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Development of a Preliminary Question Prompt List as a Communication Tool for Adults With Achalasia: A Modified Delphi Study. J Clin Gastroenterol 2023; 57:159-164. [PMID: 35180150 DOI: 10.1097/mcg.0000000000001671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/17/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Question prompt lists (QPLs) are structured sets of disease-specific questions that enhance patient-physician communication by encouraging patients to ask questions during consultations. AIM The aim of this study was to develop a preliminary achalasia-specific QPL created by esophageal experts. METHODS The QPL content was derived through a modified Delphi method consisting of 2 rounds. In round 1, experts provided 5 answers to the prompts "What general questions should patients ask when given a new diagnosis of achalasia" and "What questions do I not hear patients asking, but given my expertise, I believe they should be asking?" In round 2, experts rated questions on a 5-point Likert scale. Questions considered "essential" or "important" were accepted into the QPL. Feedback regarding the QPL was obtained in a pilot study wherein patients received the QPL before their consultation and completed surveys afterwards. RESULTS Nineteen esophageal experts participated in both rounds. Of 148 questions from round 1, 124 (83.8%) were accepted into the QPL. These were further reduced to 56 questions to minimize redundancy. Questions were categorized into 6 themes: "What is achalasia," "Risks with achalasia," "Symptom management in achalasia," "Treatment of achalasia," "Risk of reflux after treatment," and "Follow-up after treatment." Nineteen patients participated in the pilot, most of whom agreed that the QPL was helpful (84.2%) and recommended its wider use (84.2%). CONCLUSIONS This is the first QPL developed specifically for adults with achalasia. Although well-received in a small pilot, follow-up studies will incorporate additional patient feedback to further refine the QPL content and assess its usability, acceptability, and feasibility.
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Yamane T, Inaba O, Hachisuka E, Yamashita S, Yoshimura M, Nitta JI. Persistent diarrhea following catheter ablation for atrial fibrillation: A lesser-known complication of left atrial ablation procedures. HeartRhythm Case Rep 2021; 7:633-636. [PMID: 34552858 PMCID: PMC8441211 DOI: 10.1016/j.hrcr.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Osamu Inaba
- Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Eri Hachisuka
- Department of Social Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Seigo Yamashita
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Jun-Ichi Nitta
- Department of Cardiology, Sakakibara Memorial Hospital, Tokyo, Japan
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Schwameis K, Zehetner J, Rona K, Crookes P, Bildzukewicz N, Oh DS, Ro G, Ross K, Sandhu K, Katkhouda N, Hagen JA, Lipham JC. Post-Nissen Dysphagia and Bloating Syndrome: Outcomes After Conversion to Toupet Fundoplication. J Gastrointest Surg 2017; 21:441-445. [PMID: 27834011 DOI: 10.1007/s11605-016-3320-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 10/31/2016] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Protracted dysphagia and bloating are potential troublesome side effects following Nissen fundoplication. The aim of this study was to evaluate the effects of conversion from Nissen to Toupet on dysphagia and bloating. METHODS The study used a retrospective chart review of all patients who had undergone conversion from Nissen to Toupet between 2001 and 2014. Endpoints were to determine the effect of conversion on dysphagia, bloating, and reflux control. RESULTS Twenty-five patients underwent conversion at a median of 3.7 years (1.4-10.5) after initial fundoplication. Indications were dysphagia in 19 (76%) and bloating syndrome in 6 (24%) patients. The median operative time was 104 min (86-146). There were no serious complications or mortality. Median follow-up was 27 months (0.8-130). Dysphagia was relieved in 16 (84%) and bloating in all 6 patients. Two patients developed reflux requiring a redo-Nissen. Two patients had persistent dysphagia and required endoscopic dilation. The GERD-HRQL post-conversion showed a median score of 5 (3-13). CONCLUSIONS Conversion relieved dysphagia in 84% and bloating in 100%. Significant recurrence of GERD was rare. Given the absence of serious complications, conversion should be considered in patients with severe bloating or dysphagia.
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Affiliation(s)
- Katrin Schwameis
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Jörg Zehetner
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Kais Rona
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Peter Crookes
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Nikolai Bildzukewicz
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Daniel S Oh
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Geoffrey Ro
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Katherine Ross
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Kulmeet Sandhu
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Namir Katkhouda
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - Jeffrey A Hagen
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA
| | - John C Lipham
- Division of Upper GI & General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, #514, 90033, Los Angeles, CA, USA.
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