Background: Patients' negative expectations about medication can exacerbate side effect burden leading to low adherence and persistence. A novel intervention involves targeting mindsets about non-severe symptoms; reframing them as encouraging signs of medication working.
Purpose: This study aimed to assess whether a brief symptom-mindset intervention can improve symptom experience and adherence in patients starting methotrexate to treat an inflammatory rheumatic disease.
Methods: A randomized controlled trial was conducted with patients starting methotrexate. Participants were randomly assigned (1:1) to a mindset intervention or standard information control condition. Symptom mindset was assessed after 4 weeks to check intervention efficacy. The primary outcome was symptom experience after 4 weeks. Secondary outcomes were adherence and motivation to take methotrexate (4 weeks), as well as continuation and C-reactive protein (12 weeks).
Results: Forty-seven participants were randomly assigned to the intervention (n = 24) or control group (n = 23). All participants completed the study. After 4 weeks, compared to the control group, intervention participants endorsed more positive symptom mindsets, experienced less symptom burden (mean difference -2.70 [95% CI, -4.50, -0.90] P = .005), fewer general symptoms (3.53 [-6.99, .79] P = .045) and a similar number of methotrexate-specific symptoms (-0.79 [-2.29, 0.71] P = .295). The intervention group had better motivation and adherence to methotrexate at 4 weeks and better continuation, and C-reactive protein at 12 weeks than the control group. There was no difference in side effect attribution.
Conclusions: In patients starting methotrexate, a mindset intervention reframing the role of non-severe side effects is a promising approach for improving symptom experience and early stage medication persistence.
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http://dx.doi.org/10.1093/abm/kaae089 | DOI Listing |
Eur Arch Otorhinolaryngol
January 2025
Department of Otolaryngology and Head and Neck Surgery, IRCSS AOU San Martino, University of Genoa, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
Purpose: Immunoglobulin G4-related disease (IgG4-RD) is a complex systemic fibroinflammatory condition with different clinical manifestations affecting multiple organ systems. Despite its rarity, the disease presents diagnostic and therapeutic challenges due to its mimicry of malignancies and other immune-mediated disorders. The 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria for IgG4-Related Disease is the current state of art to confirm the diagnosis of IgG4-RD even in the absence of histological analysis.
View Article and Find Full Text PDFBrain Struct Funct
January 2025
Applied Psychology, Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada.
Children and adolescents with neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) may be more susceptible to early life stress compared to their neurotypical peers. This increased susceptibility may be linked to regionally-specific changes in the striatum and amygdala, brain regions sensitive to stress and critical for shaping maladaptive behavioural responses. This study examined early life stress and its impact on striatal and amygdala development in 62 children and adolescents (35 males, mean age = 10.
View Article and Find Full Text PDFInt J Psychiatry Med
January 2025
Department of Psychiatry, University of Colorado, Aurora, CO, USA.
Objective: Functional seizures (FS) are a highly debilitating symptom of functional neurological disorder (FND). FS requires a multi-disciplinary approach to treatment because the patient's initial presentation is to neurology, emergency medicine, or primary care and treatment consists of psychotherapy. People with FS commonly experience severe childhood trauma, particularly sexual trauma.
View Article and Find Full Text PDFJ Vet Intern Med
January 2025
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Background: Left ventricular (LV) volumes can be calculated from various linear, monoplane, and multiplane echocardiographic methods, and the same method can be applied to different imaging views. However, these methods and their variations have not been comprehensively evaluated against real-time 3-dimensional echocardiography (RT3D).
Hypothesis/objectives: To identify the LV volumetric approaches that produce the least bias and the best agreement with RT3D, and to assess interoperator reproducibility between an experienced and an inexperienced operator.
BMJ Evid Based Med
December 2024
Department of Public Health, History of Science, and Gynecology, Miguel Hernandez University of Elche Faculty of Medicine, Sant Joan D'Alacant, Comunidad Valenciana, Spain
Objective: The objective of this study is to analyse the perspectives of screening candidates and healthcare professionals on shared decision-making (SDM) in prostate cancer (PCa) screening using the prostate-specific antigen (PSA) test.
Design: Descriptive qualitative study (May-December 2022): six face-to-face focus groups and four semistructured interviews were conducted, transcribed verbatim and thematically analysed using ATLAS.ti software.
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