scholarly journals Efficacy of positive psychotherapy in reducing negative and enhancing positive psychological outcomes: a meta-analysis of randomised controlled trials

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046017
Author(s):  
Thole Hilko Hoppen ◽  
Nexhmedin Morina
Keyword(s):  
Effect Size ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Psychological Outcomes ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Positive Outcomes ◽  
Treatment Assessment ◽  
Trial Quality ◽  
Randomised Controlled

ObjectivePositive psychotherapy (PPT) aims at increasing positive affect, meaning and engagement. We aimed to synthesise the available evidence on PPT efficacy.DesignWe conducted a preregistered systematic literature search and meta-analysis of randomised controlled trials examining the efficacy of PPT for increasing positive (eg, satisfaction with life) or decreasing negative psychological outcomes (eg, depression).Data sourcesMedline, PsycINFO and Web of Science from 2006 (ie, inception of PPT) to February 2020 as well as related systematic reviews and meta-analyses.ResultsWe included 20 randomised controlled trial with a total of 1360 participants. Moderate effect sizes were found for increasing positive outcomes (g=−0.72, 95% CI: −1.31 to −0.14, k=10, numbers needed to treat (NNT)=2.55) and reducing negative outcomes (g=0.48, 95% CI: 0.18 to 0.78, k=8, NNT=3.76) when PPT was compared with waitlist control conditions at post-treatment assessment. When compared with active control conditions, PPT yielded large effect sizes for increasing positive outcomes (g=−0.92, 95% CI: −1.74 to −0.11, k=6, NNT=2.05) and reducing depression (g=0.94, 95% CI: 0.18 to 1.70, k=6, NNT=2.03) at post-treatment assessment. No significant differences in efficacy were found when compared with established treatments such as cognitive–behavioural therapy. Evidence was found to support an association between trial quality and effect sizes. For positive outcomes, higher trial quality was related to larger effect size. Whereas higher trial quality was associated with smaller effect size for depression. Follow-up assessments remained too scarce for most planned analyses.ConclusionsOur findings support the short-term efficacy of PPT. However, results are to be regarded with due caution in the light of low number of trials. More high-quality trials that assess efficacy at follow-ups are needed to draw firmer conclusions on the long-term efficacy of PPT.PROSPERO registration numberCRD42020173567.

scholarly journals Effect of interventions for the well-being, satisfaction and flourishing of general practitioners—a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046599
Author(s):  
Diana Naehrig ◽  
Aaron Schokman ◽  
Jessica Kate Hughes ◽  
Ronald Epstein ◽  
Ian B Hickie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Intervention Studies ◽  
Well Being ◽  
Risk Of Bias ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Positive Outcomes ◽  
Mindfulness Interventions ◽  
Randomised Controlled

ObjectivesClinician well-being has been recognised as an important pillar of healthcare. However, research mainly addresses mitigating the negative aspects of stress or burnout, rather than enabling positive aspects. With the added strain of a pandemic, identifying how best to maintain and support the well-being, satisfaction and flourishing of general practitioners (GPs) is now more important than ever.DesignSystematic review.Data sourcesWe searched MEDLINE, PsycINFO, Embase, CINAHL and Scopus from 2000 to 2020.Study selectionIntervention studies with more than 50% GPs in the sample evaluating self-reported well-being, satisfaction and related positive outcomes were included. The Cochrane Risk of Bias 2 tool was applied.ResultsWe retrieved 14 792 records, 94 studies underwent full-text review. We included 19 studies in total. Six randomised controlled trials, three non-randomised, controlled trials, eight non-controlled studies of individual or organisational interventions with a total of 1141 participants. There were two quasi-experimental articles evaluating health system policy change. Quantitative and qualitative positive outcomes were extracted and analysed. Individual mindfulness interventions were the most common (k=9) with medium to large within-group (0.37–1.05) and between-group (0.5–1.5) effect sizes for mindfulness outcomes, and small-to-medium effect sizes for other positive outcomes including resilience, compassion and empathy. Studies assessing other intervention foci or other positive outcomes (including well-being, satisfaction) were of limited size and quality.ConclusionsThere is remarkably little evidence on how to improve GPs well-being beyond using mindfulness interventions, particularly for interventions addressing organisational or system factors. This was further undermined by inconsistent reporting, and overall high risk of bias. We need to conduct research in this space with the same rigour with which we approach clinical intervention studies in patients.PROSPERO registration numberCRD42020164699.Funding sourceDr Diana Naehrig is funded through the Raymond Seidler PhD scholarship.

