences, a craniofacial-trained plastic surgeon who has worked with a local cleft organization in Austin, Texas and undergone individual mission trips to El Salvador for over a decade. Results: In the United States, outcomes in cleft care have improved due to subspecialization and multi-disciplinary care. We believe that the combination of high-level surgical care and a coordinated team approach are the two most important determinants of good cleft outcomes and pillars of what we are trying to uphold in our model in El Salvador and the developing world. Implementation of a model named the Oblique Model, which achieves synergy between immediate and lasting investments while ensuring trusting partnerships, can enrich LMICs to build sustainable local healthcare delivery services, benefiting local communities through addressing the cleft care continuum from lip/palate treatment to orthodontics and orthognathic surgery. Conclusion: Global surgical care has undergone significant changes in recent decades. To respond to the rising need for cleft care in LMICs and ensure optimal outcomes, implementation of a model that encompasses multidisciplinary care, subspecialization, culturally sensitive discussion, partnership, and fellowship style training in both the first world and host countries is crucial for optimizing craniofacial care. [ABSTRACT FROM AUTHOR]

Mitigating environmental impacts is an urgent challenge supported by (scientific) intensive care societies worldwide. However, making green choices without compromising high-quality care for critically ill patients may be challenging. The current paper describes a three-step approach towards green intensive care units. Starting with the measurement of environmental sustainability, intensive care units can identify hotspots, quantify the environmental impacts of products and procedures, and monitor sustainable progress. Subsequently, a multidisciplinary approach is proposed to improve environmental sustainability, including a collaboration of procurement specialists and healthcare professionals, using co-creation and green teams as efficient grassroots change agents. A context-specific approach for enhancing sustainable healthcare practices is key in order to fit local regulatory requirements and create support of professionals. A final step is to share results and create momentum, including publishing initiatives and participating in online (inter)national networks. Based on the core sustainability principles, this three-step approach towards green ICUs provides a valuable tool to professionals worldwide to facilitate change towards environmentally responsible intensive care units. [ABSTRACT FROM AUTHOR]

Purpose: The Therapy Outcome Measure (TOM) comprises many profession and client group-specific adapted scales based on the International Classification of Functioning Model, used by different Health Care Professionals (HCPs). A new Multidisciplinary stroke TOM scale (MDT Stroke TOMs) was developed by amalgamating the relevant scales. This study aimed to develop a scale to describe patients' abilities and improve communication and collaboration within the stroke Multidisciplinary Team (MDT). The present study investigated the inter-rater and intra-rater reliability of this adaptation. Materials and Methods: The MDT Stroke TOM Scale was developed by combining and rewording four profession-specific adapted TOM scales following iterative trials and discussions leading to an agreed version. 150 stroke Allied Health Professional (AHPs) and nurses were trained virtually in TOM and the MDT Stroke TOM Scale. Ten AHP and nursing raters from five professions evaluated ten composite stroke case studies for inter-rater reliability. Six participated in the intra-rater reliability review of the same three case studies at different time points. Reliability was quantified using intraclass correlation coefficients and measurement error using the smallest detectable change. Results: There was good to excellent concordance between the raters in terms of scoring. Raters' scores were also consistent. The MDT Stroke TOMs is being used consistently across the South West London Stroke Network. Conclusion: The Stroke MDT TOMs is psychometrically robust and should assist with improving team work in the rehabilitation of stroke patients and their carers. Future research may use MDT Stroke TOM to promote interprofessional team working and facilitate communication in Stroke Rehabilitation. IMPLICATIONS FOR REHABILITATION: The introduction of a new Multidisciplinary Team (MDT) Stroke Therapy Outcome measure to encourage interdisciplinary working and collaboration. One measure to complete and document for busy MDTs, which has good - excellent reliability. Early and timely MDT discussions regarding patient care and needs. Using this reliable outcome measure facilitates audit and benchmarking of services. [ABSTRACT FROM AUTHOR]

