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Wefer F, Krüger L, Waldréus N, Köpke S. Non-pharmacological interventions to reduce thirst in patients with heart failure or hemodialysis: A systematic review and meta-analysis. Heart Lung 2024; 67:33-45. [PMID: 38653004 DOI: 10.1016/j.hrtlng.2024.04.012] [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: 01/18/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Thirst is a frequent and burdening symptom in many patients, especially in patients with chronic heart failure (CHF) and/or receiving hemodialysis (HD). As drug therapies are not feasible, non-pharmacological strategies are needed to reduce thirst and thirst-related burden. OBJECTIVES To identify non-pharmacological interventions aiming to reduce thirst in patients with CHF and/ or HD, to describe intervention components, and to evaluate the effectiveness of these interventions. METHODS In February 2024, we completed a systematic search in MEDLINE via PubMed, Livivo, CINAHL, Cochrane Library and Web of Science. Two reviewers independently screened titles, abstracts, and full texts, performed critical appraisal and data extraction. We checked risk of bias with the checklists of the Joanna Briggs Institute and the Cochrane Risk of Bias tool and calculated meta-analyses for sufficiently homogeneous studies using fixed-effects models. RESULTS We included 15 intervention studies applying non-pharmacological interventions including chewing gum (n = 8), low-sodium diet (n = 2), acupressure (n = 1), frozen strawberries (n = 1), fluid timetables (n = 1), ice cubes and mouthwash (n = 1), and a psychological intervention (n = 1). Sample sizes varied between 11 and 88 participants. Eleven intervention studies showed a reduction of thirst as intervention effect. Meta-analyses for chewing gum showed no significant effect on thirst using a visual analogue scale (IV: -2,32 [-10.37,5.73]; p = 0.57) or the dialysis thirst inventory (IV: -0.26 [- 1.83, 1.30]; p = 0.74). Quality of studies was moderate to low. CONCLUSION Results indicate that various non-pharmacological interventions could be helpful to reduce thirst in patients with CHF or HD, but important uncertainty remains.
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Affiliation(s)
- Franziska Wefer
- Institute of Nursing Science, University of Cologne, Medical Faculty & University Hospital Cologne, Cologne, Germany; Heart and Diabetes Center NRW, Care Development, Care Directorate, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany.
| | - Lars Krüger
- Heart and Diabetes Center NRW, Care Development, Care Directorate, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Nana Waldréus
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden; Theme Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Sascha Köpke
- Institute of Nursing Science, University of Cologne, Medical Faculty & University Hospital Cologne, Cologne, Germany
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Collazo-Castiñeira P, Sánchez-Izquierdo M, Reiter LJ, Bauer S, Cruz-Jentoft AJ, Schoufour JD, Weijs PJM, Eglseer D. Analysis of behavioral change techniques used in exercise and nutritional interventions targeting adults around retirement age with sarcopenic obesity in a systematic review. Arch Gerontol Geriatr 2024; 123:105437. [PMID: 38653002 DOI: 10.1016/j.archger.2024.105437] [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: 01/26/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Sarcopenic obesity significantly burdens health and autonomy. Strategies to intervene in or prevent sarcopenic obesity generally focus on losing body fat and building or maintaining muscle mass and function. For a lifestyle intervention, it is important to consider psychological aspects such as behavioral change techniques (BCTs) to elicit a long-lasting behavioral change. PURPOSE The study was carried out to analyze BCTs used in exercise and nutritional interventions targeting community-dwelling adults around retirement age with sarcopenic obesity. METHODS We conducted an analysis of articles cited in an existing systematic review on the effectiveness of exercise and nutritional interventions on physiological outcomes in community-dwelling adults around retirement age with sarcopenic obesity. We identified BCTs used in these studies by applying a standardized taxonomy. RESULTS Only nine BCTs were identified. Most BCTs were not used intentionally (82 %), and those used derived from the implementation of lifestyle components, such as exercise classes ("instructions on how to perform a behavior," "demonstration of the behavior," "behavioral practice/rehearsal," and "body changes"). Only two studies used BCTs intentionally to reinforce adherence in their interventions. CONCLUSIONS Few studies integrated BCTs in lifestyle interventions for community-dwelling persons around retirement age with sarcopenic obesity. Future studies on interventions to counteract sarcopenic obesity should include well-established BCTs to foster adherence and, therefore, their effectiveness.
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Affiliation(s)
- Paula Collazo-Castiñeira
- Geriatric Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain; Psychology Department, Universidad Pontificia Comillas, C. Universidad Comillas, 3-5 28049 Madrid, Spain
| | - Macarena Sánchez-Izquierdo
- Psychology Department, Universidad Pontificia Comillas, C. Universidad Comillas, 3-5 28049 Madrid, Spain
| | - Lea Joanne Reiter
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Silvia Bauer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Alfonso J Cruz-Jentoft
- Geriatric Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - Doris Eglseer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria.
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Vogt CJ, Moecker R, Jacke CO, Haefeli WE, Seidling HM. Exploring the heterogeneity in community pharmacist-led medication review studies - A systematic review. Res Social Adm Pharm 2024; 20:679-688. [PMID: 38811260 DOI: 10.1016/j.sapharm.2024.03.012] [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: 08/31/2023] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Findings on the effectiveness of medication reviews led by community pharmacists (CPs) are often inconclusive. It has been hypothesized that studies are not sufficiently standardized, and thus, it is difficult to draw conclusions. OBJECTIVE(S) To examine differences in the way CP-led medication review studies are set up. This was accomplished by investigating (1) patient selection criteria, (2) components of the medication review interventions, (3) types of outcomes, and (4) measurement instruments used. METHODS A systematic literature search of randomized controlled trials of CP-led medication reviews was carried out in PubMed and Cochrane Library. Information on patient selection, intervention components, and outcome measurements was extracted, and frequencies were analyzed. Where possible, outcomes were mapped to the Core Outcome Set (COS) for medication review studies. Finally, a network analysis was conducted to explore the influence of individual factors on outcome effects. RESULTS In total, 30 articles (26 studies) were included. Most articles had a drug class-specific or disease-specific patient selection criterion (n = 19). Half of the articles included patients aged ≥60 years (n = 15), and in 40% (n = 12/30) patients taking 4 drugs or more. In 24 of 30 articles, a medication review was comprised with additional interventions, such as distribution of educational material and training or follow-up visits. About 40 different outcomes were extracted. Within specific outcomes, the measurement instruments varied, and COS was rarely represented. CONCLUSION The revealed differences in patient selection, intervention delivery, and outcome assessment highlight the need for more standardization in research on CP-led medication reviews. While intervention delivery should be more precisely described to capture potential differences between interventions, outcome assessment should be standardized in terms of outcome selection by application of the COS, and with regard to the selected core outcome measurement instruments to enable comparison of the results.
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Affiliation(s)
- Cathrin J Vogt
- Heidelberg University, Medical Faculty Heidelberg/Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany; Cooperation Unit Clinical Pharmacy, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| | - Robert Moecker
- Heidelberg University, Medical Faculty Heidelberg/Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany; Cooperation Unit Clinical Pharmacy, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| | - Christian O Jacke
- Scientific Institute of Private Health Insurance (WIP), Gustav-Heinemann-Ufer 74c, 50968, Cologne, Germany.
| | - Walter E Haefeli
- Heidelberg University, Medical Faculty Heidelberg/Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany; Cooperation Unit Clinical Pharmacy, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| | - Hanna M Seidling
- Heidelberg University, Medical Faculty Heidelberg/Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany; Cooperation Unit Clinical Pharmacy, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
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Mac Giolla Phadraig C, Healy O, Fisal AA, Yarascavitch C, van Harten M, Nunn J, Newton T, Sturmey P, Asimakopoulou K, Daly B, Hosey MT, Kammer PV, Dougall A, Geddis-Regan A, Pradhan A, Setiawan AS, Kerr B, Friedman CS, Cornelius BW, Stirling C, Hamzah SZ, Decloux D, Molina G, Klingberg G, Ayup H, Buchanan H, Anjou H, Maura I, Bernal Fernandez IR, Limeres Posse J, Hare J, Francis J, Norderyd J, Rohani MM, Prabhu N, Ashley PF, Marques PF, Chopra S, Pani SC, Krämer S. Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management. Community Dent Oral Epidemiol 2024; 52:550-571. [PMID: 38516782 DOI: 10.1111/cdoe.12953] [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: 11/11/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. METHODS Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. RESULTS The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. DISCUSSION Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.
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Affiliation(s)
| | - Olive Healy
- Trinity College Dublin, Lincoln Place Dublin 2, Ireland
| | | | | | - Maria van Harten
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | - June Nunn
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | | | - Peter Sturmey
- The Graduate Center and Queens College, City University of New York, New York, USA
| | | | - Blánaid Daly
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | | | | | - Alison Dougall
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | | | - Archana Pradhan
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Surry Hills, Australia
| | - Arlette Suzy Setiawan
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Bryan Kerr
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Clive S Friedman
- Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | | | | | | | | | - Gustavo Molina
- Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Cordoba, Argentina
| | - Gunilla Klingberg
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Hani Ayup
- Ministry of Health, Bandar Seri Begawan, Brunei Darussalam
| | | | - Helena Anjou
- Department of Paediatric Dentistry, National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | | | | | | | - Jennifer Hare
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jessica Francis
- Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Johanna Norderyd
- The Institute for Postgraduate Dental Education, Jönköping and CHILD research group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Neeta Prabhu
- The University of Sydney, School of Dentistry, Faculty of Medicine and Health AND Westmead Centre for Oral Health | Western Sydney Local Health District, Surry Hills, Australia
| | | | - Paula Faria Marques
- Faculdade de Medicina Dentária, Unidade Odontopediatria, Universidade de Lisboa, Lisboa, Portugal
| | - Shalini Chopra
- Berkshire Community Dental Service, Skimped Hill Health Centre, Berkshire, UK
| | - Sharat Chandra Pani
- Faculty of Dentistry, University of British Columbia B.C. Children's Hospital, Vancouver, British Columbia, Canada
| | - Susanne Krämer
- Facultad de Odontología, Universidad de Chile, Santiago, Chile
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Solberg Nes L, Børøsund E, Varsi C, Eide H, Waxenberg LB, Weiss KE, Morrison EJ, Støle HS, Kristjansdottir ÓB, Bostrøm K, Strand EB, Hagen MCS, Stubhaug A, Schreurs KM. Living well with chronic pain: a 12-month randomized controlled trial revealing impact from the digital pain self-management program EPIO. Pain Rep 2024; 9:e1174. [PMID: 38962688 PMCID: PMC11221858 DOI: 10.1097/pr9.0000000000001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/03/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Chronic pain affects a wide range of physical and psychological aspects of life for those impacted. Psychosocial treatment approaches may be of support, but outreach is still limited. Objectives To evaluate the efficacy of EPIO, an evidence-informed, user-centered digital self-management intervention for people with chronic pain, in a 12-month randomized controlled trial. Methods People living with chronic pain (N = 266) were randomized to the EPIO intervention (n = 132) or a usual-care control group (n = 134). The intervention was delivered in a simple blended care model, and outcome measures collected at baseline, 6 months, and 12 months. Generalized linear models for repeated measures were fitted to compare groups over time. Results Participants were primarily female (81%), median age 49 years (range 22-78), with heterogeneous pain conditions, and had lived with pain >5 years (77.6%). A mixed linear model with all timepoints included revealed no statistically significant group differences for the primary outcome of pain interference. Significant psychological benefits in favor of the intervention group were however detected for depression (P = 0.022), self-regulatory fatigue (P = 0.024), vitality (P = 0.016), and mental health (P = 0.047). Baseline to 12-month changes showed additional favorable effects for anxiety (between-group mean differences [MDs] = 0.79, P = 0.047), depression (MD = 1.08, P = 0.004), self-regulatory fatigue (MD = 2.42, P = 0.021), pain catastrophizing (MD = 2.62, P = 0.009), and health-related quality of life. Conclusions The EPIO program aims to improve outreach of evidence-based pain self-management interventions. Findings demonstrate how using EPIO can lead to sustainable psychological change, enhancing mental health and health-related quality of life for people suffering from pain, providing a chance to live well with the pain.
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Affiliation(s)
- Lise Solberg Nes
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Elin Børøsund
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Cecilie Varsi
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Eide
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lori B. Waxenberg
- Department of Clinical & Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Karen E. Weiss
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Eleshia J. Morrison
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Hanne Stavenes Støle
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Ólöf B. Kristjansdottir
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
- Mental Health Team West, Primary Care of the Capital Area, Reykjavik, Iceland
| | - Katrine Bostrøm
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
| | - Elin Bolle Strand
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Institute of Health, Faculty of Health Science, VID—Scientific University, Oslo, Norway
| | | | - Audun Stubhaug
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Regional Advisory Unit on Pain, Oslo University Hospital, Oslo, Norway
| | - Karlein M.G. Schreurs
- Department of Psychology, Health, and Technology, University of Twente, Enschede, Netherlands
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Shi Y, Stanmore E, McGarrigle L, Wang X, Wang X, Li Y, Todd C. Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach. Maturitas 2024; 186:108027. [PMID: 38820935 DOI: 10.1016/j.maturitas.2024.108027] [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: 02/14/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES There is no precedent for the use of social media in preventing sarcopenia. The aim of this study is to develop a social media-based intervention programme for the young-old population in the community in China to improve their awareness and behaviours regarding sarcopenia prevention. STUDY DESIGN Using guidelines for developing complex interventions, this study was divided into two main phases: a co-development phase and a preliminary test phase. Both were carried out in Changsha, China. The development phase employed co-design methodology with relevant stakeholders, including two rounds of consultation with patient and public involvement (12 members) and two rounds of focus groups (30 participants); this was followed by the three-week preliminary test phase (22 participants). MAIN OUTCOME MEASURES This study evaluated the consultation with patient and public involvement, and mainly collected qualitative data from the two rounds of focus group interviews and a final semi-structured interview following the preliminary test, so as to explore the participants' experiences, comments, and suggestions for revising the social media-based intervention. Handgrip strength was also evaluated. RESULTS The health education included seven videos of 4-6 min each related to sarcopenia, including information on the concept, influencing factors, adverse effects, manifestations, screening methods, and preventions. The exercise video consisted of four types of training (warm-up, aerobic, resistance, and flexibility training) and lasted 30 min, with a suggested engagement of at least 3 days/week. The specific contents and "dosage" of the final intervention were unanimously favourable to the diverse stakeholders involved (older adults with possible sarcopenia, experts, researchers). After the preliminary test, an improvement in handgrip strength was observed, from M15.92±SD5.22 kg to M19.13±SD5.44 kg (T = -5.44, P < 0.001). Subgroup analysis revealed that this improvement was evident in both men and women. CONCLUSIONS The social media-based intervention was universally endorsed by the participants and showed indications of a positive influence on sarcopenia. A feasibility study is now needed.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Nursing, School of Public Health, Yangzhou University, 225009 Yangzhou, Jiangsu Province, China; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Xiuhua Wang
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China.
| | - Xiaoqing Wang
- Department of Geriatrics, the Second Xiangya Affiliated Hospital, Central South University, 410011 Changsha, Hunan Province, China
| | - Yuhua Li
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
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Sands M, Aunger R. Process Evaluation of an Acute-Care Nurse-Centred Hand Hygiene Intervention in US Hospitals. EVALUATION REVIEW 2024; 48:663-691. [PMID: 37611926 PMCID: PMC11193912 DOI: 10.1177/0193841x231197253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
This paper describes a process evaluation of a 'wise' intervention that took place in six acute care units in two medical-surgical teaching hospitals in the United States during 2016-2017. 'Wise' interventions are short, inexpensive interventions that depend on triggering specific psychological mechanisms to achieve behaviour change. This study sought to increase the hand hygiene compliance (HHC) rates before entering a patient's room among nurses. The intervention centred on the use of threat to professional identity to prompt improved HHC. Through questionnaires administered to intervention participants and the implementation facilitator, together with independent observation of intervention delivery, we examined whether the steps in the Theory of Change occurred as expected. We found that aspects of the implementation-including mode of delivery, use of incentives, and how nurses were recruited and complied with the intervention-affected reach and likely effectiveness. While components of the intervention's mechanisms of impact-such as the element of surprise-were successful, they ultimately did not translate into performance of the target behaviour. Performance was also not affected by use of an implementation intention as repeated performance of HHC over years of being a nurse has likely already established well-ingrained practices. Context did have an effect; the safety culture of the units, the involvement of the Nurse Managers, the level of accountability for HHC in each unit, and the hospitals themselves all influenced levels of engagement. These conclusions should have implications for those interested in the applicability of 'wise' interventions and those seeking to improve HHC in hospitals.
