scholarly journals Systematic review of digital and non-digital non-pharmacological interventions that target quality of life and psychological outcomes in adults with systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110050
Author(s):  
Angela Chang ◽  
Nathan W Winquist ◽  
Annie B Wescott ◽  
Emily G Lattie ◽  
Andrea K Graham
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Experimental Studies ◽  
Psychological Outcomes ◽  
Risk Of Bias ◽  
Narrative Synthesis ◽  
Pharmacological Interventions ◽  
Systemic Lupus ◽  
Quasi Experimental

Background Patients with systemic lupus erythematous (SLE) experience psychological comorbidities and impaired quality of life (QOL). We conducted a systematic review to examine the efficacy of non-pharmacological interventions for improving psychological outcomes and/or QOL in patients with SLE. To expand on a previous systematic review in this area and enhance our understanding of efficacious interventions for this population, our search included quasi-experimental and experimental studies of interventions delivered or supported by remote methods (including digitally) or in person. Methods A comprehensive literature search was conducted with a research librarian using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered before data extraction on the international prospective register of systematic reviews PROSPERO Web site (CRD42020154962). The search included controlled-vocabulary and title/abstract terms related to non-pharmacological interventions for SLE published through October 2019 in MEDLINE (Ovid), Cochrane Library databases (Wiley), Embase (Elsevier), CINAHL (EBSCO), PsycINFO (EBSCO), Web of Science (Clarivate), ACM Digital (Association of Computer Machinery), and IEEE Xplore. Studies were synthesized using a systematic narrative synthesis framework. Risk of bias was assessed. Studies were synthesized using a systematic narrative synthesis framework. Risk of bias was assessed. Results Twenty-three studies were included: 21 randomized controlled trials and two quasi-experimental studies. Non-pharmacological diet, physical activity, psychological, and course-based interventions improved QOL and psychological outcomes, and were delivered in traditional settings (e.g., hospital) or remotely. No studies assessing digital non-pharmacological interventions were identified in our search. Quality assessments showed serious risk of bias for the two quasi-experimental studies, and high risk of bias in a subset of experimental studies. Conclusions Non-pharmacological interventions benefit patients with SLE. Future research should include more representative samples in rigorous evaluations and consider ways to incorporate digital technologies to increase accessibility.

scholarly journals The effects of pharmacological interventions on quality of life and fatigue in sarcoidosis: a systematic review

2020 ◽  
Vol 29 (155) ◽  
pp. 190057 ◽  
Author(s):  
Roeland Vis ◽  
Ewoudt M.W. van de Garde ◽  
Jan C. Grutters ◽  
Ingrid H.E. Korenromp
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Minimal Important Difference ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Qualitative Synthesis ◽  
Pharmacological Interventions ◽  
Open Label ◽  
Double Blind

AimsMany sarcoidosis patients experience a reduction in health-related quality of life (HRQoL) and a majority of patients report fatigue. Historically, drug trials in sarcoidosis have focused on changes in chest radiographs, lung function parameters and biomarkers, while HRQoL and fatigue have not been the main outcomes examined. We performed a systematic review of the literature to evaluate the existing evidence on the effects of pharmacological interventions on HRQoL and fatigue outcomes.MethodsThe systematic search was performed in Medline and Embase and yielded 15 records covering seven randomised controlled trials and seven single-arm open label studies, which were included in a qualitative synthesis (the results of one study were included in two publications). 12 studies evaluated immunosuppressive and/or immunomodulatory therapies and two studies evaluated stimulants.ResultsNine out of the 14 studies observed positive treatment effects from the interventions on HRQoL and/or fatigue, exceeding the minimal important difference. The risk of bias was generally high with only three studies rated as having a low risk of bias. The results suggest a potential for improvement in HRQoL and/or fatigue in patients with active disease who are either untreated or treated but not yet fully stabilised or therapy refractory.ConclusionMore randomised, double-blind and placebo-controlled trials are needed to expand the evidence base on these important outcome parameters.

