Effectiveness of current perioperative telemonitoring on postoperative outcome in patients undergoing major abdominal surgery: A systematic review of controlled trials

2021 ◽  
pp. 1357633X2110477
Author(s):  
Marjolein E Haveman ◽  
Leonie T Jonker ◽  
Hermie J Hermens ◽  
Monique Tabak ◽  
Jean-Paul PM de Vries
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Outcome Measures ◽  
Major Abdominal Surgery ◽  
Major Surgery ◽  
Control Group ◽  
Controlled Trials ◽  
Clinical Patient ◽  
Patient Reported ◽  
Financial Outcome

Background Perioperative telemonitoring of patients undergoing major surgery might lead to improved postoperative outcomes. The aim of this systematic review is to evaluate the effectiveness of current perioperative telemonitoring interventions on postoperative clinical, patient-reported, and financial outcome measures in patients undergoing major surgery. Methods For this systematic review, PubMed, CINAHL, and Embase databases were searched for eligible articles published between January 1, 2009 and March 15, 2021. Studies were eligible as they described: (P) patients aged 18 years or older who underwent major abdominal surgery, (I) perioperative telemonitoring as intervention, (C) a control group receiving usual care, (O) any type of postoperative clinical, patient-reported, or financial outcome measures, and (S) an interventional study design. Results The search identified 2958 articles of which 10 were eligible for analysis, describing nine controlled trials of 2438 patients. Perioperative telemonitoring comprised wearable biosensors ( n = 3), websites ( n = 3), e-mail ( n = 1), and mobile applications ( n = 2). Outcome measures were clinical ( n = 8), patient-reported ( n = 5), and financial ( n = 2). Results show significant improvement of recovery time, stoma self-efficacy and pain in the early postoperative phase in patients receiving telemonitoring. Other outcome measures were not significantly different between the groups. Conclusion Evidence for the effectiveness of perioperative telemonitoring in major surgery is scarce. There is a need for good quality studies with sufficient patients while ensuring that the quality and usability of the technology and the adoption in care processes are optimal.

scholarly journals Effect of routinely assessing and addressing depression and diabetes distress using patient-reported outcome measures in improving outcomes among adults with type 2 diabetes: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044888
Author(s):  
Rita McMorrow ◽  
Barbara Hunter ◽  
Christel Hendrieckx ◽  
Dominika Kwasnicka ◽  
Leanne Cussen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Outcome Measures ◽  
Study Design ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Diabetes Distress ◽  
Controlled Trials ◽  
Patient Reported

IntroductionType 2 diabetes is a global health priority. People with diabetes are more likely to experience mental health problems relative to people without diabetes. Diabetes guidelines recommend assessment of depression and diabetes distress during diabetes care. This systematic review will examine the effect of routinely assessing and addressing depression and diabetes distress using patient-reported outcome measures in improving outcomes among adults with type 2 diabetes.Methods and analysisMEDLINE, Embase, CINAHL Complete, PsycInfo, The Cochrane Library and Cochrane Central Register of Controlled Trials will be searched using a prespecified strategy using a prespecified Population, Intervention, Comparator, Outcomes, Setting and study design strategy. The date range of the search of all databases will be from inception to 3 August 2020. Randomised controlled trials, interrupted time-series studies, prospective and retrospective cohort studies, case–control studies and analytical cross-sectional studies published in peer-reviewed journals in the English language will be included. Two review authors will independently screen abstracts and full texts with disagreements resolved by a third reviewer, if required, using Covidence software. Two reviewers will undertake risk of bias assessment using checklists appropriate to study design. Data will be extracted using prespecified template. A narrative synthesis will be conducted, with a meta-analysis, if appropriate.Ethics and disseminationEthics approval is not required for this review of published studies. Presentation of results will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidance. Findings will be disseminated via peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42020200246.

scholarly journals The Efficacy of Multimodal Prehabilitation in Elderly Patients Undergoing Elective Major Abdominal Surgery: A Systematic Review Protocol