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Affiliation(s)
- Madeline Sands
- Health Care Provider, Oregon Health and Science University, Portland, OR, USA
| | - Robert Aunger
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
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Blumenau Pedersen M, Saxton JM, Rasmussen Villumsen B, Bjerggaard Jensen J, Birch S. Detailed description of multidisciplinary prehabilitation in patients admitted to nerve sparring radical prostatectomy - A randomized feasibility study protocol. Contemp Clin Trials Commun 2024; 40:101319. [PMID: 38947984 PMCID: PMC11211855 DOI: 10.1016/j.conctc.2024.101319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/16/2024] [Accepted: 06/01/2024] [Indexed: 07/02/2024] Open
Abstract
Background Localized prostate cancer treated with radical prostatectomy is highly effective, though severe side-effects are common after the surgery. Prehabilitation is an approach to optimize patient's physical and mental resources before surgery, to improve postoperative outcomes. The feasibility of a multi-modal home-based prehabilitation program, delivered using telehealth in patients awaiting radical prostatectomy is unknown. This paper describes the development of a prehabilitation program for patients awaiting radical prostatectomy. Method A model by The Medical Research Council for developing and evaluating complex interventions (MRC Framework) was used in the development process. The Template for Intervention Description and Replication (TIDieR) checklist was applied for ensuring sufficient description of the interventions. A total of 40 patients will be randomized to either intervention or control group. Patients in the control group will follow standard care. The 4-week prehabilitation programme consists of exercise, pelvic floor exercise, sexual counseling, stress management and nutritional support. The interventions are home-based and delivered using telehealth. Feasibility outcomes will include recruitment, attrition rates, adherence, safety and suitability. Conclusion We have developed a multimodal prehabilitation programme, which has the potential to bring tangible health benefits to men with prostate cancer awaiting radical prostatectomy. The results of the feasibility study will inform the design of a fully powered randomized controlled trial.
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Affiliation(s)
- Malene Blumenau Pedersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Gødstrup Hospital, Gødstrup, Denmark
- Department of Occupational- and Physiotherapy, Gødstrup Hospital, Gødstrup, Denmark
| | - John M. Saxton
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
| | | | - Jørgen Bjerggaard Jensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Sara Birch
- Department of Occupational- and Physiotherapy, Gødstrup Hospital, Gødstrup, Denmark
- University Clinic for Hand, Hip and Knee Surgery, Gødstrup Hospital, Gødstrup, Denmark
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Arienti C, Lazzarini SG, Zaina F, Cordani C, Minozzi S, Kiekens C, Negrini S. Lumbar braces and other assistive devices for treatment of chronic low back pain. Cochrane Database Syst Rev 2024; 7:CD015492. [PMID: 38973783 DOI: 10.1002/14651858.cd015492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of assistive technologies (i.e. non-rigid and rigid lumbar braces, belts, supports, and devices to assist mobility and gait) for improving pain and function (and consequently reducing disability) in adults with chronic low back pain.
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Affiliation(s)
- Chiara Arienti
- Clinical Epidemiology and Research Center, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | | | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University La Statale, Milan, Italy
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10
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Fernández-Morales C, Espejo-Antúnez L, Cardero-Durán MDLÁ, Falla D, Moreno-Vázquez JM, Albornoz-Cabello M. Psychophysiological responses to a multimodal physiotherapy program in fighter pilots with flight-related neck pain: A pilot trial. PLoS One 2024; 19:e0306708. [PMID: 38968243 PMCID: PMC11226082 DOI: 10.1371/journal.pone.0306708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND The physical and cognitive demands of combat flying may influence the development and persistence of flight-related neck pain (FRNP). The aim of this pilot study was to analyse the effect of a multimodal physiotherapy program which combined supervised exercise with laser-guided feedback and interferential current therapy on psychophysiological variables in fighter pilots with FRNP. METHODS Thirty-one fighter pilots were randomly assigned to two groups (Intervention Group: n = 14; Control Group: n = 17). The intervention consisted of 8 treatment sessions (twice per week) delivered over 4 weeks. The following primary outcomes were assessed: perceived pain intensity (Numeric Pain Rating Scale-NPRS) and Heart Rate Variability (HRV; time-domain, frequency-domain and non-linear variables). A number of secondary outcomes were also assessed: myoelectric activity of the upper trapezius and sternocleidomastoid, pain catastrophizing (Pain Catastrophizing Scale-PCS) and kinesiophobia (TSK-11). RESULTS Statistically significant differences (p≤0.05) within and between groups were observed for all outcomes except for frequency domain and non-linear HRV variables. A significant time*group effect (one-way ANOVA) in favour of the intervention group was found for all variables (p<0.001). Effect sizes were large (d≥0.6). CONCLUSIONS The use of a multimodal physiotherapy program consisting of supervised exercise with laser-guided feedback and interferential current appears to show clinical benefit in fighter pilots with FRNP. TRIAL REGISTRATION ClinicalTrials.gov: NCT05541848.
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Affiliation(s)
- Carlos Fernández-Morales
- Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
| | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
| | | | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), College of Life and Environmental Sciences, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | | | - Manuel Albornoz-Cabello
- Department of Physiology, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
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11
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Park JS, Page A, Clifford R, Bond C, Seubert L. Refining the CRiSPHe (checklist for reporting research using a simulated patient methodology in Health): a Delphi study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2024; 32:322-328. [PMID: 38752525 DOI: 10.1093/ijpp/riae019] [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: 07/18/2023] [Accepted: 04/10/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVES A recent applicability study highlighted the need for the existing checklist for reporting research using a simulated patient methodology (CRiSP) to be clearer and user-friendly. The aim of this study was to update the checklist to address these concerns. METHODS A fourth round of the Delphi consensus study, used in the original checklist development work, was conducted. Previous participants, who had expertise in SP methodology, were invited to complete a questionnaire including a list of 13 checklist items developed in the previous study and revised following applicability testing. Closed questions were analysed for frequency. Consensus was predefined as >80% agreement. All items were discussed in a roundtable meeting and further modified as necessary. Responses to open questions were content analysed. KEY FINDINGS Twenty-one authors participated. There was a statistical consensus in 12 out of 13 modified checklist items. CONCLUSIONS A final reporting checklist for studies in health research using SP methodology has been developed using a consensus approach. Further refinements may be needed to increase the generalizability of the checklist in different contexts.
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Affiliation(s)
- Joon Soo Park
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley 6009, Australia
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley 6009, Australia
- UWA Dental School, The University of Western Australia, Nedlands 6009, Australia
| | - Amy Page
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley 6009, Australia
| | - Rhonda Clifford
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley 6009, Australia
| | - Christine Bond
- Primary Care, University of Aberdeen Institute of Applied Health Sciences, Aberdeen AB25 2ZD, United Kingdom
| | - Liza Seubert
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley 6009, Australia
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12
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Kim SH, Kim KA, Chu SH, Kim H, Joo DJ, Lee JG, Choi J. Self-Management Using eHealth Technologies for Liver Transplant Recipients: Scoping Review. J Med Internet Res 2024; 26:e56664. [PMID: 38963937 DOI: 10.2196/56664] [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: 01/23/2024] [Revised: 03/24/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Liver transplantation has become increasingly common as a last-resort treatment for end-stage liver diseases and liver cancer, with continually improving success rates and long-term survival rates. Nevertheless, liver transplant recipients face lifelong challenges in self-management, including immunosuppressant therapy, lifestyle adjustments, and navigating complex health care systems. eHealth technologies hold the potential to aid and optimize self-management outcomes, but their adoption has been slow in this population due to the complexity of post-liver transplant management. OBJECTIVE This study aims to examine the use of eHealth technologies in supporting self-management for liver transplant recipients and identify their benefits and challenges to suggest areas for further research. METHODS Following the Arksey and O'Malley methodology for scoping reviews, we conducted a systematic search of 5 electronic databases: PubMed, CINAHL, Embase, PsycINFO, and Web of Science. We included studies that (1) examined or implemented eHealth-based self-management, (2) included liver transplant recipients aged ≥18 years, and (3) were published in a peer-reviewed journal. We excluded studies that (1) were case reports, conference abstracts, editorials, or letters; (2) did not focus on the posttransplantation phase; (3) did not focus on self-management; and (4) did not incorporate the concept of eHealth or used technology solely for data collection. The quality of the selected eHealth interventions was evaluated using (1) the Template for Intervention Description and Replication guidelines and checklist and (2) the 5 core self-management skills identified by Lorig and Holman. RESULTS Of 1461 articles, 15 (1.03%) studies were included in the final analysis. Our findings indicate that eHealth-based self-management strategies for adult liver transplant recipients primarily address lifestyle management, medication adherence, and remote monitoring, highlighting a notable gap in alcohol relapse interventions. The studies used diverse technologies, including mobile apps, videoconferencing, and telehealth platforms, but showed limited integration of decision-making or resource use skills essential for comprehensive self-management. The reviewed studies highlighted the potential of eHealth in enhancing individualized health care, but only a few included collaborative features such as 2-way communication or tailored goal setting. While adherence and feasibility were generally high in many interventions, their effectiveness varied due to diverse methodologies and outcome measures. CONCLUSIONS This scoping review maps the current literature on eHealth-based self-management support for liver transplant recipients, assessing its potential and challenges. Future studies should focus on developing predictive models and personalized eHealth interventions rooted in patient-generated data, incorporating digital human-to-human interactions to effectively address the complex needs of liver transplant recipients. This review emphasizes the need for future eHealth self-management research to address the digital divide, especially with the aging liver transplant recipient population, and ensure more inclusive studies across diverse ethnicities and regions.
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Affiliation(s)
- Soo Hyun Kim
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Kyoung-A Kim
- College of Nursing, Suwon Women's University, Suwon, Republic of Korea
| | - Sang Hui Chu
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Hyunji Kim
- School of Nursing, Yale University, Orange, CT, United States
| | - Dong Jin Joo
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Jae Geun Lee
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - JiYeon Choi
- College of Nursing, Mo-Im Kim Nursing Research Institute, Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
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13
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Huber SK, Knols RH, Held JPO, Betschart M, de Bruin ED. PEMOCS: Evaluating the effects of a concept-guided, PErsonalised, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke-study protocol for a randomised controlled trial. Trials 2024; 25:451. [PMID: 38965612 PMCID: PMC11223407 DOI: 10.1186/s13063-024-08283-7] [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: 01/16/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Many stroke survivors remain with residual cognitive and motor impairments despite receiving timely acute and sub-acute rehabilitation. This indicates that rehabilitation following stroke should be continuous to meet the needs of individual stroke patients. Both cognitive and motor functions are essential for mastering daily life and, therefore, should be aimed at with rehabilitation. Exergames, motor-cognitive exercises performed using video games, are an auspicious method to train both motor and cognitive functions and at the same time may foster the long-term motivation for training. This study aims to assess the effect of concept-guided, personalised, motor-cognitive exergame training on cognitive and motor functions in chronic stroke survivors. METHODS This study is a single-blinded, randomised controlled trial. Assessments are performed at baseline, after a 12-week intervention, and at a 24-weeks follow-up. Chronic stroke patients (≥ 18 years old, ≥ 6 months post-stroke) able to stand for 3 min, independently walk 10 m, follow a two-stage command, and without other neurological diseases apart from cognitive deficits or dementia are included. Participants in the intervention group perform the exergame training twice per week for 30 (beginning) up to 40 (end) minutes additionally to their usual care programme. Participants in the control group receive usual care without additional intervention(s). Global cognitive functioning (total Montreal Cognitive Assessment (MoCA) score) is the primary outcome. Secondary outcomes include health-related quality of life, specific cognitive functions, single- and dual-task mobility, and spatiotemporal gait parameters. The target sample size for this trial is 38 participants. Linear mixed models with the post-outcome scores as dependent variables and group and time as fixed effects will be performed for analysis. DISCUSSION Superior improvements in global cognitive functioning and in the abovementioned secondary outcomes in the intervention group compared to the control group are hypothesised. The results of this study may guide future design of long-term rehabilitation interventions after stroke. TRIAL REGISTRATION ClinicalTrials.gov (NCT05524727). Registered on September 1, 2022.
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Affiliation(s)
- S K Huber
- Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland.
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - R H Knols
- Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - J P O Held
- Rehabilitation Center Triemli Zurich, Valens Clinics, Zurich, Switzerland
| | - M Betschart
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Institute of Therapy and Rehabilitation, Kantonsspital Winterthur, Winterthur, Switzerland
| | - E D de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
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Ueno K, Nishigori T, Tokoro Y, Nakakura A, Tsunoda S, Hisamori S, Hashimoto K, Kanaya S, Hirai K, Tanaka E, Hata H, Manaka D, Sakaguchi M, Kondo M, Kan T, Itami A, Miki A, Kawamura Y, Toda K, Okabe H, Yamamoto M, Yamashita Y, Kinjo Y, Kawada H, Obama K. The efficacy of simple oral nutritional supplements versus usual care in postoperative patients with gastric cancer: study protocol for a multicenter, open-label, parallel, randomized controlled trial. Trials 2024; 25:445. [PMID: 38961505 PMCID: PMC11223300 DOI: 10.1186/s13063-024-08169-8] [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: 08/25/2023] [Accepted: 05/09/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Body weight loss (BWL) after gastrectomy impact on the short- and long-term outcomes. Oral nutritional supplement (ONS) has potential to prevent BWL in patients after gastrectomy. However, there is no consistent evidence supporting the beneficial effects of ONS on BWL, muscle strength and health-related quality of life (HRQoL). This study aimed to evaluate the effects of ONS formulated primarily with carbohydrate and protein on BWL, muscle strength, and HRQoL. METHODS This will be a multicenter, open-label, parallel, randomized controlled trial in patients with gastric cancer who will undergo gastrectomy. A total of 120 patients who will undergo gastrectomy will be randomly assigned to the ONS group or usual care (control) group in a 1:1 ratio. The stratification factors will be the clinical stage (I or ≥ II) and surgical procedures (total gastrectomy or other procedure). In the ONS group, the patients will receive 400 kcal (400 ml)/day of ONS from postoperative day 5 to 7, and the intervention will continue postoperatively for 8 weeks. The control group patients will be given a regular diet. The primary outcome will be the percentage of BWL (%BWL) from baseline to 8 weeks postoperatively. The secondary outcomes will be muscle strength (handgrip strength), HRQoL (EORTC QLQ-C30, QLQ-OG25, EQ-5D-5L), nutritional status (hemoglobin, lymphocyte count, albumin), and dietary intake. All analyses will be performed on an intention-to-treat basis. DISCUSSION This study will provide evidence showing whether or not ONS with simple nutritional ingredients can improve patient adherence and HRQoL by reducing BWL after gastrectomy. If supported by the study results, nutritional support with simple nutrients will be recommended to patients after gastrectomy for gastric cancer. TRIAL REGISTRATION jRCTs051230012; Japan Registry of Clinical Trails. Registered on Apr. 13, 2023.
