scholarly journals Self-management interventions to reduce healthcare use and improve quality of life among patients with asthma: systematic review and network meta-analysis

BMJ ◽  
2020 ◽  
pp. m2521 ◽  
Author(s):  
Alexander Hodkinson ◽  
Peter Bower ◽  
Christos Grigoroglou ◽  
Salwa S Zghebi ◽  
Hilary Pinnock ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Case Management ◽  
Usual Care ◽  
Meta Analysis ◽  
Self Management ◽  
Cochrane Library ◽  
Healthcare Use ◽  
Management Models

Abstract Objective To compare the different self-management models (multidisciplinary case management, regularly supported self-management, and minimally supported self-management) and self-monitoring models against usual care and education to determine which are most effective at reducing healthcare use and improving quality of life in asthma. Design Systematic review and network meta-analysis. Data sources Medline, the Cochrane Library, CINAHL, EconLit, Embase, Health Economics Evaluations Database, NHS Economic Evaluation Database, PsycINFO, and ClinicalTrials.gov from January 2000 to April 2019. Review methods Randomised controlled trials involving the different self-management models for asthma were included. The primary outcomes were healthcare use (hospital admission or emergency visit) and quality of life. Summary standardised mean differences (SMDs) and 95% credible intervals were estimated using bayesian network meta-analysis with random effects. Heterogeneity and publication bias were assessed. Results From 1178 citations, 105 trials comprising 27 767 participants were included. In terms of healthcare use, both multidisciplinary case management (SMD –0.18, 95% credible interval −0.32 to −0.05) and regularly supported self-management (–0.30, −0.46 to −0.15) were significantly better than usual care. For quality of life, only regularly supported self-management (SMD 0.54, 0.11 to 0.96) showed a statistically significant benefit compared with usual care. For trials including adolescents/children (age 5-18 years), only regularly supported self-management showed statistically significant benefits (healthcare use: SMD –0.21, −0.40 to −0.03; quality of life: 0.23, 0.03 to 0.48). Multidisciplinary case management (SMD –0.32, −0.50 to −0.16) and regularly supported self-management (–0.32, −0.53 to −0.11) were most effective at reducing healthcare use in patients with symptoms of severe asthma at baseline. Conclusions This network meta-analysis indicates that regularly supported self-management reduces the use of healthcare resources and improves quality of life across all levels of asthma severity. Future healthcare investments should provide support that offer reviews totalling at least two hours to establish self-management skills, reserving multidisciplinary case management for patients with complex disease. Systematic review registration PROSPERO number CRD42019121350.

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

scholarly journals Tuina for spasticity of poststroke: protocol of a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038705
Author(s):  
Qiongshuai Zhang ◽  
Guangcheng Ji ◽  
Fang Cao ◽  
Yihan Sun ◽  
Guanyu Hu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Short Form ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Primary Data ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Quality Of Life Scale

IntroductionSpasticity is a common complication of poststroke, tuina is a widely used rehabilitation treatment, although there is a lack of supportive evidence on efficacy and safety for patients with poststroke spasticity. The aim of this systematic review is to assess and synthesis evidence of efficacy and safety of tuina for spasticity of poststroke.Methods and analysisA comprehensive electronic search of EMBASE, MEDLINE, Cochrane Library, Web of Science, Wiley, Springer, PEDro, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific and Journal Database (VIP), Wanfang Database (Wanfang), Japanese medical database (CiNii), Korean Robotics Institute Summer Scholars and Thailand Thai-Journal Citation Index Centre will be conducted to search literatures of randomised controlled trials of tuina for spasticity of poststroke survivors range from the establishment to 1 January 2020.There is no time of publication limitations. The primary outcome will be measured with the Modified Ashworth Scale, and the second outcome will include Fugl-Meyer Assessment Scale, surface electromyogram RMS value, the Modified Barthel Index, Stroke Specific Quality of Life Scale, quality of life 36-Item Short-Form Health Survey and Visual Analogue Scale. Cochrane Handbook for Systematic Reviews of Interventions will be used to assess the risk of bias, and GRADE will be used to access the confidence in cumulative evidence. The protocol will be conducted according to approach and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015.Ethics and disseminationEthical approval will not be required, for no primary data of individual patients were collected. We will publish the findings in a peer-reviewed journal.PROSPERO registration numberCRD42020163384.

scholarly journals The effects of telemedicine on the quality of life of patients with lung cancer: a systematic review and meta-analysis

2020 ◽  
Vol 11 ◽  
pp. 204062232096159
Author(s):  
Lanlan Pang ◽  
Zefu Liu ◽  
Sheng Lin ◽  
Zhidong Liu ◽  
Hengyu Liu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Systematic Review ◽  
Usual Care ◽  
Cancer Patients ◽  
Usual Care Group ◽  
Meta Analysis ◽  
Care Group ◽  
Lung Cancer Patients