scholarly journals Non-pharmacological interventions for depression/anxiety in older adults with physical comorbidities affecting functioning: systematic review and meta-analysis

2018 ◽  
Vol 31 (08) ◽  
pp. 1121-1136 ◽  
Author(s):  
Rachael Frost ◽  
Yehudit Bauernfreund ◽  
Kate Walters
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Collaborative Care ◽  
Service Use ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Pharmacological Interventions

ABSTRACTObjective:To review the effectiveness of non-pharmacological interventions in older adults with depression or anxiety and comorbidities affecting functioning.Design:Systematic review and meta-analysis of randomized controlled trials, including searches of 10 databases (inception-Jul 2017).Setting:Home/community.Participants:People aged 60 and over experiencing functional difficulties from physical or cognitive comorbidities and have symptoms or a diagnosis of depression and/or anxiety.Interventions:Non-pharmacological interventions targeted at depression/anxiety.Measurements:We extracted outcome data on depressive symptoms, quality of life, functioning, and service use. We used random effects meta-analysis to pool study data where possible. Two authors assessed the risk of bias using the Cochrane Risk of Bias tool.Results:We identified 14 eligible trials including 2099 randomized participants and two subgroup analyses. Problem-solving therapy (PST) reduced short-term clinician-rated depressive symptoms (n = 5 trials, mean difference in Hamilton Depression Rating Scale score −4.94 [95% CI −7.90 to −1.98]) but not remission, with limited evidence for effects on functioning and quality of life. There was limited high-quality evidence for other intervention types. Collaborative care did not appear to affect depressive symptoms, functioning, or quality of life; and had mixed evidence for effects upon remission. No intervention consistently affected service use, but trials were limited by small sample sizes and short follow-up periods. No anxiety interventions were identified.Conclusion:PST may reduce depressive symptoms post-intervention in older people with depression and functional impairments. Collaborative care appears to have few effects in this population. Future research needs to assess cost-effectiveness, long-term outcomes, and anxiety interventions for this population.

scholarly journals 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 ◽  
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.

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

scholarly journals 105 Functional Recovery in Older Women Undergoing Surgery for Gynaecological Malignancies: A Systematic Review and Narrative Synthesis

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i34-i36
Author(s):  
F E Martin ◽  
T Kalsi ◽  
J K Dhesi ◽  
J S L Partridge
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Older Women ◽  
Functional Recovery ◽  
Narrative Synthesis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Gynaecological Malignancies

Abstract Introduction Older women are increasingly undergoing surgery for gynaecological malignancies. Although survival data is available other outcomes such as functional recovery are less well described. However older people are both more vulnerable to changes in function and often prioritise function over survival. There is limited published research examining function outside of context of sexual or urodynamic function following gynaeoncology surgery but a large body or research exists examining health-related quality of life (HrQOL) both as a pre-operative risk factor for survival and as a post-treatment outcome measure in its own right. HRQOL tools may report on physical function as a subcomponent within composite tools. This systematic review and narrative synthesis describes functional recovery after gynae-oncology surgery with respect to baseline characteristics which - if identified – could enable pre- or post-operative risk reduction. Methods Systematic search of MEDLINE and EMBASE databases and Cochrane Library between 1974-2018. Two reviewers independently reviewed abstracts/papers for inclusion against the following criteria:Mean/median age &gt;60Gynaeoncological treatment includes surgery (RCTs, observational or mixed methods studies).Any measure of functional ability as defined by WHO ICF classification section D1–D7 inclusive, D855, D860-79 and D9 using validated tool.Minimum pre-operative and one post-operative measure. Results analysed and presented using narrative synthesis. Results Sixteen studies identified (7 Endometrial, 2 Ovarian, 2 Vulval, 6 mixed cancer types). 1/16 used a standalone functional assessment tool, 15/16 used Health-Related Quality of Life tools (EORTC QLQ C30 (10), FACT-G (3), SF-36 (3)) comprising items describing function. More studies showed full recovery to baseline (n=11) than incomplete recovery (n=5 including 2 reporting age as a negative association). Recovery was more likely and occurred faster in minimally-invasive surgery. 1 study demonstrated failure to recover baseline functional independence by 12 months.

