The role of preoperative opioid use in shoulder surgery—A systematic review

Background Emerging evidence suggests preoperative opioid use may increase the risk of negative outcomes following orthopedic procedures. This systematic review evaluated the impact of preoperative opioid use in patients undergoing shoulder surgery with respect to preoperative clinical outcomes, postoperative complications, and postoperative dependence on opioids. Methods EMBASE, MEDLINE, CENTRAL, and CINAHL were searched from inception to April, 2021 for studies reporting preoperative opioid use and its effect on postoperative outcomes or opioid use. The search, data extraction and methodologic assessment were performed in duplicate for all included studies. Results Twenty-one studies with a total of 257,301 patients were included in the final synthesis. Of which, 17 were level III evidence. Of those, 51.5% of the patients reported pre-operative opioid use. Fourteen studies (66.7%) reported a higher likelihood of opioid use at follow-up among those used opioids preoperatively compared to preoperative opioid-naïve patients. Eight studies (38.1%) showed lower functional measurements and range of motion in opioid group compared to the non-opioid group post-operatively. Conclusion Preoperative opioid use in patients undergoing shoulder surgeries is associated with lower functional scores and post-operative range of motion. Most concerning is preoperative opioid use may predict increased post-operative opioid requirements and potential for misuse in patients. Level of evidence Level IV, Systematic review.

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Preventive Interventions for the Second Half of Life: A Systematic Review

American Journal of Health Promotion ◽

10.1177/0890117117712355 ◽

2017 ◽

Vol 32 (4) ◽

pp. 1122-1139 ◽

Cited By ~ 1

Author(s):

Cother Hajat ◽

Adriana Selwyn ◽

Mark Harris ◽

Derek Yach

Keyword(s):

Systematic Review ◽

Healthy Aging ◽

Data Extraction ◽

Evidence Base ◽

Noncommunicable Diseases ◽

Level Of Evidence ◽

Summary Table ◽

Age Related ◽

Meta Analyses ◽

The Impact

Objective: Recent improvements in life expectancy globally require intensified focus on noncommunicable diseases and age-related conditions. The purpose of this article is to inform the development of age-specific prevention guidelines for adults aged 50 and above, which are currently lacking. Data Source: PubMed, Cochrane database, and Google Scholar and explicit outreach to experts in the field. Study Inclusion and Exclusion Criteria: Meta-analyses, intervention-based, and prospective cohort studies that reported all-cause mortality, disease-specific mortality, or morbidity in adults were included. Data Extraction: A systematic review was undertaken in 2015 using search terms of a combination of <risk factor> and “intervention,” “mortality,” “reduction,” “improvement,” “death,” and “morbidity.” Data Synthesis: Interventions were categorized according to the Center for Evidence-Based Medicine Level of Evidence framework. Results: A summary table reports for each intervention the impact, strength of evidence, initiation, duration, and details of the intervention. Age-decade-specific preventive recommendations have been proposed relating to physical activity, diet, tobacco and alcohol use, medication adherence, screening and vaccination, and mental and cognitive health. Conclusion: Clear recommendations have been made according to the existing evidence base, but further research investment is needed to fill the many gaps. Further, personalized approaches to healthy aging complemented by population-wide approaches and broader cross-sector partnerships will help to ensure greater longevity is an opportunity, rather than a burden, for society.

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The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

Addiction Science & Clinical Practice ◽

10.1186/s13722-021-00266-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Madeline C. Frost ◽

Hannah Lampert ◽

Judith I. Tsui ◽

Matthew D. Iles-Shih ◽

Emily C. Williams

Keyword(s):

