Background The COVID-19 pandemic has led to a notable increase in psychological distress, globally. Oman is no exception to this, with several studies indicating high levels of anxiety and depression among the Omani public. There is a need for adaptive and effective interventions that aim to improve the elevated levels of psychological distress due to the COVID-19 pandemic. Objective This study aimed to comparatively assess the efficacy of therapist-guided online therapy with that of self-help, internet-based therapy focusing on COVID-19–induced symptoms of anxiety and depression among individuals living in Oman during the COVID-19 pandemic. Methods This was a 6-week-long pragmatic randomized controlled trial involving 60 participants who were recruited from a study sample surveyed for symptoms of anxiety or depression among the Omani public amid the COVID-19 pandemic. Participants in the intervention group were allocated to receive 1 online session per week for 6 weeks from certified psychotherapists in Oman; these sessions were conducted in Arabic or English. The psychotherapists utilized cognitive behavioral therapy and acceptance and commitment therapy interventions. Participants in the control group received an automatic weekly newsletter via email containing self-help information and tips to cope with distress associated with COVID-19. The information mainly consisted of behavioral tips revolving around the principles of cognitive behavioral therapy and acceptance and commitment therapy. The primary outcome was measured by comparing the change in the mean scores of Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scale from the baseline to the end of the study (ie, after 6 sessions) between the two groups. The secondary outcome was to compare the proportions of participants with depression and anxiety between the two groups. Results Data from 46 participants were analyzed (intervention group n=22, control group n=24). There was no statistical difference in the baseline characteristics between both groups. Analysis of covariance indicated a significant reduction in the GAD-7 scores (F1,43=7.307; P=.01) between the two groups after adjusting for baseline scores. GAD-7 scores of participants in the intervention group were considerably more reduced than those of participants in the control group (β=−3.27; P=.01). Moreover, a greater reduction in mean PHQ-9 scores was observed among participants in the intervention group (F1,43=8.298; P=.006) than those in the control group (β=−4.311; P=.006). Although the levels of anxiety and depression reduced in both study groups, the reduction was higher in the intervention group (P=.049) than in the control group (P=.02). Conclusions This study provides preliminary evidence to support the efficacy of online therapy for improving the symptoms of anxiety and depression during the COVID-19 crisis in Oman. Therapist-guided online therapy was found to be superior to self-help, internet-based therapy; however, both therapies could be considered as viable options. Trial Registration ClinicalTrials.gov NCT04378257; https://clinicaltrials.gov/ct2/show/NCT04378257

Purpose There is some evidence suggesting a different nature of response to selective laser trabeculoplasty (SLT) among different races. Therefore, we aimed to assess the short-term efficacy, safety and nature of outcome of SLT in Omani eyes. Patients and Methods A retrospective review was performed of patients with open-angle glaucoma (OAG) or ocular hypertension (OHTN) who underwent a single session of 360-degree SLT between January 1, 2017 and December 31, 2018. The main outcome was mean IOP reduction and attainment of treatment success at 5 weeks and 12 weeks post treatment defined as at least 20% IOP reduction from baseline without further medications or interventions. Secondary outcomes were frequency of adverse events and factors predicting success. Results A total of 33 eyes of 33 Omani patients who underwent treatment with SLT were analyzed. The nature of response to laser followed a gradual pattern as the mean IOP reduction from baseline was 20.2% (5.21 mm Hg, P <0.001) at 5 weeks and further enhanced to 27.2% (6.95 mm Hg, P <0.001) at 12 weeks. Short-term success was achieved in 51.5% and 72.2% of eyes at 5 and 12 weeks, respectively. SLT was most effective in OHTN subgroup and those with higher baseline IOP (both P <0.001). Side effects were an infrequent occurrence, minor and transient. Conclusion The short-term success of SLT in Omani eyes was clinically relevant and comparable to the gradual pattern seen in patients of Indian ancestry. It is a safe therapeutic option in selective Omani eyes.

