Access to medication and pharmacy services for resettled refugees: a systematic review

2015 ◽  
Vol 21 (3) ◽  
pp. 273 ◽  
Author(s):  
Kim Bellamy ◽  
Remo Ostini ◽  
Nataly Martini ◽  
Therese Kairuz

The difficulties that resettled refugees experience in accessing primary health-care services have been widely documented. In most developed countries, pharmacists are often the first health-care professional contacted by consumers; however, the ability of refugees to access community pharmacies and medication may be limited. This review systematically reviewed the literature and synthesised findings of research that explored barriers and/or facilitators of access to medication and pharmacy services for resettled refugees. This review adhered to guidelines for systematic reviews by PRISMA (preferred reporting items for systematic reviews and meta-analyses). Databases were searched during March 2014 and included Scopus, ProQuest Sociological Abstracts, PubMed, Embase and APAIS Health. The Australian and International grey literature was also explored. Nine studies met the quality and inclusion criteria. The research reported in seven of the nine studies was conducted in the US, one was conducted in Australia and the other in the UK. The majority of studies focussed on South-east Asian refugees. Themes identified across the studies included language and the use of interpreters; navigating the Western health-care system; culture and illness beliefs; medication non-adherence; use of traditional medicine; and family, peer and community support. There is a significant paucity of published research exploring barriers to medication and pharmacy services among resettled refugees. This systematic review highlights the need for appropriate interpreting and translation services, as well as pharmacy staff demonstrating effective cross-cultural communication skills.

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.


2017 ◽  
Vol 11 (1) ◽  
pp. 108-123 ◽  
Author(s):  
Mary Halter ◽  
Ferruccio Pelone ◽  
Olga Boiko ◽  
Carole Beighton ◽  
Ruth Harris ◽  
...  

Background: Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. Objective: We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. Method: We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Results: Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. Conclusion: We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.


2019 ◽  
Author(s):  
Kelu Yang ◽  
Ya Gao ◽  
Yitong Cai ◽  
Ming Liu ◽  
Cuncun Lu ◽  
...  

Abstract Purpose: To analyze the scientific outputs of the cancer topic of Cochrane systematic reviews (Cancer-CSR) in order to have a comprehensive understanding and lay the foundation for the following research. Patients and methods: Cochrane Database of Systematic Review and Web of Science Core Collection were retrieved limited from Jan. 1, 2009 to Dec. 12, 2018. CiteSpace IV and Excel 2018 were applied to analyze and visualize the literature information. Results: Ultimately, 607 Cancer-CSR were retrieved, 32 countries, 179 institutions and 260 authors involved. The number of publications in Cancer-CSR has been increasing over the past decades (25(2009)-77(2018)). UK, USA, Canada, Australia, and Germany worked closely with other countries, especially the UK (n=361) has taken the lead in this field. The top 10 contributive institutions, which were almost came from developed countries, collaborated closely with other institutions. Cochrane Database Syst Rev, C Hdb Sys and J Clin Oncol were the top three journals with the highest co-citation. The top three co-cited references were the two different version of Cochrane handbook for systematic reviews and the guidelines of Review Manager. The biggest cluster of keywords “cytoreductive surgery (CRS)” and the latest clusters “visual inspection” and “non-steroidal anti-inflammatory drug” were the most promising hotspots. Conclusions: Cancer-CSR has been increasing. Most of the reviews were came from the developed countries as well as the institutes in these countries. The knowledge base of was the methodology studies of systematic review, epidemiological data of cancer, and the reporting guideline of systematic reviews. The adjuvant therapy combined CRS, the screening of skin cancer and the management of cancer-related pain were the hotspots. Reasons that influence the author's preference for Cancer-CSR also deserve further investigation.


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guanlan Mao ◽  
Maria Fernandes-Jesus ◽  
Evangelos Ntontis ◽  
John Drury

Abstract Background Community engagement and volunteering are essential for the public response to COVID-19. Since March 2020 a large number of people in the UK have been regularly doing unpaid activities to benefit others besides their close relatives. Although most mutual aid groups emerged from local neighbourhoods and communities, official public institutions also fostered community volunteering, namely through the community champions scheme. By considering a broad definition of COVID-19 volunteering, this article describes a systematic review of the literature focused on one broad question: What have we learned about COVID-19 volunteering both at the UK national level and the more local community level? Methods A rapid review of the literature in peer-reviewed databases and grey literature was applied in our search, following the PRISMA principles. The search was conducted from 10 to 16 of October 2020, and sources were included on the basis of having been published between January and October 2020, focusing on COVID-19 and addressing community groups, volunteering groups, volunteers, or community champions in the UK. Results After initial screening, a total of 40 relevant sources were identified. From these, 27 were considered eligible. Findings suggest that food shopping and emotional support were the most common activities, but there were diverse models of organisation and coordination in COVID-19 volunteering. Additionally, community support groups seem to be adjusting their activities and scope of action to current needs and challenges. Volunteers were mostly women, middle-class, highly educated, and working-age people. Social networks and connections, local knowledge, and social trust were key dimensions associated with community organising and volunteering. Furthermore, despite the efforts of a few official public institutions and councils, there has been limited community engagement and collaboration with volunteering groups and other community-based organisations. Conclusions We identified important factors for fostering community engagement and COVID-19 volunteering as well as gaps in the current literature. We suggest that future research should be directed towards deepening knowledge on sustaining community engagement, collaboration and community participation over time, during and beyond this pandemic.


