A175 BEHAVIORAL INTERVENTIONS TO ADDRESS INFLAMMATORY BOWEL DISEASE-RELATED DISTRESS AND QUALITY OF LIFE: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Abstract Background Inflammatory bowel disease-associated psychological distress (IBD-PD) (inclusive of anxiety, depression, and high levels of stress) is prevalent amongst persons living with IBD. IBD-PD impairs quality of life (QoL) and worsens disease outcomes. Research relating to the efficacy of behavioral interventions for IBD-PD has been limited. Aims This systematic review and meta-analysis was conducted to evaluate the efficacy of cognitive behavioral therapy (CBT)-based interventions for the management of IBD-PD and QoL in persons living with IBD. Methods Pre-defined criteria were used to identify randomized controlled studies reporting on the efficacy of CBT-based interventions for IBD-PD and QoL in adults living with IBD. Electronic databases including CINAHL, Cochrane Library, Embase, MEDLINE, PsycArticles, PsycInfo, Pubmed, and Web of Science were searched from inception to May 30, 2020. Studies published in English or French were included. Risk of bias was assessed using the Cochrane risk-of-bias tool by two independent reviewers (CH and MRF). Data was extracted and summarized qualitatively. A random-effects model was used to generate pooled estimates. Results Eight studies (922 participants) met criteria for inclusion in this review. The studies evaluated outcomes of quality of life and IBD-PD using the IBD Questionnaire (IBDQ), United Kingdom IBDQ, Short IBSQ, 36-Item Short Form Survey (SF-36), Short Health Scale, Perceived Stress Questionnaire (PSQ), Perceived Stress Scale (PSS-10), Hospital anxiety depression scale (HADS) and the Depression, Anxiety and Stress Scale-21 Items (DASS-21). Of the 8 studies, 2 were low, 2 high, and 4 at intermediate risk of bias. Interventions, duration, and outcome assessments differed across studies and observed attrition rates were high. The pooled odds ratio for the short-term impact of CBT on IBDQ (n=3) was 0.30 (95% CI 0.17- 0.44) favoring CBT. Perceived stress (PSQ and PSS-10) were only reported in 3 studies as secondary outcomes. Overall, CBT had no observed benefit for perceived stress. Measurement of anxiety and depression was inconsistent across studies. The impact of CBT on anxiety and depression varied with studies revealing both neutral and positive results. Conclusions In patients IBD-PD, CBT-based interventions were observed to lead to short-term improvements in disease-related QoL. The impact of CBT on IBD-PD remains unclear due to limitations in study quality and heterogeneity in study design. Further studies are needed to evaluate the efficacy of CBT-based interventions for IBD-PD and to define the role of behavioral interventions delivered within the context of collaborative, biopsychosocial models of care. Expert consensus on best practice for CBT-based interventions and IBD-PD evaluation are needed. Funding Agencies None

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The Impact of Disease Specific Knowledge on Anxiety, Depression, and Quality of Life in Patients With Inflammatory Bowel Disease

The American Journal of Gastroenterology ◽

10.14309/00000434-201810001-00641 ◽

2018 ◽

Vol 113 (Supplement) ◽

pp. S362-S363

Author(s):

Aya Hamadeh ◽

Mohamad Chahrour ◽

Habib El-Khoury ◽

Jad M. Kfouri ◽

Mohammad N. Hosni ◽

...

Keyword(s):

Quality Of Life ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Specific Knowledge ◽

Inflammatory Bowel ◽

Anxiety Depression ◽

The Impact ◽

Disease Specific

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The Impact of Music Intervention on COVID-19 Patients with Mental Disorders: A Protocol for a Systematic Review and Meta-analysis

10.21203/rs.3.rs-536284/v1 ◽

2021 ◽

Author(s):

Sihan Peng ◽

Ziyan Xie ◽

Xiyu Zhang ◽

Chunguang Xie ◽

Jian Kang ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Mental Disorders ◽

Sleep Disorder ◽

Meta Analysis ◽

Risk Of Bias ◽

Efficacy And Safety ◽

Music Intervention ◽

Anxiety Depression

Abstract Background: The COVID-19 pandemic caused by the SARS-CoV-2 virus is a major health crisis that is affecting countries across the world. Patients infected with COVID-19 are often associated with mental health disorders, such as anxiety, depression, and sleep disorders. As a non-drug therapy applied in clinics for many years, music intervention is safe, effective, inexpensive, and devoid of side effects. Yet, there is a distinct lack of evidence to support the use of this technique. In this study, we aim to collect and evaluate the clinical evidence, in order to provide a basis for the efficacy and safety of music intervention in the treatment of COVID-19 patients with mental disorders.Methods: We plan to search a range of electronic databases from inception to the May 2021, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Science and Technology Periodical Database (VIP). All randomized controlled trials featuring music intervention to treat mental disorders such as anxiety, depression, or sleep disorders, for patients with COVID-19, will be included. The primary outcomes will be quantitative scores for anxiety, depression, and sleep disorder. The secondary outcomes will be quality of life and the safety profile of music intervention, including adverse events. Two reviewers will carry out the selection of studies, data extraction independently. The Cochrane risk of bias tool will be used to evaluate the risk of bias for the studies. We will use Review Manager V.5.3 software for data analysis. Subgroup analyses and sensitivity analyses are planned to assess the heterogeneity and reliability.Discussion: This is an up-to-date systematic review and meta-analysis of the efficacy and safety of music intervention on mental disorders (anxiety, depression, or sleep disorder) in COVID-19 patients, in order to provide clinicians, researchers, and policy makers, with powerful reference guidelines to facilitate treatment and improve the quality of life in COVID-19 patients with mental disorders.Systematic review registration: OSF 10.17605/OSF.IO/9RCX5