Systematic Review ◽

English Language ◽

Data Extraction ◽

Opioid Use Disorder ◽

Small Samples ◽

Future Research ◽

Opioid Use ◽

Polysubstance Use ◽

Amphetamine Use ◽

The Impact

Abstract Background Methamphetamine/amphetamine use has sharply increased among people with opioid use disorder (OUD). It is therefore important to understand whether and how use of these substances may impact receipt of, and outcomes associated with, medications for OUD (MOUD). This systematic review identified studies that examined associations between methamphetamine/amphetamine use or use disorder and 3 classes of outcomes: (1) receipt of MOUD, (2) retention in MOUD, and (3) opioid abstinence during MOUD. Methods We searched 3 databases (PubMed/MEDLINE, PsycINFO, CINAHL Complete) from 1/1/2000 to 7/28/2020 using key words and subject headings, and hand-searched reference lists of included articles. English-language studies of people with documented OUD/opioid use that reported a quantitative association between methamphetamine/amphetamine use or use disorder and an outcome of interest were included. Study data were extracted using a standardized template, and risk of bias was assessed for each study. Screening, inclusion, data extraction and bias assessment were conducted independently by 2 authors. Study characteristics and findings were summarized for each class of outcomes. Results Thirty-nine studies met inclusion criteria. Studies generally found that methamphetamine/amphetamine use or use disorder was negatively associated with receiving methadone and buprenorphine; 2 studies suggested positive associations with receiving naltrexone. Studies generally found negative associations with retention; most studies finding no association had small samples, and these studies tended to examine shorter retention timeframes and describe provision of adjunctive services to address substance use. Studies generally found negative associations with opioid abstinence during treatment among patients receiving methadone or sustained-release naltrexone implants, though observed associations may have been confounded by other polysubstance use. Most studies examining opioid abstinence during other types of MOUD treatment had small samples. Conclusions Overall, existing research suggests people who use methamphetamine/amphetamines may have lower receipt of MOUD, retention in MOUD, and opioid abstinence during MOUD. Future research should examine how specific policies and treatment models impact MOUD outcomes for these patients, and seek to understand the perspectives of MOUD providers and people who use both opioids and methamphetamine/amphetamines. Efforts to improve MOUD care and overdose prevention strategies are needed for this population.

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Opioid Use in Athletes: A Systematic Review

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120933542 ◽

2020 ◽

Vol 12 (6) ◽

pp. 534-539 ◽

Cited By ~ 1

Author(s):

Seper Ekhtiari ◽

Ibrahim Yusuf ◽

Yosra AlMakadma ◽

Austin MacDonald ◽

Timothy Leroux ◽

...

Keyword(s):

High School ◽

Systematic Review ◽

National Football League ◽

Data Extraction ◽

School Level ◽

Professional Athletes ◽

Opioid Use ◽

High School Level ◽

Level Of Evidence ◽

Athletic Population

Context: The opioid epidemic has been well-documented in the general population, but the literature pertaining to opioid use and misuse in the athletic population remains limited. Objectives: The objectives of this study were to seek answers to the following questions: (1) what are the rates of opioid use and misuse among athletes, (2) do these rates differ compared with the nonathletic population, and (3) are there specific subgroups of the athletic population (eg, based on sport, level of play) who may be at higher risk? Data Sources: The Embase, MEDLINE, and PubMed were used for the literature search. Study Selection: Records were screened in duplicate for studies reporting rates of opioid use among athletes. All study designs were included. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data regarding rates of opioid use, medication types, prescription patterns, and predictors of future opioid use were collected. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria for clinical studies and 5 key domains previously identified for survey studies. Results: A total of 11 studies were eligible for inclusion (N = 226,256 athletes). Studies included survey studies and retrospective observational designs. Opioid use among professional athletes at any given time, as reported in 2 different studies, ranged from 4.4% to 4.7%, while opioid use over a National Football League career was 52%. High school athletes had lifetime opioid use rates of 28% to 46%. Risk factors associated with opioid use included Caucasian race, contact sports (hockey, football, wrestling), postretirement unemployment, and undiagnosed concussion. Use of opioids while playing predicted use of opioids in retirement. Conclusion: Overall, opioid use is prevalent among athletes, and use during a playing career predicts postretirement use. This issue exists even at the high school level, with similar rates to professional athletes. Further higher quality observational studies are needed to better define patterns of opioid use in athletes.

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Misuse of medication in adult substance misuse services: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-047283 ◽

2021 ◽

Vol 11 (6) ◽

pp. e047283

Author(s):

Rosalind Gittins ◽

Louise Missen ◽

Ian Maidment

Keyword(s):

Systematic Review ◽

Substance Misuse ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Opioid Analgesics ◽

Physical And Mental Health ◽

Qualitative Synthesis ◽

Treatment Services ◽

The Impact

IntroductionThere is a growing concern about the misuse of over the counter (OTC) and prescription only medication (POM) because of the impact on physical and mental health, drug interactions, overdoses and drug-related deaths. These medicines include opioid analgesics, anxiolytics such as pregabalin and diazepam and antidepressants. This protocol outlines how a systematic review will be undertaken (during June 2021), which aims to examine the literature on the pattern of OTC and POM misuse among adults who are accessing substance misuse treatment services. It will include the types of medication being taken, prevalence and demographic characteristics of people who access treatment services.Methods and analysisAn electronic search will be conducted on the Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases as well as grey literature. Two independent reviewers will conduct the initial title and abstract screenings, using predetermined criteria for inclusion and exclusion. If selected for inclusion, full-text data extraction will be conducted using a pilot-tested data extraction form. A third reviewer will resolve disagreements if consensus cannot be reached. Quality and risk of bias assessment will be conducted for all included studies. A qualitative synthesis and summary of the data will be provided. If possible, a meta-analysis with heterogeneity calculation will be conducted; otherwise, Synthesis Without Meta-analysis will be undertaken for quantitative data. The reporting of this protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationEthical approval is not required. Findings will be peer reviewed, published and shared verbally, electronically and in print, with interested clinicians and policymakers.PROSPERO registration numberCRD42020135216.