scholarly journals Periodontal Health and Chronic Obstructive Pulmonary Disease (COPD) Exacerbations: A Systematic Review

2021 ◽  
Author(s):  
Niamh Kelly ◽  
Lewis Winning ◽  
Christopher Irwin ◽  
Fionnuala Lundy ◽  
Dermot Linden ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Risk Of Bias ◽  
Chronic Obstructive ◽  
Periodontal Health ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Copd Patients

Abstract BackgroundA growing body of evidence suggests a role for oral bacteria in lung infections. This systematic review aimed to analyse the association between poor periodontal health and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations. MethodsPubMed, Embase, Web of Science, CINAHL and Medline were searched for studies published until May 2020, with no language restriction. Studies reporting periodontal condition, or periodontal treatment outcomes, with data on the frequency of exacerbations of COPD, were identified. The primary outcome was the frequency of exacerbations and secondary outcomes included quality of life and hospitalisation. Studies were assessed for eligibility and quality by two assessors independently.Results Searches identified 532 records and 8 met the inclusion criteria. The data from intervention studies showed reduction in the frequency of exacerbations following periodontal treatment. Data from observational studies suggest association of worse plaque scores with exacerbation but not pocket depth or clinical attachment loss. Better periodontal health was also associated with reduced frequency of COPD exacerbations, hospitalisations and improved quality of life in COPD patients. Due to the high heterogeneity no meta-analysis was performed. The quality of some of the included studies was low and there was evidence of high risk of bias.ConclusionThe data supports possible association between poor periodontal health, the frequency of exacerbations and quality of life in COPD patients. The evidence is limited by high risk of bias suggesting need for well-designed and adequately powered randomised control trials.The PROSPERO registration number CRD42020180328

scholarly journals Reporting of Quality of Life in Clinical Trials of Biologics for Plaque Psoriasis: A Systematic Review

2018 ◽  
Vol 2 (5) ◽  
Author(s):  
Giselle Prado ◽  
Anna J Nichols ◽  
Mercedes Florez-White ◽  
Francisco Kerdel
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Trials ◽  
Plaque Psoriasis ◽  
Dermatology Life Quality Index ◽  
Quality Index ◽  
Life Quality ◽  
Risk Of Bias ◽  
The Mean

Background: Psoriasis is a chronic remitting and relapsing skin disease. For many patients, improved quality of life (QoL) is as important as clinical improvement of lesions.Objective: To review reporting of Dermatology Life Quality Index (DLQI) in randomized controlled trials (RCTs) of biologics for adult patients with plaque psoriasis.Methods: A systematic review was conducted in 4 databases for RCTs that measured DLQI at baseline and endpoint. A data collection form was created for collecting study variables. Risk of bias was assessed using the Cochrane risk of bias tool.Results: Thirty-four RCTs enrolling 16,784 patients were included. Complete baseline and final mean DLQI data was retrieved for 24 studies (70.6%). The mean DLQI at baseline was reported in 79.4% of RCTs. The median at baseline was reported in 14.7% of RCTs. The mean DLQI at endpoint was reported in 23.5% of RCTs and the median DLQI at endpoint was reported in 5.9% of RCTs. The mean change in DLQI was reported in 64.7% of RCTs.Conclusions: DLQI was measured in most clinical trials assessing the efficacy of biologics for psoriasis. Studies did not adhere to uniform standards in publishing results, making analysis of the impact on DLQI challenging.Key Words: plaque psoriasis, quality of life, Dermatology Life Quality Index, Systematic Review, biologic therapy

scholarly journals Evaluating measures of quality of life in adult scoliosis: a protocol for a systematic review and narrative synthesis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
James E. Archer ◽  
Charles Baird ◽  
Adrian Gardner ◽  
Alison B. Rushton ◽  
Nicola R. Heneghan
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Outcome Measures ◽  
Study Design ◽  
Systematic Reviews ◽  
Primary Outcome ◽  
Adult Scoliosis ◽  
Measurement Properties ◽  
Narrative Synthesis

