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Ren S, Li J, Dorado J, Sierra A, González-Díaz H, Duardo A, Shen B. From molecular mechanisms of prostate cancer to translational applications: based on multi-omics fusion analysis and intelligent medicine. Health Inf Sci Syst 2024; 12:6. [PMID: 38125666 PMCID: PMC10728428 DOI: 10.1007/s13755-023-00264-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
Prostate cancer is the most common cancer in men worldwide and has a high mortality rate. The complex and heterogeneous development of prostate cancer has become a core obstacle in the treatment of prostate cancer. Simultaneously, the issues of overtreatment in early-stage diagnosis, oligometastasis and dormant tumor recognition, as well as personalized drug utilization, are also specific concerns that require attention in the clinical management of prostate cancer. Some typical genetic mutations have been proved to be associated with prostate cancer's initiation and progression. However, single-omic studies usually are not able to explain the causal relationship between molecular alterations and clinical phenotypes. Exploration from a systems genetics perspective is also lacking in this field, that is, the impact of gene network, the environmental factors, and even lifestyle behaviors on disease progression. At the meantime, current trend emphasizes the utilization of artificial intelligence (AI) and machine learning techniques to process extensive multidimensional data, including multi-omics. These technologies unveil the potential patterns, correlations, and insights related to diseases, thereby aiding the interpretable clinical decision making and applications, namely intelligent medicine. Therefore, there is a pressing need to integrate multidimensional data for identification of molecular subtypes, prediction of cancer progression and aggressiveness, along with perosonalized treatment performing. In this review, we systematically elaborated the landscape from molecular mechanism discovery of prostate cancer to clinical translational applications. We discussed the molecular profiles and clinical manifestations of prostate cancer heterogeneity, the identification of different states of prostate cancer, as well as corresponding precision medicine practices. Taking multi-omics fusion, systems genetics, and intelligence medicine as the main perspectives, the current research results and knowledge-driven research path of prostate cancer were summarized.
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Affiliation(s)
- Shumin Ren
- Department of Urology and Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu, 610041 China
- Department of Computer Science and Information Technology, University of A Coruña, 15071 A Coruña, Spain
| | - Jiakun Li
- Department of Urology and Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Julián Dorado
- Department of Computer Science and Information Technology, University of A Coruña, 15071 A Coruña, Spain
| | - Alejandro Sierra
- Department of Computer Science and Information Technology, University of A Coruña, 15071 A Coruña, Spain
- IKERDATA S.L., ZITEK, University of Basque Country UPVEHU, Rectorate Building, 48940 Leioa, Spain
| | - Humbert González-Díaz
- Department of Computer Science and Information Technology, University of A Coruña, 15071 A Coruña, Spain
- IKERDATA S.L., ZITEK, University of Basque Country UPVEHU, Rectorate Building, 48940 Leioa, Spain
| | - Aliuska Duardo
- Department of Computer Science and Information Technology, University of A Coruña, 15071 A Coruña, Spain
- IKERDATA S.L., ZITEK, University of Basque Country UPVEHU, Rectorate Building, 48940 Leioa, Spain
| | - Bairong Shen
- Department of Urology and Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu, 610041 China
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Magedanz L, Silva HL, Galato D, Fernandez-Llimos F. Clinical pharmacy key performance indicators for hospital inpatient setting: a systematic review. Int J Clin Pharm 2024; 46:602-613. [PMID: 38570475 PMCID: PMC11133179 DOI: 10.1007/s11096-024-01717-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/21/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Key performance indicators (KPIs) are quantifiable measures used to monitor the quality of health services. Implementation guidelines for clinical pharmacy services (CPS) do not specify KPIs. AIM To assess the quality of the studies that have developed KPIs for CPS in inpatient hospital settings. METHOD A systematic review was conducted by searching in Web of Science, Scopus, and PubMed, supplemented with citation analyses and grey literature searches, to retrieve studies addressing the development of KPIs in CPS for hospital inpatients. Exclusions comprised drug- or disease-specific studies and those not written in English, French, Portuguese, or Spanish. The Appraisal of Indicators through Research and Evaluation (AIRE) instrument assessed methodological quality. Domain scores and an overall score were calculated using an equal-weight principle. KPIs were classified into structure, process, and outcome categories. The protocol is available at https://doi.org/10.17605/OSF.IO/KS2G3 . RESULTS We included thirteen studies that collectively developed 225 KPIs. Merely five studies scored over 50% on the AIRE instrument, with domains #3 (scientific evidence) and #4 (formulation and usage) displaying low scores. Among the KPIs, 8.4% were classified as structure, 85.8% as process, and 5.8% as outcome indicators. The overall methodological quality did not exhibit a clear association with a major focus on outcomes. None of the studies provided benchmarking reference values. CONCLUSION The KPIs formulated for evaluating CPS in hospital settings primarily comprised process measures, predominantly suggested by pharmacists, with inadequate evidence support, lacked piloting or validation, and consequently, were devoid of benchmarking reference values.