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The impact of intensive care unit diaries on patients’ and relatives’ outcomes: a systematic review and meta-analysis

Critical Care ◽

10.1186/s13054-019-2678-0 ◽

2019 ◽

Vol 23 (1) ◽

Cited By ~ 6

Author(s):

Bruna Brandao Barreto ◽

Mariana Luz ◽

Marcos Nogueira de Oliveira Rios ◽

Antonio Alberto Lopes ◽

Dimitri Gusmao-Flores

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Intensive Care Unit ◽

Intensive Care ◽

Psychiatric Disorders ◽

Meta Analysis ◽

Risk Of Bias ◽

The Impact ◽

Icu Diary

Abstract Background Memory gaps in intensive care unit (ICU) survivors are associated with psychiatric disorders. The ICU diaries improve the patient’s factual memory of the ICU, but it is not clear if they reduce the incidence of psychiatric disorders in patients and relatives after hospital discharge. The aim of this study is to evaluate the literature on the effect of ICU diaries for patients admitted in ICU and their relatives. Methods Two authors independently searched the online databases PubMed, OVID, Embase, EBSCO host, and PsycINFO from inception to July 2019. Studies were included if the intervention group (ICU diary) was compared with a group with no diaries and the sample was comprised patients ≥ 18 years old admitted in the ICU for more than 24 h and their relatives. Randomized clinical trials, observational studies, letter with original data, and abstracts were included, irrespective of the language. The search was not limited by any specific outcome. Review articles, commentaries, editorials, and studies without a control group were excluded. Structured tools were used to assess the methodological quality (“Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I)” for cohort studies and the “Cochrane Risk of Bias tool” for included RCTs and before/after studies). A random-effects model was employed considering the anticipated variability between the studies. Results Seven hundred eighty-five titles were identified for screening. Two additional studies were selected after a reference search, and after a full-text review, a total of 12 studies were included. When pooling the results, ICU diary was associated with lower risk of depression (RR 0.41, 95% CI 0.23–0.75) and better quality of life (10.3 points higher in SF-36 general health score, 95% CI 0.79–19.8), without a decrease in anxiety or post-traumatic stress disorder (PTSD). For the relatives receiving an ICU diary, there was no difference in the incidence of PTSD, anxiety, or depression. Conclusion and relevance This systematic review and meta-analysis supports the use of ICU diaries to reduce the risk of depression and preserve the quality of life of patients after ICU admission. ICU diaries do not seem to have any beneficial effect on the relatives of the patients. Trial registration PROSPERO, CRD42019136639

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A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders

Scientific Reports ◽

10.1038/s41598-021-99882-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Heidemarie Haller ◽

Pascal Breilmann ◽

Marleen Schröter ◽

Gustav Dobos ◽

Holger Cramer

Keyword(s):

Quality Of Life ◽

Anxiety Disorders ◽

Meta Analysis ◽

Specific Treatment ◽

Risk Of Bias ◽

Short Term ◽

Treatment As Usual ◽

Dsm 5 ◽

Statistical Heterogeneity

AbstractThis meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear. Protocol registry: Registered at Prospero on November 3rd, 2017 (CRD42017076810).

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Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data

BMJ ◽

10.1136/bmj.m4743 ◽

2021 ◽

pp. m4743

Author(s):

Joshua Z Goldenberg ◽

Andrew Day ◽

Grant D Brinkworth ◽

Junko Sato ◽

Satoru Yamada ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Type 2 Diabetes ◽