Kybernetes ◽  
2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jie Lei ◽  
Jianming Liu ◽  
Wu Li

Purpose Hospital information system (HIS) can be examined as a vital factor for developing the quality of health care and cost managing. There exists abundant literature on HISs, but implementation-based literature of HIS is rare, typically about progressive countries. However, a study that can comprehensively review published articles is scarce. Therefore, this paper aims to examine the systematic and comprehensive study of HIS in developed countries. Together, the benefits and harms relevant to HIS’s different mechanisms have been considered, and the fundamental challenges of them are addressed to design more efficient HIS in the future. Design/methodology/approach HIS has been used globally for numerous years and is now being used in a wide area. HIS is broadly used in clinical settings. Information technology (IT) and information system have been suggested as a required piece to solve the health-care-related issues. Hence, to improve HIS’s ability, this paper conducted a review method concentratating on research related to HIS until 2019. A total of 21 papers were recognized and examined as principal research for the summary. Findings The authors found that HIS can help in reduction of medical mistakes, enhancement doctors’ performance and increase in the quality of the care provided. HIS management can be used to provide better health-care services. Therefore, HIS must be sensible and use clear structures. The authors conclude that, generally, with an increase in awareness, acceptability and the need for HIS worldwide, there will be more strategies and approaches available. Research limitations/implications First, this paper provides an outline of the status of HIS. Second, it identifies some distinct research gaps that could be worth studying. Some flawless work may be removed because of applying some filters to select the original articles. Surveying all the papers on the topic of HIS is impossible, too. Practical implications Design and sustainability of HIS is still a big issue for most developing countries, despite its wide usage in the developed countries. The technology is changing rapidly, so the field should be reviewed regularly. This paper suggests a suitable framework that will guide HIS in the local conditions of developing countries. Social implications The government will be assisted by the suggested solving ways in its performance and design of electronic health-care projects. Originality/value The study brings the viewpoints on the state of HIS mechanisms in developing countries. The paper’s results can offer visions into future research requirements. By providing comparative information and analyzing the current growths in this area, this study will support researchers and professionals to understand the progress in HIS mechanisms better.


2019 ◽  
Vol 7 (31) ◽  
pp. 1-216 ◽  
Author(s):  
Catrin Evans ◽  
Ritah Tweheyo ◽  
Julie McGarry ◽  
Jeanette Eldridge ◽  
Juliet Albert ◽  
...  

Background In a context of high migration, there are growing numbers of women living in the UK who have experienced female genital mutilation/cutting. Evidence is needed to understand how best to meet their health-care needs and to shape culturally appropriate service delivery. Objectives To undertake two systematic reviews of qualitative evidence to illuminate the experiences, needs, barriers and facilitators around seeking and providing female genital mutilation-/cutting-related health care from the perspectives of (1) women and girls who have experienced female genital mutilation/cutting (review 1) and (2) health professionals (review 2). Review methods The reviews were undertaken separately using a thematic synthesis approach and then combined into an overarching synthesis. Sixteen electronic databases (including grey literature sources) were searched from inception to 31 December 2017 and supplemented by reference list searching. Papers from any Organisation for Economic Co-operation and Development country with any date and in any language were included (Organisation for Economic Co-operation and Development membership was considered a proxy for comparable high-income migrant destination countries). Standardised tools were used for quality appraisal and data extraction. Findings were coded and thematically analysed using NVivo 11 (QSR International, Warrington, UK) software. Confidence in the review findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation – Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. All review steps involved two or more reviewers and a team that included community-based and clinical experts. Results Seventy-eight papers (74 distinct studies) met the inclusion criteria for both reviews: 57 papers in review 1 (n = 18 from the UK), 30 papers in review 2 (n = 5 from the UK) and nine papers common to both. Review 1 comprised 17 descriptive themes synthesised into five analytical themes. Women’s health-care experiences related to female genital mutilation/cutting were shaped by silence and stigma, which hindered care-seeking and access to care, especially for non-pregnant women. Across all countries, women reported emotionally distressing and disempowering care experiences. There was limited awareness of specialist service provision. Good care depended on having a trusting relationship with a culturally sensitive and knowledgeable provider. Review 2 comprised 20 descriptive themes synthesised into six analytical themes. Providers from many settings reported feeling uncomfortable talking about female genital mutilation/cutting, lacking sufficient knowledge and struggling with language barriers. This led to missed opportunities for, and suboptimal management of, female genital mutilation-/cutting-related care. More positive experiences/practices were reported in contexts where there was input from specialists and where there were clear processes to address language barriers and to support timely identification, referral and follow-up. Limitations Most studies had an implicit focus on type III female genital mutilation/cutting and on maternity settings, but many studies combined groups or female genital mutilation/cutting types, making it hard to draw conclusions specific to different communities, conditions or contexts. There were no evaluations of service models, there was no research specifically on girls and there was limited evidence on psychological needs. Conclusions The evidence suggests that care and communication around female genital mutilation/cutting can pose significant challenges for women and health-care providers. Appropriate models of service delivery include language support, continuity models, clear care pathways (including for mental health and non-pregnant women), specialist provision and community engagement. Routinisation of female genital mutilation/cutting discussions within different health-care settings may be an important strategy to ensure timely entry into, and appropriate receipt of, female genital mutilation-/cutting-related care. Staff training is an ongoing need. Future work Future research should evaluate the most-effective models of training and of service delivery. Study registration This study is registered as PROSPERO CRD420150300012015 (review 1) and PROSPERO CRD420150300042015 (review 2). Funding The National Institute for Health Research Health Services and Delivery Research programme.


