Effectiveness of Jungian psychotherapy in supervised training settings

The COVID-19 pandemic has altered the way higher education is structured and delivered, presenting challenges for college students that have the potential to negatively impact mental health. The current study aimed to identify potential changes in college student psychological symptoms since the onset of the pandemic. The study used analyses of covariance to examine differences in perceived stress, depression, anxiety, and obsessive-compulsive symptoms between a sample of university students collected in Fall 2016 and a sample of students from the same university collected in Spring 2020 and Fall 2020 after the onset of the pandemic. Findings indicated that college students from the 2020 sample reported significantly higher levels of stress, depressive symptoms, and anxiety symptoms than the 2016 sample. For stress and anxiety, there was a significant interaction between cohort (2016 vs. 2020 sample) and year in school (first year vs. advanced) indicating that the pandemic may have had a more prominent negative mental health impact on advanced students in comparison to first year students. There were no significant differences between samples on obsessive-compulsive symptoms. The current sample was somewhat homogenous demographically, consisting of primarily first-year students, thus limiting generalizability. Self-report measures were used. College students may be struggling with increased stress, depressive symptoms, and anxiety symptoms during the pandemic. The current study provides important information to guide the development and implementation of prevention and intervention efforts to support college student mental health in the context of the pandemic.

Body-focused repetitive behaviors (BFRBs) and eating disorders (EDs) involve persistent, self-directed behaviors causing distress and impairment. Despite similarities, the relationship between the two is understudied. We examined clinical and subclinical BFRB prevalence in individuals with EDs, tested associations with ED and obsessive-compulsive (OC) symptoms, and compared BFRB occurrence between ED subtypes. The sample included 95 female adults and adolescents in residential ED treatment (51% anorexia nervosa-restricting, 37% anorexia nervosa-binge-eating/purging, 9% bulimia nervosa, 3% other EDs). The Habit Questionnaire, Eating Disorder Examination Questionnaire, and Dimensional Obsessive-Compulsive Scale assessed BFRBs, ED symptoms, and OC symptoms, respectively. BFRBs were highly prevalent in the sample, with 37% meeting clinically significant levels and 31% displaying subclinical BFRBs. The most common clinically significant BFRBs were skin picking (28%), mouth chewing (10%), and hair pulling (9%). Higher ED and OC symptom severity were both associated with the presence of any presence of a co-occurring BFRB. BFRB prevalence did not differ between restricting and binge-eating/purging ED subtypes. Overall, co-occurring BFRBs were common in this residential ED sample, highlighting the need for routine screening. Both ED and OC symptom severity were uniquely related to BFRB occurrence. Future research should explore the underlying mechanisms to better understand the relationship between BFRBs and EDs.

Following the outbreak of COVID-19, access to in-person oncology acupuncture service was temporarily disrupted at Dana-Farber Cancer Institute, a National Cancer Institute (NCI)-designated cancer center. During this period, a virtual acupuncturist-guided session of patient self-acupressure was implemented to provide continuity of supportive care for cancer patients. We provide preliminary findings on the feasibility and potential impact of remotely delivered acupressure on patient-reported symptom burden in cancer populations. This is a retrospective chart review of cancer patients who received virtual acupressure service at a single academic cancer center from May 11 to December 31, 2020. Each telehealth session consisted of a one-on-one appointment between the patient and acupuncturist. A semi-standardized set of acupoints were used, including Yintang, ST36, GB20, PC6, and HT7 as well as Relaxation Point on the ear. At the start of each session, Edmonton Symptom Assessment System (ESAS) was used to collect patient-reported symptom burden. For patients with at least one follow-up within 14days of the baseline visit, paired t-test was used to analyze changes in ESAS scores from baseline to first follow-up. A total of 102 virtual acupressure sessions were administered to 32 patients. Most patients were females (90.6%) and white (84.4%), and the mean age was 55.7 (range = 26-82; SD = 15.7). The most common cancer diagnosis was breast (53.1%), followed by pancreatic (12.5%) and lung (9.4%). Baseline ESAS Total, Physical, and Emotional scores were 21.5 (SD = 11.1), 12.4 (SD = 7.5), and 5.2 (SD = 3.8), respectively. Of 32 patients, 13 (41%) had a second acupressure session within 14days. For these 13 patients, there was a statistically significant reduction in Total symptom burden (-4.9 ± 7.6; p = 0.04) and in Physical (-3.5 ± 5.4; p = 0.04) and Emotional (-1.2 ± 1.8; p = 0.03) subscales from baseline to follow-up. Virtual acupressure was associated with significant reduction in symptom burden among cancer patients from their baseline to follow-up visits. Larger scale randomized clinical studies are needed to confirm these findings and better understand the impact of virtual acupressure on symptom burden in cancer populations.

