scholarly journals Fatigue self-management led by occupational therapists and/or physiotherapists for chronic conditions: A systematic review and meta-analysis

2021 ◽  
pp. 174239532110397
Author(s):  
Sungha Kim ◽  
Ying Xu ◽  
Kelly Dore ◽  
Rebecca Gewurtz ◽  
Nadine Larivière ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Chronic Conditions ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Occupational Therapists ◽  
Behavioural Therapy ◽  
Mean Difference ◽  
Self Management ◽  
Management Interventions ◽  
Quasi Experimental

Objective The aim of this study was to investigate the effectiveness of occupational therapist-/physiotherapist-guided fatigue self-management for individuals with chronic conditions. Methods Eight databases, including MEDLINE and EMBASE, were searched until September 2019 to identify relevant studies. Randomised controlled trials and quasi-experimental studies of self-management interventions specifically developed or delivered by occupational therapists/physiotherapists to improve fatigue symptoms of individuals with chronic conditions were included. A narrative synthesis and meta-analysis were conducted to determine the effectiveness of fatigue self-management. Results Thirty-eight studies were included, and fatigue self-management approaches led by occupational therapists/physiotherapists were divided into six categories based on the intervention focus: exercise, energy conservation, multimodal programmes, activity pacing, cognitive-behavioural therapy, and comprehensive fatigue management. While all exercise programmes reported significant improvement in fatigue, other categories showed both significant improvement and no improvement in fatigue. Meta-analysis yielded a standardised mean difference of the overall 13 studies: 0.42 (95% confidence interval:−0.62 to − 0.21); standardised mean difference of the seven exercise studies was −0.55 (95% confidence interval: −0.78 to −0.31). Discussion Physical exercises inspired by the self-management principles may have positive impacts on fatigue symptoms, quality of life, and other functional abilities.

Efficacy of cognitive behavioural therapy delivered over the Internet for depressive symptoms: A systematic review and meta-analysis

2017 ◽  
Vol 24 (8) ◽  
pp. 527-539 ◽  
Author(s):  
Dina M Sztein ◽  
Charles E Koransky ◽  
Leah Fegan ◽  
Seth Himelhoch
Keyword(s):  
Depressive Symptoms ◽  
Confidence Interval ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Mean Difference ◽  
The Internet ◽  
Moderate Depression ◽  
Cognitive Behavioural ◽  
Standardized Mean Difference

Introduction Cognitive behavioural therapy has been shown to improve depressive symptoms in adults with mild to moderate depression. To overcome many of the barriers associated with delivering this treatment, attempts have been made to deliver cognitive behavioural therapy via the Internet. The objective of this meta-analysis is to assess whether Internet-based cognitive behavioural therapy delivered to adults with depressive symptoms leads to a reduction in these symptoms as compared to those who receive no therapy. Methods In September 2015, the Cochrane, PubMed and PsycInfo databases were searched; studies were also found through bibliography searches. Studies were included if they were randomized controlled trials published in English between 2005–2015 conducted with adults >18 years of age experiencing mild to moderate depression where study subjects received Internet-based cognitive behavioural therapy, and the control group was placed on a wait-list. The search yielded 257 articles; 14 of these were included in the meta-analysis. Results Internet delivered cognitive behavioural therapy had a medium effect on reducing depressive symptoms at the end of the study period (standardized mean difference: 0.74, confidence interval: 0.62–0.86, p < 0.001). Internet-delivered cognitive behavioural therapy also has a large sustained effect in maintaining reduction of depressive symptoms in follow-up measures done 3–6 months after the conclusion of the therapy (standardized mean difference: 0.83, confidence interval: 0.69–0.99, p < 0.001). There was no publication bias and low heterogeneity. Discussion Cognitive behavioural therapy delivered over the Internet leads to immediate and sustained reduction in depressive symptoms; thus, it may be a good treatment modality for individuals unable or unwilling to access traditional face-to-face therapy.

