P95 Preliminary Findings on Patient Satisfaction with Telepsychiatry – A Systematic Review

Abstract Introduction During the COVID-19 pandemic, mental health services have been presented with the unique challenge of providing effective and safe patient care whilst maintaining safety regulations. Telepsychiatry has emerged as a potential solution to this and is now being used across the UK to diagnose and manage mental health conditions. Evidence has shown that its effectiveness is comparable to face to face consultations, however, is much less clear regarding patient satisfaction. We therefore initiated a systematic review to establish whether patients are satisfied with tele-delivery of psychiatric care, and to identify the predictors of a positive experience with telepsychiatry. Methods A preliminary search was performed using five databases (MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO), with a date restriction between 2010-2020 to reflect advances in technology over the past decade. Results Preliminary data shows that patient views on telepsychiatric services are largely positive. Factors that arose in literature potentially affecting this include location, cost, privacy, digital literacy and technological issues including audio/video quality. Conclusion Our study so far shows that patient views on telepsychiatry are generally positive. The review is still in process, however, we anticipate that it will only further support our preliminary findings. These findings will be used to improve patient-centred delivery and provision of telepsychiatric services. We intend to produce a checklist of factors affecting patient satisfaction and test this in a national multicentre study. We are hoping that the study results and the resulting checklist will encourage greater patient involvement in setting up and delivering telepsychiatric services.

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Why are patients dissatisfied following a total knee replacement? A systematic review

International Orthopaedics ◽

10.1007/s00264-020-04607-9 ◽

2020 ◽

Vol 44 (10) ◽

pp. 1971-2007

Author(s):

Naoki Nakano ◽

Haitham Shoman ◽

Fernando Olavarria ◽

Tomoyuki Matsumoto ◽

Ryosuke Kuroda ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Patient Satisfaction ◽

Total Knee Replacement ◽

Quality Assessment ◽

Knee Replacement ◽

Mental Health Problems ◽

Factors Affecting ◽

History Of ◽

Total Knee

Abstract Background Although total knee replacement (TKR) is an effective intervention for end-stage arthritis of the knee, a significant number of patients remain dissatisfied following this procedure. Our aim was to identify and assess the factors affecting patient satisfaction following a TKR. Materials and methods In accordance with the PRISMA guidelines, two reviewers searched the online databases for literature describing factors affecting patient satisfaction following a TKR. The research question and eligibility criteria were established a priori. Any clinical outcome study that described factors relating to overall satisfaction after primary TKR was included. Quality assessment for the included studies was performed by two accredited orthopaedic surgeons experienced in clinical research. Results The systematic review identified 181 relevant articles in total. A history of mental health problems was the most frequently reported factor affecting patient satisfaction (13 reportings). When the results of the quality assessment were taken into consideration, a negative history of mental health problems, use of a mobile-bearing insert, patellar resurfacing, severe pre-operative radiological degenerative change, negative history of low back pain, no/less post-operative pain, good post-operative physical function and pre-operative expectations being met were considered to be important factors leading to better patient satisfaction following a TKR. Conclusion Surgeons performing a TKR should take these factors into consideration prior to deciding whether a patient is suitable for a TKR. Secondarily, a detailed explanation of these factors should form part of the process of informed consent to achieve better patient satisfaction following TKR. There is a great need for a unified approach to assessing satisfaction following a TKR and also the time at which satisfaction is assessed.