Predictors of Quality of Life Change in Head-and-Neck Cancer Survivors during Concurrent Chemoradiotherapy: A Prospective Study

130 Background: Patients with metastatic prostate cancer (mPCa) undergoing treatment often experience declines in health-related quality of life (HRQoL) and increased symptom burden. Exercise interventions are known to mitigate these effects, but adherence to such programs remains a challenge. This study aimed to assess the impact of adherence to a remote, home-based exercise program on HRQoL and symptom burden among patients with mPCa in a joint cancer practice in Brazil. Methods: This prospective study recruited patients with mPCa undergoing active treatment for both hormone sensitive and hormone resistant disease. Patients were assessed at baseline (T1) and after 12 weeks (T2) using the Functional Assessment of Cancer Therapy-General (FACT-G; scale: 0-108) and the Edmonton Symptom Assessment System (ESAS; scale: 0-90). Eligible participants received weekly exercise guidance through WhatsApp and performed prescribed exercise regimens (3 to 5 hours per week of combined resistance and aerobic training), with proper techniques demonstrated using the Vedius platform. Adherence was categorized as moderate to high (MH) ≥6 weeks of exercise, or low (L) ≤5 weeks. The primary outcomes included changes in HRQoL and symptom burden. Results: A total of 35 patients were recruited. The median age of participants was 74 years (range 58-91), with a majority being white (65.7%), married (82.9%), highly educated (88.6%), and retired (85.7%). All patients were receiving ADT plus abiraterone (34.3%), or docetaxel (25.7%), or enzalutamide (22.8%), or chemotherapy + abiraterone (14.3%). At 12 weeks, patients with moderate to high adherence demonstrated significant improvements in HRQoL (MH Mean T2 =94.9, L Mean T2 =88.7, P=0.01), particularly in physical (MH Mean T2 =25.1, Mean T2 =23.6, P=0.03), functional (MH Mean T2 =22.8, L Mean T2 =20.7, P=0.03), and emotional (MH Mean T2 =22.2, L Mean T2 =20.28, P=0.03) well-being domains, compared to those with low adherence. Additionally, those with higher adherence reported a lower symptom burden (MH Mean T2 =9.1 vs L Mean T2 =14.7, P=01). Conclusions: This study demonstrates that adherence to a remote exercise program significantly improves HRQoL and reduces symptom burden in patients with prostate cancer undergoing treatment. These findings underscore the importance of promoting exercise adherence through accessible platforms, such as WhatsApp, to enhance patient outcomes in mPCa.

