scholarly journals Prevention of exacerbations in patients with stable non-cystic fibrosis bronchiectasis: a systematic review and meta-analysis of pharmacological and non-pharmacological therapies

2018 ◽  
Vol 23 (3) ◽  
pp. 96-103 ◽  
Author(s):  
Abd Moain Abu Dabrh ◽  
Adam T Hill ◽  
Claudia C Dobler ◽  
Noor Asi ◽  
Wigdan H Farah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cystic Fibrosis ◽  
Meta Analysis ◽  
Moderate Quality ◽  
Number Of Patients ◽  
Inhaled Antibiotics ◽  
Quality Evidence

BackgroundSeveral pharmacological and non-pharmacological therapies are used to treat stable bronchiectasis of non-cystic fibrosis (CF) aetiology.ObjectiveWe conducted a systematic review and meta-analysis to assess the evidence of the effectiveness of pharmacological and non-pharmacological treatment options in patients with stable non-CF bronchiectasis with a focus on reducing exacerbations.Study selectionMultiple databases were searched through September 2017. Outcomes included the number of patients with exacerbation events, mean number of exacerbations, hospitalisations, mortality, quality of life measures, and safety and adverse effects. Meta-analysis was conducted using the random effects model.Findings30 randomised controlled trials enrolled subjects with non-CF bronchiectasis using different interventions. Moderate-quality evidence supported the effect of long-term antibiotics (≥3 months) on lowering the number of patients experiencing exacerbation events (relative risk 0.77 (95% CI 0.68 to 0.89)), reducing number of exacerbations (incidence rate ratio 0.62 (95% CI 0.49 to 0.78)), improving forced expiratory volume (litre) in the first second (FEV1) (weighted mean difference (WMD); 0.02 (95% CI 0.00 to 0.04)), decreasing sputum purulence scores (numerical scale of 1-8) (WMD −0.90 (95% CI −1.58 to −0.22)) and improving quality of life scores assessed by the St George’s Respiratory Questionnaire (WMD −6.07 (95% CI −10.7 to −1.43)). Bronchospasm increased with inhaled antibiotics while diarrhoea increased particularly with oral macrolide therapy.ConclusionsModerate-quality evidence supports long-term antibiotic therapy for preventing exacerbations in stable non-CF bronchiectasis. However, data about the optimum agent, mode of therapy and length of treatment are limited. There is paucity of high-quality evidence to support the management of stable non-CF bronchiectasis including prevention of exacerbations.

Impact of temporary ileostomy on long‐term quality of life and bowel function: a systematic review and meta‐analysis

2019 ◽  
Vol 90 (5) ◽  
pp. 687-692
Author(s):  
Celia Keane ◽  
Puja Sharma ◽  
Lance Yuan ◽  
Ian Bissett ◽  
Greg O'Grady
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Bowel Function ◽  
Temporary Ileostomy

scholarly journals Health-related quality of life in patients receiving long-term opioid therapy: a systematic review with meta-analysis

2017 ◽  
Vol 26 (8) ◽  
pp. 1955-1967 ◽  
Author(s):  
J. Douglas Thornton ◽  
Rashmi Goyat ◽  
Nilanjana Dwibedi ◽  
George A. Kelley
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Opioid Therapy ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Health outcomes attributable to carbapenemase-producing Enterobacteriaceae infections: A systematic review and meta-analysis

2019 ◽  
Vol 41 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Dalton R. Budhram ◽  
Stephen Mac ◽  
Joanna M. Bielecki ◽  
Samir N. Patel ◽  
Beate Sander
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Hospital Mortality ◽  
Health Outcomes ◽  
Bloodstream Infection ◽  
Meta Analysis ◽  
Quality Appraisal ◽  
Reported Health