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Affiliation(s)
- Lucas Magedanz
- Postgraduate Program in Health Sciences and Technologies, University of Brasília, Brasília, DF, Brazil
| | - Hiolanda Lêdo Silva
- Postgraduate Program in Health Sciences and Technologies, University of Brasília, Brasília, DF, Brazil
| | - Dayani Galato
- Postgraduate Program in Health Sciences and Technologies, University of Brasília, Brasília, DF, Brazil
| | - Fernando Fernandez-Llimos
- UCIBIO-Applied Molecular Biosciences Unit, i4HB-Institute for Health and Bioeconomy, Laboratory of Pharmacology, Faculty of Pharmacy, University of Porto, Porto, Portugal.
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Viegas R, Silva F, Nørgaard LS, Duarte-Ramos F, Mendes R, Alves da Costa F. Physical activity promotion in the community pharmacy: An opportunity for an expanded role? Res Social Adm Pharm 2024; 20:345-352. [PMID: 38129220 DOI: 10.1016/j.sapharm.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Physical inactivity is a major risk factor for the development of chronic diseases, and it is increasingly prevalent in the Portuguese population. Pharmacists' role in promoting physical activity (PA) is still not well established, although health promotion is foreseen by law in Portugal. Competing tasks and location where the pharmacy is embedded can hinder this promotion in their daily practice. OBJECTIVE The aim of this study was to identify the main barriers and facilitators of physical activity promotion (PAP) in Portuguese community pharmacies and explore possible pathways for future implementation of physical activity promotion. METHODS In-depth, semi-structured interviews were conducted with purposively enrolled community pharmacists. Participant recruitment was aligned with data saturation. Data analysis comprised a mixed model of a deductive theme mapping strategy using the Theoretical Domains Framework (TDF) for the behaviour of promoting physical activity and an inductive approach for any other relevant themes and which might influence PA promotion. RESULTS Data saturation was reached at eleven interviews. Barriers and facilitators for the behaviour of promoting PA were identified from 11 out of the 14 TDF domains. Following an inductive approach, other emerging codes were clustered in additional seven major themes. Highlighted barriers focused on domains #1 - Knowledge, #10 - Memory, Attention and Decision Processes and #13 - Environmental Context and Resources. Community mapping, establishment of remuneration models and the use of digital technologies were suggested as additional potential contributors to scale up PAP. CONCLUSION Community pharmacists are well placed inside their communities to serve as a focal point for signposting, engagement with other healthcare professionals and community resources and activities organized by the pharmacy itself. Pharmacists should be supported in being knowledgeable, aware, and available when promoting PA in their daily counseling.
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Affiliation(s)
- Ruben Viegas
- Faculty of Pharmacy, University of Lisbon - imed, Research Institute for Medicines, Lisboa, Portugal.
| | - Filipa Silva
- Faculty of Sciences and Technology, University of the Algarve, Faro, Portugal
| | - Lotte Stig Nørgaard
- Faculty of Health and Medical Sciences, Department of Pharmacy, University of Copenhagen, Denmark
| | - Filipa Duarte-Ramos
- Faculty of Pharmacy, University of Lisbon - imed, Research Institute for Medicines, Lisboa, Portugal
| | - Romeu Mendes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; ACES Douro I - Marão e Douro Norte, Administração Regional de Saúde do Norte, Vila Real, Portugal
| | - Filipa Alves da Costa
- Faculty of Pharmacy, University of Lisbon - imed, Research Institute for Medicines, Lisboa, Portugal
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Okazawa Y, Kizaki H, Suzuki N, Osaka W, Hori S. Influence of Participation in a Medical-Themed Science Café on Patient Activation. Patient Prefer Adherence 2023; 17:3093-3106. [PMID: 38045110 PMCID: PMC10693243 DOI: 10.2147/ppa.s424460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/10/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose This study aims to investigate the impact of a Science Café (SC) dealing with medical topics on participants' patient activation (PA), a concept that refers to patients' involvement in managing their own health, working with their healthcare providers, and maintaining their health. Material and Methods Semi-structured interviews were conducted with patients who had participated in a medical SC (n = 10) to identify the medical SC-associated factors that influenced PA. Through a questionnaire of medical SC participants (n = 23), the impact on PA and correlations with relevant psychological measures were quantitatively assessed. Results The interviews revealed three factors: "Experience & acceptance of chronic conditions", "Features of medical SC" and "Changes as a result of participation." The questionnaire results showed a positive correlation between PA and resilience and a negative correlation with decision regret. Conclusions Participation in a medical SC by people with illnesses can improve PA by improving knowledge and skills for self-management and increasing self-awareness of illness in a supportive environment. The study highlights the potential benefits of using medical SC as a strategy for healthcare providers to improve PA and health outcomes.
