Impact of hospitalists on the efficiency of inpatient care and patient satisfaction: a systematic review and meta-analysis

e18088 Background: Patient navigation (PN) is a model of health care coordination designed to ameliorate health disparities by reducing barriers to achieving optimal health outcomes. Systematic reviews that evaluate whether PN is associated with higher patient satisfaction with cancer care are lacking. Methods: We conducted a systematic review to synthesize evidence of comparative studies evaluating the effectiveness of PN programs to improve satisfaction with cancer-related care. We included studies reported in English that: 1) evaluated a PN intervention designed to increase satisfaction with cancer care; and 2) involved a randomized controlled trial (RCT) or observational design. We abstracted data from studies using standardized forms, and evaluated these studies for methodological quality. Data were summarized qualitatively and synthesized under a random effects model. Results: The initial search yielded 831 citations, of which 3 RCTs and 6 observational studies met inclusion criteria. These nine studies involving 4,200 surveyed patients revealed either a neutral or positive effect in patient satisfaction in the majority of studies of PN and cancer-related care. However, only 5 studies (1 RCT and 4 observational) had adequate datato include in the meta-analysis. Methodological quality of eight of the included studies ranged from weak to moderate to strong, with half rated as weak. Findings of the RCT showed a statistically significant increase in satisfaction with cancer care involving PN [standardized mean difference (SMD) = 2.30; 95% Confidence Interval (CI): 1.79, 2.80, p < .001]. Pooled results from non-RCTs showed no significant association between PN and satisfaction with cancer-related care (SMD = 0.39; 95% CI: -0.02, 0.80, p = .06). Conclusions: More systematic reviews are needed to characterize the relationship between PN and satisfaction with cancer-related care across the cancer care continuum and across different types of cancer.

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Determinants of patient satisfaction: a systematic review

Perspectives in Public Health ◽

10.1177/1757913916634136 ◽

2016 ◽

Vol 137 (2) ◽

pp. 89-101 ◽

Cited By ~ 128

Author(s):

Enkhjargal Batbaatar ◽

Javkhlanbayar Dorjdagva ◽

Ariunbat Luvsannyam ◽

Matteo Mario Savino ◽

Pietro Amenta

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Measurement System ◽

English Language ◽

Care Service ◽

Meta Analysis ◽

Health Care Service ◽

Care Quality ◽

Health Providers ◽

Study Results

Aim: A large number of studies have addressed the detection of patient satisfaction determinants, and the results are still inconclusive. Furthermore, it is known that contradicting evidence exists across patient satisfaction studies. This article is the second part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction for further operationalisation procedures. The aim of this work was to systematically identify and review evidence regarding determinants of patient satisfaction between 1980 and 2014, and to seek the reasons for contradicting results in relationships between determinants and patient satisfaction in the literature to design a further robust measurement system for patient satisfaction. Method: This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search was conducted in PubMed, CINAHL, and Scopus in October 2014. Studies published in full in peer reviewed journals between January 1980 and August 2014 and in the English language were included. We included 109 articles for the synthesis. Results: We found several number of determinants of patient satisfaction investigated in a wide diversity of studies. However, study results were varied due to no globally accepted formulation of patient satisfaction and measurement system. Conclusions: Health care service quality indicators were the most influential determinants of patient satisfaction across the studies. Among them, health providers’ interpersonal care quality was the essential determinant of patient satisfaction. Sociodemographic characteristics were the most varied in the review. The strength and directions of associations with patient satisfaction were found inconsistent. Therefore, person-related characteristics should be considered to be the potential determinants and confounders simultaneously. The selected studies were not able to show all potential characteristics which may have had effects on satisfaction. There is a need for more studies on how cultural, behavioural, and socio-demographic differences affect patient satisfaction, using a standardised questionnaire.

