Lancet Regional Health-Europe最新文献

{"title":"The overlooked burden of persistent physical symptoms: a call for action in European healthcare","authors":"Anne Toussaint ,&nbsp;Angelika Weigel ,&nbsp;Bernd Löwe","doi":"10.1016/j.lanepe.2024.101140","DOIUrl":"10.1016/j.lanepe.2024.101140","url":null,"abstract":"<div><div>Regardless of their cause, persistent physical symptoms are distressing somatic complaints that occur on most days for at least several months. They are common in patients with somatic diseases, functional somatic disorders, mental disorders, and undiagnosed medical conditions and are often associated with significant impairment and medical costs. Despite their prevalence and impact, persistent physical symptoms are often overlooked in medical care. This Personal View stresses the importance of recognising persistent physical symptoms as a European health issue. It advocates improvements in research, clinical management, public health, and policy. Efforts should prioritise integrating models of symptom perception and biopsychosocial perspectives into medical care and education, fostering interdisciplinary collaboration, and developing standardised guidelines to enhance patient care, reduce stigma, and improve clinical outcomes. Increased research funding can accelerate progress in understanding and effectively managing persistent physical symptoms. Addressing these priorities will support patients and healthcare professionals, ensuring adequate care and a higher quality of life for affected individuals.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101140"},"PeriodicalIF":13.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of SQ house dust mite sublingual immunotherapy-tablet (12 SQ-HDM) in children with allergic rhinitis/rhinoconjunctivitis with or without asthma (MT-12): a randomised, double-blind, placebo-controlled, phase III trial","authors":"Antje Schuster ,&nbsp;Davide Caimmi ,&nbsp;Hendrik Nolte ,&nbsp;Silviya Novakova ,&nbsp;Jan Mikler ,&nbsp;Majken Hougaard Foss-Skiftesvik ,&nbsp;Anne Sofie Østerdal ,&nbsp;Andrzej Emeryk ,&nbsp;Remi Gagnon ,&nbsp;Oliver Pfaar","doi":"10.1016/j.lanepe.2024.101136","DOIUrl":"10.1016/j.lanepe.2024.101136","url":null,"abstract":"<div><h3>Background</h3><div>Allergic rhinitis/rhinoconjunctivitis (AR/C) induced by house dust mites (HDM) often begins in childhood and negatively impacts a child’s quality of life. The daily burden can be further compounded by comorbid asthma. Allergen immunotherapy is the only available treatment targeting the underlying cause of allergic disease. Efficacy and safety of the SQ HDM sublingual immunotherapy (SLIT)-tablet has been demonstrated in adults and adolescents with HDM AR/C with or without asthma, but data are lacking for younger children.</div></div><div><h3>Methods</h3><div>Phase III, randomised, double-blind, placebo-controlled trial in younger children (5–11 years) with HDM AR/C with or without asthma. Eligible subjects were randomised 1:1 to SQ HDM SLIT-tablet or placebo for ∼1 year and had free access to AR/C symptom-relieving medications. The primary outcome was the total combined rhinitis score (TCRS) during the final 8 weeks of the treatment period (∼1 year). Secondary outcomes included the rhinitis daily symptom score (DSS) and medication score (DMS), the rhinoconjunctivitis total combined score (TCS), and the Paediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) score. Efficacy analyses were conducted on the full analysis set (observed cases). Asthma-related outcomes were also explored. The trial was registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>: <span><span>NCT04145219</span><svg><path></path></svg></span> and EudraCT: 2019-000560-22.</div></div><div><h3>Findings</h3><div>A total of 1460 subjects were randomised to SQ HDM SLIT-tablet (n = 729) or placebo (n = 731). The primary outcome, TCRS, was statistically significantly different for SQ HDM SLIT-tablet (n = 693) versus placebo (n = 706), with an absolute difference of 1.0 (95% CI: 0.5, 1.4; p &lt; 0.0001) corresponding to a relative reduction of 22.0% (95% CI: 12.0, 31.1). Key secondary outcomes (DSS, DMS, TCS, PRQLQ) showed statistically significant reductions in symptoms and medication use, and improved disease-related quality of life for SQ HDM SLIT-tablet versus placebo. Improvements in asthma symptoms and reduced asthma medication use indicated an additional effect of SQ HDM-SLIT tablet versus placebo. The SQ HDM SLIT-tablet showed a higher event rate for treatment-related adverse events (AEs) than placebo. Most events were of mild or moderate severity and few subjects discontinued due to AEs (2.5%).</div></div><div><h3>Interpretation</h3><div>The trial confirmed the efficacy and safety of the SQ HDM SLIT-tablet for treating HDM AR/C in younger children (5–11 years) with or without asthma. The safety profile supports daily self-administration of the SQ HDM SLIT-tablet in children.</div></div><div><h3>Funding</h3><div><span>ALK-Abellό</span>, Hørsholm, Denmark.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101136"},"PeriodicalIF":13.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"17th European Public Health (EPH) conference.","authors":"Rafael Cardoso","doi":"10.1016/j.lanepe.2024.101158","DOIUrl":"https://doi.org/10.1016/j.lanepe.2024.101158","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"101158"},"PeriodicalIF":13.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with attrition from the UK healthcare workforce since the COVID-19 pandemic: results from a nationwide survey study.","authors":"Christopher A Martin, Asta Medisauskaite, Anna L Guyatt, Raman Mishra, Srinivasa Vittal Katikireddi, Katherine Woolf, Manish Pareek","doi":"10.1016/j.lanepe.2024.101133","DOIUrl":"10.1016/j.lanepe.2024.101133","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"101133"},"PeriodicalIF":13.