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Affiliation(s)
- Kohei Ueno
- Department of Surgery, Kyoto University Hospital, 54 Shogoinkawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Tatsuto Nishigori
- Department of Surgery, Kyoto University Hospital, 54 Shogoinkawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Yukinari Tokoro
- Department of Surgery, Kyoto University Hospital, 54 Shogoinkawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Akiyoshi Nakakura
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shigeru Tsunoda
- Department of Surgery, Kyoto University Hospital, 54 Shogoinkawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Shigeo Hisamori
- Department of Surgery, Kyoto University Hospital, 54 Shogoinkawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | | | | | - Kenjiro Hirai
- Department of Surgery, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Eiji Tanaka
- Department of Surgery, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Hiroaki Hata
- Department of Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Dai Manaka
- Department of Surgery, Kyoto Katsura Hospital, Kyoto, Japan
| | | | - Masato Kondo
- Department of Surgery, Kobe City Medical Center, General Hospital, Hyogo, Japan
| | - Takatsugu Kan
- Department of Surgery, Kobe City Medical Center, West Hospital, Hyogo, Japan
| | - Atsushi Itami
- Department of Surgery, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan
| | - Akira Miki
- Department of Surgery, Toyooka Hospital, Hyogo, Japan
| | | | - Kosuke Toda
- Department of Surgery, Shiga General Hospital, Shiga, Japan
| | - Hiroshi Okabe
- Department of Surgery, New Tokyo Hospital, Chiba, Japan
| | | | - Yoshito Yamashita
- Department of Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Yosuke Kinjo
- Department of Surgery, National Hospital Organization Himeji Medical Center, Hyogo, Japan
| | - Hironori Kawada
- Department of Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Kazutaka Obama
- Department of Surgery, Kyoto University Hospital, 54 Shogoinkawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
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Barbosa da Silva AC, Santana GN, Santos IS, Dos Santos PG, de Oliveira AR, Filho AVD, de Paula Gomes CAF. Multimodal therapeutic intervention program associated with photobiomodulation therapy for individuals with chronic nonspecific neck pain: protocol for a clinical trial. Trials 2024; 25:442. [PMID: 38961460 PMCID: PMC11221013 DOI: 10.1186/s13063-024-08289-1] [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: 03/18/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Neck pain is a prevalent global musculoskeletal issue, significantly contributing to the loss of years of healthy life due to disability. Chronic nonspecific neck pain (CNNP) involves diverse symptoms impacting mobility and quality of life. While therapeutic exercises demonstrate efficacy, the role of photobiomodulation therapy (PBMT) remains uncertain. This study aims to assess the additional effects of PBMT within a multimodal therapeutic intervention for CNNP. METHODS A randomized, two-arm, controlled, blind clinical trial follows CONSORT and SPIRIT guidelines. Participants diagnosed with CNNP will receive a stand-alone multimodal therapeutic intervention or the same program with additional PBMT. The primary outcomes will be assessed by the functional disability identified through applying the NDI (Neck Disability Index). Secondary outcomes will be pain intensity during rest and active neck movement, catastrophizing and kinesiophobia, functionality, and disability assessed at baseline, after 8 weeks, and at a 4-week follow-up. Both groups receive pain education before personalized interventions, including resistance exercises, neuromuscular activities, mobility, and body balance. The PBMT group undergoes low-level light therapy. Intention-to-treat analysis, using linear mixed models, employs data presented as mean, standard deviation, and differences with a 95% confidence interval. Non-normally distributed variables transform. Statistical significance is set at 5%. DISCUSSION This study addresses a critical gap in understanding the combined effects of PBMT and therapeutic exercises for CNNP. The findings aim to guide clinicians, researchers, and CNNP sufferers through rigorous methodology and diverse outcome assessments, offering valuable insights into evidence-based practices for CNNP management. Data confidentiality is maintained throughout, ensuring participant privacy during statistical analysis. TRIAL REGISTRATION Effects of adding photobiomodulation to a specific therapeutic exercise program for the treatment of individuals with chronic nonspecific neck pain, registration number: NCT05400473, on 2022-05-27.
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Affiliation(s)
- Aron Charles Barbosa da Silva
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, Vergueiro Street, N°: 235/249, Liberdade, São Paulo, SP, CEP: 01504-001, Brazil.
| | - Gabriela Nascimento Santana
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, Vergueiro Street, N°: 235/249, Liberdade, São Paulo, SP, CEP: 01504-001, Brazil
| | - Inaê Silva Santos
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, Vergueiro Street, N°: 235/249, Liberdade, São Paulo, SP, CEP: 01504-001, Brazil
| | - Patrícia Gabrielle Dos Santos
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, Vergueiro Street, N°: 235/249, Liberdade, São Paulo, SP, CEP: 01504-001, Brazil
| | - Adriano Rodrigues de Oliveira
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, Vergueiro Street, N°: 235/249, Liberdade, São Paulo, SP, CEP: 01504-001, Brazil
| | - Almir Vieria Dibai Filho
- Postgraduate Program in Physical Education, Federal University of Maranhão, São Luís, MA, Brazil
| | - Cid André Fidelis de Paula Gomes
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, Vergueiro Street, N°: 235/249, Liberdade, São Paulo, SP, CEP: 01504-001, Brazil
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Ford ALB, Kuchler K, Cakir-Dilek B, Elmquist M, Finestack LH. A Tutorial for Enhancing Clarity and Transparency in Speech-Language-Hearing Sciences Intervention Research With the TIDieR. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1608-1618. [PMID: 38889209 DOI: 10.1044/2024_ajslp-23-00389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE The speech-language-hearing sciences (SLHS) field relies on rigorous research to inform clinical practice and improve outcomes for individuals with communication, swallowing, and hearing needs. However, a significant challenge in our field is the lack of accessibility, transparency, and reproducibility of this research. Such insufficiencies limit the generalizability and impact of study findings, particularly intervention research, as it becomes difficult to replicate and use the interventions in both clinical practice and research. In this tutorial, we highlight one particularly useful tool, the Template for Intervention Description and Replication (TIDieR; Hoffmann et al., 2014) checklist, which researchers can follow to improve reproducibility practices in SLHS. CONCLUSIONS We provide an overview and guide on using the TIDieR checklist with a practical example of its implementation. Additionally, we discuss the potential benefits of increased transparency and reproducibility for SLHS, including improved clinical outcomes and increased confidence in the effectiveness of interventions. We also provide specific recommendations for scientists, journal reviewers, editors, and editorial boards as they seek to adopt, implement, and encourage using the TIDieR checklist.
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Affiliation(s)
- Andrea L B Ford
- Department of Communication Sciences & Disorders, University of Cincinnati, OH
| | - Kirstin Kuchler
- Department of Speech-Language-Hearing Sciences, University of Minnesota Twin Cities
| | - Betul Cakir-Dilek
- Department of Educational Psychology, University of Minnesota Twin Cities
| | | | - Lizbeth H Finestack
- Department of Speech-Language-Hearing Sciences, University of Minnesota Twin Cities
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Vandervelde S, Van den Bosch N, Vlaeyen E, Dierckx de Casterlé B, Flamaing J, Belaen G, Tuand K, Vandendriessche T, Milisen K. Determinants influencing the implementation of multifactorial falls risk assessment and multidomain interventions in community- dwelling older people: a systematic review. Age Ageing 2024; 53:afae123. [PMID: 38952187 DOI: 10.1093/ageing/afae123] [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: 12/18/2023] [Revised: 05/08/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Multifactorial falls risk assessment and multidomain interventions are recommended by the World guidelines for falls prevention and management. To successfully implement these interventions, it is important to understand determinants influencing the implementation. METHODS A literature search was conducted for this systematic review on the 3 December 2021 and updated on the 3 April 2023 in five databases: PubMed (including MEDLINE), EMBASE (via Embase.com), Cochrane Central Register of Controlled Trials (via Cochrane Library), Web of Science Core Collection and CINAHL (via EBSCO). Studies were included if they reported on determinants influencing the implementation of a multifactorial falls risk assessment and/or multidomain interventions in community-dwelling older people. Editorials, opinion papers, systematic reviews and studies focusing on one population (e.g. Parkinson) were excluded. Two researchers independently screened the articles on title, abstract and full text. The quality was evaluated based on a sensitivity analysis. 'The Comprehensive Integrated Checklist of Determinants of practice' was used to categorise the determinants. RESULTS Twenty-nine studies were included. Determinants were classified as barriers (n = 40) and facilitators (n = 35). The availability of necessary resources is the most reported determinant. Other commonly reported determinants are knowledge, intention/beliefs and motivation at the levels of older people and healthcare professionals, fitting of the intervention into current practice, communication, team and referral processes and financial (dis)incentives. CONCLUSIONS Mapping of the barriers and facilitators is essential to choose implementation strategies tailored to the context, and to enhance the uptake and effectiveness of a multifactorial falls risk assessment and/or multidomain interventions.
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Affiliation(s)
- Sara Vandervelde
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, Kapucijnenvoer 7 bus 7001, Leuven 3000, Belgium
| | - Natalie Van den Bosch
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 7 bus 7001, Leuven 3000, Belgium
| | - Ellen Vlaeyen
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, Kapucijnenvoer 7 bus 7001, Leuven 3000, Belgium
- Hasselt University, Faculty of Medicine and Life Sciences, Agoralaan, 3590 Diepenbeek, Belgium
| | - Bernadette Dierckx de Casterlé
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 7 bus 7001, Leuven 3000, Belgium
| | - Johan Flamaing
- KU Leuven, Department of Public Health and Primary Care, Gerontology and Geriatrics, Kapucijnenvoer 7 bus 7001 3000 Leuven, Belgium
- KU Leuven, University Hospital Leuven, Department of Geriatric Medicine, Herestraat 49 3000 Leuven, Belgium
| | - Goedele Belaen
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, Kapucijnenvoer 7 bus 7001, Leuven 3000, Belgium
| | - Krizia Tuand
- KU Leuven Libraries, 2Bergen - Learning Centre Désiré Collen, Herestraat 49, 3000 Leuven, Belgium
| | - Thomas Vandendriessche
- KU Leuven Libraries, 2Bergen - Learning Centre Désiré Collen, Herestraat 49, 3000 Leuven, Belgium
| | - Koen Milisen
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, Kapucijnenvoer 7 bus 7001, Leuven 3000, Belgium
- KU Leuven, University Hospital Leuven, Department of Geriatric Medicine, Herestraat 49 3000 Leuven, Belgium
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De Dios Pérez B, das Nair R, Radford K. Development of a Job Retention Vocational Rehabilitation Intervention for People with Multiple Sclerosis Following the Person-Based Approach. Clin Rehabil 2024; 38:965-978. [PMID: 38418389 PMCID: PMC11118787 DOI: 10.1177/02692155241235956] [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: 05/09/2023] [Accepted: 02/12/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To describe the process of developing a job retention vocational rehabilitation intervention for people with multiple sclerosis. DESIGN We used the person-based approach, to develop interventions through an iterative process incorporating stakeholders' views, resulting in an intervention that is likely to be more acceptable, contextually relevant, and implementable for end-users. Phase 1 combined the results of a systematic review and interview study to develop the guiding principles and intervention logic model. Phase 2 involved conceptual testing and refining the intervention with stakeholder feedback. We present the final intervention following the template for intervention description and replication. PARTICIPANTS We recruited 20 participants for Phase 1 (10 people with multiple sclerosis, four employers, six healthcare professionals), and 10 stakeholders (three people with multiple sclerosis, seven healthcare professionals) for Phase 2 to contribute to the intervention refinement process. RESULTS Stakeholders described the need for an individually tailored intervention to support people with multiple sclerosis to manage symptoms and workplace relationships. A stepped-care approach and remote support were deemed essential. The resulting intervention involves an initial assessment of employment needs, vocational goal setting, up to 10 h of tailored support (e.g., reasonable adjustments, employer engagement, legal rights), and a final review to discuss future steps. People with multiple sclerosis can include their employer for advice to optimise the management of the employee with multiple sclerosis at work. CONCLUSION The person-based approach provided a rigorous framework to systematically understand the vocational needs of people with multiple sclerosis and develop a vocational rehabilitation intervention.
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Affiliation(s)
- Blanca De Dios Pérez
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Roshan das Nair
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire NHS Foundation Trust, Nottingham, UK
- Health Research, SINTEF Digital, Trondheim, Norway
| | - Kathryn Radford
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
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King MG, Scholes MJ, Fan I, Govil D, Semciw AI. Response to: You et al., 'Comment on: How effective are exercises delivered digitally (requiring internet), amongst patients with hip or knee osteoarthritis? A systematic review and meta-analysis'. Osteoarthritis Cartilage 2024; 32:964-965. [PMID: 38734366 DOI: 10.1016/j.joca.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Matthew G King
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Australian IOC Research Centre, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Mark J Scholes
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Australian IOC Research Centre, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Iryoung Fan
- Northern Health, Epping, Victoria, Australia
| | - Dhruv Govil
- Bass Coast Health, Wonthaggi, Victoria, Australia
| | - Adam I Semciw
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Northern Health, Epping, Victoria, Australia
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20
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Girard A, Doucet A, Lambert M, Ouadfel S, Caron G, Hudon C. What is known about the role of external facilitators during the implementation of complex interventions in healthcare settings? A scoping review. BMJ Open 2024; 14:e084883. [PMID: 38951001 DOI: 10.1136/bmjopen-2024-084883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVE To synthesise current knowledge about the role of external facilitators as an individual role during the implementation of complex interventions in healthcare settings. DESIGN A scoping review was conducted. We reviewed original studies (between 2000 and 2023) about implementing an evidence-based complex intervention in a healthcare setting using external facilitators to support the implementation process. An information specialist used the following databases for the search strategy: MEDLINE, CINAHL, APA PsycINFO, Academic Search Complete, EMBASE (Scopus), Business Source Complete and SocINDEX. RESULTS 36 reports were included for analysis, including 34 different complex interventions. We performed a mixed thematic analysis to synthesise the data. We identified two primary external facilitator roles: lead facilitator and process expert facilitator. Process expert external facilitators have specific responsibilities according to their role and expertise in supporting three main processes: clinical, change management and knowledge/research management. CONCLUSIONS Future research should study processes supported by external facilitators and their relationship with facilitation strategies and implementation outcomes. Future systematic or realist reviews may also focus on outcomes and the effectiveness of external facilitation.