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Affiliation(s)
- Yuta Okazawa
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, 105-8512, Japan
| | - Hayato Kizaki
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, 105-8512, Japan
| | | | - Wakako Osaka
- Keio University Faculty of Nursing and Medical Care, Tokyo, 160-8582, Japan
| | - Satoko Hori
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, 105-8512, Japan
- Patient Salon Association, Tokyo, Japan
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Bourne JE, Foster C, Forte C, Aning J, Potter S, Hart EC, Armstrong MEG. Study protocol for two pilot randomised controlled trials aimed at increasing physical activity using electrically assisted bicycles to enhance prostate or breast cancer survival. Pilot Feasibility Stud 2023; 9:68. [PMID: 37095588 PMCID: PMC10124052 DOI: 10.1186/s40814-023-01293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND In 2020, 1.4 and 2.3 million new cases of prostate cancer and breast cancer respectively were diagnosed globally. In the UK, prostate cancer is the most common male cancer, while breast cancer is the most common female cancer. Engaging in physical activity (PA) is a key component of treatment. However, rates of PA are low in these clinical populations. This paper describes the protocol of CRANK-P and CRANK-B, two pilot randomised controlled trials, involving an e-cycling intervention aimed at increasing PA in individuals with prostate cancer or breast cancer respectively. METHODS These two trials are single-centre, stratified, parallel-group, two-arm randomised waitlist-controlled pilot trials in which forty individuals with prostate cancer (CRANK-P) and forty individuals with breast cancer (CRANK-B) will be randomly assigned, in a 1:1 allocation ratio, to an e-cycling intervention or waitlist control. The intervention consists of e-bike training with a certified cycle instructor, followed by the provision of an e-bike for 12 weeks. Following the intervention period, participants in the e-bike condition will be directed to community-based initiatives through which they can access an e-bike. Data will be collected at baseline (T0), immediately post intervention (T1) and at 3-month follow-up (T2). In addition, in the intervention group, data will be collected during the intervention and follow-up periods. Quantitative and qualitative methods will be used. The primary objectives are to determine effective recruitment strategies, establish recruitment and consent rates, adherence and retention in the study, and determine the feasibility and acceptability of the study procedures and intervention. The potential impact of the intervention on clinical, physiological and behavioural outcomes will be assessed to examine intervention promise. Data analyses will be descriptive. DISCUSSION The findings from these trials will provide information on trial feasibility and highlight the potential of e-cycling as a strategy to positively impact the health and behaviour of individuals with prostate cancer and breast cancer. If appropriate, this information can be used to design and deliver a fully powered definitive trial. TRIAL REGISTRATION CRANK-B: [ISRCTN39112034]. CRANK-P [ISRCTN42852156]. Registered [08/04/2022] https://www.isrctn.com .