1520 Background: Improving lung cancer care among Veterans is a priority within the Veterans Affairs due to higher rates of lung cancer incidence, morbidity, and mortality among Veterans compared to non-veterans. Unaddressed symptom burden is common due to many factors including complex comorbidities, psychosocial challenges, smoking history and limited social support networks. Additionally, complications from social determinants of health can obstruct successful discussions of symptom-burden between Veterans and their clinical care teams which can limit compliance with recommended symptom management strategies. To overcome these barriers, we conducted a randomized controlled trial to test the effectiveness of a lay volunteer-led proactive symptom assessment and symptom intervention. The objective was to determine if the intervention improved clinician documentation from baseline to 6-months post-enrollment compared to usual care. Secondary outcomes included change in patient activation, health-related quality of life (HrQOL), and symptom-burden. Methods: Patients were randomized into the lay volunteer proactive symptom assessment intervention plus usual cancer care (intervention group) or usual cancer care alone (control group). We conducted electronic health record review to assess primary cancer-clinician symptom documentation of Veterans’ symptoms identified as moderate-to-severe at baseline and 6-months using the Edmonton Symptom Assessment Scale. Patient surveys with validated assessments were used to assess patient activation, HrQOL and symptom burden at baseline (time of enrollment) and 6-months post-enrollment. We used regression models to evaluate differences in our primary and secondary outcomes. Results: 60 Veterans were consented and randomized into the study (29 control; 31 intervention). There were no differences in demographic or clinical factors across groups. The median age was 70 years (range 56-85), 95% were male, 70% identified their race as White, 53% were married and 48% had a 2-year or 4-year college degree. The majority had at least 3 comorbidities (54%), diagnosed with stage 3 or 4 (62%) and received systemic treatment with chemotherapy and/or radiation (77%). At 6-months post-enrollment as compared to baseline, the intervention group had greater improvements in symptom documentation (56% from 12.5% vs. 29% from 43%, p = 0.01), greater improvements in patient activation (p<0.001), HrQOL (<0.001), and lower symptom burden (p<0.001) than the control group. Conclusions: Integration of proactive symptom assessment by lay volunteers has a significant and meaningful effect on symptom documentation, patient activation, quality of life, and reducing symptom burden among Veterans with lung cancer. Clinical trial information: NCT03216109.

Multicomponent electronic patient-reported outcome cancer symptom management systems reduce symptom burden. Whether all components contribute to symptom reduction is unknown. To deconstruct intervention components of the Symptom Care at Home (SCH) system, a digital symptom monitoring and management intervention that has demonstrated efficacy, to determine which component or combination of components results in the lowest symptom burden. This randomized clinical trial included participants who were older than 18 years, had been diagnosed with cancer, had a life expectancy of 3 months or greater, were beginning a chemotherapy course planned for at least 3 cycles, spoke English, and had daily access and ability to use a telephone. Eligible participants were identified from the Huntsman Cancer Institute, University of Utah (Salt Lake City), and from Emory University Winship Cancer Institute, including Grady Memorial Hospital (Atlanta, Georgia), from August 7, 2017, to January 17, 2020. Patients receiving concurrent radiation therapy were excluded. Dates of analysis were from February 1, 2020, to December 22, 2023. Participants reported symptoms daily during a course of chemotherapy and received automated self-management coaching with an activity tracker without (group 1) and with (group 2) visualization, nurse practitioner (NP) follow-up for moderate-to-severe symptoms without (group 3) and with (group 4) decision support, or the complete SCH intervention (group 5). The primary outcome, symptom burden, was assessed as the summed severity of 11 chemotherapy-related symptoms rated on a scale of 1 to 10 (with higher scores indicating greater severity), if present. The 757 participants (mean [SD] age, 59.2 [12.9] years) from 2 cancer centers were primarily female (61.2%). The most common cancer diagnoses were breast (132 [17.4%]), lung (107 [14.1%]), and colorectal (99 [13.1%]) cancers; 369 patients (48.7%) had metastatic disease. The complete SCH intervention including automated self-management coaching and NP follow-up with decision support (group 5) was superior in reducing symptom burden to either of the self-management coaching groups, as shown by the mean group differences in area under the curve (group 1, 1.86 [95% CI, 1.30-2.41] and group 2, 2.38 [95% CI, 1.84-2.92]; both P < .001), and to either of the NP follow-up groups (group 3, 0.57 [95% CI, 0.03-1.11]; P =.04; and group 4, 0.66 [95% CI, 0.14-1.19]; P = .014). Additionally, NP follow-up was superior to self-management coaching (group 1 vs group 3, 1.29 [95% CI, 0.72-1.86]; group 1 vs group 4, 1.20 [95% 12 CI, 0.64-1.76]; group 2 vs group 3, 1.81 [95% CI, 1.25-2.37]; and group 2 vs group 4, 1.72 [95% CI, 1.17-2.26]; all P < .001), but there was no difference between the 2 self-management coaching groups (-0.52 [95% CI, -1.09 to 0.05]; P = .07) or between the 2 NP groups (-0.10 [95% CI, -0.65 to 0.46]; P = .74). In this randomized clinical trial of adult participants undergoing chemotherapy treatment for cancer, the complete intervention, rather than any individual component of the SCH system, achieved the greatest symptom burden reduction. These findings suggest that a multicomponent digital approach to cancer symptom management may offer optimal symptom burden reduction. ClinicalTrials.gov Identifier: NCT02779725.

