Explore the vast range of titles available.

Background 3D-printing, compared to conventional medicine manufacturing technologies, is a versatile and highly modifiable technique that has the flexibility to produce medicine that meet patients’ specific requirements such as individualized dosing, but also to customize the appearance of the dosage form, e.g., shape and colour. Objective To explore polypharmacy patients’ perceptions and preferences regarding 3D-printed medicine, including their acceptability of patient-designed medicine. Setting The study was conducted in Zealand, Denmark. Method Polypharmacy patients were recruited using convenience sampling (mostly on Facebook) and interviewed twice using semi-structured interviews. Interviews were analysed thematically into five predetermined themes (shapes, colours, embossing designs, polypills, and patient-designed dosage forms). At the first interview patients were asked about their perceptions and preferences towards 3D-printed solid dosage forms, and were presented to different shapes, colours, embossing designs and examples of polypills. They were also invited to design their own medicine from the ones presented. Their self-designed medicines were presented at the second interview, where acceptability of both their self-designed medicine and the concept of designing one’s own medicine, was investigated. Main outcome measure Patients’ perceptions, preferences towards and acceptability of 3D-printed medicines. Results Eight patients were included. They tended to prefer shapes similar to conventional medicine. Different colours were preferred by different people. The presented embossing designs seemed to be irrelevant. Polypills were generally believed to be a good idea due to the reduction of number of medicines. Acceptability of patient-designed medicine was mainly determined by whether patients thought 3Dprinting technology was reliable or not. Conclusions The patients had various perceptions and preferences of 3D-printed medicine. Factors affecting the patient views were aesthetic (appealing), physiological (swallowing), practical (handling), pedagogical (understanding) and psychological (relate to). Trust in the technology seemed to be important for acceptability.

Since their introduction, chewable dosage forms have gained traction due to their ability to facilitate swallowing, especially in paediatric, geriatric and dysphagia patients. Their benefits stretch beyond human use to also include veterinary applications, improving administration and palatability in different animal species. Despite their advantages, current chewable formulations do not account for individualised dosing and palatability preferences. In light of this, three-dimensional (3D) printing, and in particular the semi-solid extrusion technology, has been suggested as a novel manufacturing method for producing customised chewable dosage forms. This advanced approach offers flexibility for selecting patient-specific doses, excipients, and organoleptic properties, which are critical for ensuring efficacy, safety and adherence to the treatment. This review provides an overview of the latest advancements in chewable dosage forms for human and veterinary use, highlighting the motivations behind their use and covering formulation considerations, as well as regulatory aspects.

Abstract Background It is unclear whether moderate-intensity aerobic exercise is feasible and safe for inpatients with non-hematological cancer receiving one cycle of chemotherapy. Objectives To evaluate adherence, compliance, acceptability, adverse events, and clinical stability during a short-term moderate-intensity aerobic training in non-hematological inpatients undergoing one cycle of chemotherapy. Methods This feasibility and safety study included adults with non-hematological cancer inpatients receiving one cycle of chemotherapy. Patients participated in four consecutive days of moderate-intensity aerobic training using a cycle ergometer, during which vital signs and perceived exertion were monitored. Following the intervention, patients were assessed for the acceptability of intervention. Adherence rates, compliance, and adverse events related to the training were also recorded. Results Twenty patients (mean age 61 ± 15 years, mean BMI 25 ± 8 kg/m2; 75% with digestive cancers, 50% physically active) were analyzed. Adherence to the intervention was 92%, compliance was 68.6%, and acceptability was reported at 100%. Vital signs and perceived exertion remained stable throughout all training sessions (heart rate P = .99, peripheral O2 saturation P = .54, mean arterial blood pressure P = .79, sensation of dyspnea P = .97). Two patients reported adverse events during training (vomiting and extreme fatigue), while three experienced adverse effects post-training (tremor, nausea, and back pain). Conclusions Short-term moderate-intensity aerobic training for inpatients with non-hematological cancer undergoing one cycle of chemotherapy is feasible and safe.

