Cargando…
Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give?
This perspective review considers analytic features of the design of a longitudinal trial regarding antimicrobial therapy in older terminal cancer patients receiving palliative care. We first overview antimicrobial use at the end of life; both the potential hazards and benefits. Antimicrobial prescr...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378640/ https://www.ncbi.nlm.nih.gov/pubmed/30800269 http://dx.doi.org/10.1177/2042098618820210 |
_version_ | 1783395961126518784 |
---|---|
author | Juthani-Mehta, Manisha Allore, Heather G. |
author_facet | Juthani-Mehta, Manisha Allore, Heather G. |
author_sort | Juthani-Mehta, Manisha |
collection | PubMed |
description | This perspective review considers analytic features of the design of a longitudinal trial regarding antimicrobial therapy in older terminal cancer patients receiving palliative care. We first overview antimicrobial use at the end of life; both the potential hazards and benefits. Antimicrobial prescribing should consider both initiation as well as cessation of medications when analyzing the burden of medications. Approaches to decision making regarding antimicrobial use are presented and the importance of health literacy in these decision processes. We next present aspects of both feasibility and comparative trial design with a health literacy intervention to reduce antimicrobial use in older terminal cancer patients receiving palliative care. Considerations to clustered randomization and given that infections can reoccur over a trial period, we share suggestions of longitudinal modeling of clustered randomized trial data. |
format | Online Article Text |
id | pubmed-6378640 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-63786402019-02-22 Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? Juthani-Mehta, Manisha Allore, Heather G. Ther Adv Drug Saf Review This perspective review considers analytic features of the design of a longitudinal trial regarding antimicrobial therapy in older terminal cancer patients receiving palliative care. We first overview antimicrobial use at the end of life; both the potential hazards and benefits. Antimicrobial prescribing should consider both initiation as well as cessation of medications when analyzing the burden of medications. Approaches to decision making regarding antimicrobial use are presented and the importance of health literacy in these decision processes. We next present aspects of both feasibility and comparative trial design with a health literacy intervention to reduce antimicrobial use in older terminal cancer patients receiving palliative care. Considerations to clustered randomization and given that infections can reoccur over a trial period, we share suggestions of longitudinal modeling of clustered randomized trial data. SAGE Publications 2019-02-08 /pmc/articles/PMC6378640/ /pubmed/30800269 http://dx.doi.org/10.1177/2042098618820210 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Review Juthani-Mehta, Manisha Allore, Heather G. Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? |
title | Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? |
title_full | Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? |
title_fullStr | Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? |
title_full_unstemmed | Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? |
title_short | Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? |
title_sort | design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378640/ https://www.ncbi.nlm.nih.gov/pubmed/30800269 http://dx.doi.org/10.1177/2042098618820210 |
work_keys_str_mv | AT juthanimehtamanisha designandanalysisoflongitudinaltrialsofantimicrobialuseattheendoflifetogiveornottogive AT alloreheatherg designandanalysisoflongitudinaltrialsofantimicrobialuseattheendoflifetogiveornottogive |