Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials

2016 ◽  
Vol 46 (16) ◽  
pp. 3263-3274 ◽  
Author(s):  
Y. T. Nigatu ◽  
Y. Liu ◽  
M. Uppal ◽  
S. McKinney ◽  
S. Rao ◽  
...  

Common mental disorders (CMDs) are highly prevalent in the working population, and are associated with long-term sickness absence and disability. Workers on sick leave with CMDs would benefit from interventions that enable them to successfully return to work (RTW). However, the effectiveness of RTW interventions for workers with a CMD is not well studied. The objective of this review is to assess the effectiveness of existing workplace and clinical interventions that were aimed at enhancing RTW. A systematic review of studies of interventions for improving RTW in workers with a CMD was conducted. The main outcomes were proportion of RTW and sick-leave duration until RTW. Randomized controlled trials (RCTs) were identified from Medline/PubMed, PsycINFO, EMBASE, SocINDEX, and Human resource and management databases from January 1995 to 2016. Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently homogeneous in different comparison groups and assessed the overall quality of the evidence. We reviewed 2347 abstracts from which 136 full-text articles were reviewed and 16 RCTs were included in the analysis. Combined results from these studies suggested that the available interventions did not lead to improved RTW rates over the control group [pooled risk ratio 1.05, 95% confidence interval (CI) 0.97–1.12], but reduced the number of sick-leave days in the intervention group compared to the control group, with a mean difference of −13.38 days (95% CI −24.07 to −2.69).

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 345
Author(s):  
Filipe Manuel Clemente ◽  
Rodrigo Ramirez-Campillo ◽  
Hugo Sarmento

This systematic review with meta-analysis was conducted to assess the effects of small-sided games (SSGs)-based programs on the systolic and diastolic blood pressure of untrained hypertensive adults. The data sources utilized were Web of Science, Scopus, SPORTDiscus, and PubMed. The eligibility criteria were: (i) randomized controlled trials including a control group and an intervention group exclusively using soccer SSGs; (ii) intervention and control groups including an untrained hypertensive adult population; (iii) articles written in English; and (iv) only full-text and original articles. The database search initially identified 241 titles. From those, five articles were eligible for the systematic review and meta-analysis. The included randomized controlled studies involved five individual experimental groups and 88 participants, and 68 participants in the five control groups. The results showed a large and beneficial effect of SSG on systolic (ES = 1.69; 95% CI = 0.71 to 2.66; p = 0.001; I2 = 85.2%; Egger’s test p = 0.101) and diastolic blood pressure (ES = 2.25; 95% CI = 1.44 to 3.06; p < 0.001; I2 = 74.8%; Egger’s test p = 0.118) when compared to the control groups. The findings of the current systematic review and meta-analysis revealed consistent beneficial effects of recreational soccer SSGs on untrained men and women from the hypertensive population, although high levels of heterogeneity.


2020 ◽  
Author(s):  
Yue Chang ◽  
Zhezhe Cui ◽  
Guanghong Yang ◽  
Xin Zhang ◽  
Lei Tang

Abstract Background The global health system is improperly using antibiotics. We aimed to examine the effectiveness of implementing a feedback intervention for the unreasonable control of antibiotic prescriptions. Methods Relevant literature published in the databases of Pubmed, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Journal Full-text (CNKI), Science Direct, Proquest and Wanfang was searched. Data were independently filtered and extracted based on the pre-designed inclusion and exclusion criteria by two reviewers. The Cochrane collaborative bias risk tool was used to evaluate the quality of the included study. RevMan 5.3 software was used for meta-analysis. Results Nine relevant randomized controlled trials were included in this study, of which 1 was written in Chinese and 8 in English. Tabulation resulted in a total of 238,196 prescriptions (103,370 in the intervention group and 134,826 in the control group) from seven countries: China, the United States, England, Spain, Norway, Germany, and France. The meta-analysis showed that the antibiotic prescription rate in the intervention group was significantly lower than that in the control group after the feedback intervention, and the difference was statistically significant (risk difference = -0.12, 95% CI = -0.16, -0.07, P <0.01). Due to the large heterogeneity of the results, subgroup analysis was performed according to the study area, whether prescription recommendations were given to doctors by peer experts, and the intervention mode. Conclusion Implementing feedback interventions in hospitals can effectively reduce antibiotic prescription rates. Adding multiple feedback interventions to educational interventions may be a more reasonable control method.Registrations: This systematic review was registered in PROSPERO, registration number: CRD42020192560.


2021 ◽  
Author(s):  
Fu-An Yang ◽  
Hung-Lun Chen ◽  
Chih-Wei Peng ◽  
Tsan-Hon Liou ◽  
Reuben Escorpizo ◽  
...  