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Affiliation(s)
- Ariane Girard
- School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Amélie Doucet
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Mireille Lambert
- Department of Family Medicine and Emergency, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sarah Ouadfel
- Department of Family Medicine and Emergency, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Genève Caron
- Departement of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Catherine Hudon
- Department of Family Medicine and Emergency, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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21
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Hand RK, Schofield MK. Expanding Time Covered for Medical Nutrition Therapy: A Need for Clear Reporting on the Intensity of Nutrition Interventions. J Acad Nutr Diet 2024; 124:797-803. [PMID: 38286250 DOI: 10.1016/j.jand.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Rosa K Hand
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio.
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22
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McDonald B, Michelson D, Lester KJ. Intervention for school anxiety and absenteeism in children (ISAAC): Co-designing a brief parent-focused intervention for emotionally-based school avoidance. Clin Child Psychol Psychiatry 2024; 29:850-866. [PMID: 38130129 PMCID: PMC11188550 DOI: 10.1177/13591045231222648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Emotionally-based school avoidance (EBSA) is an important driver of persistent school absenteeism and may have worsened in the context of COVID-19. This paper describes the development of a brief parent-focused psychosocial intervention with the goal to address the lack of accessible early interventions for EBSA. The developmental process used a person-based approach with two phases. In Phase 1, qualitative data were collected about intervention preferences and priorities from N = 10 parents and N = 7 practitioners in a series of co-design workshops. Phase 2 refined an intervention blueprint based on iterative consultations with N = 4 parents and N = 3 practitioners. Framework analysis was used to organise findings around key intervention parameters, including relevant mechanisms, content, and delivery methods needed to provide effective, acceptable and feasible support for families affected by EBSA. The resulting blueprint incorporates three online modules to be delivered over three weeks with each module consisting of psychoeducational videos, self-completed learning tasks and a corresponding coaching session. Respective module content includes: (i) self-care strategies to increase parent wellbeing and self-efficacy; (ii) parenting strategies to change behavioural patterns that maintain child distress and avoidance of school; and (iii) strategic communication strategies to increase the quality of home-school relationships. The blueprint has been developed into a full prototype for a forthcoming feasibility study.
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Affiliation(s)
| | - Daniel Michelson
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, UK
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23
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Fleurent-Grégoire C, Burgess N, Denehy L, Edbrooke L, Engel D, Testa GD, Fiore JF, McIsaac DI, Chevalier S, Moore J, Grocott MP, Copeland R, Levett D, Scheede-Bergdahl C, Gillis C. Outcomes reported in randomised trials of surgical prehabilitation: a scoping review. Br J Anaesth 2024; 133:42-57. [PMID: 38570300 PMCID: PMC11213997 DOI: 10.1016/j.bja.2024.01.046] [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: 11/29/2023] [Revised: 01/09/2024] [Accepted: 01/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Heterogeneity of reported outcomes can impact the certainty of evidence for prehabilitation. The objective of this scoping review was to systematically map outcomes and assessment tools used in trials of surgical prehabilitation. METHODS MEDLINE, EMBASE, PsychInfo, Web of Science, CINAHL, and Cochrane were searched in February 2023. Randomised controlled trials of unimodal or multimodal prehabilitation interventions (nutrition, exercise, psychological support) lasting at least 7 days in adults undergoing elective surgery were included. Reported outcomes were classified according to the International Society for Pharmacoeconomics and Outcomes Research framework. RESULTS We included 76 trials, mostly focused on abdominal or orthopaedic surgeries. A total of 50 different outcomes were identified, measured using 184 outcome assessment tools. Observer-reported outcomes were collected in 86% of trials (n=65), with hospital length of stay being most common. Performance outcomes were reported in 80% of trials (n=61), most commonly as exercise capacity assessed by cardiopulmonary exercise testing. Clinician-reported outcomes were included in 78% (n=59) of trials and most frequently included postoperative complications with Clavien-Dindo classification. Patient-reported outcomes were reported in 76% (n=58) of trials, with health-related quality of life using the 36- or 12-Item Short Form Survey being most prevalent. Biomarker outcomes were reported in 16% of trials (n=12) most commonly using inflammatory markers assessed with C-reactive protein. CONCLUSIONS There is substantial heterogeneity in the reporting of outcomes and assessment tools across surgical prehabilitation trials. Identification of meaningful outcomes, and agreement on appropriate assessment tools, could inform the development of a prehabilitation core outcomes set to harmonise outcome reporting and facilitate meta-analyses.
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Affiliation(s)
- Chloé Fleurent-Grégoire
- School of Human Nutrition, McGill University, Montreal, QC, Canada; Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Nicola Burgess
- Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia
| | - Linda Denehy
- Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia; Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia; Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Dominique Engel
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Giuseppe Dario Testa
- Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Julio F Fiore
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Daniel I McIsaac
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, Montreal, QC, Canada; Research Institute of the McGill University Health Centre, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada
| | - John Moore
- Department of Anaesthesia, Manchester University NHS Foundation Trust, Manchester, UK
| | - Michael P Grocott
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton - University of Southampton, Southampton, UK
| | - Robert Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Denny Levett
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton - University of Southampton, Southampton, UK
| | - Celena Scheede-Bergdahl
- Department of Kinesiology and Physical Education, McGill Research, Centre for Physical Activity & Health, McGill University, Montreal, QC, Canada
| | - Chelsia Gillis
- School of Human Nutrition, McGill University, Montreal, QC, Canada; Department of Surgery, McGill University, Montreal, QC, Canada; Department of Anesthesia, McGill University, Montreal, QC, Canada.
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24
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Stokes Y, Lewis KB, Tricco AC, Hambrick E, Jacob JD, Demery Varin M, Gould J, Aggarwal D, Cloutier P, Landriault C, Greenham S, Ward M, Kennedy A, Boggett J, Sheppard R, Murphy D, Robb M, Gandy H, Lavergne S, Graham ID. Trauma-Informed Care Interventions Used in Pediatric Inpatient or Residential Treatment Mental Health Settings and Strategies to Implement Them: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1737-1755. [PMID: 37694809 PMCID: PMC11155220 DOI: 10.1177/15248380231193444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Trauma-informed care (TIC) is an approach to care emerging in research and in practice that involves addressing the needs of individuals with histories of trauma. The aim of this scoping review was to examine the current literature relating to TIC interventions used in pediatric mental health inpatient and residential settings. We sought to answer the following two research questions: (a) What are the TIC interventions used in pediatric inpatient and residential treatment mental healthcare settings and what are their components? and (b) What are the implementation goals and strategies used with these TIC interventions? We conducted this scoping review according to JBI (formerly Joanna Briggs Institute) methodology for scoping reviews. We included any primary study describing a TIC intervention that was implemented at a specific site which identified and described implementation strategies used. Of 1,571 identified citations and 54 full-text articles located by handsearching, 49 met the eligibility criteria and were included, representing 21 distinct TIC interventions. We present the reported aim, ingredients, mechanism, and delivery (AIMD) of TIC interventions as well as the implementation goals and strategies used, which varied in detail, ranging from very little information to more detailed descriptions. In the context of these findings, we emphasize the complexity of TIC and of TIC interventions, and the importance of identifying and clearly reporting TIC intervention goals, intervention details, and implementation strategies. We suggest applying intervention frameworks or reporting guidelines to support clear and comprehensive reporting, which would better facilitate replication and synthesis of published TIC interventions.
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Affiliation(s)
- Yehudis Stokes
- University of Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
- CHEO Research Institute, Ottawa, Canada
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Krystina B. Lewis
- University of Ottawa, ON, Canada
- University of Ottawa Heart Institute, ON, Canada
- Ottawa Hospital Research Institute, ON, Canada
| | - Andrea C. Tricco
- Queen’s University, Kingston, ON, Canada
- University of Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, ON, Canada
| | | | | | - Melissa Demery Varin
- University of Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
- CHEO Research Institute, Ottawa, Canada
| | - Justine Gould
- CHEO Research Institute, Ottawa, Canada
- Queen’s University, Kingston, ON, Canada
| | - Dhiraj Aggarwal
- University of Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
- CHEO Research Institute, Ottawa, Canada
| | | | | | - Stephanie Greenham
- University of Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
- CHEO Research Institute, Ottawa, Canada
| | - Michelle Ward
- University of Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
- CHEO Research Institute, Ottawa, Canada
| | - Allison Kennedy
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
- CHEO Research Institute, Ottawa, Canada
| | | | | | - David Murphy
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Marjorie Robb
- University of Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
- CHEO Research Institute, Ottawa, Canada
| | - Hazen Gandy
- University of Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Sonia Lavergne
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Ian D. Graham
- University of Ottawa, ON, Canada
- Ottawa Hospital Research Institute, ON, Canada
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25
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Gärtner HS, Shabnam J, Aagesen M, Guldin MB, Vind AB, Marsaa K, Bergenholtz HM, Graven V, Sampedro Pilegaard M, Thuesen J. Combined rehabilitation and palliative care interventions for patients with life-threatening diseases - PREGOAL. A scoping review of intervention programme goals. Disabil Rehabil 2024; 46:2989-2998. [PMID: 37580981 DOI: 10.1080/09638288.2023.2246373] [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: 02/07/2023] [Revised: 07/14/2023] [Accepted: 07/28/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE WHO recommends integrating rehabilitation into palliative care when providing services for people with life-threatening conditions. Recently, there has been increasing interest in exploring how rehabilitation and palliative care approaches could be combined. The aim of this study was to map and discuss the goals of intervention programmes that combine rehabilitation and palliative care. METHODS A scoping review was performed. The electronic databases MEDLINE, EMBASE, and CINAHL were searched for papers published between January 2014 and September 2022. Papers were considered eligible if the participants in question had a life-threatening disease and if interventions included both rehabilitation and palliative care. All study types were included. RESULTS Ten papers describing five interventions were included. Qualitative goals were narratively described, and quantitative goals were analysed according to the International Classification of Functioning, Disability and Health, and the Total Pain framework. Findings showed an overall focus on functioning and quality of life. Further analysis indicated an emphasis on physical and psychological dimensions. Social participation, and the social and spiritual dimensions were rarely evaluated. CONCLUSION This review indicates that goals relative to social participation, the social and spiritual dimensions, and the patient's own goals may well be overlooked as points of orientation for interventions.
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Affiliation(s)
- Henriette Søby Gärtner
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jahan Shabnam
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Public Health, Aarhus University, Aarhus, Denmark
| | - Ane Bonnerup Vind
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kristoffer Marsaa
- North Zealand Hospital, University of Copenhagen, Kobenhavn, Denmark
| | - Heidi Maria Bergenholtz
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Zealand University Hospital, Research Support Unit, Koge, Denmark
| | - Vibeke Graven
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marc Sampedro Pilegaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Regional Hospital Gødstrup, Herning, Denmark
| | - Jette Thuesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Kwon CS, Chua MMJ, Jetté N, Rolston JD. A knowledge synthesis of health research reporting standards relevant to epilepsy surgery. Epilepsia 2024. [PMID: 38949199 DOI: 10.1111/epi.18047] [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: 03/20/2024] [Revised: 05/08/2024] [Accepted: 06/07/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE Numerous studies have examined epilepsy surgery outcomes, yet the variability in the level of detail reported hampers our ability to apply these findings broadly across patient groups. Established reporting standards in other clinical research fields enhance the quality and generalizability of results, ensuring that the insights gained from studying these surgeries can benefit future patients effectively. This study aims to assess current reporting standards for epilepsy surgery research and identify potential gaps and areas for enhancement. METHODS The Enhancing the Quality and Transparency of Health Research (EQUATOR) repository was accessed from inception to April 27, 2023, yielding 561 available reporting standards. Reporting standards were manually reviewed in duplicate independently for applicability to epilepsy and/or neurosurgery research. The reporting standards had to cover the following aspects in human studies: (1) reporting standards for epilepsy/epilepsy surgery and (2) reporting standards for neurosurgery. Disagreements were resolved by a third author. The top five neurosurgery, neurology, and medicine journals were also identified through Google Scholar's citation index and examined to determine the relevant reporting standards they recommended and whether those were registered with EQUATOR. RESULTS Of the 561 EQUATOR reporting standards, 181 were pertinent to epilepsy surgery. One was related to epilepsy, six were specific to surgical research, and nine were related to neurological/neurosurgical research. The remaining 165 reporting standards were applicable to research across various disciplines and included but were not limited to CONSORT (Consolidated Standards of Reporting Trails), STROBE (Strengthening the Reporting of Observational Studies in Epidemiology), and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). None of these required reporting factors associated with epilepsy surgery outcomes, such as duration of epilepsy or magnetic resonance imaging findings. SIGNIFICANCE Reporting standards specific to epilepsy surgery are lacking, reflecting a gap in standards that may affect the quality of publications. Improving this gap with a set of specific reporting standards would ensure that epilepsy surgery studies are more transparent and rigorous in their design.
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Affiliation(s)
- Churl-Su Kwon
- Departments of Neurology, Epidemiology, and Neurosurgery and Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Melissa M J Chua
- Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nathalie Jetté
- Department of Clinical Neurosciences and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - John D Rolston
- Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
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27
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Bak SY, Uhm JY. A Nurse-Led App-Based Home Exercise Program After Total Knee Arthroplasty: A Quasi-Experimental Study. Rehabil Nurs 2024; 49:103-114. [PMID: 38904651 DOI: 10.1097/rnj.0000000000000465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
PURPOSE Reduced activity because of pain is a major health issue associated with total knee arthroplasty. This study evaluated the effectiveness of a nurse-led app-based home exercise program for patients who underwent total knee arthroplasty. METHODS A nonequivalent control group of pretest-posttest design was used. Data from 45 patients were collected. The control group received individualized face-to-face exercise education, whereas the experimental group received training on the use of app-based home exercise education, including exercise videos and app push notifications to encourage exercise after discharge. Pain, range of motion, exercise self-efficacy, and quality of life were measured at baseline and 3 and 12 weeks after surgery. Nursing care satisfaction was evaluated 12 weeks after surgery. RESULTS There were significant overall reductions in pain intensity ( p = .001), improvements in limited range of motion ( p < .001), and increases in exercise self-efficacy ( p = .034) and quality of life ( p = .033) in the experimental group ( n = 22) compared with those in the control group ( n = 23). Nursing care satisfaction was significantly higher in the experimental group than in the control group ( p < .001). CONCLUSIONS Rehabilitation nurses can offer app-based home exercise education with push notifications to alleviate pain, enhance range of motion, improve exercise self-efficacy, and increase nursing care satisfaction for patients who have had a knee arthroplasty.