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Efficacy of Platelet-rich Plasma for Low Back Pain: A Systematic Review and Meta-analysis

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1709170 ◽

2020 ◽

Vol 81 (06) ◽

pp. 529-534 ◽

Cited By ~ 1

Author(s):

Zhaopeng Xuan ◽

Wenjun Yu ◽

Yichen Dou ◽

Tao Wang

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Patient Satisfaction ◽

Back Pain ◽

Pain Relief ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Low Back ◽

Pain Scores ◽

Control Intervention

Abstract Background Platelet-rich plasma (PRP) may be beneficial for patients with low back pain. However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the efficacy of PRP for low back pain. Methods PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were searched systematically. Randomized controlled trials (RCTs) assessing the effect of PRP on low back pain were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was pain scores within 8 weeks. Meta-analysis was performed using the random-effects model. Results Three RCTs involving 131 patients were included in the meta-analysis. Overall, compared with control intervention for low back pain, PRP injection was found to reduce pain scores significantly (mean difference: − 1.47; 95% confidence interval [CI], − 2.12 to − 0.81; p < 0.0001), improve the number of patients with > 50% pain relief at 3 months (risk ratio [RR]: 4.14; 95% CI, 2.22–7.74; p < 0.00001), and offer relatively good patient satisfaction (RR: 1.91; 95% CI, 1.04–3.53; p = 0.04). No increase in adverse events was reported after PRP injection (RR: 1.92; 95% CI, 0.94-3.91; p = 0.07). Conclusions Compared with control intervention for low back pain, PRP injection was found to improve pain relief and patient satisfaction significantly with no increase in adverse events.

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Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia in Abdominal Surgery: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-16057/v1 ◽

2020 ◽

Author(s):

Junheng Chen ◽

Chao Chen ◽

Guoliang Sun ◽

Chunming Guo ◽

Weifeng Yao

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Side Effects ◽

Abdominal Surgery ◽

Meta Analysis ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Transversus Abdominis Plane ◽

Quadratus Lumborum ◽

Vas Scores

Abstract Background: The aim of this systematic review and meta-analysis was to compare the analgesic efficacy of the quadratus lumborum block (QLB) and transversus abdominis plane block (TAPB). Methods: We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement guidelines. Only trials comparing QLB with TAPB were included. The primary outcomes were visual analog scale (VAS) scores at rest and at movement during the first 48 h after surgery and postoperative analgesic requirements. Secondary outcomes included rates of side effects, such as postoperative nausea and vomiting (PONV) and dizziness, and patient satisfaction. Results: A total of 15 controlled trials, including 1013 patients, were identified. VAS scores at rest at 0–1, 2, 4, 6, 8, 12, and 24 h and at movement at 24 and 48 h were significantly lower in patients who underwent QLB when compared with those in patients who underwent TAPB. QLB performed better in terms of postoperative analgesic requirements, with patients requiring lower levels of intravenous morphine and sufentanil over the first 24 h, fewer patients requiring rescue analgesics, and longer times to first rescue analgesic. Among patients who underwent QLB, rates of PONV and dizziness were lower and the Bruggemann comfort scale (BCS) scores were higher. Conclusion: QLB leads to significantly better outcomes in terms of postoperative VAS scores, opioid consumption, incidence of side effects, and patient satisfaction when compared with TAPB following abdominal surgery.

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Vaginal dinoprostone versus placebo for pain relief during intrauterine device insertion: a systematic review and meta-analysis of randomized controlled trials

10.1101/2020.10.08.20209239 ◽

2020 ◽

Author(s):

Ahmed Abu-Zaid ◽

Majed S. Alshahrani ◽

Nisreen A. Albezrah ◽

Najlaa T. Miski ◽

Saud A. Aboudi ◽

...