A cancer of unknown primary site of origin (CUP) is a definition for neoplasms whose first—and unique—presentation is of a neck mass. The urgent need to identify and characterize the primary tumor imposes a precise, prompt, and individualized diagnostic pathway to best guide the treatment. For the aim of this work, 5323 patients were identified from case series ranging from the year 2016 to 2023, selecting, from the 605 total cases in 2019, the clinical cases that met the characteristics of a CUP, which concerned 28 individuals. The 5-year follow-up of the 28 patients examined in 2019 revealed that, in more than half of the patients, the site of onset of primary tumors could not be revealed. Of these, 9 patients were classified as being affected by a CUP, and 9 patients died of carcinoma of uncertain origin; in the remaining 10 patients, the investigations were able to reveal the primary tumor. The lack of identification of a primary tumor prevents the patient from being treated with a curative intent. The identification of the primary tumor is achieved through a pathway of investigations that involves several approaches from a multidisciplinary perspective. The contribution of imaging and its increasingly important role, along with the implementation of its techniques and technologies, help make certain diagnoses in less time. [ABSTRACT FROM AUTHOR]

Solitary fibular metastasis from lung adenocarcinoma is exceedingly rare, with only five documented cases. This report presents a 40-year-old non-smoking Asian male who initially presented with painful swelling in the right knee. Imaging revealed bony destruction of the right fibular head, and further investigations with chest CT, PET/C, pathologic biopsy and genetic testing identified a primary lung adenocarcinoma with EGFR exon 19 deletion mutation. The patient was treated with Osimertinib, resulting in significant tumor reduction. This was followed by thoracoscopic lobectomy and systematic lymph node dissection, and local radiotherapy for the fibular metastasis. The patient experienced complete pain relief and showed no recurrence or metastasis over a 26-month follow-up. This case highlights the diagnostic challenge posed by atypical presentations of metastasis and underscores the importance of comprehensive evaluation, adherence to treatment guidelines, and a multidisciplinary approach in managing oncological patients. The successful outcome in this young patient emphasizes the effectiveness of personalized treatment strategies in optimizing patient prognosis, offering valuable insights for similar clinical scenarios. [ABSTRACT FROM AUTHOR]

In this paper we provide an overview of Clinical Associates in Psychology (CAPs): their training, how they complement existing psychological professions and mental health teams, and showcasing the work they have undertaken throughout the country. This takes the form of a case series, based on service-related research projects and conference presentations undertaken by CAPs themselves. We hope this can help clinicians consider how CAPs fit within the psychology professions and also how they can benefit various services. [ABSTRACT FROM AUTHOR]

The radiologic diagnosis of biliary disease can be challenging due to atypical or delayed presentation, rare or less common entities, and imaging overlap of benign and malignant processes. Establishing a specific diagnosis, when possible, is important to avoid progression of infections to sepsis and multiorgan failure, and for appropriate staging and management in cases of malignancy. Gallstones are the most common biliary disease, and along with stone-related complications, including cholecystitis and choledocholithiasis, constitute the majority of acute biliary pathology. Late and atypical manifestations of acute cholecystitis demonstrate imaging overlap with primary gallbladder cholangiocarcinoma, especially with cases of exuberant inflammatory reaction such as xanthogranulomatous cholecystitis. Additional challenging scenarios related to gallbladder disease, that may be benign or malignant, include adjacent fistulas and lymphadenopathy. Dropped gallstones, especially in atypical locations, may be misdiagnosed as neoplastic. Recurrent cholecystitis after cholecystectomy, whether related to subtotal cholecystectomy or to stumpitis, is another entity that can be confusing to the radiologist with a documented history of cholecystectomy. Inflammatory and autoimmune conditions, such as pseudotumors and IgG4 disease, are a less common but not infrequent cause of diagnostic dilemma. Furthermore, biliary strictures and hepatobiliary cystic lesions can be benign or malignant and could constitute a diagnostic and management challenge. The goal of this manuscript is to present the lessons learned from multidisciplinary conferences on the above entities and suggest tips and pearls to maximize the value of radiologists' contribution to patient management. [ABSTRACT FROM AUTHOR]

Coupling a biomass gasifier with a solid oxide fuel cell system through a high-temperature syngas compressor holds great promise to achieve low-emission, small-scale combined heat and power, since it reduces the number of heat exchangers and increases the system efficiency. However, due to the demanding operating conditions (high temperatures, toxic and explosive gases), electrical motors are not suitable to drive the syngas compressor. Therefore, a high-speed, small-scale cantilever steam turbine that can valorize the system's waste heat to power the compression is designed and developed. An iterative holistic process involving preliminary design, meanline analysis, commercial tools, and in-house codes is used for the design. The design is then numerically analyzed using computational fluid dynamics. The 2.8 kW cantilever steam turbine with a tip diameter of 21 mm runs up to 210 krpm at temperatures of 525 °C while being supported on dynamic steam-lubricated bearings. A low-reaction, full-admission design has been chosen to lower the steam consumption, the axial forces, and the turbine backface leakage. The turbine rotor is made of Ti6Al4V and coated for structural integrity and to withstand high temperatures. Despite the small scale of this design, the results obtained from the established correlations based on large-scale turbines yield a remarkable concordance with the results from the numerical analysis, in particular for the isentropic expansion efficiency prediction. [ABSTRACT FROM AUTHOR]