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Affiliation(s)
- Song-Yi Bak
- Department of Nursing, Pukyong National University, Busan, South Korea
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28
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Vogel JP, Nguyen PY, Ramson J, De Silva MS, Pham MD, Sultana S, McDonald S, Adu-Bonsaffoh K, McDougall ARA. Effectiveness of care bundles for prevention and treatment of postpartum hemorrhage: a systematic review. Am J Obstet Gynecol 2024; 231:67-91. [PMID: 38336124 DOI: 10.1016/j.ajog.2024.01.012] [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: 11/01/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Care bundles are a promising approach to reducing postpartum hemorrhage-related morbidity and mortality. We assessed the effectiveness and safety of care bundles for postpartum hemorrhage prevention and/or treatment. DATA SOURCES We searched MEDLINE, Embase, Cochrane CENTRAL, Maternity and Infant Care Database, and Global Index Medicus (inception to June 9, 2023) and ClinicalTrials.gov and the International Clinical Trials Registry Platform (last 5 years) using a phased search strategy, combining terms for postpartum hemorrhage and care bundles. STUDY ELIGIBILITY CRITERIA Peer-reviewed studies evaluating postpartum hemorrhage-related care bundles were included. Care bundles were defined as interventions comprising ≥3 components implemented collectively, concurrently, or in rapid succession. Randomized and nonrandomized controlled trials, interrupted time series, and before-after studies (controlled or uncontrolled) were eligible. METHODS Risk of bias was assessed using RoB 2 (randomized trials) and ROBINS-I (nonrandomized studies). For controlled studies, we reported risk ratios for dichotomous outcomes and mean differences for continuous outcomes, with certainty of evidence determined using GRADE. For uncontrolled studies, we used effect direction tables and summarized results narratively. RESULTS Twenty-two studies were included for analysis. For prevention-only bundles (2 studies), low-certainty evidence suggests possible benefits in reducing blood loss, duration of hospitalization, and intensive care unit stay, and maternal well-being. For treatment-only bundles (9 studies), high-certainty evidence shows that the E-MOTIVE intervention reduced risks of composite severe morbidity (risk ratio, 0.40; 95% confidence interval, 0.32-0.50) and blood transfusion for bleeding, postpartum hemorrhage, severe postpartum hemorrhage, and mean blood loss. One nonrandomized trial and 7 uncontrolled studies suggest that other postpartum hemorrhage treatment bundles might reduce blood loss and severe postpartum hemorrhage, but this is uncertain. For combined prevention/treatment bundles (11 studies), low-certainty evidence shows that the California Maternal Quality Care Collaborative care bundle may reduce severe maternal morbidity (risk ratio, 0.64; 95% confidence interval, 0.57-0.72). Ten uncontrolled studies variably showed possible benefits, no effects, or harms for other bundle types. Nearly all uncontrolled studies did not use suitable statistical methods for single-group pretest-posttest comparisons and should thus be interpreted with caution. CONCLUSION The E-MOTIVE intervention improves postpartum hemorrhage-related outcomes among women delivering vaginally, and the California Maternal Quality Care Collaborative bundle may reduce severe maternal morbidity. Other bundle designs warrant further effectiveness research before implementation is contemplated.
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Affiliation(s)
- Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Phi-Yen Nguyen
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jen Ramson
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Manarangi S De Silva
- Department of Obstetrics, Gynaecology and Newborn Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Minh D Pham
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Saima Sultana
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Steve McDonald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kwame Adu-Bonsaffoh
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana
| | - Annie R A McDougall
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
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Choi S, Pionke JJ. Characteristics of Physical Activity Interventions for People With Visual Impairments: A Scoping Review. Adapt Phys Activ Q 2024; 41:450-474. [PMID: 38218179 DOI: 10.1123/apaq.2023-0113] [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: 08/16/2023] [Revised: 11/18/2023] [Accepted: 12/04/2023] [Indexed: 01/15/2024] Open
Abstract
This study evaluated physical activity interventions designed for individuals with visual impairments and sought to guide health intervention scientists aiming to promote physical activity in this demographic. We delved into the specifics of participants' visual impairments, intervention features, accommodation approaches, and replicability prospects. The search spanned four databases, namely PubMed, CINAHL, SportDiscus, and Scopus, providing a wide scope and diversity of potential studies. There were no restrictions on publication years. We reviewed 13 studies, totaling 15 interventions. A consensus on visual-impairment definitions remains elusive, and the intervention dosages displayed variability. Notably, 66.7% (n = 7) integrated behavior-change techniques to amplify physical activity levels. Multiple studies employed audio descriptions as an accommodation method. While most studies provided adequate information for potential replication, detailed study protocols were frequently absent. It is essential for developed interventions to be persistently evaluated and fine-tuned to optimize results.
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Affiliation(s)
- Soyoung Choi
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - J J Pionke
- School of Information Studies, Syracuse University, Syracuse, NY, USA
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Haines M, Vandyk A, Skidmore B, Orser L, O'Byrne P. A Systematic Review of Oral Pre-exposure Prophylaxis HIV Adherence Interventions. J Assoc Nurses AIDS Care 2024; 35:309-324. [PMID: 38564213 PMCID: PMC11195928 DOI: 10.1097/jnc.0000000000000460] [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] [Indexed: 04/04/2024]
Abstract
ABSTRACT Clinical trials of pre-exposure prophylaxis (PrEP) to prevent HIV infection have established its efficacy as upwards of 99%. Despite this, the effectiveness of this medication has been shown to be diminished by individual factors, such as medication adherence. We completed a systematic review to identify and describe interventions to improve oral PrEP adherence. Overall, 16 articles were located. Two of the articles reported on results from the same trial and were collapsed for analysis, bringing the total to 15 studies. Twelve unique PrEP adherence interventions were tested, with the most common intervention being the use of mobile phone technology, which was used in 7 (46%) of the studies. Ten (67%) studies found that medication adherence improved when participants received an intervention to support adherence. Adherence intervention strategies effectively improved PrEP adherence. Further research into PrEP adherence interventions is warranted, particularly among diverse groups.
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Affiliation(s)
- Marlene Haines
- Marlene Haines, RN, BHSc, BScN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada ( )
- Amanda Vandyk, RN, PhD, is an Associate Professor, School of Nursing, University of Ottawa, Ottawa, Canada
- Becky Skidmore, MLIS, is an Information Specialist, Ottawa Hospital Research Institute, Ottawa, Canada
- Lauren Orser, RN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada
- Patrick O'Byrne, RN-EC, PhD, is a Full Professor, School of Nursing, University of Ottawa, Ottawa, Canada
| | - Amanda Vandyk
- Marlene Haines, RN, BHSc, BScN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada ( )
- Amanda Vandyk, RN, PhD, is an Associate Professor, School of Nursing, University of Ottawa, Ottawa, Canada
- Becky Skidmore, MLIS, is an Information Specialist, Ottawa Hospital Research Institute, Ottawa, Canada
- Lauren Orser, RN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada
- Patrick O'Byrne, RN-EC, PhD, is a Full Professor, School of Nursing, University of Ottawa, Ottawa, Canada
| | - Becky Skidmore
- Marlene Haines, RN, BHSc, BScN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada ( )
- Amanda Vandyk, RN, PhD, is an Associate Professor, School of Nursing, University of Ottawa, Ottawa, Canada
- Becky Skidmore, MLIS, is an Information Specialist, Ottawa Hospital Research Institute, Ottawa, Canada
- Lauren Orser, RN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada
- Patrick O'Byrne, RN-EC, PhD, is a Full Professor, School of Nursing, University of Ottawa, Ottawa, Canada
| | - Lauren Orser
- Marlene Haines, RN, BHSc, BScN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada ( )
- Amanda Vandyk, RN, PhD, is an Associate Professor, School of Nursing, University of Ottawa, Ottawa, Canada
- Becky Skidmore, MLIS, is an Information Specialist, Ottawa Hospital Research Institute, Ottawa, Canada
- Lauren Orser, RN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada
- Patrick O'Byrne, RN-EC, PhD, is a Full Professor, School of Nursing, University of Ottawa, Ottawa, Canada
| | - Patrick O'Byrne
- Marlene Haines, RN, BHSc, BScN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada ( )
- Amanda Vandyk, RN, PhD, is an Associate Professor, School of Nursing, University of Ottawa, Ottawa, Canada
- Becky Skidmore, MLIS, is an Information Specialist, Ottawa Hospital Research Institute, Ottawa, Canada
- Lauren Orser, RN, is a Research Assistant, School of Nursing, University of Ottawa, Ottawa, Canada
- Patrick O'Byrne, RN-EC, PhD, is a Full Professor, School of Nursing, University of Ottawa, Ottawa, Canada
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Hug S, Cavalheri V, Lawson-Smith H, Gucciardi DF, Hill K. Interventions with a clear focus on achieving behaviour change are important for maintaining training-related gains in people with chronic obstructive pulmonary disease: a systematic review. J Physiother 2024; 70:193-207. [PMID: 38918084 DOI: 10.1016/j.jphys.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/09/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
QUESTIONS In people with chronic obstructive pulmonary disease (COPD) who complete an exercise training program (ETP) offered at a sufficient dose to result in training-related gains, to what extent are these gains maintained 12 months after program completion? Do variables such as the application of behaviour change techniques moderate the maintenance of these training-related gains? DESIGN Systematic review, meta-analysis and meta-regression of randomised controlled trials. PARTICIPANTS People with stable COPD. INTERVENTION Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component. OUTCOME MEASURES Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living. DATA SOURCES EMBASE, PEDro, PubMed and the Cochrane Library. RESULTS Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program. CONCLUSION At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains. REGISTRATION CRD42020193833.
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Affiliation(s)
- Sarah Hug
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Physiotherapy Department, Royal Perth Hospital, Perth, Australia.
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Allied Health, South Metropolitan Health Service, Perth, Australia; Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Hollie Lawson-Smith
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Daniel F Gucciardi
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Kylie Hill
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Australia
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Silva FM, Amorim Adegboye AR, Curioni C, Gomes F, Collins GS, Kac G, Cook J, Ismail LC, Page MJ, Khandpur N, Lamb S, Hopewell S, Saleh S, Kirtley S, Bernardes S, Durão S, Vorland CJ, Lima J, Rebelo F, Cunha Figueiredo AC, Braga Tibaes JR, Tavares M, da Silva Fink J, Maia de Sousa T, Chester-Jones M, Bi D, Naude C, Schlussel M. Reporting completeness of nutrition and diet-related randomised controlled trials protocols. Clin Nutr 2024; 43:1626-1635. [PMID: 38795681 DOI: 10.1016/j.clnu.2024.04.038] [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] [Revised: 04/16/2024] [Accepted: 04/28/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND AND AIMS There is a need to consolidate reporting guidance for nutrition randomised controlled trial (RCT) protocols. The reporting completeness in nutrition RCT protocols and study characteristics associated with adherence to SPIRIT and TIDieR reporting guidelines are unknown. We, therefore, assessed reporting completeness and its potential predictors in a random sample of published nutrition and diet-related RCT protocols. METHODS We conducted a meta-research study of 200 nutrition and diet-related RCT protocols published in 2019 and 2021 (aiming to consider periods before and after the start of the COVID pandemic). Data extraction included bibliometric information, general study characteristics, compliance with 122 questions corresponding to items and subitems in the SPIRIT and TIDieR checklists combined, and mention to these reporting guidelines in the publications. We calculated the proportion of protocols reporting each item and the frequency of items reported for each protocol. We investigated associations between selected publication aspects and reporting completeness using linear regression analysis. RESULTS The majority of protocols included adults and elderly as their study population (n = 73; 36.5%), supplementation as intervention (n = 96; 48.0%), placebo as comparator (n = 89; 44.5%), and evaluated clinical status as the outcome (n = 80; 40.0%). Most protocols described a parallel RCT (n = 188; 94.0%) with a superiority framework (n = 141; 70.5%). Overall reporting completeness was 52.0% (SD = 10.8%). Adherence to SPIRIT items ranged from 0% (n = 0) (data collection methods) to 98.5% (n = 197) (eligibility criteria). Adherence to TIDieR items ranged from 5.5% (n = 11) (materials used in the intervention) to 98.5% (n = 197) (description of the intervention). The multivariable regression analysis suggests that a higher number of authors [β = 0.53 (95%CI: 0.28-0.78)], most recent published protocols [β = 3.19 (95%CI: 0.24-6.14)], request of reporting guideline checklist during the submission process by the journal [β = 6.50 (95%CI: 2.56-10.43)] and mention of SPIRIT by the authors [β = 5.15 (95%CI: 2.44-7.86)] are related to higher reporting completeness scores. CONCLUSIONS Reporting completeness in a random sample of 200 diet or nutrition-related RCT protocols was low. Number of authors, year of publication, self-reported adherence to SPIRIT, and journals' endorsement of reporting guidelines seem to be positively associated with reporting completeness in nutrition and diet-related RCT protocols.
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Affiliation(s)
- Flávia Moraes Silva
- Nutrition Department and Graduate Program of Nutrition Science, Federal University of Health Science of Porto Alegre, Brazil
| | - Amanda Rodrigues Amorim Adegboye
- Research Centre for Healthcare & Communities, Coventry University, Coventry, UK; Centre for Agroecology, Water and Resilience (CAWR), Coventry University, UK
| | - Cintia Curioni
- Department of Nutrition in Public Health, State University of Rio de Janeiro, Brazil
| | - Fabio Gomes
- Pan-American Health Organisation, World Health Organisation, Washington DC, USA
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil
| | - Jonathan Cook
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, P. O. Box 27272 Sharjah, United Arab Emirates; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Matthew J Page
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Neha Khandpur
- Division of Human Nutrition and Health, Washington University, Department of Nutrition, University of São Paulo, Brazil; Department of Nutrition, Harvard T.H. Chan School of Public Health, USA
| | - Sarah Lamb
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Shaima Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, P. O. Box 27272 Sharjah, United Arab Emirates
| | - Shona Kirtley
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Simone Bernardes
- Nutrition Department and Graduate Program of Nutrition Science, Federal University of Health Science of Porto Alegre, Brazil
| | - Solange Durão
- Health Systems Research Unit, South African Medical Research Council, South Africa
| | - Colby J Vorland
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, USA
| | | | - Fernanda Rebelo
- Clinical Research Unit, National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Amanda C Cunha Figueiredo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil; Health Science Center, Serra dos Órgãos University Center, Rio de Janeiro, Brazil
| | | | - Marina Tavares
- Department of Nutrition in Public Health, State University of Rio de Janeiro, Brazil
| | | | - Taciana Maia de Sousa
- Department of Nutrition in Public Health, State University of Rio de Janeiro, Brazil
| | - Mae Chester-Jones
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Dongquan Bi
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Celeste Naude
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health. Faculty of Medicine and Health Sciences. Stellenbosch University, Cape Town, South Africa
| | - Michael Schlussel
- UK EQUATOR Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
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Moschogianis S, Darley S, Coulson T, Peek N, Cheraghi-Sohi S, Brown BC. Patient experiences of an online consultation system: a qualitative study in English primary care post-COVID-19. Br J Gen Pract 2024; 74:e489-e497. [PMID: 38164550 PMCID: PMC10966478 DOI: 10.3399/bjgp.2023.0076] [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: 02/16/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Online consultation systems (OCSs) allow patients to contact their healthcare teams online. Since 2020 they have been rapidly rolled out in primary care following policy initiatives and the COVID-19 pandemic. In-depth research of patients' experiences using OCSs is lacking. AIM Explore patients' experiences of using an OCS. DESIGN AND SETTING Qualitative study in English GP practices using the Patchs OCS (www.Patchs.ai) from March 2020 to July 2022. METHOD Thematic analysis of 25 patient interviews and 21 467 written comments from 11 851 patients who used the OCS from nine and 240 GP practices, respectively. RESULTS Patients cited benefits of using the OCS as speed, flexibility, and efficiency. Nevertheless, some patients desired a return to traditional consultation methods. GP practices often did not clearly advertise the OCS or use it as patients expected, which caused frustration. Patients reported advantages of having a written record of consultations and the opportunity to communicate detailed queries in free text. Views differed on how the OCS influenced clinical safety and discussions of sensitive topics. Patients who struggled to communicate in traditional consultations often preferred using the OCS, and male patients reported being more likely to use it. CONCLUSION Globally, this is the largest in-depth study of patient experiences of an OCS. It contributes new knowledge that the patient experience of using OCSs can be influenced by previously unreported patient characteristics and the conditions they consult about. Further, it contributes recommendations on the design and implementation of the OCS in practice.