scholarly journals New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-Analysis of Randomised Controlled Trials (Preprint)

2021 ◽  
Author(s):  
Marion Sommers-Spijkerman ◽  
Judith Austin ◽  
Ernst Bohlmeijer ◽  
Wendy Pots
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Well Being ◽  
Evidence Base ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Long Term Follow Up ◽  
Randomised Controlled

BACKGROUND There is a need for regularly updating the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing. OBJECTIVE The current study presents an updated meta-analysis of randomised controlled trials assessing the effects of online MBIs on mental health, as well as the potential moderators of those effects. METHODS A systematic literature search was conducted in PsycINFO, PubMed and Web of Science up to July 19th, 2019. Seventy trials totalling 91 comparisons were included. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges’ g) were calculated for depression, anxiety, stress, well-being and mindfulness, using a random effects model. RESULTS The findings revealed statistically significant moderate pre-to-post effects on stress (g=0.41) and mindfulness (g=0.43) and small effects on depression (g=0.31) and anxiety (g=0.23). For well-being, a significant effect was found only when omitting low quality studies (g=0.34). Significant but small follow-up effects were found for depression (g=0.25), anxiety (g=0.17) and stress (g=-0.11). Subgroup analyses revealed that online MBIs resulted in higher effect sizes for stress when offered with guidance. For stress and mindfulness, studies that used an inactive control condition yielded larger effects. CONCLUSIONS Our findings do not only demonstrate that the field of online MBIs is booming, but also corroborate previous evidence that online MBIs are beneficial for improving mental health outcomes in a broad range of samples. To advance the field of online MBIs, future trials should pay specific attention to methodological quality, adherence and long-term follow-up measurements.

scholarly journals Unravelling the Effects of Soluble Dietary Fibre Supplementation on Energy Intake and Perceived Satiety in Healthy Adults: Evidence from Systematic Review and Meta-Analysis of Randomised-Controlled Trials

Foods ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 15 ◽  
Author(s):  
Siti Nurshabani Salleh ◽  
Ahmad Adli Hamizi Fairus ◽  
Mohd Nizam Zahary ◽  
Naresh Bhaskar Raj ◽  
Abbe Maleyki Mhd Jalil
Keyword(s):  
Systematic Review ◽  
Energy Intake ◽  
Effect Size ◽  
Dietary Fibre ◽  
Randomised Controlled Trials ◽  
Guar Gum ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Soluble Dietary Fibre ◽  
Randomised Controlled

Consumption of soluble dietary fibre is recommended as part of a healthy diet. Evidence has shown that soluble dietary fibre slows gastric emptying, increases perceived satiety and plays a significant role in appetite regulation. This systematic review examined the effects of soluble dietary fibre using randomised-controlled trials (RCTs). Three different electronic databases were used, namely PubMed, Scopus® and the Cochrane Central Register of Controlled Trials (CENTRAL). Effect size (Cohen’s d) was calculated based on the intergroup mean difference and standard deviation (SD) followed by Cochran’s Q and I2 determination. The effect size was statistically pooled in the meta-analyses and presented as a forest plot. The risk of bias was high for each study as assessed using the Jadad scale. Meta-analysis of statistically pooled data for guar gum showed a sizeable effect on post-meal energy intake, followed by β-glucan, alginate, polydextrose and pectin, with pooled effect sizes of −0.90, −0.44, −0.42, −0.36 and −0.26, respectively. Guar gum (5 g) effectively reduced energy intake when prepared in milk beverages compared with control milk (p < 0.001). Alginate, when prepared in liquid (5 g) or solid (9 g) meals, effectively reduced energy intake compared with control (p < 0.001). A high dose of polydextrose (25 g) prepared in liquid meal form significantly reduced energy intake (p = 0.01). This study suggests that soluble fibres are not all created equal. Further interventional studies are needed to determine whether combinations of these soluble fibres might have greater effects than individual fibres per se.

