Interventions that improve adherence to antihypertensive medications in coronary heart disease patients: a systematic review

A systematic review is conducted to identify effective interventions that improved adherence to antihypertensive drugs among patients with coronary heart diseases (CHDs). Primary studies designed to measure interventions to improve adherence on antihypertensive drugs in patients with CHD were included. Three online databases, COCHRANE, EMBASE and MEDLINE, were searched for primary studies published in English from 2005 to 2019. Studies were screened independently for eligibility. Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were used for quality assessment of randomised controlled trials (RCTs) and non-randomised studies, respectively. Of the 2000 entries identified, seven articles, including one cross-sectional study and six RCTs, met the inclusion criteria and were reviewed. One of the articles evaluated two interventions, so eight interventions were evaluated in total. Quality of the included studies was generally high, with the cross-sectional study rated as having good quality under Newcastle-Ottawa Scale, while four and two RCTs were rated as having low and some risk of bias under Cochrane risk-of-bias tool, respectively. Six of the intervention programmes were considered effective. An intervention was considered effective if it is associated with a significant (p≤0.05) and non-trivial (Cohen’s d≥0.2) improvement in compliance-related outcomes such as in terms of the Morisky 8-item Medication Adherence Scale. Medication education, disease education, health education, constant reminders and medications dispensed using blister packs were identified to be effective in improving patients’ compliance to medications. The importance of the continuity of interventions was also established. It is recommended that health service institutions should provide continuous education programmes, daily reminders and regular follow-ups for their patients who have CHD. It is recommended that further research ought to be carried out by using only one intervention in each trial with a standardised outcome measure, or using factorial designs, so that further cost-effectiveness evaluation of each intervention can be carried out independently, leading to the formulation of a comprehensive, optimised intervention programme for patients with CHD taking antihypertensives.

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Selecting Risk of Bias Tools for Observational Studies for a Systematic Review of Anthropometric Measurements and Dental Caries among Children

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168623 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8623

Author(s):

Rokiah Mamikutty ◽

Ameera Syafiqah Aly ◽

Jamaludin Marhazlinda

Keyword(s):

Systematic Review ◽

Dental Caries ◽

Observational Studies ◽

Cross Sectional Study ◽

Risk Of Bias ◽

Anthropometric Measurements ◽

Sectional Study ◽

Kappa Score ◽

Cross Sectional ◽

Advantages And Disadvantages

In conducting a systematic review, assessing the risk of bias of the included studies is a vital step; thus, choosing the most pertinent risk of bias (ROB) tools is crucial. This paper determined the most appropriate ROB tools for assessing observational studies in a systematic review assessing the association between anthropometric measurements and dental caries among children. First, we determined the ROB tools used in previous reviews on a similar topic. Subsequently, we reviewed articles on ROB tools to identify the most recommended ROB tools for observational studies. Of the twelve ROB tools identified from the previous steps, three ROB tools that best fit the eight criteria of a good ROB tool were the Newcastle–Ottawa Scale (NOS) for cohort and case-control studies, and Agency for Healthcare Research and Quality (AHRQ) and the Effective Public Health Practice Project (EPHPP) for a cross-sectional study. We further assessed the inter-rater reliability for all three tools by analysing the percentage agreement, inter-class correlation coefficient (ICC) and kappa score. The overall percentage agreements and reliability scores of these tools ranged from good to excellent. Two ROB tools for the cross-sectional study were further evaluated qualitatively against nine of a tool’s advantages and disadvantages. Finally, the AHRQ and NOS were selected as the most appropriate ROB tool to assess cross-sectional and cohort studies in the present review.

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Self-medication practices to prevent or manage COVID-19: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0259317 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259317

Author(s):

Alvaro Quincho-Lopez ◽

Christeam A. Benites-Ibarra ◽

Maryori M. Hilario-Gomez ◽

Renatta Quijano-Escate ◽

Alvaro Taype-Rondan

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Original Data ◽

Risk Of Bias ◽

Self Medication ◽

Cross Sectional ◽

Specific Symptom ◽

Newcastle Ottawa Scale ◽

Cross Sectional Studies ◽

Ottawa Scale

Background Previous studies have assessed the prevalence and characteristics of self-medication in COVID-19. However, no systematic review has summarized their findings. Objective We conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19. Methods We used different keywords and searched studies published in PubMed, Scopus, Web of Science, Embase, two preprint repositories, Google, and Google Scholar. We included studies that reported original data and assessed self-medication to prevent or manage COVID-19. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) modified for cross-sectional studies. Results We identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess self-medication. The recall period was heterogeneous across studies. Of the eight studies, seven assessed self-medication without focusing on a specific symptom: four performed in the general population (self-medication prevalence ranged between <4% to 88.3%) and three in specific populations (range: 33.9% to 51.3%). In these seven studies, the most used medications varied widely, including antibiotics, chloroquine or hydroxychloroquine, acetaminophen, vitamins or supplements, ivermectin, and ibuprofen. The last study only assessed self-medication for fever due to COVID-19. Most studies had a risk of bias in the “representativeness of the sample” and “assessment of outcome” items of the NOS. Conclusions Studies that assessed self-medication for COVID-19 found heterogeneous results regarding self-medication prevalence and medications used. More well-designed and adequately reported studies are warranted to assess this topic.

