В данной статье рассматриваются вопросы назначения периоперационной нутритивной поддержки больным колоректальным раком. Спецификой данной группы является исходно высокая доля пациентов с нарушениями питания, а также невозможность возвращения к полноценному обычному режиму питания в раннем послеоперационном периоде. Своевременное назначение лечебного питания позволяет снизить риски послеоперационных осложнений и смертности у данной категории больных. Энтеральная поддержка связана с меньшим риском послеоперационных осложнений и должна применяться у большинства пациентов.
Funding Acknowledgements
Type of funding sources: None.
Background
Atrial fibrillation (AF) is associated with substantially reduced quality of life (QoL). Both catheter ablation (CA) and education have a potential to improve QoL in AF patients (pts).
Purpose
To assess the impact of preventive counseling with long-term support on QoL in pts after CA performed for paroxysmal AF.
Methods
A prospective randomized controlled study with 2 parallel groups of pts with paroxysmal AF after CA (radiofrequency or cryoablation). Pts were randomized (1:1) into 2 groups. Before discharge, both groups received 1 preventive counseling session with focus on their individual risk factors profile. After discharge pts from intervention group received biweekly preventive counseling via email for 3 months (6 sessions). Control group received usual care. QoL was assessed at baseline and at 12 months using SF-36 questionnaire.
Results
A total of 90 pts aged 35 to 80 years were enrolled (mean age, 57.4 ± 9.9 years, men, 52.2%). Both groups had a poor QoL at baseline, and both groups experienced improvement in the physical health component at 1 year, but the degree of this improvement in the intervention group was similar to the control (table).
Conclusions
Preventive counseling with remote support via email does not further improve QoL in AF pts after CA.
Intervention group Control group P Integral component of physical health Baseline (points) mean ± SD 44.1 ± 7.9 40.2 ± 8.7 0.028 Mе (25%; 75%) 44.5 (38.7; 50.1) 38.6 (34.4; 47.1) At 12 months (points) mean ± SD 49.4 ± 6.0* 45.7 ± 7.7* 0.010 Ме (25%; 75%) 51.0 (45.2; 53.9) 46.3 (42.4; 50.6) Δ% after 12 months, Ме (25%; 75%) 11.8 (1.4; 32.7) 18.7 (-0.3; 30.4) n/s Integral component of mental health Baseline (points) mean ± SD 46.1 ± 9.0 45.0 ± 8.4 n/s Mе (25%; 75%) 47.8 (39.1; 53.9) 48.0 (37.2; 52.0) At 12 months (points) mean ± SD 48.2 ± 8.1 46.8 ± 8.7 n/s Ме (25%; 75%) 50.1 (46.1; 53.6) 48.0 (41.0; 54.3) Δ% after 12 months, Ме (25%; 75%) 3.6 (-10.8; 32.6) 8.9 (-15.6; 30.8) n/s * p <0.001 vs baseline
Funding Acknowledgements
Type of funding sources: None.
Background
Poor medication adherence is a major contributor to suboptimal health outcomes and increased costs in cardiovascular (CV) diseases including atrial fibrillation (AF).
Purpose
To assess the impact of different preventive counseling programs on medication adherence in AF patients (pts) after catheter ablation (CA).
Methods
A prospective randomized controlled study with 3 parallel groups of pts with paroxysmal AF after CA (radiofrequency or cryoablation). Pts were randomized (1:1:1) into 3 groups. Before discharge, pts from all groups received 1 preventive counseling session with focus on their individual risk factors profile. After discharge both intervention groups received 6 sessions of biweekly remote preventive counseling by phone (Group 1) or via email(Group 2) for 3 months after enrollment. Group 3 received usual care. Medication adherence was assessed using the 4-item Morisky-Green scale at baseline and at 12 months.
Results
A total of 135 pts aged 35 to 80 years were enrolled (mean age, 57.3 ± 9.1 years, men, 51.8%). The groups were well balanced according to demographic and clinical features. Baseline levels of non-adherenсe and partial adherence were high in all groups (53.4%, 71.1% and 73.3% respectively). At 1 year of follow-up pts from both intervention groups demonstrated a significant improvement of medication adherence vs control (table).
Conclusions
Preventive counseling programs with remote support via phone or e-mail improve medication adherence in AF pts after CA.
Мedication adherence 1 group (support via phone) 2 group (support via e-mail) Control group P for Group 1 vs. control at 12 months P for Group 2 vs. control at 12 months Baseline After 12 months Baseline After 12 months Baseline After 12 months Adherence,% 46.7 60 28.9 60 26.7 31.1 <0.01 <0.01 Partial adherence ,% 17.8 20 31.1 20 24.4 33.3 n/s n/s Non-adherence,% 35.6 60 40 20 48.9 35.6 n/s n/s
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