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Affiliation(s)
- Susan Moschogianis
- School of Health Sciences, Health Services Research and Primary Care, University of Manchester, Manchester
| | - Sarah Darley
- School of Health Sciences, Health Services Research and Primary Care, University of Manchester, Manchester
| | | | - Niels Peek
- Imaging and Data Science, University of Manchester, Manchester Academic Health Science Centre, Manchester; NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester
| | - Sudeh Cheraghi-Sohi
- School of Health Sciences, Health Services Research and Primary Care, University of Manchester, Manchester; NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester
| | - Benjamin C Brown
- School of Health Sciences, Health Services Research and Primary Care, University of Manchester, Manchester; and chief medical officer, Patchs Health, London
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Ben-Porat T, Yousefi R, Stojanovic J, Boucher VG, Fortin A, Lavoie K, Bacon SL. Completeness of intervention reporting of nutrition-focused weight management interventions adjunct to metabolic and bariatric surgery: effect of the TIDieR checklist. Int J Obes (Lond) 2024; 48:901-912. [PMID: 38459257 DOI: 10.1038/s41366-024-01506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
Nutrition-focused interventions are essential to optimize the bariatric care process and improve health and weight outcomes over time. Clear and detailed reporting of these interventions in research reports is crucial for understanding and applying the findings effectively in clinical practice and research replication. Given the importance of reporting transparency in research, this study aimed to use the Template for Intervention Description and Replication (TIDieR) checklist to evaluate the completeness of intervention reporting in nutritional weight management interventions adjunct to metabolic and bariatric surgery (MBS). The secondary aim was to examine the factors associated with better reporting. A literature search in PubMed, PsychINFO, EMBASE, Scopus, and the Cochrane Controlled Register of Trials was conducted to include randomized controlled trials (RCT), quasi-RCTs and parallel group trials. A total of 22 trials were included in the final analysis. Among the TIDieR 12 items, 6.6 ± 1.9 items were fully reported by all studies. None of the studies completely reported all intervention descriptors. The main areas where reporting required improvement were providing adequate details of the materials and procedures of the interventions, intervention personalization, and intervention modifications during the study. The quality of intervention reporting remained the same after vs. before the release of the TIDieR guidelines. Receiving funds from industrial organizations (p = 0.02) and having the study recorded within a registry platform (p = 0.08) were associated with better intervention reporting. Nutritional weight management interventions in MBS care are still below the desirable standards for reporting. The present study highlights the need to improve adequate reporting of such interventions, which would allow for greater replicability, evaluation through evidence synthesis studies, and transferability into clinical practice.
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Affiliation(s)
- Tair Ben-Porat
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montreal, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
| | - Reyhaneh Yousefi
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montreal, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
| | - Jovana Stojanovic
- Canadian Agency for Drugs and Health Technologies in Health (CADTH), Ottawa, Canada
| | - Vincent Gosselin Boucher
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, Canada
| | - Annabelle Fortin
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Kim Lavoie
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montreal, Canada.
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada.
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35
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Wong G, Guha C, Mallitt KA, van Zwieten A, Khalid R, Francis A, Jaure A, Kim S, Teixeira-Pinto A, Aquino M, Bernier-Jean A, Johnson DW, Hahn D, Reidlinger D, Ryan EG, Mackie F, McCarthy H, Varghese J, Kiriwandeniya C, Howard K, Larkins N, Macauley L, Walker A, Howell M, Caldwell P, Woodleigh R, Jesudason S, Carter S, Kennedy S, Alexander S, McTaggart S, Craig JC, Hawley CM. The randomized controlled trial (NAVKIDS2) of a patient navigator program created for children with chronic kidney disease. Kidney Int 2024:S0085-2538(24)00450-2. [PMID: 38959996 DOI: 10.1016/j.kint.2024.05.031] [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: 01/15/2024] [Revised: 05/25/2024] [Accepted: 05/30/2024] [Indexed: 07/05/2024]
Abstract
Patient navigators enable adult patients to circumnavigate complex health systems, improving access to health care and outcomes. Here, we aimed to evaluate the effects of a patient navigation program in children with chronic kidney disease (CKD). In this multi-center, randomized controlled trial, we randomly assigned children (aged 0-16 years) with CKD stages 1-5 (including children on dialysis or with kidney transplants), from low socioeconomic status backgrounds, and/or residing in remote areas, to receive patient navigation at randomization (immediate) or at six months (waitlist). The primary outcome was self-rated health (SRH) of participating children at six months, using intention to treat analysis. Secondary outcomes included caregivers' SRH and satisfaction with health care, children's quality of life, hospitalizations, and missed school days. Repeated measures of the primary outcome from baseline to six months were analyzed using cumulative logit mixed effects models. Semi-structured interviews were thematically evaluated. Of 398 screened children, 162 were randomized (80 immediate and 82 waitlist); mean age (standard deviation) of 8.8 (4.8) years with 64.8% male. SRH was not significantly different between the immediate and wait-listed groups at six months. There were also no differences across all secondary outcomes between the two groups. Caregivers' perspectives were reflected in seven themes: easing mental strain, facilitating care coordination, strengthening capacity to provide care, reinforcing care collaborations, alleviating family tensions, inability to build rapport and unnecessary support. Thus, in children with CKD, self-rated health may not improve in response to a navigator program, but caregivers gained skills related to providing and accessing care.
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Affiliation(s)
- Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Kylie-Ann Mallitt
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Rabia Khalid
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, New South Wales, Australia
| | - Anna Francis
- Child and Adolescent Renal Services, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Allison Jaure
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Siah Kim
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Martha Aquino
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia
| | - Amelie Bernier-Jean
- CIUSSS du Nord-de-l'Île de Montréal, University of Montréal, Montreal, Canada
| | - David W Johnson
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia
| | - Deirdre Hahn
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Donna Reidlinger
- Translational Research Institute, Brisbane, Queensland, Australia; The University of Queensland, Brisbane, Queensland, Australia
| | - Elizabeth G Ryan
- QCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Fiona Mackie
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia
| | - Hugh McCarthy
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Julie Varghese
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia
| | - Charani Kiriwandeniya
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia
| | - Kirsten Howard
- Menzies Centre for Health Policy and Economics and Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicholas Larkins
- Department of Nephrology, Perth Children's Hospital, Perth, Western Australia, Australia; School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | | | - Amanda Walker
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Menzies Centre for Health Policy and Economics and Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Patrina Caldwell
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Reginald Woodleigh
- Prostate and Breast Cancer Foundation (CanCare), Sydney, New South Wales, Australia
| | - Shilpa Jesudason
- Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Simon Carter
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sean Kennedy
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia; School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen Alexander
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Steve McTaggart
- Child and Adolescent Renal Services, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
| | - Carmel M Hawley
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia; The University of Queensland, Brisbane, Queensland, Australia
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van Ierssel JJ, Galea O, Holte K, Luszawski C, Jenkins E, O'Neil J, Emery CA, Mannix R, Schneider K, Yeates KO, Zemek R. How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:537-547. [PMID: 37619783 PMCID: PMC11184319 DOI: 10.1016/j.jshs.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/20/2023] [Accepted: 07/12/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE The study aimed to examine the reporting completeness of randomized controlled trials (RCTs) of non-pharmacological interventions following concussion. METHODS We searched MEDLINE, Embase, PsycInfo, CINAHL, and Web of Science up to May 2022. Two reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication (TIDieR), Consensus on Exercise Reporting Template (CERT), and international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) checklists. Additional information was sought my study authors where reporting was incomplete. Risk of bias (ROB) was assessed with the Cochrane ROB-2 Tool. RCTs examining non-pharmacological interventions following concussion. RESULTS We included 89 RCTs (n = 53 high ROB) examining 11 different interventions for concussion: sub-symptom threshold aerobic exercise, cervicovestibular therapy, physical/cognitive rest, vision therapy, education, psychotherapy, hyperbaric oxygen therapy, transcranial magnetic stimulation, blue light therapy, osteopathic manipulation, and head/neck cooling. Median scores were: TIDieR 9/12 (75%; interquartile range (IQR) = 5; range: 5-12), CERT 17/19 (89%; IQR = 2; range: 10-19), and i-CONTENT 6/7 (86%; IQR = 1; range: 5-7). Percentage of studies completely reporting all items was TIDieR 35% (31/89), CERT 24% (5/21), and i-CONTENT 10% (2/21). Studies were more completely reported after publication of TIDieR (t87 = 2.08; p = 0.04) and CERT (t19 = 2.72; p = 0.01). Reporting completeness was not strongly associated with journal impact factor (TIDieR: rs = 0.27; p = 0.01; CERT: rs = -0.44; p = 0.06; i-CONTENT: rs = -0.17; p = 0.48) or ROB (TIDieR: rs = 0.11; p = 0.31; CERT: rs = 0.04; p = 0.86; i-CONTENT: rs = 0.12; p = 0.60). CONCLUSION RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness, but are often missing key components, particularly modifications, motivational strategies, and qualified supervisor. Reporting completeness improved after TIDieR and CERT publication, but publication in highly cited journals and low ROB do not guarantee reporting completeness.
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Affiliation(s)
| | - Olivia Galea
- The Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin 9016, New Zealand
| | - Kirsten Holte
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 1N4, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Caroline Luszawski
- Alberta Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 1N4, Canada; Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Elizabeth Jenkins
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Jennifer O'Neil
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Bruyère Research Institute, Ottawa, ON K1N 5C8, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 1N4, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Rebekah Mannix
- Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Kathryn Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 1N4, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 1N4, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Roger Zemek
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
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Sandström L, Kaunonen M, Aho AL. A group intervention for pregnant multiparas with fear of childbirth: A protocol of a feasibility study of the MOTIVE trial. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 41:101003. [PMID: 38959678 DOI: 10.1016/j.srhc.2024.101003] [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: 07/07/2023] [Revised: 06/20/2024] [Accepted: 06/29/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Although research interest in fear of childbirth has increased, interventions targeting especially multiparas with fear of childbirth have been overlooked, although untreated fear can cause serious adverse effects on the mother and the whole family. Thus MOTIVE (Multiparas overcoming Childbirth Fear Through Intervention and Empowerment), an intervention for pregnant multiparas with fear of childbirth, was designed. METHODS This is a protocol of a single-arm non-randomized feasibility study of the MOTIVE trial with a mixed-methods design. The primary aim of the intervention is to assist pregnant multiparas with fear of childbirth, with the desired outcome to alleviate fear. MOTIVE consists of four group sessions (2 h each); three during pregnancy and one after giving birth and in addition of a phone call after birth. The intervention is provided by a midwife and a psychiatric nurse at the maternity hospital. Quantitative data will be gathered via self-report questionnaires at three time points, at baseline, at 4 weeks post-baseline and post-intervention. Qualitative data will be gathered by diaries, open-ended questions from post-intervention questionnaires, and individual interviews. The target is to assemble four groups of four multiparas over a 12-month period. DISCUSSION The findings will provide insights into the feasibility and acceptability of the intervention and will inform revisions to it. The results will guide the development of a definitive, larger-scale trial evaluation to further examine the efficacy of the refined intervention.
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Affiliation(s)
- Laura Sandström
- Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland.
| | - Marja Kaunonen
- Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland; Joint Municipal Authority for Social and Health Services in Tampere Region, Finland.
| | - Anna Liisa Aho
- Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland.
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Sousa Filho LF, Farlie MK, Haines T, Borrelli B, Carroll C, Mathews C, Ribeiro DC, Fritz JM, Underwood M, Foster NE, Lamb SE, Sanchez ZM, Malliaras P. Developing an international consensus Reporting guideline for intervention Fidelity in Non-Drug, non-surgical trials: The ReFiND protocol. Contemp Clin Trials 2024; 142:107575. [PMID: 38750951 DOI: 10.1016/j.cct.2024.107575] [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: 02/07/2024] [Revised: 04/23/2024] [Accepted: 05/11/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Inadequate reporting of fidelity to interventions in trials limits the transparency and interpretation of trial findings. Despite this, most trials of non-drug, non-surgical interventions lack comprehensive reporting of fidelity. If fidelity is poorly reported, it is unclear which intervention components were tested or implemented within the trial, which also hinders research reproducibility. This protocol describes the development process of a reporting guideline for fidelity of non-drug, non-surgical interventions (ReFiND) in the context of trials. METHODS The ReFiND guideline will be developed in six stages. Stage one: a guideline development group has been formed to oversee the guideline methodology. Stage two: a scoping review will be conducted to identify and summarize existing guidance documents on the fidelity of non-drug, non-surgical interventions. Stage three: a Delphi study will be conducted to reach consensus on reporting items. Stage four: a consensus meeting will be held to consolidate the reporting items and discuss the wording and structure of the guideline. Stage five: a guidance statement, an elaboration and explanation document, and a reporting checklist will be developed. Stage six: different strategies will be used to disseminate and implement the ReFiND guideline. DISCUSSION The ReFiND guideline will provide a set of items developed through international consensus to improve the reporting of intervention fidelity in trials of non-drug, non-surgical interventions. This reporting guideline will enhance transparency and reproducibility in future non-drug, non-surgical intervention research.
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Affiliation(s)
| | - Melanie K Farlie
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
| | | | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Daniel C Ribeiro
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Julie M Fritz
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, UT, USA.
| | - Martin Underwood
- Warwick Clinical Trials Unit, University of Warwick, Warwick, UK.; University Hospitals of Coventry and Warwickshire, Coventry, UK.
| | - Nadine E Foster
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Australia; School of Medicine, Keele University, Keele, UK.
| | - Sarah E Lamb
- University of Exeter, St Luke's Campus, Exeter, UK.