Objectives To assess the impact on patient outcomes of the spondyloarthritis (SpA) and inflammatory bowel disease (IBD) multidisciplinary team (MDT) meetings in a large university hospital. Methods A single-centre retrospective observational case-note review was conducted assessing the outcome of all 226 cases discussed at the SpA–IBD MDT meetings in a large UK university hospital between 2017 and 2022. Results A total of 226 patients were discussed. It was deemed that 97% of MDT meetings helped to improve communication between teams, and 100% were educational. A total of 57% of discussions led to an instant change of disease management, while 40% of discussions resulted in a treatment plan that avoided the use of dual advanced therapy. This improved patient safety by reducing immunosuppression. The MDT meetings were highly cost and time efficient; 125 referrals between specialists were avoided, and in 51 cases there was a significant chance of reducing future drug costs. A timely investigation or appointment was arranged following 50% of MDT discussions, helping to clarify the diagnosis and optimize patient care. Nine percent of meetings enabled drugs to be prescribed to patients that are not yet licensed for the other speciality, thereby improving treatment options available in the management of complex cases. Conclusion The MDT meetings have been beneficial for patients, the clinical team and the institution. This approach might be considered by other rheumatology and gastroenterology departments. [ABSTRACT FROM AUTHOR]

Background/Aims: Effective teamwork represents a significant component of high-quality maternity care. Midwives and ambulance clinicians are sometimes required to work together in the pre-hospital setting, but these interactions are not well documented or understood. This study aimed to explore the views and experiences of clinicians, to describe the barriers to and facilitators of effective teamwork in this context. Methods: Focus group discussions and in-depth interviews were conducted with 30 London-based clinicians who had experience of providing emergency maternity care in the pre-hospital setting as part of a multidisciplinary team. Data were analysed thematically, informed by principles of grounded theory. Results: Three overarching themes emerged: significance of the patient environment, reaching a shared mental model and interpersonal dynamics. Challenges included conflicting priorities and lack of understanding each other's roles and skillsets. Civility and multidisciplinary training were perceived as conducive to effective teamwork. Conclusions: The findings provide insight to the factors that were perceived to impact teamwork in a pre-hospital maternity context. Actions to improve patient safety include increased partnership working between acute and ambulance trusts, including the provision of multidisciplinary training. Implications for practice: Midwives and ambulance clinicians report a shared goal of a safe and positive experience for the families in their care. When working towards these outcomes, teams require leadership that acknowledges the various professional remits present. [ABSTRACT FROM AUTHOR]

Background: Asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) are chronic respiratory conditions that frequently coexist. However, an integrated assessment tool for both conditions is currently lacking. This study aimed to develop and preliminarily evaluate a composite score capable of simultaneously assessing asthma and CRSwNP in comorbid patients. Methods: An expert panel comprising three pulmonologists, one allergist/clinical immunologist, and four ear, nose and throat (ENT) specialists developed a tool to capture asthma and CRSwNP severity. The tool (D'Amato-De Corso score, or DAMADECO score) incorporates eight parameters, four specific to asthma and four specific to CRSwNP, to assign individual scores for each condition. A composite score is then calculated to reflect the overall disease burden (ranging from −8: poor control and +8: optimal control). A retrospective pilot study was conducted to evaluate the tool. Results: The DAMADECO composite score was applied to 21 comorbid patients. The mean partial scores for asthma and CRSwNP were −1.57 and −1.67, respectively, with a mean total composite score of −3.24. A total of 13 out of 21 patients had uncontrolled domains in both diseases, while fewer patients had only uncontrolled domains in asthma (1/21) or CRSwNP (6/21). The DAMADECO score also allows researchers to track disease progression and monitor treatment effectiveness. Conclusions: The preliminary results suggest that the DAMADECO score is a promising tool for simultaneously assessing asthma and CRSwNP, addressing the unmet need for an integrated approach to comorbid respiratory diseases. Further validation studies are needed to validate the tool in larger patient populations. [ABSTRACT FROM AUTHOR]