Mindfulness-Based Interventions for Youth With Anxiety: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 29 (2) ◽  
pp. 195-205 ◽  
Author(s):  
Debra S. Borquist-Conlon ◽  
Brandy R. Maynard ◽  
Kristen Esposito Brendel ◽  
Anne S. J. Farina
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Confidence Interval ◽  
Anxiety Disorders ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Risk Of Bias ◽  
Quasi Experimental ◽  
Disorder Risk

Purpose: To examine the effects on anxiety of mindfulness-based interventions (MBIs) among youth with anxiety disorders. Method: Systematic review and meta-analytic procedures were employed to synthesize experimental and quasi-experimental studies authored between 1980 and 2015. Results: The search yielded five studies from five countries reporting results for a total of 188 youth between the ages of 5 and 18 (mean age 13.26) who met criteria for an anxiety disorder. Risk of bias varied across studies. Meta-analytic results suggest a moderate and significant effect ( g = .62; 95% confidence interval = [0.20, 1.04], p = .004). Heterogeneity was moderate ( I2 = 47.22) and not statistically significant ( Q = 7.58, df = 4, p = .11), thus moderator analyses were not warranted. Discussion: The findings of this review suggest that MBIs for the treatment of anxiety in youth with anxiety disorders are effective.

scholarly journals Comparing the effectiveness and cost-effectiveness of self-management interventions in four high-priority chronic conditions in Europe (COMPAR-EU): a research protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034680
Author(s):  
Marta Ballester ◽  
Carola Orrego ◽  
Monique Heijmans ◽  
Pablo Alonso-Coello ◽  
Matthijs Michaël Versteegh ◽  
...  
Keyword(s):  
Decision Making ◽  
Cost Effectiveness ◽  
Chronic Conditions ◽  
Current Knowledge ◽  
Meta Analysis ◽  
Core Outcome Set ◽  
Self Management ◽  
Chronic Obstructive ◽  
Horizon 2020 ◽  
Management Interventions

IntroductionPopulation ageing and increasing chronic illness burden have sparked interest in innovative care models. While self-management interventions (SMIs) are drawing increasing attention, evidence of their efficacy is mostly based on pairwise meta-analysis, generally derived from randomised controlled trials comparing interventions versus a control or no intervention. As such, relevant efficacy data for comparisons among different SMIs that can be applied to specific chronic conditions are missing. Therefore, the relevance of the available evidence for decision-making at clinical, organisational and policy levels is limited.AimTo identify, compare and rank the most effective and cost-effective SMIs for adults with four high-priority chronic conditions: type 2 diabetes, obesity, chronic obstructive pulmonary disease,and heart failure.Methods and analysisAll activities will be conducted as part of the cost-effectiveness of self-management interventions in four high-priority chronic conditions in Europe(COMPAR-EU, Comparing effectiveness of self-management interventions in 4 high priority chronic diseases inEurope) Project, an European Union (EU)-funded project designed to bridge the gap between current knowledge and practice on SMIs. In the first phase of the project, we will develop and validate a taxonomy, and a Core Outcome Set for each condition. These activities will inform a series of systematic review and network meta-analysis about the effectiveness of SMIs. We will also perform a cost-effectiveness analysis of the most effective SMIs and an evaluation of contextual factors. We will finally develop tailored decision-making tools for the different relevant stakeholders.Ethics and disseminationEthical approval was obtained from the local ethics committee (University Institute for Primary Care Research - IDIAP Jordi Gol). All patients and other stakeholders will provide informed consent prior to participation. This project has been funded by the EU Horizon 2020 research and innovation programme (grant agreement no. 754936). Results will be of interest to relevant stakeholder groups (patients, professionals, managers, policymakers and industry), and will be disseminated in a tailored multi-pronged approach that will include deployment of an interactive platform.

scholarly journals Statins and Thyroid Carcinoma: a Meta-Analysis

2018 ◽  
Vol 47 (4) ◽  
pp. 1422-1431 ◽  
Author(s):  
Junyu Zhao ◽  
Chunmei Xu ◽  
Jinming Yao ◽  
Changzhen Yu ◽  
Lin Liao ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Thyroid Carcinoma ◽  
Clinical Studies ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Mean Difference ◽  
In Vitro Studies ◽  
Weighted Mean