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Side Effects ◽

Pain Relief ◽

Meta Analysis ◽

Intrauterine Device ◽

Cochrane Library ◽

Pain Patient ◽

Controlled Trials ◽

Uterine Perforation

AbstractObjectiveTo investigate the safety and efficacy of vaginal dinoprostone versus placebo in pain relief during intrauterine device (IUD) insertion.DesignSystematic review and meta-analysis of randomized placebo-controlled trials.SettingNot applicable.Patient(s)Women undergoing IUD insertion and receiving vaginal dinoprostone or placebo.Intervention(s)PubMed, Scopus, Web of Science, and Cochrane Library were screened from inception to 01-October-2020, using the following search strategy: (dinoprostone OR cervidil OR prepidil) AND (intrauterine device OR iud).Main outcome measure(s)IUD insertion related pain, patient satisfaction, provider ease of IUD insertion, and side effects.Result(s)Five studies met the study inclusion criteria, comprising 862 patients; equally 431 patients received vaginal dinoprostone and placebo. All studies had an overall low risk of bias. When compared to placebo, dinoprostone significantly correlated with decreased pain at tenaculum placement (SMD=−0.79, 95% CI [−1.43, −0.16], p=0.01), decreased pain at uterine sounding (SMD=−0.88, 95% CI [−1.54, −0.22], p=0.009), decreased pain at IUD insertion (SMD=−1.18, 95% CI [−1.74, −0.61], p<0.001), decreased need for additional analgesia (RR=0.34, 95% CI [0.22, 0.53], p<0.001), increased patient satisfaction (SMD=1.41, 95% CI [0.62, 2.20], p<0.001), and increased provider ease of IUD insertion (SMD=−1.17, 95% CI [−1.62, −0.73], p<0.001). Fever was statistically significantly higher in dinoprostone versus placebo group (RR=3.73, 95% CI [1.47, 9.44], p=0.006). All other side effects—including nausea, vomiting, shivering, diarrhea, abdominal cramps, vasovagal attack, uterine perforation, and postprocedural bleeding—did not substantially differ between both groups.ConclusionsThis first ever meta-analysis advocates that dinoprostone is safe, effective, and yields favorable analgesic outcomes during IUD insertion.

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Telemental health for reaching out to patients in a time of pandemic: Provider survey and systematic review with meta-analysis of patient satisfaction (Preprint)

JMIR Mental Health ◽

10.2196/26187 ◽

2020 ◽

Author(s):

Raffaele Mazziotti ◽

Grazia Rutigliano

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Meta Analysis ◽

Telemental Health ◽

Provider Survey

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Effectiveness of Whitening Strips Use Compared With Supervised Dental Bleaching: A Systematic Review and Meta-analysis

Operative Dentistry ◽

10.2341/19-160-l ◽

2020 ◽

Vol 45 (6) ◽

pp. E289-E307

Author(s):

GRV da Rosa ◽

BM Maran ◽

VL Schmitt ◽

AD Loguercio ◽

A Reis ◽

...

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Color Change ◽

Meta Analysis ◽

Permanent Dentition ◽

Dental Bleaching ◽

Color Alteration ◽

Human Eyes ◽

At Home

Clinical Relevance Bleaching performed at home while under the supervision of a dentist provides greater color alteration compared with whitening strips when evaluated with a spectrophotometer, although the color alteration was undetectable by unaided human eyes. SUMMARY Objective: A systematic review and meta-analysis were performed to answer the following research question: Does the use of whitening strips (WS) lead to an equivalent color change compared with supervised dental bleaching in patients with permanent dentition? Methods: A search was performed on August 10, 2017 (updated on March 22, 2019), in PubMed, the Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature database, Cochrane Library, Scopus, Web of Science, and SIGLE, without restrictions regarding date or language. Abstracts from the International Association for Dental Research, unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (parallel or split mouth) in patients with permanent dentition that compared WS with dentist-supervised dental bleaching performed at home (AH) or in office (IO) were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A meta-analysis with subgroup analysis (low and high peroxide concentration) was conducted for color change ΔE* (spectrophotometer) and ΔSGU (shade guide units), risk and intensity of tooth sensitivity (TS), gingival irritation (GI), and patient satisfaction using a random effects model. Heterogeneity was assessed with the Cochrane Q test and I2 statistics. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) was used to assess the quality of the evidence. Results: After the removal of duplicates, followed by title and abstract screening, 20 studies remained. Only two studies were considered to have a low RoB; 11 had a high RoB, and seven had an unclear RoB. For WS versus IO, data were not available for the meta-analysis. For WS versus AH bleaching, a significant difference in ΔE* favoring the AH group was observed (standardized mean difference [SMD] = −0.50, 95% confidence interval [CI] −0.79 to 0.21), but the risk (risk ratio = 0.78, 95% CI 0.65 to 0.93) and intensity of TS (SMD = −0.30, 95% CI −0.56 to −0.04) were lower in the WS group. Color change in ΔSGU, risk and intensity of GI, and patient satisfaction were not significantly different between groups (p>0.20). The quality of evidence for ΔE*, risk and intensity of TS, and intensity of GI were graded as moderate. Conclusion: Although the risk and intensity of TS were lower in the WS group, dentist-supervised at-home bleaching led to a better color change when measured with a spectrophotometer, although the color alteration was undetectable by unaided human eyes.

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