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Faculty Opinions recommendation of A Multicenter Cross-Sectional Study and Systematic Review of Necrobiotic Xanthogranuloma With Proposed Diagnostic Criteria.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737217058.793576033 ◽

2020 ◽

Author(s):

Iris Zalaudek ◽

Claudio Conforti

Keyword(s):

Systematic Review ◽

Diagnostic Criteria ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Cardiopulmonary fitness in children with congenital heart diseases versus healthy children: A multicenter cross-sectional study

Archives of Cardiovascular Diseases Supplements ◽

10.1016/j.acvdsp.2018.02.178 ◽

2018 ◽

Vol 10 (2) ◽

pp. 257-258

Author(s):

M. Rola ◽

A. Gavotto ◽

S. Guillaumont ◽

M. Vincenti ◽

C. Bredy ◽

...

Keyword(s):

Congenital Heart ◽

Heart Diseases ◽

Cross Sectional Study ◽

Congenital Heart Diseases ◽

Healthy Children ◽

Sectional Study ◽

Cross Sectional ◽

Cardiopulmonary Fitness

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Methodological quality of systematic reviews on treatments for depression: a cross-sectional study

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000208 ◽

2017 ◽

Vol 27 (6) ◽

pp. 619-627 ◽

Cited By ~ 6

Author(s):

V. C. H. Chung ◽

X. Y. Wu ◽

Y. Feng ◽

R. S. T. Ho ◽

S. Y. S. Wong ◽

...

Keyword(s):

Systematic Reviews ◽

Methodological Quality ◽

A Priori ◽

Cross Sectional Study ◽

Risk Of Bias ◽

Sectional Study ◽

Pharmacological Treatments ◽

Cross Sectional ◽

Depression Treatments

Aims.Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments.Methods.A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis.Results.A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an ‘a priori’ design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report ‘a priori’ designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09–1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06–1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06–1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81–0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04–1.25), completed by more review authors (AOR 1.12, 95% CI 1.01–1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01–2.59) were associated with better performance in publication bias assessment.Conclusion.The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.

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Relationship between the non-HDLc-to-HDLc ratio and carotid plaques in a high stroke risk population: A cross-sectional study in China

10.21203/rs.3.rs-26172/v3 ◽

2020 ◽

Author(s):

Yan Liu ◽

Zhenwen Zhang ◽

Binlan Xia ◽

Liping Wang ◽

Hengzhong Zhang ◽

...

Keyword(s):

High Risk ◽

Stroke Risk ◽

Heart Diseases ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Carotid Plaques ◽

Lack Of Exercise ◽

The Relationship

Abstract Background: Evidence on the association between the non-high-density lipoprotein cholesterol (non-HDLc)-to-high-density lipoprotein cholesterol (HDLc) ratio (non-HDLc/HDLc) and carotid plaques is still limited. This study aims to assess the relationship between the non-HDLc/HDLc and carotid plaques in a population with a high risk of stroke.Methods: A cross-sectional study based on the community was conducted in Yangzhou, China. Residents (no younger than 40 years old) underwent questionnaire interviews, physical examinations, and laboratory testing during 2013-2014. The subjects with a high risk of stroke were further selected (at least three of eight risk factors including hypertension, atrial fibrillation, type 2 diabetes mellitus, dyslipidaemia, smoking, lack of exercise, overweight, and family history of stroke) or a transient ischaemic attack (TIA) or stroke history. Carotid ultrasonography was then performed on the high stroke risk participants. Carotid plaque was defined as a focal carotid intima-media thickness (cIMT) ≥1.5 cm or a discrete structure protruding into the arterial lumen at least 50% of the surrounding cIMT. Logistic regression was employed to evaluate the relationship between the non-HDLc/HDLc and carotid plaques.Results: Overall, 839 subjects with a high risk of stroke were ultimately included in the analysis, and carotid plaques were identified in 341 (40.6%) of them. Participants in the highest non-HDLc/HDLc tertile group presented a higher proportion of carotid plaques than did those in the other two groups. After adjustment for other confounders, each unit increase in the non-HDLc/HDLc was significantly associated with carotid plaques (OR 1.55, 95%CI 1.28-1.88). In the subgroup analysis, the non-HDLc/HDLc was positively and significantly associated with the presence of carotid plaques in most subgroups. Additionally, the non-HDLc/HDLc interacted significantly with three stratification variables, including sex (OR 1.31 for males vs. OR 2.37 for females, P interaction = 0.016), exercise (OR 1.18 for subjects without lack of exercise vs. OR 1.99 for subjects with lack of exercise, P interaction = 0.004) and heart diseases (OR 1.40 for subjects without heart diseases vs. OR 3.12 for subjects with heart diseases, P interaction = 0.033). Conclusion: The non-HDLc/HDLc was positively associated with the presence of carotid plaques in a Chinese high stroke risk population. A prospective study or randomized clinical trial of lipid-lowering therapy in the Chinese population is needed to evaluate their causal relationship.

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