Background Integrating patient and community input is essential to the relevance and impact of patient-focused research. However, specific techniques for generating patient and community-informed research decisions remain limited. This manuscript describes a novel CASCADE method (Community-Engaged Approach for Scientific Collaborations and Decisions) that was developed and implemented to make actionable, patient-centered research decisions during a federally funded clinical trial. Methods The CASCADE method was developed to facilitate decision-making, combining techniques from a variety of past methodologies with new approaches that aligned with project constraints and goals. The final result was a series of procedures that spanned seven thematic pillars (1) identifying a shared, specific, and actionable goal; (2) centering community input; (3) integrating both pre-registered statistical analyses and exploratory “quests”; (4) fixed-pace scheduling, supported by technology; (5) minimizing opportunities for cognitive biases typical to group decision making; (6) centering diversity experiences and perspectives, including those of individual patients; (7) making decisions that are community-relevant, rigorous, and feasible. The final approach was piloted within an active clinical trial, with the primary goal of describing feasibility (participation, discussion topics, timing, quantity of outputs). Results The inaugural CASCADE panel aimed to identify ways to improve an algorithm for matching patients to specific types of telehealth programs within an active, federally funded clinical trial. The panel was attended by 27 participants, including 5 community interest-holders. Data reviewed to generate hypotheses and make decisions included (1) pre-registered statistical analyses, (2) results of 12 “quests” that were launched during the panel to answer specific panelist questions via exploratory analyses or literature review, (3) qualitative and quantitative patient input, and (4) team member input, including by staff who represented the focal patient population for the clinical trial. CASCADE pillars were successfully integrated to generate 18 initial and 6 final hypotheses, which were translated to 19 decisional changes. Conclusions The CASCADE approach was an effective tool for rapidly, efficiently making patient-centered decisions during an ongoing, federally funded clinical trial. Opportunities for further development will include exploring best-practice structural procedures, enhancing greater opportunities for pre-panel input by community interest-holders, and determining how to best standardize CASCADE outputs. Trial registration The CASCADE procedure was developed in the context of NCT05999448.

Despite the development of effective drugs for treatment, tuberculosis remains one of the leading causes of death from an infectious disease worldwide. One of the greatest challenges to tuberculosis control is patient adherence to treatment. Recent research has shown that video-based directly observed therapy is a feasible and effective approach to supporting treatment adherence in high-income settings. However, few studies have explored the potential for such a solution in a low- or middle-income country setting. Globally, these countries' rapidly rising rate of mobile penetration suggests that the potential for translation of these results may be high. We sought to examine patient perceptions related to the use of mobile health, and specifically video-based directly observed therapy, in a previously unstudied patient demographic: patients with tuberculosis in a low-income country setting (Cambodia). We conducted a cross-sectional qualitative study in urban and periurban areas in Cambodia, consisting of 6 focus groups with tuberculosis patients who were receiving treatment (standard directly observed therapy) through a nongovernmental organization. Familiarity with mobile technology and apps was widespread in this population, and overall willingness to consider a mobile app for video-based directly observed therapy was high. However, we identified potential challenges. First, patients very much valued their frequent in-person interactions with their health care provider, which may be reduced with the video-based directly observed therapy intervention. Second, there may be technical issues to address, including how to make the app suitable for illiterate participants. While video-based directly observed therapy is a promising technology, even in country settings where mobile penetration is reportedly almost universal, it should be introduced with caution. However, the results were generally promising and yielded important insights that not only will be translated into the further adaptation of key features of video-based directly observed therapy for tuberculosis patients in Cambodia, but also can inform the future design and successful implementation of video-based directly observed therapy interventions in low- and middle-income settings more generally.

Cognitive behaviour therapy (CBT) is widely used to treat depression. However, CBT is not always available to patients because of a shortage of therapists and long waiting times. Computerized CBT (CCBT) is one of several alternatives currently available to treat patients with depression. Evidence of its clinical effectiveness has led to programs being used increasingly within the UK and elsewhere. However, little information is available regarding the acceptability of CCBT to patients. A systematic review of sources of information on acceptability to patients of CCBT for depression. Sources of information on acceptability included: recruitment rates, patient drop-outs and patient-completed questionnaires. We identified 16 studies of CCBT for the treatment of depression that provided at least some information on these sources. Limited information was provided on patient take-up rates and recruitment methods. Drop-out rates were comparable to other forms of treatment. Take-up rates, when reported, were much lower. Six of the 16 studies included specific questions on patient acceptability or satisfaction although information was only provided for those who had completed treatment. Several studies have reported positive expectancies and high satisfaction in routine care CCBT services for those completing treatment. Trials of CCBT should include more detailed information on patient recruitment methods, drop-out rates and reasons for dropping out. It is important that well-designed surveys and qualitative studies are included alongside trials to determine levels and determinants of patient acceptability.

Background Wearable sensors and other smart technology may be especially beneficial in providing remote monitoring of sub-clinical changes in pregnancy health status. Yet, limited research has examined perceptions among pregnant patients and providers in incorporating smart technology into their daily routine and clinical practice. Objective The purpose of this study was to examine the perceptions of pregnant women and their providers at a rural health clinic on the use of wearable technology to monitor health and environmental exposures during pregnancy. Methods An anonymous 21-item e-survey was administered to family medicine or obstetrics and gynecology (n=28) providers at a rural health clinic; while a 21-item paper survey was administered to pregnant women (n=103) attending the clinic for prenatal care. Results Smartphone and digital technology use was high among patients and providers. Patients would consider wearing a mobile sensor during pregnancy, reported no privacy concerns, and felt comfortable sharing information from these devices with their physician. About seven out of 10 women expressed willingness to change their behavior during pregnancy in response to receiving personalized recommendations from a smartphone. While most providers did not currently use smart technologies in their medical practice, about half felt it will be used more often in the future to diagnose and remotely monitor patients. Patients ranked fetal heart rate and blood pressure as their top preference for health monitoring compared to physicians who ranked blood pressure and blood glucose. Patients and providers demonstrated similar preferences for environmental monitoring, but patients as a whole expressed more interests in tracking environmental measures compared to their providers. Conclusions Patients and providers responded positively to the use of wearable sensor technology in prenatal care. More research is needed to understand what factors might motivate provider use and implementation of wearable technology to improve the delivery of prenatal care.