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Efficacy of compression stockings in preventing post-thrombotic syndrome in patients with deep venous thrombosis: a systematic review and metaanalysis

VASA ◽

10.1024/0301-1526/a000508 ◽

2016 ◽

Vol 45 (2) ◽

pp. 141-147 ◽

Cited By ~ 7

Author(s):

Jakob Martin Burgstaller ◽

Johann Steurer ◽

Ulrike Held ◽

Beatrice Amann-Vesti

Keyword(s):

Systematic Review ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Cochrane Library ◽

Compression Stockings ◽

Post Thrombotic Syndrome ◽

Study Results ◽

Preventive Efficacy ◽

One Year ◽

The Cochrane Library

Abstract. Background: Here, we update an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials. The aims are to synthesize the results of the original studies, and to identify details to explain heterogeneous results. Methods: We searched the Cochrane Library, PubMed, Scopus, and Medline for original studies that compared the preventive efficacy of active compression stockings with placebo or no compression stockings in patients with diagnosed proximal DVT. Only randomized controlled trials (RCTs) were included. Results: Five eligible RCTs with a total of 1393 patients (sample sizes ranged from 47 to 803 patients) were included. In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, we refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. Conclusions: At this time, it does not seem to be justifiable to entirely abandon the recommendations regarding compression stockings to prevent PTS in patients with DVT. There is evidence favoring compression stockings, but there is also evidence showing no benefit of compression stockings.

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Virtual reality in social skills training programs for people with schizophrenia: A systematic review and focus group

British Journal of Occupational Therapy ◽

10.1177/03080226211011391 ◽

2021 ◽

pp. 030802262110113

Author(s):

Catarina Oliveira ◽

Raquel Simões de Almeida ◽

António Marques

Keyword(s):

Mental Health ◽

Systematic Review ◽

Virtual Reality ◽

Social Skills ◽

Focus Group ◽

Social Skills Training ◽

Occupational Therapists ◽

Skills Training ◽

Training Programme ◽

Cochrane Library

Introduction This study aims to determine the guidelines for the design of a social skills training programme for people with schizophrenia using virtual reality. Methods This article encompasses two studies: Study 1, a systematic review of five articles indexed in the databases B-on, PubMed, Clinical trials and Cochrane Library (2010–2020); Study 2, a focus group of occupational therapists trained in mental health and multimedia professionals, in which they discussed the outline of such a programme. Results A set of guidelines were identified as central and consensual which should be included in the programme. It must have multilevel logic and gradual learning, with simulations of everyday situations, in which it is possible to practise the skills of conversation and communication. Virtual reality provides people with schizophrenia with unlimited opportunities, enhancing a personalized intervention. Conclusion Social skills training could be part of the treatment for people with schizophrenia, and virtual reality is a promising tool to complement traditional training, although still little implemented in mental health services. Occupational therapists have a prominent role in the development and application of this because of their knowledge of activity analysis and their ability to facilitate the generalization of skills in different contexts.

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Influence of Femoral Version on the Outcomes of Hip Arthroscopic Surgery for Femoroacetabular Impingement or Labral Tears: A Systematic Review and Meta-analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211009192 ◽

2021 ◽

Vol 9 (6) ◽

pp. 232596712110091

Author(s):

Chenghui Wang ◽

Yaying Sun ◽

Zheci Ding ◽

Jinrong Lin ◽

Zhiwen Luo ◽

...

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Femoroacetabular Impingement ◽