scholarly journals Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomised controlled trials, with meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032045 ◽  
Author(s):  
Laura Catherine Armitage ◽  
Aikaterini Kassavou ◽  
Stephen Sutton
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Effect Size ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Controlled Trials ◽  
Behaviour Change Techniques ◽  
Registration Number ◽  
Randomised Controlled

ObjectivesTo estimate the efficacy of app-based interventions designed to support medication adherence and investigate which behaviour change techniques (BCTs) used by the apps are associated with efficacy.DesignSystematic review of randomised controlled trials (RCTs), with meta-analysis.SettingMedline/PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Embase and Web of Science were searched from 1990 to November 2018 for RCTs conducted in any healthcare setting.ParticipantsStudies of participants of any age taking prescribed medication for any health condition and for any duration.InterventionAn app-based intervention delivered through a smartphone, tablet computer or personal digital assistant to help, support or advise about medication adherence.ComparatorOne of (1) usual care, (2) a control app which did not use any BCTs to improve medication adherence or (3) a non-app-based comparator.Primary and secondary outcome measuresThe primary outcome was the pooled effect size of changes in medication adherence. The secondary outcome was the association between BCTs used by the apps and the effect size.ResultsThe initial search identified 13 259 citations. After title and abstract screening, full-text articles of 83 studies were screened for eligibility. Nine RCTs with 1159 recruited participants were included. The mean age of participants was >50 years in all but one study. Health conditions of target populations included cardiovascular disease, depression, Parkinson’s disease, psoriasis and multimorbidity. The meta-analysis indicated that patients who use mobile apps to support them in taking medications are more likely to self-report adherence to medications (OR 2.120, 95% CI 1.635 to 2.747, n=988) than those in the comparator groups. Meta-regression of the BCTs did not reveal any significant associations with effect size.ConclusionsApp-based medication adherence interventions may have a positive effect on patient adherence. Larger scale studies are required to further evaluate this effect, including long-term sustainability, and intervention and participant characteristics that are associated with efficacy and app usage.Prospero registration numberPROSPERO Protocol Registration Number: CRD42017080150.

scholarly journals Blinding and Expectancy Confounds in Psychedelic Randomised Controlled Trials

2021 ◽  
Author(s):  
Suresh Muthukumaraswamy ◽  
Anna Forsyth ◽  
Thomas Lumley
Keyword(s):  
Effect Size ◽  
Randomised Controlled Trials ◽  
Clinical Trial Design ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Response Expectancy ◽  
Psychedelic Drugs ◽  
Health Disorders ◽  
Randomised Controlled ◽  
Size Estimates

There is increasing interest in the potential for psychedelic drugs such as psilocybin, LSD and ketamine to treat a number of mental health disorders. To gain evidence for the therapeutic effectiveness of psychedelics, a number of randomised controlled trials (RCTs) have been conducted using the traditional RCT framework and these trials have generally shown promising results, with large effect sizes reported. However, in this paper we argue that estimation of treatment effect sizes in psychedelic clinical trials are likely over-estimated due to de-blinding of participants and high levels of response expectancy generated by RCT trial contingencies. The degree of over-estimation is at present difficult to estimate. We conduct systematic reviews of psychedelic RCTs and show that currently reported RCTs have failed to measure and report expectancy and malicious de-blinding. In order to overcome these confounds we argue that RCTs should routinely measure de-blinding and expectancy and that careful attention should be paid to the clinical trial design used and the instructions given to participants to allow these confounds to be estimated and removed from effect size estimates. We urge caution in interpreting effect size estimates from extant psychedelic RCTs.