Abstract Phonophoresis is an alternative treatment for knee osteoarthritis. However, evidence supporting the advantages of phonophoresis remains inconsistent. This systematic review and meta-analysis was conducted to illustrate the effect of phonophoresis. The PubMed, Cochrane Library, and Embase databases were searched for relevant studies from the date of their inception to 28 June, 2021. The eligibility criteria were: (1) randomized controlled trials (RCTs); (2) patients diagnosed as having knee osteoarthritis; (3) treatment with either phonophoresis or therapeutic ultrasound with placebo gels; and (4) reporting clinical and functional outcomes. Continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analysis was performed using RevMan 5.3 software. The analysis included nine RCTs covering a total of 423 patients. The intervention group significantly outperformed the control group in visual analog scale score [SMD = −0.65, 95% CI (−1.04, −0.25), P = 0.001], Western Ontario and McMaster Universities Arthritis Index (WOMAC) score [SMD = −0.71, 95% CI (−1.26, −0.16), P = 0.01], and walk test score [SMD = −0.67, 95% CI (−1.21, −0.13), P = 0.02]. As a result, phonophoresis might alleviate pain and improve function in the short term. Further high-quality, large-scale RCTs are required to confirm the benefits.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhongbao Zhou ◽  
Yuanshan Cui ◽  
Xiaoyi Zhang ◽  
Youyi Lu ◽  
Zhipeng Chen ◽  
...  

Abstract Objectives This meta-analysis aimed to evaluate the efficacy and safety of antimuscarinics for the prevention or treatment of catheter related bladder discomfort (CRBD). Methods The MEDLINE, EMBASE, and Cochrane Controlled Trials Register (from 1987 to July 2021) were used to search randomized controlled trials. The PRISMA checklists were followed. RevMan5.4.0 was used for statistical analysis. Results Eleven studies involving 1165 patients were involved in the analysis. The study reported that the incidence of CRBD observed in the antimuscarinics group was significantly lower than that of the control group at 0-, 1-, 2-, and 6-h after drug therapy (P = 0.001, P < 0.0001, P = 0.0005, and P = 0.001, respectively). For side effects, there were not statistical differences between the antimuscarinics group and the control group, mainly including dry mouth (risk ratio (RR) = 1.31, 95% confidence interval (CI) = 0.95 to 1.80, P = 0.09), postoperative nausea and vomiting (RR = 1.02, 95% CI = 0.55 to 1.90, P = 0.87), facial flushing (RR = 1.06, 95% CI = 0.43 to 2.61, P = 0.90), and blurred vision (RR = 0.95, 95% CI = 0.35 to 2.58, P = 0.91). Besides, rescue analgesics were required less in the antimuscarinics group than in the control group (RR = 0.51, 95% CI = 0.32 to 0.80, P = 0.003). Conclusions Compared with the control group, the antimuscarinics group had a significant improvement on CRBD, the patients were well tolerated and the use rate of rescue analgesics was low.


2020 ◽  
Vol 150 (5) ◽  
pp. 1151-1159 ◽  
Author(s):  
Oliver M Shannon ◽  
Inês Mendes ◽  
Christina Köchl ◽  
Mohsen Mazidi ◽  
Ammar W Ashor ◽  
...  

ABSTRACT Background The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. Objective To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. Methods Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. Results Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P &lt;0.001; I2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)—the reference method for noninvasive, clinical measurement of endothelial function—by 1.66% (absolute change; 95% CI: 1.15, 2.17; P &lt;0.001; I2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P &gt;0.05). Conclusions MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD. This study has the PROSPERO registration number: CRD42018106188.


2016 ◽  
Vol 70 (11) ◽  
pp. 1221-1229 ◽  
Author(s):  
T Isomura ◽  
S Suzuki ◽  
H Origasa ◽  
A Hosono ◽  
M Suzuki ◽  
...  

Abstract There remain liver-related safety concerns, regarding potential hepatotoxicity in humans, induced by green tea intake, despite being supposedly beneficial. Although many randomized controlled trials (RCTs) of green tea extracts have been reported in the literature, the systematic reviews published to date were only based on subjective assessment of case reports. To more objectively examine the liver-related safety of green tea intake, we conducted a systematic review of published RCTs. A systematic literature search was conducted using three databases (PubMed, EMBASE and Cochrane Central Register of Controlled Trials) in December 2013 to identify RCTs of green tea extracts. Data on liver-related adverse events, including laboratory test abnormalities, were abstracted from the identified articles. Methodological quality of RCTs was assessed. After excluding duplicates, 561 titles and abstracts and 119 full-text articles were screened, and finally 34 trials were identified. Of these, liver-related adverse events were reported in four trials; these adverse events involved seven subjects (eight events) in the green tea intervention group and one subject (one event) in the control group. The summary odds ratio, estimated using a meta-analysis method for sparse event data, for intervention compared with placebo was 2.1 (95% confidence interval: 0.5–9.8). The few events reported in both groups were elevations of liver enzymes. Most were mild, and no serious liver-related adverse events were reported. Results of this review, although not conclusive, suggest that liver-related adverse events after intake of green tea extracts are expected to be rare.