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Peter Malliaras
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
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Souto LR, De Oliveira Silva D, Pazzinatto MF, Siqueira MS, Moreira RFC, Serrão FV. Are adjunct treatments effective in improving pain and function when added to exercise therapy in people with patellofemoral pain? A systematic review with meta-analysis and appraisal of the quality of interventions. Br J Sports Med 2024; 58:792-804. [PMID: 38889956 DOI: 10.1136/bjsports-2024-108145] [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] [Accepted: 05/22/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To compare the effectiveness of adjunct treatments combined with exercise to exercise alone in people with patellofemoral pain (PFP) and explore the quality of intervention descriptions in randomised controlled trials (RCTs). DESIGN Systematic review. DATA SOURCES Seven databases were searched in November 2023. ELIGIBILITY RCTs that evaluated the effectiveness of any adjunct treatment combined with exercise to exercise alone on self-reported pain and function in people with PFP. RESULTS We included 45 RCTs (2023 participants), with 25 RCTs (1050 participants) contributing to meta-analyses. Pooled analysis indicated very low-certainty evidence that neuromuscular electrical stimulation or monopolar dielectric diathermy combined with exercise leads to small and large improvements in self-reported pain when compared with exercise alone (standardised mean difference (95% CI)=-0.27 (-0.53 to -0.02) and -2.58 (-4.59 to -0.57), respectively) in the short-term. For self-reported pain and function, very low-certainty evidence indicates that knee taping, whole-body vibration, electromyographic biofeedback and knee brace combined with exercise do not differ from exercise alone. Interventions are poorly described in most RCTs, adjunct treatments scored on average 14/24 and exercise therapy 12/24 in the Template for Intervention Description and Replication checklist. CONCLUSION Neuromuscular electrical stimulation and monopolar dielectric diathermy combined with exercise seem to improve self-reported pain in people with PFP compared with exercise alone. Knee taping, whole-body vibration, electromyographic biofeedback and knee brace do not offer additional benefits to exercise alone. Most interventions are poorly described, which is detrimental to translating research knowledge into clinical practice. PROSPERO REGISTRATION NUMBER CRD42020197081.
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Affiliation(s)
- Larissa Rodrigues Souto
- Departament of Physiotherapy, Universidade Federal de Sao Carlos, Sao Carlos, São Paulo, Brazil
| | - Danilo De Oliveira Silva
- La Trobe Sport and Medicine Research Centre (LASEM), La Trobe University, Bundoora/Melbourne, Victoria, Australia
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, LaTrobe University, Melbourne, Victoria, Australia
| | - Marcella F Pazzinatto
- La Trobe Sport and Medicine Research Centre (LASEM), La Trobe University, Bundoora/Melbourne, Victoria, Australia
| | - Malu Santos Siqueira
- Departament of Physiotherapy, Universidade Federal de Sao Carlos, Sao Carlos, São Paulo, Brazil
| | | | - Fábio Viadanna Serrão
- Departament of Physiotherapy, Universidade Federal de Sao Carlos, Sao Carlos, São Paulo, Brazil
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Al-Nemr A. Synergistic effect of functional strength training and cognitive intervention on gross motor function in children with cerebral palsy. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:246-255. [PMID: 36571210 DOI: 10.1080/21622965.2022.2159408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cerebral palsy (CP) is a posture and movement disorder, however; it often includes disturbance of different aspects of cognitive function. This study aimed to investigate if combined functional strength training (FST) and cognitive intervention are more effective than either of them alone on gross motor function in children with spastic diplegic CP. METHODS Sixty-four children with spastic diplegic CP, with ages ranging from 8 to 12 years, were assigned randomly into four treatment groups; Group I; FST, group II; cognitive training, group III; combined FST and cognitive training, group IV; conventional physical therapy. The Gross Motor Function Measure (GMFM-88) was used to assess gross motor function at baseline, post-treatment, and 6 months follow-up. RESULTS Group III achieved a significant improvement in GMFM-88 when compared to other groups post-treatment and at follow-up. CONCLUSION This study suggests that combined lower limb FST and cognitive intervention had the potential to produce significantly more favorable effects than the single use of either of them on gross motor function in children with spastic diplegia.
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Affiliation(s)
- Alaa Al-Nemr
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Fandim JV, Amaral AL, Andrade LM, Almeida L, Giangiardi VF, Oshima RKA, Quel De Oliveira C, da Silva ML, Saragiotto BT. Effectiveness of kinesio taping for chronic stroke patients: a systematic review with meta-analysis. Disabil Rehabil 2024; 46:2966-2978. [PMID: 37530391 DOI: 10.1080/09638288.2023.2241822] [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: 12/19/2022] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Kinesio taping (KT) is an approach that has been used in the rehabilitation of patients with chronic stroke. The aim of this review is to evaluate the effectiveness of KT alone or combined with other interventions for patients with chronic stroke. MATERIALS AND METHODS The search was performed on CENTRAL, EMBASE, PEDro, and five other databases and two trial registries up to July 2022. We included randomized controlled trials that evaluated the effectiveness of KT compared to control interventions. The primary outcomes were upper limb function and gait. We assessed the risk of bias in the included studies using the PEDro scale. The certainty of the evidence was assessed using the GRADE approach. RESULTS We included 14 RCTs undertaken in six different countries. PEDro score ranged from 4 to 9 points. There is very-low certainty evidence that KT has no effect on gait, balance, and postural control. We found very-low certainty evidence of a slightly benefit when used in addition to other therapies for gait, balance and postural control, and pain intensity. CONCLUSIONS Our study findings show KT does not have enough robust evidence for improving upper limb function, gait, balance and postural control, and pain intensity in chronic stroke patients.
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Affiliation(s)
- Junior Vitorino Fandim
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Angel Lopes Amaral
- Physical Therapy Department, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | | - Lisandra Almeida
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Vivian Farahte Giangiardi
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | | - Camila Quel De Oliveira
- Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Maria Liliane da Silva
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Bruno Tirotti Saragiotto
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, Australia
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Grant SJ, Liu S, Rhodes RE. A web-based physical activity intervention targeting affect regulation: a randomized feasibility trial. Psychol Health 2024:1-23. [PMID: 38946146 DOI: 10.1080/08870446.2024.2372658] [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: 10/12/2023] [Accepted: 06/20/2024] [Indexed: 07/02/2024]
Abstract
Early career professionals (ECPs) are a critical target for physical activity (PA) promotion. Affect contributes to an established PA intention-behaviour gap and is pertinent among ECPs. OBJECTIVE The purpose of this study was to examine the feasibility and acceptability of a web-based intervention and explore the effects on secondary outcomes (moderate-to-vigorous PA (MVPA), emotion regulation, multi-process action control constructs). METHODS Adults aged 25-44 who were employed at least part-time in a desk-based job and not meeting PA guidelines (<150 min MVPA) were recruited and randomized into a 6-week online intervention integrating acceptance and commitment principles and affect regulation strategies, or a control group. RESULTS Forty adults were recruited and randomized to the web-based intervention (n = 21) and waitlist control (n = 19). The recruitment rate was 29%, retention was 75%, engagement was 68%, and satisfaction was high in both quantitative and qualitative assessment. Participants allocated to the intervention improved MVPA (ηp2=0.30), emotion regulation (ηp2 =0.49), behavioural regulation (ηp2=0.53), affective attitude (ηp2=0.23), identity (ηp2=0.24), and constructs of mindfulness (ηp2=0.44), and valued living (ηp2=0.20). CONCLUSIONS Primary outcomes concerning feasibility were adequate and secondary outcomes improved, suggesting a full-scale randomized controlled trial is feasible with minor modifications. A large-scale study is warranted to establish intervention effectiveness.
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Affiliation(s)
- Stina J Grant
- Behavioural Medicine Lab, @bmedlab, University of Victoria, Victoria, BC, Canada
| | - Sam Liu
- Digital Health Lab, University of Victoria, Victoria, BC, Canada
| | - Ryan E Rhodes
- Behavioural Medicine Lab, @bmedlab, University of Victoria, Victoria, BC, Canada
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Bretherton CP, Achten J, Jogarah V, Petrou S, Peckham N, Achana F, Appelbe D, Kearney R, Claireux H, Bell P, Griffin XL. Early versus delayed weight-bearing following operatively treated ankle fracture (WAX): a non-inferiority, multicentre, randomised controlled trial. Lancet 2024; 403:2787-2797. [PMID: 38848738 DOI: 10.1016/s0140-6736(24)00710-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/24/2024] [Accepted: 04/05/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND After surgery for a broken ankle, patients are usually instructed to avoid walking for 6 weeks (delayed weight-bearing). Walking 2 weeks after surgery (early weight-bearing) might be a safe and preferable rehabilitation strategy. This study aimed to determine the clinical and cost effectiveness of an early weight-bearing strategy compared with a delayed weight-bearing strategy. METHODS This was a pragmatic, multicentre, randomised, non-inferiority trial including 561 participants (aged ≥18 years) who received acute surgery for an unstable ankle fracture in 23 UK National Health Service (NHS) hospitals who were assigned to either a delayed weight-bearing (n=280) or an early weight-bearing rehabilitation strategy (n=281). Patients treated with a hindfoot nail, those who did not have protective ankle sensation (eg, peripheral neuropathy), did not have the capacity to consent, or did not have the ability to adhere to trial procedures were excluded. Neither participants nor clinicians were masked to the treatment. The primary outcome was ankle function measured using the Olerud and Molander Ankle Score (OMAS) at 4 months after randomisation, in the per-protocol population. The pre-specified non-inferiority OMAS margin was -6 points and superiority testing was included in the intention-to-treat population in the event of non-inferiority. The trial was prospectively registered with ISRCTN Registry, ISRCTN12883981, and the trial is closed to new participants. FINDINGS Primary outcome data were collected from 480 (86%) of 561 participants. Recruitment was conducted between Jan 13, 2020, and Oct 29, 2021. At 4 months after randomisation, the mean OMAS score was 65·9 in the early weight-bearing and 61·2 in the delayed weight-bearing group and adjusted mean difference was 4·47 (95% CI 0·58 to 8·37, p=0·024; superiority testing adjusted difference 4·42, 95% CI 0·53 to 8·32, p=0·026) in favour of early weight-bearing. 46 (16%) participants in the early weight-bearing group and 39 (14%) in the delayed weight-bearing group had one or more complications (adjusted odds ratio 1·18, 95% CI 0·80 to 1·75, p=0·40). The mean costs from the perspective of the NHS and personal social services in the early and delayed weight-bearing groups were £725 and £785, respectively (mean difference -£60 [95% CI -342 to 232]). The probability that early weight-bearing is cost-effective exceeded 80%. INTERPRETATION An early weight-bearing strategy was found to be clinically non-inferior and highly likely to be cost-effective compared with the current standard of care (delayed weight-bearing). FUNDING National Institute for Health and Care Research (NIHR), NIHR Barts Biomedical Research Centre, and NIHR Applied Research Collaboration Oxford and Thames Valley.
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Affiliation(s)
- Christopher Patrick Bretherton
- Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK; Department of Trauma and Orthopaedic Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK.
| | - Juul Achten
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK
| | - Vidoushee Jogarah
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nicholas Peckham
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK
| | - Felix Achana
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Duncan Appelbe
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK
| | - Rebecca Kearney
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Clifton, Bristol, UK
| | - Harry Claireux
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK
| | - Philip Bell
- Patient and Public Representative, Anglesey, UK
| | - Xavier L Griffin
- Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK; Department of Trauma and Orthopaedic Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
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Tappan RS, Roth HR, McGaghie WC. Using Simulation-Based Mastery Learning to Achieve Excellent Learning Outcomes in Physical Therapist Education. JOURNAL, PHYSICAL THERAPY EDUCATION 2024:00001416-990000000-00116. [PMID: 38954765 DOI: 10.1097/jte.0000000000000358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 05/24/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION The 2 aims of this observational study are (a) to describe the implementation and feasibility of a bed mobility skills simulation-based mastery learning (SBML) curricular module for physical therapist students and (b) to measure learning outcomes and student perceptions of this module. REVIEW OF LITERATURE Simulation-based mastery learning is an outcome-based educational approach that has been successful in other health professions but has not been explored in physical therapy education. SUBJECTS Eighty-seven students in a single cohort of a Doctor of Physical Therapy program. METHODS The SBML module in this pretest-posttest study included a pretest, instruction, initial posttest, and additional rounds of instruction and assessment as needed for all learners to achieve the minimum passing standard (MPS) set using the Mastery Angoff and Patient Safety methods. Outcome measures were bed mobility assessment pass rates and scores, additional student and faculty time compared with a traditional approach, and student perceptions of their self-confidence and the module. RESULTS All students achieved the MPS after 3 rounds of training and assessment beyond the initial posttest. Mean Total Scores improved from 67.6% (12.9%) at pretest to 91.4% (4.8%) at mastery posttest (P < .001, Cohen's d = 1.8, 95% CI [1.4-2.1]); mean Safety Scores improved from 75.2% (16.0%) at pretest to 100.0% (0.0%) at mastery posttest (P < .001, Cohen's d = 1.5, 95% CI [1.2-1.9]). Students who did not achieve the MPS at the initial posttest (n = 30) required a mean of 1.2 hours for additional instruction and assessment. Survey results revealed an increase in student confidence (P < .001) and positive student perceptions of the module. DISCUSSION AND CONCLUSION Implementation of this SBML module was feasible and resulted in uniformly high levels of bed mobility skill acquisition. Based on rigorous learning outcomes, feasible requirements for implementation, and increased student confidence, SBML offers a promising approach for wider implementation in physical therapy education.
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Affiliation(s)
- Rachel S Tappan
- Rachel S. Tappan is a board-certified clinical specialist in neurologic physical therapy and an associate professor in the Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois . Please address all correspondence to Rachel S. Tappan
- Heidi R. Roth is a board-certified clinical specialist in neurologic physical therapy and an assistant professor in the Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University
- William C. McGaghie is a professor in the Department of Medical Education, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University.
| | - Heidi R Roth
- Rachel S. Tappan is a board-certified clinical specialist in neurologic physical therapy and an associate professor in the Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois . Please address all correspondence to Rachel S. Tappan
- Heidi R. Roth is a board-certified clinical specialist in neurologic physical therapy and an assistant professor in the Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University
- William C. McGaghie is a professor in the Department of Medical Education, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University.
| | - William C McGaghie
- Rachel S. Tappan is a board-certified clinical specialist in neurologic physical therapy and an associate professor in the Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois . Please address all correspondence to Rachel S. Tappan
- Heidi R. Roth is a board-certified clinical specialist in neurologic physical therapy and an assistant professor in the Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University
- William C. McGaghie is a professor in the Department of Medical Education, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University.