scholarly journals Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials and cross-sectional studies

2017 ◽  
Vol 117 (10) ◽  
pp. 1422-1431 ◽  
Author(s):  
Katsuhiko Yokoi ◽  
Aki Konomi
Keyword(s):  
Sensitivity Analysis ◽  
Therapeutic Effect ◽  
Effect Size ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
Randomised Controlled ◽  
Meta Analyses

AbstractFe deficiency is a prevalent nutritional disease, and fatigue is a common complaint in the general and patient population. The association between Fe deficiency without anaemia (IDNA) and fatigue is unclear. Here, we performed a meta-analysis to evaluate the therapeutic effect of Fe on fatigue in patients with IDNA and the association between IDNA and fatigue in the population. Articles from the PubMed database up to 19 January 2016 were systematically searched. A total of six relevant randomised controlled trials (RCT) and six relevant cross-sectional studies were identified. All outcomes were converted into effect sizes. In the meta-analysis of the six RCT, we identified a significant therapeutic effect of Fe in fatigue patients with IDNA (pooled effect size 0·33; 95 % CI 0·17, 0·48;I2=0·0 %;P<0·0001). A sensitivity analysis found that the overall results (i.e. significant association) were robust. In the meta-analysis of the six cross-sectional studies, the association between IDNA and fatigue was not significant (pooled effect size 0·10; 95 % CI −0·11, 0·31;I2=57·4 %;P=0·362). A sensitivity analysis found that the overall results (i.e. no significant association) were not robust; removal of one study made the outcomes significant. These meta-analyses suggest that improving Fe status may decrease fatigue. Further research is necessary to identify diagnostic criteria for selecting fatigue patients who might benefit from Fe therapy and to assess the prevalence of IDNA with fatigue in the general population.

scholarly journals Effects of diet on obesity-related anthropometric characteristics in adults: a protocol for an umbrella review of meta-analyses of randomised controlled trials

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e050579
Author(s):  
Shunlian Fu ◽  
Qian Zhou ◽  
Lijun Yuan ◽  
Zinan Li ◽  
Qiu Chen
Keyword(s):  
Effect Size ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Measurement Tool ◽  
Controlled Trials ◽  
Umbrella Review ◽  
Effect Model ◽  
Anthropometric Characteristics ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionThere have been many meta-analyses of randomised controlled trials on the influence of different diets on obesity-related anthropometric characteristics in adults. However, whether diet interventions can effectively decrease obesity-related anthropometric characteristics remains unclear. The objective of this study is to summarise and synthesise the evidence on the effects of diet on obesity-related anthropometric characteristics in adults by an umbrella review of meta-analyses of randomised controlled trials.Methods and analysisWe will first retrieve English articles only published before 15 December 2021 by searching PubMed, Embase and Web of Science. Only articles that are meta-analyses of randomised controlled trials will be included. Three researchers will independently screen the titles and abstracts of retrieved articles and check the data extracted from each eligible meta-analysis. In each meta-analysis, we will consider calculating the effect size of the mean difference of the effect of each diet on obesity-related anthropometric characteristics in adults using a random-effect model or a fixed-effect model according to heterogeneity. Study heterogeneity (Cochrane’s Q and I2 statistics) and small-study effects (Egger’s test or Begg’s test) will be considered. Evidence of each effect size will be graded according to the NutriGrade scoring system. We will use AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews V.2) to assess the methodological quality of each meta-analysis.Ethics and disseminationThis umbrella review will provide information on the effects of different diets on obesity-related anthropometric characteristics in adults. Ethical approval is not necessary for this study. We will publish the completed umbrella review and related data online.PROSPERO registration numberCRD42021232826.

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