This article explores current global research on voluntarily stopping eating and drinking (VSED) and presents a detailed, deidentified case study of a patient who elected VSED in a hospice setting in the Southeastern United States. It highlights the collaborative efforts of health care professionals in effectively supporting the patient and family, sharing multiple perspectives from various health care team members who cared for the patient and family. It offers evidence-based recommendations to guide health care teams through the ethical, medical, and emotional challenges of VSED, ensuring compassionate and competent care. The article emphasizes the importance of structured protocols and empathetic care in hospice settings, advocating for the education and preparation of health care teams and families to address the complex challenges associated with VSED. By promoting open communication, interdisciplinary collaboration, and comprehensive support, hospices can respect the autonomy of patients and families choosing VSED, ensuring a compassionate and dignified end-of-life experience. [ABSTRACT FROM AUTHOR]

The battle against cancer remains a top priority for society, with an urgent need to develop therapies capable of targeting challenging tumours while preserving patient's quality of life. Hadron Therapy (HT), which employs accelerated beams of protons, carbon ions, and other charged particles, represents a significant frontier in cancer treatment. This modality offers superior precision and efficacy compared to conventional methods, delivering therapeutic the dose directly to tumours while sparing healthy tissue. Even though 350,000 patients have already been treated worldwide with protons and 50,000 with carbon ions, HT is still a relatively young field and more research as well as novel, cost-effective and compact accelerator technologies are needed to make this treatment more readily available globally. Interestingly the very first patient was irradiated with protons in September 1954, the same month and year CERN was founded. Both of these endeavours are embedded in cutting edge technologies and multidisciplinary collaboration. HT is finally gaining ground and, even after 70 years, the particle therapy field continues innovating and improving for the benefits of patients globally. Developing technologies that are both affordable and easy to use is key and would allow access to more patients. Advances in accelerator-driven Boron Neutron Capture Therapy (BNCT), image-guided hadron beams delivery, clinical trials and immunotherapy, together with the recent interest and advances in FLASH therapy, which is currently an experimental treatment modality that involves ultrahigh-dose rate delivery, are just a few examples of innovation that may eventually help to provide access to a larger number of patients. [ABSTRACT FROM AUTHOR]

Background: Complications due to frailty and injury after falls are a significant problem for people living in residential aged care. This can lead to a range of negative outcomes including poor physical, social, and psychological well-being. The Australian Royal Commission into Aged Care Quality and Safety highlighted many aspects of care in residential aged care homes requiring improvement, leading to specific recommendations aimed at improving the outcomes in this area. This contributed to four recommendations calling for increased allied health interventions to meet the unmet needs in residential aged care. This intervention aims to implement and evaluate evidence-based allied health interventions for people living in residential aged care specifically relating to frailty, preventing falls, and maintaining engagement in everyday activities. Method: This is a pragmatic, non-randomised, pre–post design study where six groups of up to 10 residents of an aged care home will start the intervention at staggered times. The EAHOP intervention is an integrated application of a suite of allied health services (occupational therapy, physiotherapy, dietetics, speech pathology, pharmacy, and optometry), with general practitioner involvement, using allied health assistants in an integrated transdisciplinary model of care. The baseline period is 6 weeks, and intervention is a maximum of 36 weeks with follow-up at 12 and 24 weeks. Primary outcomes measure changes in falls, frailty, and quality of life. A qualitative program evaluation will be completed as well as an economic analysis. Conclusion: The results of the study will provide information about the clinical, implementation, and effectiveness outcomes of this integrated, transdisciplinary allied health service model for people living in residential aged care. The results will be used to develop evidence-informed guidelines for residential aged care providers on the delivery of allied health services. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is the most common arrhythmia globally, associated with serious complications such as stroke and heart failure, as well as significant impacts on patients' quality of life. Objectives: This theoretical article explores the role of integrated care in the management of AF, highlighting the need for a multidisciplinary approach that goes beyond rhythm and heart rate control. Methods: Through a review of the literature, this article explores the prevalence of AF, the challenges of diagnosis, the socioeconomic and psychological impact, as well as the benefits of integrating medical, psychological, and social interventions, drawing on insights from studies about integrative care in AF. Results: The findings highlight the challenges of managing AF, including its high prevalence, complex diagnosis, and significant socioeconomic and psychological impacts on patients. Integrated care models, combining medical, psychological, and social interventions, improve treatment adherence, reduce complications like stroke and heart failure, and enhance patient quality of life. Conclusions: Integrated care models hold significant promise in improving outcomes in AF patients through structured, multidisciplinary approaches. Evidence supports reductions in cardiovascular events, hospitalizations, and mortality when adhering to clinical guidelines, emphasizing patient education, and implementing individualized care strategies. Despite challenges, like regional disparities and suboptimal implementation, the integration of multidisciplinary teams and emerging technologies offers a way to enhance care delivery and accessibility. Future efforts should focus on personalizing care, promoting professional collaboration, and taking advantage of technological advances to optimize AF management and promote sustainable health systems. [ABSTRACT FROM AUTHOR]