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Hurley E, Dalton K, Byrne S, Foley T, Walsh E. Pharmacist-Led Deprescribing Using STOPPFrail for Frail Older Adults in Nursing Homes. J Am Med Dir Assoc 2024:105122. [PMID: 38950585 DOI: 10.1016/j.jamda.2024.105122] [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: 02/21/2024] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To evaluate the impact of pharmacist-guided deprescribing using the STOPPFrail (Screening Tool of Older Persons' Prescriptions in Frail adults with a limited life expectancy) criteria in frail older nursing home residents. DESIGN Prospective, unblinded, nonrandomized, intervention study. SETTING AND PARTICIPANTS Adults ≥65 years with advanced frailty resident in 6 independent nursing homes in Ireland. METHODS STOPPFrail-based deprescribing recommendations were developed by a pharmacist and presented to residents' general practitioners (GPs), who decided to implement or not. Measured outcomes included number of prescribed medications, medication costs, anticholinergic cognitive burden (ACB), drug burden index (DBI), modified medication appropriateness index (MMAI), quality of life (QoL), nonelective hospitalizations, emergency department visits, falls, and mortality were measured at baseline, post review, and at 6 months post review. RESULTS Ninety-nine residents were recruited. Most (94%) were prescribed ≥1 potentially inappropriate medication (PIM). The most frequent PIMs were medications without a clearly documented indication (29.6%) and vitamin D (16.9%). Of 348 recommendations provided to GPs, 203 (58%) were accepted and 193 (55%) were implemented. Relating to baseline, post review, and at 6 months: the mean ± standard deviation (SD) number of medications was 16.0 ± 6.1, 14.6 ± 5.7 (P < .001), and 15.4 ± 5.5 (P < .001). The monthly mean ± SD medication cost per patient was €186.8 ± 123.7, €172.7 ± 119.0 (P < .001), and €186.4 ± 121.2 (P = .95). There were significant post-review decreases in the mean DBI, ACB, and MMAI of 9.7%, 9.6%, and 3.7%, respectively (P < .001), which remained significant at 6 months (P < .001). There were no significant differences in falls, emergency department visits, nonelective hospitalizations, or QoL. CONCLUSIONS AND IMPLICATIONS STOPPFrail-guided deprescribing led by a pharmacist in nursing homes appeared to significantly reduce PIMs, medication costs (initially), and anticholinergic and sedative burdens, without adversely affecting other patient outcomes. Greater consideration should therefore be given to the wider integration of pharmacists into nursing homes to optimize the medications and health outcomes of frail older adults.
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Affiliation(s)
- Eoin Hurley
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
| | - Kieran Dalton
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Stephen Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Tony Foley
- Department of General Practice, School of Medicine and Health, University College Cork, Cork, Ireland
| | - Elaine Walsh
- Department of General Practice, School of Medicine and Health, University College Cork, Cork, Ireland
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46
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Kiely B, Hobbins A, Boland F, Clyne B, Galvin E, Byers V, Loomba S, O'Donnell P, Connolly D, Shea EO', Smith SM. An exploratory randomised trial investigating feasibility, potential impact and cost effectiveness of link workers for people living with multimorbidity attending general practices in deprived urban communities. BMC PRIMARY CARE 2024; 25:233. [PMID: 38943076 PMCID: PMC11212363 DOI: 10.1186/s12875-024-02482-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Social prescribing link workers are non-health or social care professionals who connect people with psychosocial needs to non-clinical community supports. They are being implemented widely, but there is limited evidence for appropriate target populations or cost effectiveness. This study aimed to explore the feasibility, potential impact on health outcomes and cost effectiveness of practice-based link workers for people with multimorbidity living in deprived urban communities. METHODS A pragmatic exploratory randomised trial with wait-list usual care control and blinding at analysis was conducted during the COVID 19 pandemic (July 2020 to January 2021). Participants had two or more ongoing health conditions, attended a general practitioner (GP) serving a deprived urban community who felt they may benefit from a one-month practice-based social prescribing link worker intervention.. Feasibility measures were recruitment and retention of participants, practices and link workers, and completion of outcome data. Primary outcomes at one month were health-related quality of life (EQ-5D-5L) and mental health (HADS). Potential cost effectiveness from the health service perspective was evaluated using quality adjusted life years (QALYs), based on conversion of the EQ-5D-5L and ICECAP-A capability index to utility scoring. RESULTS From a target of 600, 251 patients were recruited across 13 general practices. Randomisation to intervention (n = 123) and control (n = 117) was after baseline data collection. Participant retention at one month was 80%. All practices and link workers (n = 10) were retained for the trial period. Data completion for primary outcomes was 75%. There were no significant differences identified using mixed effects regression analysis in EQ-5D-5L (MD 0.01, 95% CI -0.07 to 0.09) or HADS (MD 0.05, 95% CI -0.63 to 0.73), and no cost effectiveness advantages. A sensitivity analysis that considered link workers operating at full capacity in a non-pandemic setting, indicated the probability of effectiveness at the €45,000 ICER threshold value for Ireland was 0.787 using the ICECAP-A capability index. CONCLUSIONS While the trial under-recruited participants mainly due to COVID-19 restrictions, it demonstrates that robust evaluations and cost utility analyses are possible. Further evaluations are required to establish cost effectiveness and should consider using the ICE-CAP-A wellbeing measure for cost utility analysis. REGISTRATION This trial is registered on ISRCTN. TITLE Use of link workers to provide social prescribing and health and social care coordination for people with complex multimorbidity in socially deprived areas. TRIAL ID ISRCTN10287737. Date registered 10/12/2019. Link: https://www.isrctn.com/ISRCTN10287737.
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Affiliation(s)
- Bridget Kiely
- Department of General Practice, Clinical Research Fellow, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Dublin, Ireland.
| | - Anna Hobbins
- Centre for Research in Medical Devices (CÚRAM, RC/2073_P2) and Health Economics and Policy Analysis Centre, University of Galway, SFI 13, Galway, Ireland
| | - Fiona Boland
- Data Science Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Dublin, Ireland
| | - Barbara Clyne
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Dublin, Ireland
| | - Emer Galvin
- Royal College of Surgeons in Ireland University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Dublin, Ireland
| | - Vivienne Byers
- Environment Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Sonali Loomba
- Royal College of Surgeons in Ireland University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Dublin, Ireland
| | - Patrick O'Donnell
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College, Dublin, Ireland
| | - Eamon O ' Shea
- School of Business and Economics, University of Galway, Galway, Ireland
| | - Susan M Smith
- Discipline of Public Health and Primary Care, Trinity College, Dublin, Ireland
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Biswas I, Nalbant G, Lewis S, Chattopadhyay K. Key characteristics of effective yoga interventions for managing osteoarthritis: a systematic review and meta-analysis. Rheumatol Int 2024:10.1007/s00296-024-05652-y. [PMID: 38935121 DOI: 10.1007/s00296-024-05652-y] [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: 03/25/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
This systematic review aimed to synthesise the content, structure, and delivery characteristics of effective yoga interventions for managing osteoarthritis symptoms, including joint pain and joint function. JBI guidelines were followed. 17 databases were searched for randomised controlled trials (RCTs) assessing yoga's effectiveness on osteoarthritis symptoms. Meta-analyses and a narrative synthesis were conducted to address the objective. The systematic review and meta-analysis included 18 and 16 articles (representing 16 and 14 RCTs), respectively. Overall, the included studies had low methodological quality scores. 10 of 14 yoga interventions effectively reduced pain (standardised mean difference (SMD) - 0.70; 95% confidence interval (CI) - 1.08, - 0.32) and/or improved function (- 0.40; - 0.75, - 0.04). Notably, 8 effective interventions had centre-based (supervised, group) sessions, and 6 included additional home-based (unsupervised, individual) sessions. Effective interventions included 34 yogic poses (12 sitting, 10 standing, 8 supine, 4 prone), 8 breathing practices, and 3 meditation and relaxation practices. 8 interventions included yogic poses, and 7 also incorporated breathing practices and/or meditation and relaxation practices. 4 interventions included yogic pose modifications for osteoarthritis. The median duration of centre-based sessions was 8 weeks and each session was around 53 min, mostly delivered once a week. The median duration of home-based sessions was 10 weeks and each session was 30 min, usually instructed to practice 4 times a week. Given previous studies' limitations, a high-quality long-term RCT should be conducted using synthesised findings of previous effective yoga interventions.
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Affiliation(s)
- Isha Biswas
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK.
| | - Gamze Nalbant
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Sarah Lewis
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
- The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, NG5 1PB, UK
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48
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Fernández MG, Pantiga MM, Fernández CP, Muñoz LA, Guerrero CG. Fall assessment and intervention among community-dwelling older people in a primary health care center in Spain: a best practice implementation project. JBI Evid Implement 2024:02205615-990000000-00108. [PMID: 38916444 DOI: 10.1097/xeb.0000000000000440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
INTRODUCTION The implementation of fall prevention programs in the community is complex. Although there is solid scientific evidence that supports the effectiveness of such programs, there are multiple barriers that should be addressed using multifaceted strategies. AIMS The aim of this project was to increase compliance with evidence-based recommendations regarding fall risk screening and preventive interventions among older adults in a primary health care setting. METHODS This project used a pre-/post-implementation clinical audit based on the JBI Evidence Implementation Framework. Eight audit criteria were derived from JBI evidence summaries. The sample size was 62 patients aged 70 years or older. Data collection methods included a review of medical records and a questionnaire. A baseline audit was conducted and five barriers to best practice were identified. Strategies were then developed to increase compliance with the evidence-based recommendations, guided by JBI's Getting Research into Practice (GRiP) analysis. A follow-up audit was conducted in July 2022 to evaluate changes in compliance with best practices. RESULTS The baseline audit showed 0% compliance with best practice recommendations for seven out of eight audit criteria. Five barriers were identified: (1) absence of fall risk screening tools, (2) lack of fall prevention intervention protocols, (3) insufficient reporting of fall episodes in the records, (4) need for staff training, and (5) high staff turnover. Following the implementation of a fall risk assessment and intervention protocol, along with staff training, seven out of eight audit criteria increased from 0% to between 22.6% and 100%. CONCLUSIONS This evidence-based implementation project improved nursing practice in relation to compliance with best practice interventions to prevent falls. SPANISH ABSTRACT http://links.lww.com/IJEBH/A229.
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Affiliation(s)
- María García Fernández
- Health Service of the Principality of Asturias, Oviedo, Spain
- Spanish Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Laura Albornos Muñoz
- Spanish Centre for Evidence Based Healthcare: A JBI Centre of Excellence, Nursing and Health Care Research Unit (Investén-isciii), Research Network on Chronicity, Primary Care and Prevention and Health Promotion (RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
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Fox MN, Dickson JM, Burch P, Hind D, Hawksworth O. Delivering relational continuity of care in UK general practice: a scoping review. BJGP Open 2024:BJGPO.2024.0041. [PMID: 38438196 DOI: 10.3399/bjgpo.2024.0041] [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: 02/08/2024] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Relational continuity of care (patients seeing the same GP) is associated with better outcomes for patients, but it has been declining in general practice in the UK. AIM To understand what interventions have been tried to improve relational continuity of care in general practice in the UK. DESIGN & SETTING Scoping review of articles on UK General Practice and written in English. METHOD An electronic search of MEDLINE, Embase, and Scopus from 2002 to the present day was undertaken. Sources of grey literature were also searched. Studies that detailed service-level methods of achieving relational continuity of care with a GP in the UK were eligible for inclusion. Interventions were described narratively in relation to the elements listed in the Template for Intervention Description and Replication (TIDieR). A logic model describing the rationale behind interventions was constructed. RESULTS Seventeen unique interventions were identified. The interventions used a wide variety of strategies to try to improve relational continuity. This included personal lists, amended booking processes, regular reviews, digital technology, facilitated follow-ups, altered appointment times, and use of acute hubs. Twelve of the interventions targeted specific patient groups for increased continuity while others focused on increasing continuity for all patients. Changes in continuity levels were measured inconsistently using several different methods. CONCLUSION Several different strategies have been used in UK general practices in an attempt to improve relational continuity of care. While there is a similar underlying logic to these interventions, their scope, aims, and methods vary considerably. Furthermore, owing to a weak evidence base, comparing their efficacy remains challenging.
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Affiliation(s)
- Miglena N Fox
- Centre for Health and Related Research, University of Sheffield, Sheffield, UK
- Medicine Optimisation Team, South Yorkshire Integrated Care Board, SY ICB, Sheffield, UK
| | - Jon M Dickson
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Patrick Burch
- Centre for Primary Care, University of Manchester, Manchester, UK
| | - Daniel Hind
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Olivia Hawksworth
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
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Pickles K, Haas R, Guppy M, O'Connor DA, Pathirana T, Barratt A, Buchbinder R. Clinician and health service interventions to reduce the greenhouse gas emissions generated by healthcare: a systematic review. BMJ Evid Based Med 2024:bmjebm-2023-112707. [PMID: 38782560 DOI: 10.1136/bmjebm-2023-112707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To synthesise the available evidence on the effects of interventions designed to improve the delivery of healthcare that reduces the greenhouse gas (GHG) emissions of healthcare. DESIGN Systematic review and structured synthesis. SEARCH SOURCES Cochrane Central Register of Controlled Trials, PubMed, Web of Science and Embase from inception to 3 May 2023. SELECTION CRITERIA Randomised, quasi-randomised and non-randomised controlled trials, interrupted time series and controlled or uncontrolled before-after studies that assessed interventions primarily designed to improve the delivery of healthcare that reduces the GHG emissions of healthcare initiated by clinicians or healthcare services within any setting. MAIN OUTCOME MEASURES Primary outcome was GHG emissions. Secondary outcomes were financial costs, effectiveness, harms, patient-relevant outcomes, engagement and acceptability. DATA COLLECTION AND ANALYSIS Paired authors independently selected studies for inclusion, extracted data, and assessed risk of bias using a modified checklist for observational studies and the certainty of the evidence using Grades of Recommendation, Assessment, Development and Evaluation. Data could not be pooled because of clinical and methodological heterogeneity, so we synthesised results in a structured summary of intervention effects with vote counting based on direction of effect. RESULTS 21 observational studies were included. Interventions targeted delivery of anaesthesia (12 of 21), waste/recycling (5 of 21), unnecessary test requests (3 of 21) and energy (1 of 21). The primary intervention type was clinician education. Most (20 of 21) studies were judged at unclear or high risk of bias for at least one criterion. Most studies reported effect estimates favouring the intervention (GHG emissions 17 of 18, costs 13 of 15, effectiveness 18 of 20, harms 1 of 1 and staff acceptability 1 of 1 studies), but the evidence is very uncertain for all outcomes (downgraded predominantly for observational study design and risk of bias). No studies reported patient-relevant outcomes other than death or engagement with the intervention. CONCLUSIONS Interventions designed to improve the delivery of healthcare that reduces GHG emissions may reduce GHG emissions and costs, reduce anaesthesia use, waste and unnecessary testing, be acceptable to staff and have little to no effect on energy use or unintended harms, but the evidence is very uncertain. Rigorous studies that measure GHG emissions using gold-standard life cycle assessment are needed as well as studies in more diverse areas of healthcare. It is also important that future interventions to reduce GHG emissions evaluate the effect on beneficial and harmful patient outcomes. PROSPERO REGISTRATION NUMBER CRD42022309428.
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Affiliation(s)
- Kristen Pickles
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
| | - Romi Haas
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michelle Guppy
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
| | - Denise A O'Connor
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Thanya Pathirana
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Griffith University School of Medicine and Dentistry, Gold Coast, Queensland, Australia
| | - Alexandra Barratt
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Healthy Environments and Lives (HEAL) National Research Network, Canberra, Victoria, Australia
| | - Rachelle Buchbinder
- Wiser Healthcare Research Collaboration, Sydney, New South Wales, Australia
- Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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