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Chloe Forte
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Jonathan Aning
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK
| | - Shelley Potter
- Bristol Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK
- Bristol Medical School, Translational Health Sciences, University of Bristol, 5 Tyndall Avenue, Bristol, BS8 1UD, UK
| | - Emma C Hart
- Biomedical Sciences Building, School of Physiology, Pharmacology & Neuroscience, University of Bristol, University Walk, Bristol, BS8 1TD, UK
| | - Miranda E G Armstrong
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
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Vohra Y, Brown CM, Moczygemba LR, Wilfong L. Evaluating the relationship between patient activation and health-related quality of life (HRQOL) in patients with pancreatic cancer (PwPC). Support Care Cancer 2023; 31:191. [PMID: 36847972 DOI: 10.1007/s00520-023-07632-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/06/2023] [Indexed: 02/28/2023]
Abstract
PURPOSE Advanced pancreatic cancer is synonymous with a high mortality rate, debilitating symptom profile, and minimal prolongation in overall survival. Therefore, health-related quality of life (HRQOL) is important in patients with pancreatic cancer (PwPC). In chronic conditions, patient activation is positively associated and higher HRQOL. However, no known study has evaluated patient activation, HRQOL, and their association in PwPC. METHODS A 43-item cross-sectional survey assessed patient activation and HRQOL of patients with locally advanced and metastatic pancreatic cancer undergoing chemotherapy. Variables were analyzed descriptively, and relationships were assessed using bivariate statistics (sig p < 0.05). RESULTS Fifty-six patients participating in the study had an average age of 69.5 ± 11.1 years, and the majority were females (51.8%), Caucasians (61.8%), married/partnered (64.3%), and had at least a college degree (59%). Almost half were at stage 4 (48.2%), and most were newly diagnosed (66.1%). Mean patient activation score was 63.5 ± 17.2 (scale range: 0-100), with most at higher activation levels of 3 or 4 (66.7%). Mean HRQOL score of 41.0 ± 12.7 (scale range: 0-72) was low. Patient activation levels, age, education level, and gender explained 21% of variation in overall HRQOL scores. Patients at activation level 4 had significantly higher overall HRQOL versus those at lower activation (level 1 or 2). Higher patient activation was significantly associated with having either private insurance only or multiple insurances and being partnered. CONCLUSION Patient activation significantly predicted HRQOL in PwPC despite the low sample size. Initiatives to increase patient activation should focus on patients of low socioeconomic status and those without partner support.
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Affiliation(s)
- Yogesh Vohra
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA.
| | - Carolyn M Brown
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
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Pano O, Rincón MG, Bullón-Vela V, Aguilera-Buenosvinos I, Diaz ZR, Minder B, Kopp-Heim D, Laine-Carmeli J, Martínez González M, Martinez J, Sayón-Orea C. Eating behaviors and health-related quality of life: A scoping review. Maturitas 2022; 165:58-71. [DOI: 10.1016/j.maturitas.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 10/31/2022]
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Wang J, Wang Q, Bao Z, Peng Y, Liu S, Yu T, Wang L, Yang G, Gao M, Sun G. The Combined Effects of Patient Activation and Relational Aspects on the Quality of Life in Atrial Fibrillation Patients. Front Psychol 2021; 12:761149. [PMID: 34867661 PMCID: PMC8636326 DOI: 10.3389/fpsyg.2021.761149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Objective: This study aims to explore the influence of patient activation (PA) and relational aspects on the quality of life (QoL) in patients with Atrial Fibrillation (AF) for developing measures to improve PA and QoL. Methods: A cross-sectional study was undertaken in 2021 among 190 AF patients in Nanjing, China. Research instruments included a self-designed social-demographic characteristics scale, the Patient Activation Measure (PAM), the Atrial Fibrillation Effect on Quality of Life (AFEQT). The data analysis was performed using IBM SPSS 25.0. Spearman correlation analysis, multiple linear regression analysis, and Wilcoxon rank-sum tests were used to assess the association accordingly. Results: The average AFEQT score for the 190 AF patients was 69.32 ± 14.52. The distribution of activation Levels 1, 2, 3, and 4, were where 4.7, 34.2, 47.4, and 13.7%, respectively. The multiple linear regression analysis revealed that patient activation, work status, and cardiac rehabilitation of AF patients predicted AF-related QoL (β = 0.270, -0.205, and 0.183, respectively; all P < 0.05). The influences of PA level on subdimensions of AF-related QoL were as follows: symptoms, daily activities and treatment concern. Conclusion: The level of QoL of patients with AF was moderate. Higher levels of patient activation in those with AF were associated with milder symptoms, more positive daily activities and fewer treatment concern. Based on our findings, we suggest that healthcare personnel should encourage AF patients to take active participation in cardiac rehabilitation, disease self-management and foster progression of PA level. Future research is warranted to develop tailor-made interventions aimed at the activation level.
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Affiliation(s)
- Jie Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Qin Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhipeng Bao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuanyuan Peng
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Shenxinyu Liu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Tianxi Yu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Lin Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Gang Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Min Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guozhen Sun
- School of Nursing, Nanjing Medical University, Nanjing, China
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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