Arthroscopic Surgery ◽

Harris Hip Score ◽

Cochrane Library ◽

Femoral Version ◽

Labral Tears ◽

Significant Difference ◽

Secondary Outcomes

Background: It remains controversial whether abnormal femoral version (FV) affects the outcomes of hip arthroscopic surgery for femoroacetabular impingement (FAI) or labral tears. Purpose: To review the outcomes of hip arthroscopic surgery for FAI or labral tears in patients with normal versus abnormal FV. Study Design: Systematic review; Level of evidence, 4. Methods: Embase, PubMed, and the Cochrane Library were searched in July 2020 for studies reporting the outcomes after primary hip arthroscopic surgery for FAI or labral tears in patients with femoral retroversion (<5°), femoral anteversion (>20°), or normal FV (5°-20°). The primary outcome was the modified Harris Hip Score (mHHS), and secondary outcomes were the visual analog scale (VAS) for pain, Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), failure rate, and patient satisfaction. The difference in preoperative and postoperative scores (Δ) was also calculated when applicable. Results: Included in this review were 5 studies with 822 patients who underwent hip arthroscopic surgery for FAI or labral tears; there were 166 patients with retroversion, 512 patients with normal version, and 144 patients with anteversion. Patients with retroversion and normal version had similar postoperative mHHS scores (mean difference [MD], 2.42 [95% confidence interval (CI), –3.42 to 8.26]; P = .42) and ΔmHHS scores (MD, –0.70 [96% CI, –8.56 to 7.15]; P = .86). Likewise, the patients with anteversion and normal version had similar postoperative mHHS scores (MD, –3.09 [95% CI, –7.66 to 1.48]; P = .18) and ΔmHHS scores (MD, –1.92 [95% CI, –6.18 to 2.34]; P = .38). Regarding secondary outcomes, patients with retroversion and anteversion had similar ΔNAHS scores, ΔHOS-SSS scores, ΔVAS scores, patient satisfaction, and failure rates to those with normal version, although a significant difference was found between the patients with retroversion and normal version regarding postoperative NAHS scores (MD, 5.96 [95% CI, 1.66-10.26]; P = .007) and postoperative HOS-SSS scores (MD, 7.32 [95% CI, 0.19-14.44]; P = .04). Conclusion: The results of this review indicated that abnormal FV did not significantly influence outcomes after hip arthroscopic surgery for FAI or labral tears.

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A Systematic Review of the Current State and Validity of Digital Assessment Tools for Psychiatry (Preprint)

10.2196/preprints.32824 ◽

2021 ◽

Author(s):

Nayra Anna Martin-Key ◽

Benedetta Spadaro ◽

Erin Funnell ◽

Eleanor Jane Barker ◽

Thea Sofie Schei ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Depressive Disorder ◽

Diagnostic Accuracy ◽

Mental Healthcare ◽

Risk Of Bias ◽

Assessment Tools ◽

Cochrane Library ◽

Digital Assessment ◽

Current State

BACKGROUND Given the role digital technologies are likely to play in the future of mental healthcare, there is a need for a comprehensive appraisal of the current state and validity (i.e., screening/diagnostic accuracy) of digital mental health assessments. OBJECTIVE To explore the current state and validity of question-and-answer-based digital tools for diagnosing and screening psychiatric conditions in adults. METHODS This systematic review was based on the Population, Intervention, Comparison, and Outcome (PICO) framework and was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Embase, Cochrane Library, ASSIA, Web of Science Core Collection, CINAHL, and PsycINFO were systematically searched for articles published between 2005 and 2020. A descriptive evaluation of the study characteristics and digital solutions and a quantitative appraisal of the screening/diagnostic accuracy of the included tools was conducted. Risk of bias and applicability were assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines. RESULTS A total of 25 studies met the inclusion criteria, with the most frequently evaluated conditions encompassing generalized anxiety disorder (GAD), major depressive disorder (MDD), and any depressive disorder. The majority of the studies employed digitized versions of existing pen-and-paper questionnaires, with findings revealing poor to excellent screening/diagnostic accuracy (sensitivity = 0.36-1.00, specificity = 0.37-1.00, AUC = 0.57-0.98) and a high risk of bias for most of the included studies. CONCLUSIONS The current state of the field of digital mental health tools is in its early stages and high-quality evidence is lacking. INTERNATIONAL REGISTERED REPORT RR2-10.2196/25382

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Mapping of modifiable barriers and facilitators of medication adherence in bipolar disorder to the Theoretical Domains Framework: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2018-026980 ◽

2019 ◽

Vol 9 (2) ◽

pp. e026980 ◽

Cited By ~ 1

Author(s):

Asta Ratna Prajapati ◽

Alexandra Lelia Dima ◽

Allan B Clark ◽

Claire Gant ◽

Chris Gibbons ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Bipolar Disorder ◽

