We hypothesise that this approach, which combines self-initiated action plans and nurse support, will accelerate proper treatment actions and lead to better control of deteriorating symptoms.
Furthermore in patients with preexisting OSD prolonged topical glaucoma medication treatment additionally deteriorates symptoms [ 18].
Nurses showed patients how to use their symptom diary cards to recognise deteriorating symptoms and activate their self management plan.
Another study using a comprehensive face-to-face hospital based self-management education program in COPD [ 10] found that in addition to physical activity, improved nutrition and managing deteriorating symptoms were behaviours addressed by some patients.
On univariate analysis, five factors (extent of WMLs, size of contrast-enhanced lesions, locations of contrast-enhanced lesions in the mediolateral and superoinferior directions, cysts and local mass effects) were significantly correlated with deteriorating symptoms (P<0.001, P=0.005, P<0.001, P<0.001, P<0.001 and P=0.01, respectively).
However, since telephone follow-up of patients with skin infections has been previously used in a similar research study, 13 and patients with deteriorating symptoms will be instructed to re-present to an ED for assessment, we believe this method of patient follow-up is feasible.
Only 1 of these subjects deteriorated in Symptoms, and 2 in Sports/Rec, none in the other subscales.
As renal function deteriorates, symptoms become more prevalent due to the accumulation of uraemic toxins [ 31].
By mid-February the symptoms of those involved were deteriorating; their symptoms included burn wounds, swollen hands, diarrhoea, fever, and hair loss.
For patients whose cancer first presents with or rapidly deteriorates to symptoms such as bowel obstruction, fits, pancytopenia or stroke symptoms, emergency admission is entirely appropriate.