Stroke survivors experience multidimensional symptom burdens that impair quality of life. However, existing interventions addressing the overall symptom burden of stroke survivors remain limited, and the efficacy of nurse‒patient interaction rehabilitation programs for symptom management remains unclear. This study aimed to evaluate the effect of an intervention based on Cox’s interaction model of client health behavior (IMCHB) on reducing symptom burden and improving self-management in stroke survivors. A two-arm, parallel-group, single-blinded, single-center, randomized controlled trial was conducted with 41 participants per group. The intervention based on Cox’s IMCHB included six phases: (1) program overview (week 1), (2) identification of symptoms (week 2), (3) personalized symptom management codesign through clinical assessments (weeks 3–6), and (4) nurse-guided behavioral intensification with goal reinforcement (weeks 7–9), followed by a wrap-up session (week 10). Outcomes were assessed at baseline (T0), immediately post-intervention (T1), and 12 weeks follow-up (T2) via generalized estimating equation models. This study adhered to the CONSORT 2010 guidelines. The nurse-led intervention demonstrated significant benefits across key outcome areas. Specifically, significant improvement was observed in the Southampton Stroke Self-Management Questionnaire at 12 weeks follow-up (β = 8.07, 95% CI: 1.13–15.02, P = 0.023). At the 12 weeks follow-up, participants in the intervention group reported significantly fewer problems regarding secondary prevention (OR = 7.31, 95% CI: 1.90–28.10, P = 0.004), activities of daily living (OR = 7.45, 95% CI: 2.51–22.14, P < 0.001), and emotion (OR = 8.11, 95% CI: 2.64–24.88, P < 0.001). Rehabilitation participation increased significantly both immediately post-intervention (β = 1.21, 95% CI: 0.66–1.76, P < 0.001) and 12 weeks (β = 0.95, 95% CI: 0.21–1.69, P = 0.011). Finally, stroke-specific quality of life showed significant improvement both immediately post-intervention (β = 35.18, 95% CI: 16.09–54.27, P < 0.001) and at 12 weeks follow-up (β = 42.52, 95% CI: 21.92–63.11, P < 0.001). The intervention based on Cox’s IMCHB effectively enhances self-management in stroke survivors and reduces multidimensional symptom burden through structured nurse‒patient interactions. By integrating evidence-based support, emotional reinforcement, and shared decision-making, it provides a framework centered on nurse‒patient interactions for holistic stroke rehabilitation. Future research should validate long-term efficacy and explore symptom burden through network analysis. Chinese Clinical Trial Registry (ChiCTR2400092947). Recruitment: Jan to April 2024. [Registration date 2024/11/26 (Retrospectively registered)].

