Informed consent for clinical trials in acute stroke is characterized by challenges related to urgency, cognitive impairment, and geographical separation. Context-appropriate approaches are needed for this setting. We conducted a mixed-methods project involving focus groups and interviews as well as collaboration with a patient advisory panel and a central institutional review board (CIRB) to design and implement a patient-driven consent process for a multicenter trial incorporating adaptive randomization. Remote consent was recognized as challenging but acceptable. Adaptive randomization was viewed positively, but significant potential for misunderstanding was appreciated. Collaboration between the patient advisory panel and the CIRB resulted in a shortened, more patient-centered consent form that was approved at all sites with few modifications. An information sheet was developed as a resource for patients and surrogates after enrollment. Collaboration between investigators, patient partners, and a CIRB can facilitate innovation and implementation of patient-centered, context-appropriate consent strategies.
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http://dx.doi.org/10.1002/eahr.500122 | DOI Listing |
Health Res Policy Syst
January 2025
China Center for Health Development Studies, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, China.
Background: An increasing number of people live with chronic disease or multi-morbidity. Current consensus is that their care requires an integrated model bringing different professionals together to provide person-centred care. Although primary care has a central role in managing chronic disease, and integration may be important in strengthening this role, previous research has shown insufficient attention to the relationships between primary care and integration.
View Article and Find Full Text PDFJ Anesth Analg Crit Care
January 2025
Department of Emergency Surgery and Trauma, Anesthesia and Intensive Care Unit, Bufalini Hospital, Azienda Unità Sanitaria Locale (AUSL) Della Romagna, Cesena, Italy.
Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included.
View Article and Find Full Text PDFQual Life Res
January 2025
MRL, Merck & Co., Inc., Rahway, NJ, USA.
Purpose: Cost-utility analyses examining the value of new vaccines for pneumococcal disease will require health state utilities as inputs. Existing utilities for pneumococcal infections in young children are limited. The purpose of this study was to estimate health state utilities associated with pneumococcal infections in young children.
View Article and Find Full Text PDFAdv Ther
January 2025
CSL Vifor, Glattbrugg, Switzerland.
Introduction: Chronic kidney disease-associated pruritus (CKD-aP) is a common, yet underdiagnosed condition among patients on hemodialysis. Considering the lack of established treatment pathways, we sought to evaluate the use of antidepressant, systemic antihistamines, or gabapentinoid medications among patients with CKD-aP in the year following pruritus assessment.
Methods: We included 6209 patients on hemodialysis in the analysis.
Harm Reduct J
December 2024
Unit for Clinical Research on Addictions, Oslo University Hospital Health Trust, PB 4959 Nydalen, Oslo, 0424, Norway.
Background: Little attention has been paid to the experiences of clinicians and health personnel who provide heroin-assisted treatment (HAT). This study provides the first empirical findings about the clinicians' experiences of providing HAT in the Norwegian context.
Methods: 23 qualitative interviews were conducted with 31 clinicians shortly after HAT clinics opened in Norway's two largest cities: Oslo and Bergen.
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