Self-Administered Intravesical Hyaluronic Acid Improves Symptoms and Quality of Life in a Patient-Centred Approach To Bladder Pain Syndrome Management
Notice bibliographique
Résumé
Background and Objectives Bladder pain syndrome (BPS) is an uncommon and potentially debilitating spectrum of chronic pain typically accompanied by lower urinary tract symptoms. Intravesical hyaluronic acid (HA) is a commonly used treatment option, but requires multiple follow-up clinic appointments. We introduced a novel patient-led ‘at-home’ pathway of self-administered HA treatment to reduce the number hospital visits required by patients. We assessed and compared patient-reported outcome measures (PROMS) from patients receiving nurse-administered ‘in-hospital’ and patient-led self-administered ‘at-home’ intravesical HA (Cystistat® and Hyacyst®, respectively). Secondary outcome measures included differences between waiting times for treatment, frequency of treatments, number of clinician and nurse clinic appointments, and estimated financial costs. Patients and Methods Sixty consecutive patients commencing intravesical HA for BPS symptoms between 1 st January 2016 and 31 st March 2019 were included. O’Leary-Sant Interstitial Cystitis Symptom Index questionnaires were completed prior to, and following, six treatments. Relevant clinical and demographic data were also collected. Results Overall, 76.6% of the patients had improvement in symptoms after HA treatment. Mean O’Leary-Sant questionnaire symptom and problem scores were significantly improved following HA treatment (11.8 (range 6–17) to 8.5 (range 4–13) (p=0.00005) and 11.4 (range 4–16) to 7.9 (range 4–14) (p=0.0002), respectively. There were no significant differences in symptom improvements between patients on either pathway. Mean waiting time for treatment and number of treatments were lower in the patient-led pathway, and number of hospital visits was significantly lower in the patient-led at home pathway. The patient-led pathway could ‘save’ approximately 76 nurse clinic and 11 outpatient clinic appointments per year, and confer cost-savings of more than £1,500 per patient, per year. Conclusions Our case series analyses suggest that patient-led ‘at-home’ intravesical HA administration (Hyacyst®) is acceptable to patients and confers similar symptomatic benefit to ‘in-hospital’ nurse-led HA (Cystistat®). In addition, it appears that BPS sufferers established on the patient-led pathway require fewer HA treatments and fewer hospital visits, and as such, the patient-led pathway may also confer financial cost savings, and relieve some pressures on clinic appointment availability.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».