There is limited evidence of an association between the burden of atrial fibrillation (AF)-related symptoms and depressed mood (DM). We used follow-up data from two randomized trials to relate AF symptoms, perceived AF burden, and DM. Baseline data on 319 persistent AF patients from the Flec-SL trial and 244 paroxysmal AF patients from the ANTIPAF trial were available. Data on 400 patients were available at 6-month follow-up. Depressed mood was measured using the major depression inventory, AF symptoms using the AF Symptom Checklist. Generalized estimating equation models were used to assess the association between symptom burden and DM. At baseline, 194 patients (35.2%) reported DM, 294 (52.2%) reported severe AF symptom burden. Burden from all symptoms except fainting was significantly elevated in patients with DM. An improvement in DM from baseline to follow-up was associated with reduced symptom burden [odds ratio (OR) = 2.06; 95% confidence interval (CI): 1.22-3.51]. Patients with DM had three-fold increased odds of severe symptom burden after adjustment for perceived AF-frequency and -duration, sex, and chronic obstructive pulmonary disorder (COPD) (OR = 3.19; 95% CI: 2.65-8.45). Women reported significantly more severe symptom burden than men (OR = 1.44; 95% CI: 1.36-1.95). Uneasiness, nausea, and shortness of breath were most strongly associated with DM. The effect of DM on nausea was more pronounced for men (P(interaction) = 0.041). Perceived AF-frequency and -duration were not associated with DM (P = 0.717 and 0.236, respectively). Depressed mood is associated with AF symptom burden over 6 months after adjustment for perceived frequency and duration of AF episodes, COPD, and sex.

231 Background: Although effective communications regarding symptoms may decrease distress and patients and their spouses, families tend to experience barriers to open communication. The purpose of this cross-sectional survey study is to examine the role of cancer-related communications in symptom burden in families coping with advanced non-small cell lung cancer. Methods: Couples were approached while waiting for their routine visit at the thoracic center. 25 patients (58% female; 78% white; mean age: 62.7 years; 72% stage III; 2.3 months post diagnosis) and their spouses completed measures of cancer symptoms (ESAS), psychological distress (BSI), and illness communication (CCAT_PF). Results: Dyadic analyses using multi-level modeling revealed that patients generally rated their own symptom burden significantly lower compared to spouses rating patient symptoms (P &lt; .0001). However, this discrepancy in perceptions of symptoms was a function of cancer communication (P &lt; .001) so that the more couples communicate about cancer-related issues (e.g., treatment decision making) the more they agreed regarding symptom burden. Importantly, a discrepancy in symptoms ratings was significantly related to spouses’ depressive symptoms (P &lt; . 01) so that the greater the discrepancy, the greater spouses depression. Lastly, more effective cancer communication was related to lower cancer symptoms in patients (P &lt; .05) as well as depression (P &lt; .01) and anxiety (P &lt; .05) in both patients and spouses. Conclusions: These findings highlight the importance of effective cancer communication in reducing symptom burden in couples coping with advanced lung cancer. Behavioral interventions that target communication skills taining may improve symptom management in patients and reduce psychological distress in spouses.