Abstract Background Adult scoliosis represents a distinct subgroup of scoliosis patients for whom the diagnosis can have a large impact on their health-related quality of life (HR-QOL). Therefore, HR-QOL patient-reported outcome measures (PROMs) are essential to assess disease progression and the impact of interventions. The objective of this systematic review is to evaluate the measurement properties of HR-QOL PROMs in adult scoliosis patients. Methods We will conduct a literature search, from their inception onwards, of multiple electronic databases including AMED, CINAHL, EMBASE, Medline, PsychINFO and PubMed. The searches will be performed in two stages. For both stages of the search, participants will be aged 18 and over with a diagnosis of scoliosis. The primary outcome of interest in the stage one searches will be studies which use PROMs to investigate HR-QOL as defined by the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy, the secondary outcome will be to assess the frequency of use of the various PROMs. In stage two, the primary outcome of interest will be studies which assess the measurement properties of the HR-QOL PROMs identified in stage one. No specific measurement property will be given priority. No planned secondary outcomes have been identified but will be reported if discovered. In stage one, the only restriction on study design will be the exclusion of systematic reviews. In Stage two the only restriction on study design will be the exclusion of full-text articles not available in the English language. Two reviewers will independently screen all citations and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or risk of bias) will be appraised using the Consensus-based Standards for the selection of Health Measurement Instruments (COSMIN) checklist. The overall strength of the body of evidence will then be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A narrative synthesis will be provided with information presented in the main text and tables to summarise and explain the characteristics and findings of the included studies. The narrative synthesis will explore the evidence for currently used PROMs in adult scoliosis patients and any areas that require further study. Discussion The review will help clinicians and researchers identify a HR-QOL PROM for use in patients with adult scoliosis. Findings from the review will be published and disseminated through a peer-reviewed journal and conference presentations. Systematic review registration This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), reference number: CRD42020219437

scholarly journals Quality of life of elderly patients with solid tumours undergoing adjuvant cancer therapy: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e018101 ◽  
Author(s):  
Karis Kin-Fong Cheng ◽  
Ethel Yee-Ting Lim ◽  
Ravindran Kanesvaran
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Elderly Patients ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Risk Of Bias ◽  
Solid Tumours

ObjectivesThe measurement of quality of life (QoL) in elderly cancer population is increasingly being recognised as an important element of clinical decision-making and the evaluation of treatment outcome. This systematic review aimed to summarise the evidence of QoL during and after adjuvant therapy in elderly patients with cancer.MethodsA systematic search was conducted of studies published in CINAHL plus, CENTRAL, PubMed, PsycINFO and Web of Science from the inception of these databases to December 2016. Eligible studies included RCTs and non-RCTs in which QoL was measured in elderly patients (aged 65 years or above) with stage I–III solid tumours who were undergoing adjuvant chemotherapy and/or radiotherapy. Because of the heterogeneity and the insufficient data among the included studies, the results were synthesised narratively.ResultsWe included 4 RCTs and 14 non-RCTs on 1785 participants. In all four RCTs, the risk of bias was low or unclear for most items but high for detection. Of the 14 non-RCTs, 5 studies were judged to have a low or moderate risk of bias for all domains, and the other 9 studies had a serious risk of bias in at least one domain. The bias was observed mainly in the confounding and in the selection of participants for the study. For most elderly patients with breast cancer, the non-significant negative change in the QoL was transient. A significant increase in the QoL during the course of temozolomide in elderly patients with glioblastoma but a decreasing trend in QoL after radiotherapy was shown. This review also shows a uniform trend of stable or improved QoL during adjuvant therapy and at follow-up evaluations across the studies with prostate, colon or cervical cancer population.ConclusionsThis review suggests that adjuvant chemotherapy and radiotherapy may not have detrimental effects on QoL in most elderly patients with solid tumours.

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