2020 ◽  
Author(s):  
Yun Diao ◽  
Hang Yang ◽  
Yang Chun Zhou ◽  
Biao Du

Abstract Objective: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound,the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45,P<0.00001, RR=1.63,95%CI:1.46~1.82,P<0.00001, RR=1.22,95%CI:1.15~1.29,P<0.00001, RR=1.32,95%CI:1.22~1.42,P<0.00001, RR=1.16,95%CI:1.05~1.27,P=0.002), all the differences were statistically significant. Conclusions: For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine.


Author(s):  
Tarun Krishna Boppana ◽  
Saurabh Mittal ◽  
Karan Madan ◽  
Anant Mohan ◽  
Vijay Hadda ◽  
...  

There is an urgent need for effective treatment modalities for coronavirus disease 2019 (COVID-19). Data for the use of steroids in COVID-19 is emerging. We conducted this systematic review and meta-analysis to estimate the effectiveness of steroid administration in mortality reduction due to COVID-19 compared to the control group. A systematic search of the Pubmed and Embase databases was performed to extract randomized controlled trials (RCTs) regarding the use of steroid therapy for COVID-19. An overall and subgroup (based upon the type of steroid) pooled mortality analysis was performed, and odds ratios were reported. Cochrane risk of bias assessment tool was used to assess the risk of bias. Heterogeneity was assessed using the I2 statistic. Six RCTs, including 7707 patients, were selected for review. Three trials reported 28-day mortality, and two trials reported 21-day mortality, and one trial reported in-hospital mortality. There were 730 deaths among 2837 participants in the steroid group while 1342 deaths among 4870 patients randomized to the control group (Odds ratio 0.76, 95% confidence interval 0.58-1.00, p=0.05). The effect was significant in patients on oxygen or mechanical ventilation. There was no difference in the various preparations and doses of the steroids. There was heterogeneity among the trials as the I2 value was 53%, with a p-value of 0.06. There was no indication of increased serious adverse events. This meta-analysis of RCTs demonstrated that the use of systemic corticosteroids is associated with a reduction in all-cause mortality in patients with COVID-19 on oxygen or mechanical ventilation.


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Xiandu Pan ◽  
Li Tian ◽  
Fan Yang ◽  
Jiahao Sun ◽  
Xinye Li ◽  
...  

Objective. This study systematically evaluated the effects of Tai Chi exercise on blood pressure, body mass index (BMI), and quality of life (QOL) in patients with hypertension. A meta-analysis was performed to provide a reliable reference for clinical practice. Methods. We searched for randomized controlled trials (RCTs) in five English databases and two Chinese databases, with the earliest data dated December 5, 2020. A quality assessment of the methods and a meta-analysis were also conducted. Results. The meta-analysis of 24 studies showed that the intervention group showed better outcomes in terms of systolic blood pressure (SBP) (SMD −1.05, 95% CI −1.44 to −0.67, P ≤ 0.001 ; I2 = 93.7%), diastolic blood pressure (DBP) (SMD −0.91, 95% CI −1.24 to −0.58, P ≤ 0.001 ; I2 = 91.9%), and QOL (physical functioning (SMD 0.86, 95% CI 0.36 to 1.37, P = 0.001 ; I2 = 91.3%), role-physical (SMD 0.86, 95% CI 0.61 to 1.11, P ≤ 0.001 ; I2 = 65%), general health (SMD 0.75, 95% CI 0.32 to 1.17, P = 0.001 ; I2 = 88.1%), bodily pain (SMD 0.65, 95% CI 0.29 to 1.00, P ≤ 0.001 ; I2 = 83.1%), vitality (SMD 0.71, 95% CI 0.34 to 1.07, P ≤ 0.001 ; I2 = 84.3%), social functioning (SMD 0.63, 95% CI 0.07 to 1.19, P = 0.027 ; I2 = 93.1%), role-emotional (SMD 0.64, 95% CI 0.22 to 1.06, P = 0.003 ; I2 = 88.1%), and mental health (SMD 0.73, 95% CI 0.31 to 1.16, P = 0.001 ; I2 = 88.2%)) compared to those of the control group. However, no significant improvements were seen in BMI of the intervention group (SMD −0.08, 95% CI −0.35 to −0.19, P = 0.554 ; I2 = 69.4%) compared to that of the control group. Conclusion. Tai Chi is an effective intervention to improve SBP and DBP in patients with essential hypertension.


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