Myelofibrosis (MF), polycythaemia vera (PV) and essential thrombocythaemia (ET) are associated with a considerable disease burden and a reduced quality of life (QoL) (Emanuel et al, 2012; Mesa et al, 2016). Patients with myeloproliferative neoplasms (MPN) experience many symptoms, with fatigue being one of the most severe (Scherber et al, 2011; Johansson et al, 2012; Abelsson et al, 2013). Few studies have explored how symptom burden affects the work productivity and daily activities of these patients (Mesa et al, 2016). We previously conducted a survey, the 'US MPN Landmark Survey', reporting a substantial reduction in QoL and work productivity, suggesting a reduction of symptom burden may improve QoL and productivity of MPN patients (Harrison et al, 2017). As previous studies have suggested that QoL and overall symptom burden can differ between countries, we conducted the Landmark Survey in 6 countries outside the US. Here we present the first UK-specific analysis of the survey data exploring the impact of the overall symptom burden experienced by MPN patients. The methodology used was a cross-sectional survey of MPN patients and treating physicians conducted in 2016 in Australia, Canada, Germany, Italy, Japan and the UK. Physician and patient surveys were not linked and explored: physician-patient relationship, disease management/treatment attitudes, treatment and treatment goals and the economic, emotional and physical burden of the disease. Work productivity, absenteeism, presenteeism and activity impairment were measured using the Work Productivity and Activity Impairment Index (Reilly et al, 1993). Each domain was measured on a 0–100% scale with a higher percentage indicating a greater amount of impairment. Data were stratified by overall symptom severity, calculated by combining the number of symptoms and their associated severity for each patient. This was used to allocate patients into quartiles (Q1 = lowest symptoms burden; Q4 = highest symptom burden) at a global level (Table 1). Eligibility included ≥18 years of age, a diagnosis of MF, PV or ET, and not participating in a clinical trial. Patients were recruited in the UK via their managing physician following routine consultations or via a patient organization, MPN Voice (http://www.mpnvoice.org.uk/). All respondent data were anonymised with analysis presented at an aggregated level. All analyses presented are descriptive in nature with relevant descriptive statistics reported. Confidence intervals are presented for numeric outcomes (i.e. means) and for patient-reported impact ratings. No formal hypothesis testing was performed. Overall, 286 patients (45 MF, 78 PV, 163 ET) and 31 physicians completed the survey in the UK. Respondent demographics are presented in Table 1. UK physicians reported a numerically higher number of patients under their care than the rest of the world (ROW) (UK vs. ROW; 26·58 vs. 13·66 MF, 49·84 vs. 19·81 PV, 52·45 vs. 20·02 ET respectively) and mostly agreed with the statement 'There is not enough time during the appointment to discuss all of the symptoms a patient is experiencing' (74% agreed in UK vs. 54% agreed in ROW) (Table 1). Over 98% of patients had experienced symptoms in the previous 12 months. Almost half of Q3 and Q4 patients agreed with the statement 'MPN symptoms reduce my life quality' (49% "agree strongly"). However, 40% of Q1 and Q2 patients stated they "Somewhat agree" with the statement (Table 1). Q3 and Q4 patients reported a higher emotional burden in that more patients reported they experienced each emotional burden more 'frequently' than those in Q1 and Q2. This burden was particularly marked when interfering in the patients' family/social life (Q3 and Q4 57% vs. Q1 and Q2 24%) and interfering in patients' sex life (Q3 and Q4 58% vs .Q1 and Q2 22%) (Fig 1). A third of patients in Q3 and Q4 reported reducing their hours at work compared with Q1 and Q2 patients (34% vs. 16%), voluntarily terminating a job (17% vs. 7%) or going on disability allowance (12% vs. 1%) (Fig 1). A higher overall work impairment, absenteeism (missing work due to condition), presenteeism (working whilst sick) and activity impairment was reported by Q3 and Q4 patients compared to Q1 and Q2 patients (48·6% vs. 21·7%, 13% vs. 1·9%, 41·3% vs. 20·4% and 49·9% vs. 21·8%, respectively) (Fig 1). Our data demonstrates that UK MPN patients experience a high disease burden. This burden was higher than in ROW cohorts (Harrison et al, 2017). The stratification of patients into symptom severity quartiles was conducted at a global level, with UK patients disproportionately represented in the higher symptom burden group. Patients reported that 'MPN symptoms reduce my life quality' regardless of their overall symptom burden, suggesting a significant impact QoL in the lower burden groups. High emotional burden was noted with patients 'frequently' experiencing anxiety, worry and frustration, and impact on family and social life, suggesting that the burden could be felt further afield than the patient directly. Impact on patients' work productivity and activity impairment was high and demonstrated a greater societal burden of MPNs, with Q3 and Q4 patients associated with a higher burden across all facets. It is possible that financial burdens associated with work-related stress increases emotional and symptom burden associated with MPNs. Whilst further research would need to be conducted to confirm this relationship, the assumption is supported by data demonstrating that patients with high symptom burden also experience a higher emotional and work/financial burden. The development of improved treatments and management strategies aimed at improving the symptom burden patients experience will assist in alleviating this burden. UK physicians felt there was not enough time in appointments to address all symptoms, more so than ROW. To help mitigate this, patient support structures are needed, such as adopting telemedicine to collect symptom feedback prior to appointments. The high impact of symptom burden proves to be a challenge for both the clinical and patient community. Both groups require further support from the wider stakeholder community. Such strategies would also be complimentary to the patient support structures mentioned above (i.e. telephone clinics, remote symptom monitoring via mobile apps), and have previously demonstrated to be of benefit in previous trials across various disease areas, including haematological cancers (Breen et al, 2015). Ali: Novartis: consultancy, honoraria, expenses for travel and accommodations. Harrison: Novartis: consultancy, honoraria, expenses for travel and accommodations, research funding, speakers bureau; Shire: honoraria, speakers bureau; Gilead: honoraria, speakers bureau; Baxalta: consultancy, honoraria, speakers bureau; Incyte: honoraria, speakers bureau. Mead: Novartis: consultancy, honoraria, expenses for travel and accommodations, research funding, speakers bureau; Taylor -Stokes: Adelphi Real World: employment. Waller: Adelphi Real World: employment. All authors designed the research survey. John Waller analysed the data and wrote the paper.