AbstractBackground:Carbapenemase-producing Enterobacteriaceae (CPE) pose a significant global health threat.Objective:To conduct a systematic review of health outcomes and long-term sequelae attributable to CPE infection.Methods:We followed PRISMA reporting guidelines and published our review protocol on PROSPERO (CRD42018097357). We searched Medline, Embase, CINAHL and the Cochrane Library. We included primary studies with a carbapenem-susceptible control group in high-income countries, published in English. Quality appraisal was completed using Joanna Briggs Institute checklists. We qualitatively summarized frequently reported outcomes and conducted a meta-analysis.Results:Our systematic review identified 8,671 studies; 17 met the eligibility criteria for inclusion. All studies reported health outcomes; none reported health-related quality-of-life. Most studies were from Europe (65%), were conducted in teaching or university-affiliated hospitals (76%), and used case-control designs (53%). Mortality was the most commonly reported consequence of CPE-infections; in-hospital mortality was most often reported (62%). Our meta-analysis (n = 5 studies) estimated an absolute risk difference (ARD) for in-hospital bloodstream infection mortality of 0.25 (95% confidence interval [CI], 0.17–0.32). Duration of antibiotic therapy (range, 4–29.7 vs 1–23.6 days) and length of hospital stay (range, 21–87 vs 15–43 days) were relatively higher for CPE-infected patients than for patients infected with carbapenem-susceptible pathogens. Most studies (82%) met >80% of their respective quality appraisal criteria.Conclusions:The risk of in-hospital mortality due to CPE bloodstream infection is considerably greater than carbapenem-susceptible bloodstream infection (ARD, 0.25; 95% CI, 0.17–0.32). Health outcome studies associated with CPE infection are focused on short-term (eg, in-hospital) outcomes; long-term sequelae and quality-of-life are not well studied.Trial Registration:PROSPERO (CRD42018097357).

scholarly journals Inhaled antibiotics therapy for stable non-cystic fibrosis bronchiectasis: a meta-analysis

2020 ◽  
Vol 14 ◽  
pp. 175346662093686 ◽  
Author(s):  
Meng-Jiao Xu ◽  
Bing Dai
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Meta Analysis ◽  
Bacterial Load ◽  
Great Promise ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Life Questionnaire ◽  
Inhaled Antibiotics

Background: The optimum antibiotic therapy for non-cystic fibrosis bronchiectasis (NCFB) has yet to be determined. A meta-analysis was conducted to evaluate the efficacy and safety of inhaled antibiotics in adults with stable NCFB. Methods: PubMed, EMBASE, MEDLINE and the Cochrane Central Register of Controlled Trials were searched through November 2019. Results: A total of 16 randomized controlled trials (RCTs), recruiting 2748 NCFB patients, were finally included. Inhaled antibiotics treatment significantly reduced the sputum bacterial load [standard mean difference (SMD) = –0.74, 95% CI: –1.16–0.32, p < 0.001, I2 = 68.1%], prolonged median time [hazard risk (HR) = 0.73, 95% confidence interval (CI): 0.57–0.93, p < 0.001, I2 = 53.6%] and reduced frequency [incidence rate ratio (IRR) = 0.74, 95% CI 0.63–0.87, p < 0.001, I2 = 20.5%] of exacerbations, with good tolerance. However, it failed to improve Pseudomonas aeruginosa eradication, [forced expiratory volume in 1 s (FEV1)] % predicted, quality of life questionnaire (QoL-B) and St. George’s respiratory questionnaire (SGRQ) scores, and may induce higher risk of P. aeruginosa resistance. Subgroup analysis showed Ciprofloxacin was more effective than other antibiotics in reducing bacterial load (SMD = –1.35, 95% CI: –1.85–0.85, I2 = 63.4%, p = 0.042). Conclusion: Inhaled antibiotics therapy holds great promise for stable NCFB as it is effective in reducing sputum bacterial load and the risk of acute attack, delaying disease progression, and is well tolerated. Although this study brings some constructive ideas in the field of clinical medication, further clinical trials should be carried out, particularly in solving drug-resistance and improving health-related quality of life (HRQoL), which we believe will finally provide benefits for patients suffering from bronchiectasis. The reviews of this paper are available via the supplemental material section.

scholarly journals Long-term health-related quality of life in bariatric surgery patients: A systematic review and meta-analysis