Medication Adherence ◽

Mental Health Treatment ◽

Theoretical Domains Framework ◽

Barriers And Facilitators ◽

Primary Data ◽

Cochrane Library ◽

Long Term Treatment

IntroductionPeople with bipolar disorder require long-term treatment but it is estimated that 40% of these people do not adhere to prescribed medication regimens. Non-adherence increases the risk of relapse, hospitalisation and suicide. Some evidence syntheses report barriers to mental health treatment adherence but rarely delineate between modifiable and non-modifiable barriers. They also fail to distinguish between the patients’ perspective and that of other stakeholders such as clinicians despite of their different understanding and priorities about adherence. Facilitators of adherence, which are also important for informing adherence intervention design, are also lacking from syntheses and few syntheses focus on medications for bipolar disorder.This systematic review aims to identify modifiable barriers and facilitators (determinants) of medication adherence in bipolar disorder. We also plan to report determinants of medication adherence from perspectives of patients, carers, healthcare professionals and other third parties. A unique feature of this systematic review in the context of mental health is the use of the Theoretical Domains Framework (TDF) to organise the literature identified determinants of medication adherence.Methods and analysisThe protocol adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and ENhancing Transparency in REporting the synthesis of Qualitative research (ENTREQ) guidelines. This review will include both qualitative and quantitative primary studies exploring determinants of medication adherence in bipolar disorder. We will search the following databases using a preplanned strategy: CINAHL, Cochrane Library (CENTRAL), Embase, LiLACS, Medline, PsychINFO, PubMed without date restrictions. We will report the quality of included studies. We will use framework synthesis using the TDF as an a priori ‘framework’. We will map the literature identified modifiable determinants to the domains of TDF.Ethics and disseminationEthical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication.PROSPERO registration numberCRD42018096306.

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Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2019-200448 ◽

2020 ◽

pp. bmjsrh-2019-200448

Author(s):

Mia Schmidt-Hansen ◽

Jonathan Lord ◽

Elise Hasler ◽

Sharon Cameron

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Medical Abortion ◽

Cochrane Library ◽

Published Data ◽

Study Results ◽

Randomised Controlled ◽

Meta Analyses

BackgroundMedical abortion with mifepristone and misoprostol usually involves an interval of 36–48 hours between administering these drugs; however, it is possible that the clinical efficacy at early gestations may be maintained when the drugs are taken simultaneously. The objective of this systematic review was to determine the safety and effectiveness of simultaneous compared with interval administration of mifepristone and misoprostol for abortion up to 10+0 weeks’ gestation.MethodsWe searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily, and Epub Ahead-of-Print, In-Process & Other Non-Indexed Citations; and Cochrane Library on 11 December 2019. We included randomised controlled trials (RCTs), published in English from 1985, comparing simultaneous to interval administration of mifepristone and misoprostol for early abortion. Risk of bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs) using the Mantel-Haenszel method were performed. The quality of the evidence was assessed using GRADE.ResultsMeta-analyses of three RCTs (n=1280) showed no differences in ‘ongoing pregnancy’ (RR 1.78, 95% CI 0.38 to 8.36), ‘haemorrhage requiring transfusion or ≥500 mL blood loss’ (RR 0.11, 95% CI 0.01 to 2.03) and ‘incomplete abortion with the need for surgical intervention’ (RR 1.30, 95% CI 0.76 to 2.25) between the interventions. Individual study results showed no difference in patient satisfaction, or ‘need for repeat misoprostol’, although ‘time to onset of bleeding or cramping’ was longer after simultaneous than interval administration. The quality of evidence was very low to moderate.ConclusionThe published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration.

