Can we recommend mirtazapine and bupropion for patients at risk for bleeding?: A systematic review and meta-analysis

IntroductionThe gradual changes over the decades in the longevity and ageing of European society as a whole can be directly related to the prolonged decline in the birth rate and increase in the life expectancy. According to the WHO, there is an increased risk of dementia or other cognitive disorders as the population ages, which have a major impact on public health. Mild cognitive impairment (MCI) is described as a greater than expected cognitive decline for an individual’s age and level of education, but that does not significantly interfere with activities of daily living. Patients with MCI exhibit a higher risk of dementia compared with others in the same age group, but without a cognitive decline, have impaired walking and a 50% greater risk of falling.The urban lifestyle and advent of smartphones, mobility and immediate access to all information via the internet, including health information, has led to a totally disruptive change in most general aspects.This systematic review protocol is aimed at evaluating the effectiveness of technology-based interventions in the detection, prevention, monitoring and treatment of patients at risk or diagnosed with MCI.Methods and analysisThis review protocol follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols reporting guidelines. The search will be performed on MEDLINE (PubMed), CENTRAL, CINAHL Plus, ISI Web of Science and Scopus databases from 2010 to 2020. Studies of interventions either randomised clinical trials or pre–post non-randomised quasi-experimental designs, published in English and Spanish will be included. Articles that provide relevant information on the use of technology and its effectiveness in interventions that assess improvements in early detection, prevention, follow-up and treatment of the patients at risk or diagnosed with MCI will be included.Ethics and disseminationEthics committee approval not required. The results will be disseminated in publications and congresses.

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Faculty Opinions recommendation of A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1059781.511712 ◽

2007 ◽

Author(s):

Patrick Wouters

Keyword(s):

Systematic Review ◽

Coronary Artery Disease ◽

At Risk ◽

Coronary Artery ◽

Meta Analysis ◽

Patients At Risk ◽

Artery Disease

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MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: a systematic review and meta-analysis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2547-7 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 13

Author(s):

Hayden F. Atkinson ◽

Trevor B. Birmingham ◽

Rebecca F. Moyer ◽

Daniel Yacoub ◽

Lauren E. Kanko ◽

...

Keyword(s):

Systematic Review ◽

At Risk ◽

Knee Osteoarthritis ◽

Meta Analysis ◽

Patients At Risk

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Apixaban Compared With Low Molecular Weight Heparins For Prophylaxis In The Patients At Risk Of Venous Thromboembolism: A Systematic Review And Meta-Analysis

Value in Health ◽

10.1016/j.jval.2018.04.338 ◽

2018 ◽

Vol 21 ◽

pp. S56

Author(s):

A Talwar ◽

D Jiang ◽

W Wu

Keyword(s):

Systematic Review ◽

At Risk ◽

Molecular Weight ◽

Venous Thromboembolism ◽

Meta Analysis ◽

Low Molecular Weight ◽

Low Molecular Weight Heparins ◽

Patients At Risk

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Use of anti-platelet agents in the prevention of hepatic fibrosis in patients at risk for chronic liver disease: a systematic review and meta-analysis

Hepatology International ◽

10.1007/s12072-018-9918-2 ◽

2018 ◽

Vol 13 (1) ◽

pp. 84-90 ◽

Cited By ~ 3

Author(s):

Umair Iqbal ◽

Brittany B. Dennis ◽

Andrew A. Li ◽

George Cholankeril ◽

Donghee Kim ◽

...

Keyword(s):

Systematic Review ◽

At Risk ◽

Liver Disease ◽

Chronic Liver Disease ◽

Hepatic Fibrosis ◽

Meta Analysis ◽

Chronic Liver ◽

Patients At Risk

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Effectiveness of interventions for the implementation of thromboprophylaxis in hospitalised patients at risk of venous thromboembolism: an updated abridged Cochrane systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽

10.1136/bmjopen-2018-024444 ◽

2019 ◽

Vol 9 (5) ◽

pp. e024444 ◽

Cited By ~ 3

Author(s):

Susan R Kahn ◽

Gisele Diendéré ◽

David R Morrison ◽

Alexandre Piché ◽

Kristian B Filion ◽

...