Disentangling orthorexia nervosa from healthy eating and other eating disorder symptoms: Relationships with clinical impairment, comorbidity, and self-reported food choices

There appears to be reduced symptom burden in those waiting for tonsillectomy during the COVID-19 pandemic Despite reduced symptom burden, most patients wished to go ahead with elective tonsillectomy COVID-19 infection does not appear to be a factor in those patients no longer wishing to have a tonsillectomy Patients should be reassessed during long waiting times to see if symptom burden has improved and if tonsillectomy is still required Due to long waiting times it is important to ensure information giving can be repeated to allow adequate informed consent given the morbidity of tonsillectomy.

BackgroundBronchial rheoplasty (BR) addresses mucosal inflammation and hypersecretion associated with chronic bronchitis (CB) by ablating goblet cell hyperplasia with nonthermal pulsed electric fields. This study assessed if BR continues to demonstrate a safe profile and symptom burden reduction in CB patients.MethodsThis observational, post-market, single-arm registry was conducted at eight centres in Austria and Germany. Patients with CB and high symptom burden (COPD assessment test (CAT) score ≥7 points in the first two questions) were treated with two bronchoscopic BR procedures. The primary outcomes were safety and symptom burden at 12 months, evaluated by (serious) adverse events ((S)AEs) and questionnaire scores (CAT and St. George's Respiratory Questionnaire (SGRQ)). Subgroup analyses were performed to identify treatment responders.Results106 BR procedures were performed in 54 patients (mean forced expiratory volume in 1 s (FEV1) 57.8±25.3% predicted, residual volume 166.2±39.6% predicted, CAT 24.8±6.8) with a follow-up time of up to 12 months (n=40). The procedure could be performed safely, with only two SAEs (thoracic pain) and 10 respiratory AEs (mainly COPD exacerbation) deemed to be related to the device or procedure over 12 months. Patients experienced statistically significant questionnaire score improvements in CAT (−5.5±8.0 at 6 months, −4.2±7.4 at 12 months) and SGRQ at 6 and 12 months. CAT responders (improvement ≥the minimal clinically important difference of 2 points) had more preserved lung function and better exercise capacity at baseline than CAT nonresponders.ConclusionThe real-world clinical experience demonstrates that BR is a relatively safe and promising treatment option for CB patients with significant symptom burden.

Ambulatory Reflux Monitoring Guides Proton Pump Inhibitor Discontinuation in Patients With Gastroesophageal Reflux Symptoms: A Clinical Trial