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Theory of change for the delivery of talking therapies by lay workers to survivors of humanitarian crises in low-income and middle-income countries: protocol of a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-018193 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018193 ◽

Cited By ~ 2

Author(s):

Grace Kathryn Ryan ◽

Andreas Bauer ◽

Judith K Bass ◽

Julian Eaton

Keyword(s):

Mental Health ◽

Systematic Review ◽

Low Income ◽

Tertiary Education ◽

Grey Literature ◽

Theory Of Change ◽

Cochrane Library ◽

Middle Income ◽

Middle Income Countries ◽

Humanitarian Crises

IntroductionThere is a severe shortage of specialist mental healthcare providers in low-income and middle-income countries (LMICs) affected by humanitarian crises. In these settings, talking therapies may be delivered by non-specialists, including lay workers with no tertiary education or formal certification in mental health. This systematic review will synthesise the literature on the implementation and effectiveness of talking therapies delivered by lay workers in LMICs affected by humanitarian crises, in order to develop a Theory of Change (ToC).Methods and analysisQualitative, quantitative and mixed-methods studies assessing the implementation or effectiveness of lay-delivered talking therapies for common mental disorders provided to adult survivors of humanitarian crises in LMICs will be eligible for inclusion. Studies set in high-income countries will be excluded. No restrictions will be applied to language or year of publication. Unpublished studies will be excluded. Seven electronic databases will be searched: MEDLINE, Embase, PsycINFO, PsycEXTRA, Global Health, Cochrane Library and ClinicalTrials.gov. Contents pages of three peer-reviewed journals will be hand-searched. Sources of grey literature will include resource directories of two online mental health networks (MHPSS.net and MHInnovation.net) and expert consultation. Forward and backward citation searches of included studies will be performed. Two reviewers will independently screen studies for inclusion, extract data and assess study quality. A narrative synthesis will be conducted, following established guidelines. A ToC map will be amended iteratively to take into account the review results and guide the synthesis.Ethics and disseminationFindings will be presented in a manuscript for publication in a peer-reviewed journal and disseminated through a coordinated communications strategy targeting knowledge generators, enablers and users.PROSPERO registration numberCRD42017058287.

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Instruments for Measuring Satisfaction With Physical Therapy Care: A Systematic Review

Physical Therapy ◽

10.1093/ptj/pzaa111 ◽

2020 ◽

Vol 100 (9) ◽

pp. 1690-1700

Author(s):

Daniel Gutiérrez-Sánchez ◽

David Pérez-Cruzado ◽

Antonio I Cuesta-Vargas

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Physical Therapy ◽

Psychometric Properties ◽

Methodological Quality ◽

Cochrane Library ◽

Measurement Instruments ◽

Health Measurement ◽

Selection Of

Abstract Objective Several instruments to measure patient satisfaction have been developed to assess satisfaction with physical therapy care. The selection of the most appropriate instrument is very important. The purpose of this study was to identify instruments for assessing satisfaction with physical therapy care and their psychometric properties and to evaluate the methodological quality of studies on psychometric properties. Methods A systematic search was conducted in ProQuest Medline, SciELO, ProQuest PsycINFO, Theseus, Cochrane Library, and Google Scholar. Articles published from 1990 to 2019, in English and Spanish, were used as limits. This systematic review followed the Consensus-based Standards for the Selection of Health Measurement Instruments and Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. The articles were evaluated by 2 independent reviewers using the Consensus-based Standards for the Selection of Health Measurement Instruments 4-point checklist. Eighteen studies were included. Results Nine instruments were found to be specifically designed to assess satisfaction with physical therapy care. The methodological quality of the studies was “fair” for most of the psychometric characteristics analyzed (43 items), with 24 properties scored as “poor,” 5 as “good,” and 3 as “excellent.” Conclusions Different instrument characteristics—such as the scope and population with which the instrument will be used, its dimensions, the number of items, and the evidence shown in the evaluation of each psychometric property—should be considered by clinicians and researchers to decide which instrument is the best to measure the construct of patient satisfaction with physical therapy. Impact Evaluating patient satisfaction is very useful in clinical practice at the hospital, community, and primary care levels. Physical therapist clinicians and researchers can use this systematic review to select instruments whose characteristics will best measure their patients’ satisfaction with physical therapy care.

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