Background/Aims: Experimental studies have reported the antineoplastic effects of statins in thyroid carcinoma; however, observational studies suggested that statins might increase the risk of thyroid carcinoma. Therefore, this study evaluated the antineoplastic effects of statins in both in vitro studies and animal models, as well as the epidemiological evidence. Methods: Databases—PubMed, Cochrane Library, SinoMed, CNKI, Wanfang, and clinical trial registries— were searched. A meta-analysis was performed with sufficiently homogeneous studies. Eighteen articles were involved. Results: In in vitro studies, statins showed a concentration-dependent inhibition of cell line growth (weighted mean difference –34.68, 95% confidence interval –36.53 to –32.83). A significant efficacy of statin-induced apoptosis was observed (weighted mean difference [95% confidence interval]: 24 h, 57.50 [55.98–59.03]; 48 h, 23.43 [22.19–24.66]; 72 h, 51.29 [47.52–55.07]). Early apoptosis was increased in a dose- and time-dependent manner. In in vivo antitumor studies, lovastatin inhibited tumor growth, as shown by a reduction in tumor volume. However, two clinical studies showed discordant results from the experimental studies. Conclusion: Experimental studies revealed the antineoplastic efficacy of statins but statins were associated with thyroid carcinoma in clinical studies. This discrepancy may be due to the different concentrations of statins used and the effects of hyperlipidemia interventions, and thus further study is required.

scholarly journals Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001647
Author(s):  
Andréa Marques ◽  
Eduardo Santos ◽  
Elena Nikiphorou ◽  
Ailsa Bosworth ◽  
Loreto Carmona
Keyword(s):  
Systematic Review ◽  
Full Text ◽  
Inflammatory Arthritis ◽  
Data Extraction ◽  
Management Strategies ◽  
Psychosocial Interventions ◽  
Behavioural Therapy ◽  
Self Management ◽  
Cochrane Library ◽  
Management Interventions

ObjectiveTo perform a systematic review (SR) on the effectiveness of self-management interventions, in order to inform the European League Against Rheumatism Recommendations for its implementation in patients with inflammatory arthritis (IA).MethodsThe SR was conducted according to the Cochrane Handbook and included adults (≥18 years) with IA. The search strategy was run in Medline through PubMed, Embase, Cochrane Library, CINAHL Plus with Full Text, and PEDro. The assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. A narrative Summary of Findings was provided according to the Grading of Recommendations, Assessment, Development and Evaluation.ResultsFrom a total 1577 references, 57 were selected for a full-text review, and 32 studies fulfilled the inclusion criteria (19 randomised controlled trials (RCTs) and 13 SRs). The most studied self-management components were specific interactive disease education in ten RCTs, problem solving in nine RCTs, cognitive–behavioural therapy in eight RCTs, goal setting in six RCTs, patient education in five RCTs and response training in two RCTs. The most studied interventions were multicomponent or single exercise/physical activity in six SRs, psychosocial interventions in five SRs and education in two SRs. Overall, all these specific components and interventions of self-management have beneficial effects on IAs-related outcomes.ConclusionsThe findings confirm the beneficial effect of the self-management interventions in IA and the importance of their implementation. Further research should focus on the understanding that self-management is a complex intervention to allow the isolation of the effectiveness of its different components.

scholarly journals Effects of probiotic and synbiotic supplementation on insulin resistance in women with polycystic ovary syndrome: a meta-analysis

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110317
Author(s):  
Chenyun Miao ◽  
Qingge Guo ◽  
Xiaojie Fang ◽  
Yun Chen ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Confidence Interval ◽  
Polycystic Ovary ◽  
Serum Insulin ◽  
Meta Analysis ◽  
Mean Difference ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Synbiotic Supplementation