Keyword(s):

Systematic Review ◽

At Risk ◽

Venous Thromboembolism ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Absolute Increase ◽

Patients At Risk ◽

Multifaceted Interventions ◽

Randomised Controlled

ObjectiveTo assess the effectiveness of system-wide interventions designed to increase the implementation of thromboprophylaxis and decrease the incidence of venous thromboembolism (VTE) in hospitalised medical and surgical patients at risk of VTE.DesignSystematic review and meta-analysis of randomised controlled trials (RCTs).Data sourcesMedline, PubMed, Embase, BIOSIS, CINAHL, Web of Science, CENTRAL, DARE, EED, LILACS and clinicaltrials.gov without language restrictions from inception to 7 January 2017, as well as the reference lists of relevant review articles.Eligibility criteria for selecting studiesRCTs that evaluated the effectiveness of system-wide interventions such as alerts, multifaceted, education, and preprinted orders when compared with no intervention, existing policy or another intervention.ResultsWe included 13 RCTs involving 35 997 participants. Eleven RCTs had data available for meta-analysis. Compared with control, we found absolute increase in the prescription of prophylaxis associated with alerts (21% increase, 95% CI [15% to 275%]) and multifaceted interventions (4% increase, 95% CI [3% to 11%]), absolute increase in the prescription of appropriate prophylaxis associated with alerts (16% increase, 95% CI [12% to 20%]) and relative risk reductions (risk ratio 64%, 95% CI [47% to 86%]) in the incidence of symptomatic VTE associated with alerts. Computer alerts were found to be more effective than human alerts, and multifaceted interventions with an alert component appeared to be more effective than multifaceted interventions without, although comparative pooled analyses were not feasible. The quality of evidence for improvement in outcomes was judged to be low to moderate certainty.ConclusionsAlerts increased the proportion of patients who received prophylaxis and appropriate prophylaxis, and decreased the incidence of symptomatic VTE. Multifaceted interventions increased the proportion of patients who received prophylaxis but were found to be less effective than alerts interventions.Trial registration numberCD008201.

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The Management of Anticoagulants in Patients With Atrial Fibrillation and History of Falls or Risk of Falls: The Liverpool Af-falls Project. Protocol for a Systematic Review and Meta-analysis

10.21203/rs.3.rs-638316/v1 ◽

2021 ◽

Author(s):

Thibaut Galvain ◽

Ruaraidh Hill ◽

Sarah Donegan ◽

Paulo Lisboa ◽

Gregory Y. H. Lip ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

At Risk ◽

Meta Analysis ◽

Vitamin K Antagonist ◽

Risk Of Bias ◽

Safety And Efficacy ◽

Risk Of Falls ◽

Patients At Risk ◽

History Of

Abstract BackgroundAtrial fibrillation affects an estimated 33 million individuals worldwide and is a major cause of stroke, heart failure, and death. Anticoagulants substantially reduces risk of stroke but are also associated with an increased risk of bleeding and especially intracranial hemorrhages which are the most feared complication. Because of this many patients are not offered anticoagulants, particularly patients at risk of falls or with history of falls. It is unclear what anticoagulant treatment these patients should be offered, and the Liverpool AF-Falls project aims to investigate this area. This protocol for a systematic review and meta-analysis aims to define what is the most appropriate anticoagulant treatment option for the for the management of atrial fibrillation patients at risk of falls or with a history of falls. MethodsThis systematic review and meta-analysis will include randomized and non-randomized studies evaluating safety and efficacy of different anticoagulant treatments (vitamin K antagonist, non-vitamin K antagonist oral anti-coagulant, anti-platelet agent and no treatment). Bibliographic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Scopus, CINAHL, Web of Science and ClinicalTrials.gov) will be searched according to a pre-specified search strategy. Titles, abstracts, and full texts will be assessed by two independent reviewers and disagreement resolved with a third independent reviewer. The Cochrane Risk of Bias tool 2 will be used to assess risk of bias in randomized trials and the Newcastle-Ottawa-Scale tool will be used for non-randomized studies. Pairwise meta-analysis based on the fixed and random-effects models will be conducted. Publication bias will be evaluated with a funnel plot and the Egger’s test. Heterogeneity will be assessed with the I2 statistic. If conditions for indirect comparison are met and sufficient data are available, a network meta-analysis will be conducted using frequentist and Bayesian methodologies. DiscussionThis review will be the first to summarize direct and indirect evidence on safety and efficacy of anticoagulant treatments in atrial fibrillation patients at risk of falls or with history of falls. The findings will be important to patients, clinicians, and health policy-makers to inform best practice in the use of these treatments. Systematic review registrationPROSPERO registry number: CRD42020201086

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