Improving outcomes and the integration of diabetes care for adults is a National Health Service ambition. In north east Essex, United Kingdom, an innovative interprofessional community-based diabetes service (North East Essex Diabetes Service (NEEDS)) was developed to provide a single point of access and continuity of care across an integrated, interprofessional care pathway. The aim was to evaluate how NEEDS was embedded into Primary Care, and gain insight into how it works from the perspective of staff delivering the service and from those receiving care. A mixed methods approach was used. Retrospective data from GP surgeries involved in NEEDS were analyzed. Online surveys (n = 21) and focus groups (workforce n = 23; service users n = 6) were conducted. A clear pathway of diabetes care across an integrated, interprofessional care system was demonstrated. Standard care processes and patient outcomes were higher than those recorded for other GP surgeries across England. Service users reported that they received support with more control over their care. The workforce reported a reduction in bureaucracy, blurring of professional boundaries, and thus autonomy to develop the service. The “virtual ward” provided a true interprofessional team approach. Patients and the workforce reported feeling empowered, demonstrating a holistic high-quality approach to patient care. [ABSTRACT FROM AUTHOR]

Background: Patients need to be supported in combining treatment with daily life. However, measurement of supportive care indicators related to treatment-related side effects is under-reported. This review aimed to identify a list of quality indicators for managing cancer treatment-induced toxicities for adult patients with cancer. Methods: A review was conducted on PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews, and Embase from September 26, 2013 to December 26, 2023. Published English articles that developed or analyzed quality indicators of managing cancer treatment-induced toxicities for adult patients with cancer were selected. The identified indicators were classified according to Donabedian's model for quality of care in healthcare. Results: Forty-two indicators (4 structural, 27 process, and 11 outcome indicators) in 18 articles were identified. Eight articles (44.4%) were from North America, four (22.2%) from Europe, two (11.1%) from Oceania, two (11.1%) from Asia, and one (5.6%) from Africa; 64.3% of the indicators were process indicators based on guidelines. The prevalence of patient symptoms determined using a patient-reported outcome measure was proposed as an outcome indicator. In seven studies (38.9%), these indicators were selected by multidisciplinary experts. None of the studies involved patients or family members in the indicator selection process. Conclusion: The quality of supportive care should be improved by measuring these indicators, considering the patient's needs for supportive care at each hospital such that patients can continue their lives while undergoing treatment. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study investigates the effects of multidisciplinary telerehabilitation for the post-COVID-19 condition. Methods: Recruitment was announced during 2021/22 through the COVID patient organisation in Sweden. The key inclusion criteria were persistent symptoms and functional impairments longer than 12 weeks after an acute SARS-CoV-2 infection, a stable health condition, and satisfactory skills to use the Internet. Participants were randomised into a rehabilitation group or a waiting list. Telerehabilitation was performed by a multidisciplinary team. Measured outcomes included health- and pain-related parameters and pain-related disability after eight weeks and when followed up after six months. Results: In total, 164 participants registered for the study. Of them, 67 participated in an eight-week group telerehabilitation programme (mean age 43, 78% women) and 42 stayed on a waiting list (mean age 47, 88% women) after eight weeks. Sixty participants from the rehabilitation group and 21 from the waiting list completed the data at the six-month follow-up. The results show greater improvements in both health- and pain-related parameters within the telerehabilitation group after eight weeks and six months than within the waiting list group (Cohen's d effect size varied between moderate and large). However, no statistically significant differences were found between the groups, except participants being at a lower risk of anxiety measured based on the Hospital Anxiety and Depression Scale after eight weeks of telerehabilitation compared to those on the waiting list. Conclusions: The results indicate that multidisciplinary group telerehabilitation is beneficial for improving health- and pain-related parameters in people suffering from the post-COVID-19 condition and should be further developed and adapted for similar conditions, such as chronic pain, fatigue, etc. [ABSTRACT FROM AUTHOR]