Objective This meta-analysis evaluated the effect of probiotics and synbiotics on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods A systematic search was performed to identify all relevant publications listed on the electronic databases (PubMed®, Web of Science, Embase® and China National Knowledge Infrastructure) between inception and 30 October 2020. All statistical analyses were performed on randomized controlled trials (RCTs) using RevMan version 5.3 software provided by the Cochrane Collaboration. Results A total of 486 patients from seven RCTs were included in the meta-analysis. Probiotic and synbiotic supplementation appeared to improve levels of homeostatic model assessment of insulin resistance (mean difference = –0.37; 95% confidence interval –0.69, –0.05) and serum insulin (standardized mean difference = –0.66; 95% confidence interval –1.19, –0.12). The results failed to show any influence of probiotic and synbiotic supplementation on body mass index, waist circumference, hip circumference and fasting blood sugar. Conclusions Probiotics and synbiotics appear to have a partially beneficial effect on indices of insulin resistance in patients with PCOS.

scholarly journals A Meta-Analysis of the Efficacy of Hyaluronic Acid Eye Drops for the Treatment of Dry Eye Syndrome

2021 ◽  
Vol 18 (5) ◽  
pp. 2383
Author(s):  
Yun-Jung Yang ◽  
Won-Young Lee ◽  
Young-jin Kim ◽  
Yeon-pyo Hong
Keyword(s):  
Hyaluronic Acid ◽  
Confidence Interval ◽  
Dry Eye ◽  
Test Scores ◽  
Meta Analysis ◽  
Mean Difference ◽  
Dry Eye Syndrome ◽  
Eye Drops ◽  
Cochrane Central Register ◽  
Standard Mean Difference

Hyaluronic acid (HA) is commonly used for treating dry eye syndrome (DES). This meta-analysis was performed to compare the efficacies of HA- and non-HA-based eye drops, including saline and conventional artificial tears (ATs), for the treatment of dry eye disease. Eight databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, DBpia, KoreaMed, KMBASE, RISS, KISS) were searched for studies comparing the efficacies of HA- and non-HA-based ATs in patients with DES published up to September 2020. Two independent reviewers assessed the quality and extracted the relevant data. The mean differences of Schirmer’s (SH) test scores, tear breakup times (TBUT), corneal fluorescein staining scores (Oxford scale, 0–4), and ocular surface disease indexes were calculated. The standard mean difference and 95% confidence interval were calculated using a random effect model. Nineteen studies, including 2078 cases, were included. HA eye drops significantly improved tear production compared with non-HA-based eye drops (standard mean difference (SMD) 0.18; 95% confidence interval (CI) 0.03, 0.33). In a subgroup analysis, the SH test scores and TBUT values after using HA significantly increased compared to those measured after using saline (SMD 0.27; 95% CI 0.05, 0.49 and SMD 0.28; 95% CI 0.03, 0.52, respectively). Based on these results, HA eye drops may be superior to non-HA eye drops including normal saline and ATs. Further research is needed to assess the efficacies stratified by age, treatment duration, the severity of dry eye, and optimal dosages.

Self-Management Interventions for Women With Cardiac Pain: A Systematic Review and Meta-analysis

2018 ◽  
Vol 34 (4) ◽  
pp. 458-467 ◽  
Author(s):  
Monica Parry ◽  
Ann Kristin Bjørnnes ◽  
J. Charles Victor ◽  
Ana Patricia Ayala ◽  
Erica Lenton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Self Management ◽  
Management Interventions ◽  
Cardiac Pain

scholarly journals Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Carmen Varela ◽  
Camila Oda-Montecinos ◽  
Ana Andrés ◽  
Carmina Saldaña
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Weight Control ◽  
Meta Analysis ◽  
Treatment Options ◽  
Overweight And Obesity ◽  
Mean Difference ◽  
Effective Treatment Option ◽  
Web Based ◽  
Self Help

Abstract Background Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine). Method From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis. Results Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference − 1.86 kg; 95% Confidence Interval: − 3.61, − 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference − 4.31 kg; 95% Confidence Interval: − 5,22, − 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities. Conclusions Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.

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