Osteoporosis is a global health concern causing severe fractures, and timely diagnosis with thorough bone assessment is crucial for effective management. Diagnostic tools such as Bindex (a novel ultrasound-based diagnostic technology) and DXA (X-ray-based) play a key role in identifying and assessing bone conditions. This study aimed to evaluate and compare these two approaches' overall acceptability, comfort, and preference. Feelings of pain and perceptions regarding the scan length during the Bindex scanning procedure were also assessed. Two diagnostic imaging tools were used in this comparative study: Bindex (pulse-echo ultrasound technology) and DXA (X-ray technology). A bespoke questionnaire was employed to gather the participants' responses, which were coded numerically, and data were analysed statistically. Despite minor discomfort associated with the gel application, Bindex received significantly higher acceptability and comfort ratings than DXA, with many participants preferring its non-ionising radiation. Both methods were generally well-received, though some favoured DXA for not requiring gel. In addition to enhancing diagnostic workflows, we demonstrated that Bindex scans can improve patient satisfaction. This study emphasised the importance of innovating medical imaging diagnostic tools to prioritise patient acceptability and comfort.

Background Plaque disclosing agents facilitate the visualization of dental biofilm and support effective oral hygiene instruction. Erythrosine remains the most commonly used agent; however, concerns regarding its safety and regulatory restrictions have prompted the search for alternative colorants. This study aimed to evaluate and compare the clinical performance and user acceptability of three plaque disclosing formulations: 3% erythrosine, 3% D&C Red No. 33, and a mixed formulation of 3% D&C Red No. 33 with green powder. Methods A randomized cross-over clinical design was employed. Subjective outcomes were assessed using visual analogue scales (VAS) for plaque visibility, residual staining, brushing difficulty, and taste satisfaction. Objective plaque accumulation was measured with the Turesky modification of the Quigley–Hein Plaque Index (TQHPI) by a calibrated examiner before and after oral hygiene procedures. Results Erythrosine produced the highest plaque visibility scores, significantly exceeding those of both alternative agents. However, all formulations showed comparable percentage reductions in plaque index following brushing and flossing. Residual staining was greatest with erythrosine, particularly on oral mucosa and lips, whereas D&C Red No. 33 produced the least. The mixed formulation yielded intermediate outcomes but demonstrated the lowest overall plaque visibility. Participants reported significantly greater difficulty in stain removal with erythrosine compared to D&C Red No. 33. Taste acceptability was highest for D&C Red No. 33, intermediate for the mixed formulation, and lowest for erythrosine. Conclusions While erythrosine provides superior plaque visibility, its drawbacks in staining persistence, brushing difficulty, and taste limit acceptability. D&C Red No. 33 demonstrated a more favorable balance between effectiveness and user acceptance, supporting its potential as an alternative plaque disclosing agent. Trial registration The trial was registered at Thai Clinical Trials Registry (Trial registration number: TCTR20250313002) on 13 March 2025.

Introduction: Sodium picosulfate plus magnesium citrate is a bowel preparation agent with high patient acceptability. However, it is unclear which patients are more likely to have inadequate bowel preparation when using this agent. This study aimed to identify the risk factors for inadequate bowel preparation when using sodium picosulfate plus magnesium citrate for colonoscopy and to develop a scoring model to predict which patients will have inadequate bowel preparation. Methods: A total of 350 Japanese patients were enrolled from June 2021 to April 2022. Data on patient background, details of colonoscopy, and satisfaction assessment questionnaire results were prospectively collected. The scoring model for inadequate bowel preparation was developed based on multiple logistic regression analyses, and its performance was internally validated using bootstrapping. Results: Adequate bowel preparation was obtained in 295 patients (84.3%); 335 (95.7%) were able to ingest the drug without difficulty. The scoring model consisted of five independent risk factors and points of risk scores were assigned to each one as follows: American Society of Anesthesiologists physical status III (1 point), diabetes comorbidities (5 points), use of laxatives (4 points), no defecation once in a day (2 points), and drug use for mental disorder (6 points). The C-statistics of the scoring system for inadequate bowel preparation was 0.75. Discussion: We identified five risk factors for inadequate bowel preparation when using sodium picosulfate plus magnesium citrate regimen and developed a scoring model for inadequate bowel preparation with satisfactory discrimination and calibration.