Background and aims: Lung cancer patients suffer from deterioration in their physical and psychological function, which exerts a negative influence on their quality of life (QOL). Telemedicine has been proven to be an effective intervention for patients with several chronic diseases. The aim of this systematic review and meta-analysis was to investigate the efficacy of telemedicine in improving QOL in lung cancer patients. Methods: PubMed, Cochrane Library, EMBASE, Web of Science and Scopus databases were searched for randomized controlled trials that investigated the effectiveness of telemedicine in lung cancer patients. Review Manager 5.3 and Stata 15.1 were used to perform data analysis. Results: Our meta-analysis included eight clinical trials with a total of 635 lung cancer patients. The results showed that the telemedicine group had significantly higher QOL than the usual care group [standard mean difference (SMD) 0.96, 95% confidence interval (CI) 0.29–1.63, I2 = 91%]. In addition, the telemedicine group had lower anxiety (SMD −0.44, 95% CI −0.66 to −0.23, I2 = 3%) and depression scores (SMD −0.48, 95% CI −0.91 to −0.05, I2 = 66%) than the usual care group. However, no significant differences were found in fatigue and pain outcomes between the two groups. Conclusion: Telemedicine may be an effective method of improving QOL in lung cancer patients and the further development and use of telemedicine care is recommended.

scholarly journals Effectiveness of Horticultural Therapy in People with Schizophrenia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (3) ◽  
pp. 964
Author(s):  
Shan Lu ◽  
Yajie Zhao ◽  
Jianjiao Liu ◽  
Feng Xu ◽  
Zhiwen Wang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Social Functioning ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Horticultural Therapy ◽  
Rehabilitation Outcomes ◽  
Hospital Environments

Horticultural therapy is increasingly being used in the non-pharmacological treatment of patients with schizophrenia, with previous studies demonstrating its therapeutic effects. The healing outcomes are positively correlated with the settings of the intervention. This review aimed to evaluate the effectiveness of horticultural therapy on the symptoms, rehabilitation outcomes, quality of life, and social functioning in people with schizophrenia, and the different effectiveness in hospital and non-hospital environments. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We researched studies through PubMed, Embase, the Cochrane Library, Science Direct, and the China National Knowledge Infrastructure. We included randomized controlled trials (RCTs) and quasi-experimental studies about horticultural therapy for people with schizophrenia, from January 2000 to December 2020, with a total of 23 studies involving 2024 people with schizophrenia included in this systematic review. This study provided evidence supporting the positive effect of horticultural therapy. This review demonstrated that non-hospital environments have a better therapeutic effect on all indicators than hospital environments. The results also demonstrated the effectiveness of horticultural therapy on symptoms, rehabilitation outcomes, quality of life, and social functioning in patients in hospital and non-hospital environments, providing further evidence-based support for landscape design.

scholarly journals Physical Exercise and Health-Related Quality of Life in Office Workers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3791
Author(s):  
Thi Mai Nguyen ◽  
Van Huy Nguyen ◽  
Jin Hee Kim
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Physical Exercise ◽  
Meta Analysis ◽  
Office Workers ◽  
Cochrane Library ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Office workers are at high risk for many chronic diseases, lowering their health-related quality of life (HRQOL). This systematic review and meta-analysis aimed to summarize the effects of physical exercise on HRQOL in office workers with and without health problems using data obtained from randomized controlled trials (RCTs), quasi-experimental, and observational studies. We searched PubMed, Web of Science, Scopus, Cochrane Library, and several grey literature databases, and identified 26 relevant studies for the synthesis. Overall, physical exercise significantly improved general (standardized mean difference (SMD) = 1.05; 95% confidence interval (CI): 0.66 to 1.44) and mental (SMD = 0.42; 95% CI: 0.19 to 0.66) HRQOL in office workers. Compared with healthy office workers, unhealthy office workers experienced greater improvements in general (unhealthy, SMD = 2.76; 95% CI: 1.63 to 3.89; healthy, SMD = 0.23; 95% CI: −0.09 to 0.56) and physical (unhealthy, SMD = 0.38; 95% CI: 0.17 to 0.58; healthy, SMD = −0.20; 95% CI: −0.51 to 0.11) HRQOL. Unsupervised physical exercise significantly improved general and mental HRQOL, while directly supervised physical exercise significantly improved only general HRQOL. Although physical exercise, especially unsupervised physical exercise, should be encouraged to improve HRQOL in office workers, detailed recommendations could not be made because of the diverse exercise types with different intensities. Therefore, further studies are needed to determine the optimal exercise for office workers with different health conditions.

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