Obesity ◽  
2015 ◽  
Vol 24 (1) ◽  
pp. 60-70 ◽  
Author(s):  
Shannon Driscoll ◽  
Deborah M. Gregory ◽  
John M. Fardy ◽  
Laurie K. Twells
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Bariatric Surgery ◽  
Meta Analysis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Effectiveness of caregiver interventions for people with cancer and non-cancer-related chronic pain: a systematic review and meta-analysis

2021 ◽  
pp. 204946372110227
Author(s):  
Toby O. Smith ◽  
Matthew Pearson ◽  
Matthew J Smith ◽  
Jessica Fletcher ◽  
Lisa Irving ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Chronic Pain ◽  
Confidence Interval ◽  
Meta Analysis ◽  
Informal Caregivers ◽  
Mean Difference ◽  
Caregiver Interventions ◽  
Quality Evidence

Background: People with chronic pain frequently have difficulties in completing everyday tasks to maintain independence and quality of life. Informal caregivers may provide support to these individuals. However, the effectiveness of interventions to train and support these individuals in caregiving remains unclear. The purpose of this study was to systematically review the evidence to determine the effectiveness of caregiver interventions to support informal caregivers of people with chronic pain. Methods: A systematic review of published and unpublished literature databases was undertaken (9 April 2021). Trials reporting clinical outcomes of caregiver interventions to train informal caregivers to support community-dwelling people with chronic pain were included. Meta-analysis was undertaken and each outcome was assessed using Grading of Recommendations, Assessment, Development and Evaluation. Results: Twenty-seven studies were eligible (N = 3427 patients). Twenty-four studies assessed patients with cancer pain and three with musculoskeletal pain. No other patient groups were identified. There was very low-quality evidence that caregiver interventions were beneficial for caregiver health-related quality of life (standardised mean difference = 0.26, 95% confidence interval = 0.01 to 0.52; N = 231). There was moderate-quality evidence that caregiving interventions were effective in reducing pain in the short-term (standardised mean difference = 0.16, 95% confidence interval = −0.29 to −0.03). There was low-quality evidence that caregiving interventions had no beneficial effect over usual care for psychological outcomes, fatigue, coping or physical function in the long-term. Conclusion: Caregiving interventions may be effective for patients and caregivers but only in the shorter-term and for a limited number of outcomes. There is insufficient evidence examining the effectiveness of caregiver interventions for people with non-cancer-related pain.

scholarly journals Impact of aquatic exercise on persons with kidney disease: a systematic review and meta-analysis

2020 ◽  
Vol 37 (5) ◽  
pp. 339-347
Author(s):  
D Rodríguez Rey ◽  
MA Sanchez-Lastra ◽  
C Ayán Pérez
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Kidney Disease ◽  
Physical Exercise ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Aquatic Exercise ◽  
The Impact

Objective: Analyze the scientific evidence on the effects that aquatic physical exercise has on people with chronic kidney disease (CKD). Material and method: A systematic review was carried out following the checklist Preferred Reporting Items for Systematic review and Meta-Analysis Protocols, with the objective of locating the largest number of investigations that aimed to identify the effects of the practice of aquatic physical exercise in people with ERC. A search of the PubMed, PEDro, Scopus and Cochrane databases were carried out until March 2019, using the PEDro, CERT, MINORS and NIH scales to determine the methodological quality of the same. Results: Five investigations were located, two of them were randomized control trials, another two studies comparatives and one was uncontrolled. The mean score and the median obtained after applying PEDro scale were 4 and 4 respectively. All the interventions proposed aerobic exercise programs, being generally of short duration and highly supervised, without any adverse effects arising from their practice. In a large part of the studies, significant effects were observed in physical condition, physiological parameters and quality of life, to a lesser extent. The practice of exercise had no significant impact on either the activity of the disease or the perceived pain in patients. Conclusions: Practice of aquatic exercise is beneficial in people with ERC. More longitudinal studies are needed to assess the impact of aquatic exercises as well as its effect and quality of life in long term.

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