2021 ◽  
Author(s):  
Yu Xiang Tan ◽  
Miny Samuel ◽  
Ning Qi Pang
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
The Elderly ◽  
Major Abdominal Surgery ◽  
Walking Distance ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Introduction Multimodal prehabilitation has been touted as a potential strategy to better prepare our elderly and frail patients for major surgery. While randomized controlled trials and systematic reviews have been done to investigate the effect of prehabilitation on various surgical cohorts, most of these studies have focused on single modality prehabilitation and without an emphasis on the elderly. This systematic review aims to assess the effect of a multimodal prehabilitation program on elderly patients undergoing major abdominal surgery. MethodsThis protocol has been written according to the PRISMA-P statement and is registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number 250281). MEDLINE, EMBASE, CENTRAL, CINAHL and PsychINFO databases will be searched. Only randomized controlled trials with an average study population age ≥65 that has undergone major abdominal operation with at least two components (physical, nutritional, psychological) of prehabilitation will be included. Clinical outcomes that will be collected include post-operative morbidity and mortality, length of stay, 30-day readmission and peri-operative 6-minute walking distance. The risk of bias in included studies will be assessed. Data will be pooled where possible. DiscussionThis systematic review will evaluate and establish the effectiveness of multimodal prehabilitation for the elderly, who represents the group of patients most likely to benefit from prehabilitation. This review with its focus on the elderly will provide us with fresh insight into the utility of prehabilitation that will better inform policy makers in its implementation.PROSPERO Registration: On 20/04/2021, ID 250281

scholarly journals Effectiveness of Exercise Therapy in Treatment of Patients With Patellofemoral Pain Syndrome: Systematic Review and Meta-Analysis

2014 ◽  
Vol 94 (12) ◽  
pp. 1697-1708 ◽  
Author(s):  
Ron Clijsen ◽  
Janine Fuchs ◽  
Jan Taeymans
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Exercise Therapy ◽  
Meta Analysis ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Randomized Controlled ◽  
Patient Reported

Background and Purpose This systematic review and meta-analysis was accomplished to determine whether exercise therapy is an effective intervention to reduce pain and patient-reported measures of activity limitations and participation restrictions (PRMALP) in patients with patellofemoral pain. Data Sources and Study Selection Randomized controlled trials in English and German languages published in the MEDLINE, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform, and Cochrane databases were searched. Eligibility was assessed in 2 stages. The methodological quality of the studies was rated using the PEDro scale. Data were pooled using random-effects meta-analysis, allowing for variability among studies. For clinical use, overall estimates were re-expressed in the original visual analog scale scores. Significance was set at 5%. Data Extraction and Data Synthesis Fifteen studies, with a total of 748 participants, were included and pooled for the meta-analysis. Six studies compared the effect of exercise therapy with a control group receiving neither exercise therapy nor another intervention. Four studies compared the effect of exercise therapy versus additive therapy, and 5 studies compared different exercise interventions. In both comparisons, exercise therapy resulted in strong pain reduction and improvement of PRMALP effects. Significant short-term effects (≤12 weeks) of exercise therapy were found for pain and PRMALP, whereas long-term effects (≥26 weeks) were observed for PRMALP only. Limitations and Conclusion The 15 studies included in this analysis were of variable quality. Large-scale, high-quality randomized controlled trials are needed to further the evaluation of the possible effects of different exercise therapy modalities on patellofemoral pain. This meta-analysis presents evidence that exercise therapy has a strong pain-reducing effect and decreases PRMALP in patients with patellofemoral pain. However, the question of which exercise modality yields the strongest reducing effect on pain and PRMALP remains unanswered.

Effect of Fasting on Coagulation Factors in Patients who Undergo Major Abdominal Surgery

2010 ◽  
Vol 76 (2) ◽  
pp. 168-171 ◽  
Author(s):  
Yoshihiro Moriwaki ◽  
Mitsugi Sugiyama
Keyword(s):  
Abdominal Surgery ◽  
Vitamin K ◽  
Oral Intake ◽  
Coagulation Factors ◽  
Major Abdominal Surgery ◽  
Major Surgery ◽  
Control Group ◽  
Bleeding Tendency ◽  
Preoperative Fasting ◽  
Normal Limits

Major abdominal surgery without preoperative adequate oral intake with some cephalosporins may result in vitamin K deficiency and bleeding tendency. The aim of this study is to clarify the effect of preoperative fasting on postoperative coagulation factors. We prospectively examined 16 patients who underwent major abdominal surgery. Patients were divided into a preoperative fast group (Group F, n = 7, mean period of preoperative fasting 8.7 days) and a control group (Group C, n = 9). We did not administer vitamin K and initiated feeding after the seventh postoperative day. In Group C, prothrombin time (PT) and Factors II, VII, IX, and X levels were decreased after the surgery to within normal limits. In Group F, the PT and Factors II, VII, and X levels were decreased after the surgery. Abnormal lower levels of PT and Factors II, VII, and X were seen in 67, 33, 67, and 67 per cent of patients after the surgery, respectively. Factors VII and X levels were higher than in Group C by the third postoperative day. The protein induced by vitamin K absence or antagonist-II levels in Group F were increased at all postoperative points. Clinicians should realize that preoperative fasting for as little as 1 week can induce precoagulopathy, resulting in postoperative coagulopathy after major surgery.

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