Weight Loss ◽

Meta Analysis ◽

Risk Of Bias ◽

Low Carbohydrate ◽

Remission Of Diabetes

Abstract Objective To determine the efficacy and safety of low carbohydrate diets (LCDs) and very low carbohydrate diets (VLCDs) for people with type 2 diabetes. Design Systematic review and meta-analysis. Data sources Searches of CENTRAL, Medline, Embase, CINAHL, CAB, and grey literature sources from inception to 25 August 2020. Study selection Randomized clinical trials evaluating LCDs (<130 g/day or <26% of a 2000 kcal/day diet) and VLCDs (<10% calories from carbohydrates) for at least 12 weeks in adults with type 2 diabetes were eligible. Data extraction Primary outcomes were remission of diabetes (HbA 1c <6.5% or fasting glucose <7.0 mmol/L, with or without the use of diabetes medication), weight loss, HbA 1c , fasting glucose, and adverse events. Secondary outcomes included health related quality of life and biochemical laboratory data. All articles and outcomes were independently screened, extracted, and assessed for risk of bias and GRADE certainty of evidence at six and 12 month follow-up. Risk estimates and 95% confidence intervals were calculated using random effects meta-analysis. Outcomes were assessed according to a priori determined minimal important differences to determine clinical importance, and heterogeneity was investigated on the basis of risk of bias and seven a priori subgroups. Any subgroup effects with a statistically significant test of interaction were subjected to a five point credibility checklist. Results Searches identified 14 759 citations yielding 23 trials (1357 participants), and 40.6% of outcomes were judged to be at low risk of bias. At six months, compared with control diets, LCDs achieved higher rates of diabetes remission (defined as HbA 1c <6.5%) (76/133 (57%) v 41/131 (31%); risk difference 0.32, 95% confidence interval 0.17 to 0.47; 8 studies, n=264, I 2 =58%). Conversely, smaller, non-significant effect sizes occurred when a remission definition of HbA 1c <6.5% without medication was used. Subgroup assessments determined as meeting credibility criteria indicated that remission with LCDs markedly decreased in studies that included patients using insulin. At 12 months, data on remission were sparse, ranging from a small effect to a trivial increased risk of diabetes. Large clinically important improvements were seen in weight loss, triglycerides, and insulin sensitivity at six months, which diminished at 12 months. On the basis of subgroup assessments deemed credible, VLCDs were less effective than less restrictive LCDs for weight loss at six months. However, this effect was explained by diet adherence. That is, among highly adherent patients on VLCDs, a clinically important reduction in weight was seen compared with studies with less adherent patients on VLCDs. Participants experienced no significant difference in quality of life at six months but did experience clinically important, but not statistically significant, worsening of quality of life and low density lipoprotein cholesterol at 12 months. Otherwise, no significant or clinically important between group differences were found in terms of adverse events or blood lipids at six and 12 months. Conclusions On the basis of moderate to low certainty evidence, patients adhering to an LCD for six months may experience remission of diabetes without adverse consequences. Limitations include continued debate around what constitutes remission of diabetes, as well as the efficacy, safety, and dietary satisfaction of longer term LCDs. Systematic review registration PROSPERO CRD42020161795.

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Exercise efficacy and prescription during treatment for pancreatic ductal adenocarcinoma: a systematic review

BMC Cancer ◽

10.1186/s12885-020-07733-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dominic O’Connor ◽

Malcolm Brown ◽

Martin Eatock ◽

Richard C. Turkington ◽

Gillian Prue

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Pancreatic Cancer ◽

Adjuvant Therapy ◽

Physical Function ◽

Meta Analysis ◽

Ductal Adenocarcinoma ◽

Key Stakeholders ◽

The Impact

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.

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Impact of flooding on health-related quality of life in England: results from the National Study of Flooding and Health

European Journal of Public Health ◽

10.1093/eurpub/ckaa049 ◽

2020 ◽

Vol 30 (5) ◽

pp. 942-948

Author(s):

Charlotte Robin ◽

Charles Beck ◽

Ben Armstrong ◽

Thomas David Waite ◽

G James Rubin ◽

...

Keyword(s):

Quality Of Life ◽

A Priori ◽

National Study ◽

Health Related Quality ◽

Euroqol Group ◽

Related Quality ◽

Health Related ◽

Anxiety Depression ◽

The Impact

Abstract Background Flooding can have extensive effects on the health and wellbeing of affected communities. The impact of flooding on psychological morbidity has been established; however, the wider impacts of flooding exposure, including on health-related quality of life (HRQoL), have not been described. Methods Using data from the English National Study of Flooding and Health cohort, HRQoL 2 and 3 years post-flooding was assessed with the EuroQol Group EQ-5D-5L tool. Associations between exposure groups (flooding and disruption from flooding) and HRQoL were assessed, using ordinal and linear regression, adjusting for a priori confounders. Results For both 2 and 3 years post-flooding, the median HRQoL scores were lower in the flooded and disrupted groups, compared with unaffected respondents. A higher proportion of flooded and disrupted respondents reported HRQoL problems in most dimensions of the EQ-5D-5L, compared with unaffected respondents. In year 2, independent associations between exposure to flooding and experiencing anxiety/depression [adjusted odds ratio (aOR) 7.7; 95% CI 4.6–13.5], problems with usual activities (aOR 5.3; 95% CI 2.5–11.9) and pain/discomfort (aOR 2.4; 95% CI 1.5–3.9) were identified. These problems persisted 3 years post-flooding; associations between exposure to flooding and experiencing anxiety/depression (aOR 4.3; 95% CI 2.5–7.7), problems with usual activities (aOR 2.9; 95% CI 1.5–6.1) and pain/discomfort (aOR 2.5; 95% CI 1.5–4.2) were identified. Conclusions Exposure to flooding and disruption from flooding significantly reduces HRQoL. These findings extend our knowledge of the impacts of flooding on health, with implications for multi-agency emergency response and recovery plans.

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