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health, the missing chapter in the Draghi Report on Europe's future","authors":"Martin McKee ,&nbsp;Anniek de Ruijter ,&nbsp;Tamara Hervey","doi":"10.1016/j.lanepe.2024.101150","DOIUrl":"10.1016/j.lanepe.2024.101150","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101150"},"PeriodicalIF":13.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHO's iSupport model for dementia care: why the mode and measures matter","authors":"Bianca Brijnath ,&nbsp;Josefine Antoniades","doi":"10.1016/j.lanepe.2024.101144","DOIUrl":"10.1016/j.lanepe.2024.101144","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101144"},"PeriodicalIF":13.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Persistent hesitancy for SARS-CoV-2 vaccines among healthcare workers in the United Kingdom: analysis of longitudinal data from the UK-REACH cohort study” [The Lancet Regional Health – Europe, Volume 13, February 2022, 100299]","authors":"Christopher A. Martin ,&nbsp;Katherine Woolf ,&nbsp;Luke Bryant ,&nbsp;Sue Carr ,&nbsp;Laura J. Gray ,&nbsp;Amit Gupta ,&nbsp;Anna L. Guyatt ,&nbsp;Catherine John ,&nbsp;Carl Melbourne ,&nbsp;I. Chris McManus ,&nbsp;Joshua Nazareth ,&nbsp;Laura B. Nellums ,&nbsp;Martin D. Tobin ,&nbsp;Daniel Pan ,&nbsp;Kamlesh Khunti ,&nbsp;Manish Pareek ,&nbsp;of the UK-REACH Study Collaborative Group","doi":"10.1016/j.lanepe.2024.101148","DOIUrl":"10.1016/j.lanepe.2024.101148","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101148"},"PeriodicalIF":13.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UK","authors":"Gill Windle ,&nbsp;Greg Flynn ,&nbsp;Zoe Hoare ,&nbsp;Nia Goulden ,&nbsp;Rhiannon Tudor Edwards ,&nbsp;Bethany Anthony ,&nbsp;Patricia Masterson Algar ,&nbsp;Suman Kurana ,&nbsp;Aimee Spector ,&nbsp;Gwenllian Hughes ,&nbsp;Ryan Innes ,&nbsp;John Connaghan ,&nbsp;Danielle Proctor ,&nbsp;Fatene Abakar Ismail ,&nbsp;Kiara Jackson ,&nbsp;Kieren Egan ,&nbsp;Joshua Stott","doi":"10.1016/j.lanepe.2024.101125","DOIUrl":"10.1016/j.lanepe.2024.101125","url":null,"abstract":"<div><h3>Background</h3><div>Sustaining the capabilities of dementia carers is a global priority. ‘iSupport’ is a self-guided online intervention designed by the World Health Organization (WHO) to reduce mental health problems in dementia carers. iSupport is undergoing global implementation, however there is an absence of effectiveness evidence. This study tested the effectiveness of iSupport to reduce distress and depression in dementia carers.</div></div><div><h3>Methods</h3><div>A pragmatic randomised controlled trial was conducted in three centres. Adult carers (18+) living in the community were recruited in England, Wales and Scotland and randomly assigned (1:1) through a web-based system to iSupport or usual care. Outcome assessors were masked to allocation. The primary outcomes assessed the difference in distress and depression between baseline and six-months. The target sample size was 350 to enable 90% power, significance at 2.5% including 25% attrition (262 completers) on either outcome. Analysis followed the intention-to-treat (ITT) principle. The trial was registered with ISRCTN registry (17420703).</div></div><div><h3>Findings</h3><div>Between 12th November 2021 and 31st March 2023,177 carers (50.3%) were randomised to usual care and 175 (49.7%) to iSupport. 263 (74.7%) completed the trial. All were included in the ITT analysis. Mean distress scores at six-months were 20.0 (SD = 8.3) for usual care and 20.6 (SD = 8.6) for iSupport. The mean difference was 0.16 (95% CI −1.17 to 1.49, p = 0.29) after adjusting for covariates. Mean depression scores at six-months were 9.5 (SD = 7.0) for usual care and 9.8 (SD = 6.5) for iSupport. The mean difference at six-months was −0.54 (95% CI = −1.70 to 0.62, p = 0.44). No serious adverse events were linked to the trial.</div></div><div><h3>Interpretation</h3><div>To our knowledge this is the largest trial evaluating a self-guided online intervention in UK dementia carers, and the first to successfully evaluate the effectiveness of iSupport. The null findings are significant given the ongoing global implementation of iSupport by the WHO and the adoption of self-guided interventions into mainstream care delivery as part of digital health transformations.</div></div><div><h3>Funding</h3><div>NIHR.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101125"},"PeriodicalIF":13.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Antihypertensive medication classes and risk of incident dementia in primary care patients: a longitudinal cohort study in the Netherlands” [The Lancet Regional Health—Europe, Volume 42, July 2024, 100927]","authors":"Jakob L. Schroevers ,&nbsp;Marieke P. Hoevenaar-Blom ,&nbsp;Wim B. Busschers ,&nbsp;Monika Hollander ,&nbsp;Willem A. Van Gool ,&nbsp;Edo Richard ,&nbsp;Jan Willem Van Dalen ,&nbsp;Eric P. Moll van Charante","doi":"10.1016/j.lanepe.2024.101132","DOIUrl":"10.1016/j.lanepe.2024.101132","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101132"},"PeriodicalIF":13.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wealth and health: the neglected economic determinant","authors":"Rebeka Balogh,&nbsp;S Vittal Katikireddi","doi":"10.1016/j.lanepe.2024.101138","DOIUrl":"10.1016/j.lanepe.2024.101138","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101138"},"PeriodicalIF":13.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}