BACKGROUND The coronavirus (COVID-19) pandemic has led to a notable increase in psychological distress, globally. Oman is no exception to this, with several studies indicating high levels of anxiety and depression among the Omani public. There is a need for adaptive and effective interventions aiming at improving the increased levels of psychological distress arising from the COVID-19 pandemic. OBJECTIVE This study aimed at assessing the efficacy of therapist guided Online-Therapy versus self-help, e-mail delivered, therapy focusing on COVID-19-induced symptoms of anxiety and depression among individuals living in Oman during the COVID-19 pandemic. METHODS This was a 6-week pragmatic randomized controlled trial involving 60 participants who were recruited from a study sample surveyed for symptoms of anxiety/depression among the public in Oman amid the COVID-19 pandemic. The participants in the intervention group were allocated to receive 1 online session per week for 6 weeks from certified psychotherapists in Oman in Arabic or English. The Psychotherapists utilized Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) interventions. The participants in the control group received an automatic weekly newsletter via e-mail containing self-help information and tips to cope with distress associated with COVID-19. The information mainly consisted of behavioral tips revolving around the principles of CBT and ACT. The primary outcome was measured by comparing the change in the mean Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scores from baseline to the end of the study (after six sessions) between the two arms. The secondary outcome was comparing the proportions of participants with depression and anxiety in the two groups. RESULTS Data from 46 participants were analyzed (22 in intervention arm and 24 in control arm). There was no statistical difference in baseline characteristics between both arms. Analysis of covariance indicated a significant reduction in the GAD scores (F(1,43) = 7.307; P = 0.010) between the two arms after adjusting for baseline scores. The intervention arm GAD scores reduced more than those of the control arm (B = -3.27; P = 0.010). The intervention arm had a greater reduction in PHQ-9 mean scores (F(1,43) = 8.298; P = 0.006) when compared to the control arm (B = -4.311; P = 0.006). While the levels of anxiety and depression reduced in both study arms, the reduction was higher in the intervention group (P values of <0.049 and <0.022, respectively). CONCLUSIONS This study provides preliminary evidence to support the efficacy of Online-Therapy for improving the symptoms of anxiety and depression during the COVID-19 crisis in Oman. Therapist guided Online-Therapy was noted to be superior to self-help Internet-based therapy, however, both therapies could be considered as viable options. CLINICALTRIAL ClinicalTrials.gov NCT04378257

Management of chronic diseases is complex and requires a long-term commitment to therapeutic medications. However, medication adherence is suboptimal. There is limited understanding of factors predicting medication adherence in chronic diseases in Oman. This study aimed to examine predictors of medication adherence (i.e. patient clinical and demographic data, patient-physician relationship, health literacy, social support) among Omani patients with chronic diseases. This study used a cross-sectional correlation design. Data were collected from 800 participants using convenience sampling between December 2019 and April 2020. Arabic versions of the Brief Health Literacy Screening tool, Multidimensional Scale of Perceived Social Support, Patient-Doctor Relationship Questionnaire, and Adherence in Chronic Disease Scale were used to measure study variables. Descriptive statistics, independent t tests, one-way ANOVA, Pearson correlations, and multivariate linear regression were used for analysis. The study found that factors such as the patient-physician relationship, social support, disease duration, employment status, and medication frequency significantly predicted medication adherence. Medication adherence was higher among those who were unemployed, had a better patient-physician relationship, and greater social support. However, medication adherence was lower with longer disease duration and higher daily medication frequency. Additionally, medication adherence was positively associated with perceived social support and the patient-physician relationship, but not with health literacy. In conclusion, the study reveals that patient characteristics, social support, and patient-physician relationships are key factors in predicting medication adherence in patients with chronic diseases in the Middle East. It emphasizes the importance of improving these aspects, considering factors like employment status, disease duration, and medication frequency, and enhancing healthcare provider-patient relationships and social support systems to boost adherence.

No abstract