10.2196/16929 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e16929
Author(s):  
Michelle Helena Van Velthoven ◽  
Madison Milne-Ives ◽  
Caroline de Cock ◽  
Mary Mooney ◽  
Edward Meinert

Background The decline in the uptake of routine childhood vaccinations has resulted in outbreaks of vaccine-preventable diseases. Vaccination apps can be used as a tool to promote immunization through the provision of reminders, dissemination of information, peer support, and feedback. Objective The aim of this review is to systematically review the evidence on the use of apps to support childhood vaccination uptake, information storage, and record sharing. Methods We will identify relevant papers by searching the following electronic databases: PubMed, Embase by Ovid, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Education Resources Information Center (ERIC). We will review the reference lists of those studies that we include to identify relevant additional papers not initially identified using our search strategy. In addition to the use of electronic databases, we will search for grey literature on the topic. The search strategy will include only terms relating to or describing the intervention, which is app use. As almost all titles and abstracts are in English, 100% of these will be reviewed, but retrieval will be confined to papers written in the English language. We will record the search outcome on a specifically designed record sheet. Two reviewers will select observational and intervention studies, appraise the quality of the studies, and extract the relevant data. All studies will involve the use of apps relating to child vaccinations. The primary outcome is the uptake of vaccinations. Secondary outcomes are as follows: (1) use of app for sharing of information and providing vaccination reminders and (2) use of app for storage of vaccination information; knowledge and decision making by parents regarding vaccination (ie, risks and benefits of vaccination); costs and cost-effectiveness of vaccination apps; use of the app and measures of usability (eg, usefulness, acceptability, and experiences of different users: parents and health care professionals); use of technical standards for development of the app; and adverse events (eg, data leaks and misinformation). We will exclude studies that do not study an app. We anticipate a limited scope for meta-analysis and will provide a narrative overview of findings and tabular summaries of extracted data. Results This project was funded by the Sir David Cooksey Fellowship in Healthcare Translation at the University of Oxford, Oxford, United Kingdom. We will submit the full systematic review for publication in the Journal of Medical Internet Research. Conclusions This review will follow, where possible, the Cochrane Collaboration and the Centre for Review and Dissemination methodologies for conducting systematic reviews. We will report our findings based on guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review results will be used to inform the development of a vaccination app. International Registered Report Identifier (IRRID) PRR1-10.2196/16929


10.2196/16930 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e16930
Author(s):  
Ching Lam ◽  
Madison Milne-Ives ◽  
Michelle Helena Van Velthoven ◽  
Edward Meinert

Background Childhood obesity is a serious global issue, leading to increased medical spending on obesity-related diseases such as cardiovascular diseases and diabetes. There is a need for health care services that link health behavior to risk factors, such as diet and physical activity, and that provide better advice and feedback to users, which Internet of Things–enabled technologies could facilitate. Objective The objective of the systematic review will be to identify available Internet of Things–enabled technologies for weight management of children and adolescents (users younger than 18 years). It will also aim to understand the use, effectiveness, and feasibility of these technologies. Methods We will search the Medline, PubMed, Web of Science, Scopus, ProQuest Central, and IEEE Xplore Digital Library databases for studies published after 2010, using a combination of keywords and subject headings related to health activity tracking, youth, and Internet of Things. In addition, a Google search to identify grey literature will be conducted. Two authors will independently screen the titles and abstracts identified from the search and accept or reject the studies according to the study inclusion criteria. Any discrepancies will then be discussed and resolved. The quality of the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklists. Data from included studies will be extracted into a predesigned form to identify the types of devices or apps, Internet of Things applications, and health outcomes related to weight management. Results A preliminary search on Medline returned 484 results. The publication of the final systematic review is expected in mid-2020. Conclusions The effectiveness and feasibility of physical activity trackers and consumer wearables for different patient groups have been well reviewed, but there are currently no published reviews that look into these technologies in the wider Internet of Things context. This review aims to address this gap by examining Internet of Things–enabled technologies that are designed for youth weight management and thus inform further research and clinical studies to reduce childhood obesity. International Registered Report Identifier (IRRID) PRR1-10.2196/16930


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