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Systematic review of the factors affecting cat and dog owner compliance with pharmaceutical treatment recommendations

Veterinary Record ◽

10.1136/vr.104793 ◽

2018 ◽

Vol 184 (5) ◽

pp. 154-154 ◽

Cited By ~ 1

Author(s):

Kathryn Jennifer Wareham ◽

Marnie Louise Brennan ◽

Rachel S Dean

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Relevant Literature ◽

Evidence Base ◽

Treatment Recommendations ◽

Social Risk ◽

Dosing Regimen ◽

Pharmaceutical Treatment ◽

Level Of Evidence ◽

Factors Affecting

The aim of this systematic review is to describe and assess the quality of the existing evidence base concerning factors that influence the compliance of cat and dog owners to pharmaceutical and specifically polypharmacy treatment recommendations. PubMed, CAB Abstracts and Google were searched to identify relevant literature and search results were filtered according to predetermined inclusion and exclusion criteria. Standardised data extraction and critical appraisal were carried out on each included study, and a Centre for Evidence-Based Medicine level of evidence grading was applied. Of the 8589 studies, eight studies were included in the review. Majority (five of eight) of the included studies were examining compliance with short-term antimicrobial therapies and none examined polypharmacy. Multiple definitions of compliance, methods of measurement and different factors potentially affecting compliance were used. Factors reported to have affected compliance in at least one study were dosing regimen, discussion of dosing regimen in light of owners’ circumstances, consultation time, disease, month of consultation/treatment, physical risk, social risk and method of administration. The evidence available regarding factors affecting client compliance with pharmaceutical treatment recommendations in cats and dogs is scarce and of poor quality.

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Cancer services during the COVID-19 pandemic: systematic review of patients' and caregivers' experiences

10.1101/2021.03.19.21253949 ◽

2021 ◽

Author(s):

Symran Dhada ◽

Derek Stewart ◽

Ejaz Cheema ◽

Muhammed Abdul Hadi ◽

Vibhu Paudyal

Keyword(s):

Systematic Review ◽

Cancer Screening ◽

Cancer Patients ◽

English Language ◽

Resource Constraints ◽

Data Extraction ◽

Psychological Wellbeing ◽

Cancer Services ◽

Data Extraction Form ◽

The Impact

Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients' and caregivers' experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing. Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears.

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Arthroscopic Dorsal Capsuloplasty in Scapholunate Tears EWAS 3: Preliminary Results after a Minimum Follow-up of 1 Year

Journal of Wrist Surgery ◽

10.1055/s-0038-1660446 ◽

2018 ◽

Vol 07 (04) ◽

pp. 324-330

Author(s):

Rémy Coulomb ◽

Pascal Kouyoumdjian ◽

Olivier Mares ◽

Benjamin Degeorge

Keyword(s):

Range Of Motion ◽

Grip Strength ◽

Case Series ◽

Contralateral Side ◽

Wrist Arthroscopy ◽

Level Of Evidence ◽

Test Range ◽

Flexion Extension ◽

Functional Scores

Purpose We retrospectively evaluated the results of all arthroscopic dorsal scapholunate (SL) capsuloplasty without pinning in patients presenting predynamic instability and dorsal capsuloscapholunate septum lesions on arthro–computed tomography scan after failed medical treatment. Materials and Methods Fifteen patients, mean age 34.3 years, underwent all arthroscopically assisted dorsal capsuloplasty. Patients were assessed preoperatively and postoperatively by a clinical (pain, Watson's test, range of motion, and strength), functional (quick disabilities of the arm, shoulder, and hand), patient-rated wrist evaluation, and Mayo wrist score scores), and radiological (SL gap and dorsal intercalated segmental instability [DISI]) examination. SL tears were evaluated during surgery by European Wrist Arthroscopy Society (EWAS) classification. Results The mean follow-up period was 20.2 months (range, 12–41). Preoperatively, positive Watson's test was noted in all cases. DISI deformity was noted in three cases without any SL gap. The SL instability was graded EWAS IIIB (n = 8) or EWAS IIIC (n = 7). Postoperatively, positive Watson's test was noted in only one case. Activity pain decreased from 7.8 preoperatively to 2.4 postoperatively. Range of motion in flexion–extension increased from 92.9 degrees preoperatively to 126.2 degrees postoperatively. Grip strength increased from 24.2 preoperatively to 38.2 postoperatively. At final follow-up, range of motion in flexion–extension and grip strength were estimated at 87 and 91% compared with contralateral side, respectively. All functional scores were significantly improved at the last follow-up. No radiographic SL gapping in grip views or DISI deformity was noted. Discussion Cadaveric studies demonstrated that the dorsal portion of SL ligament is critical for the stability of the SL complex. The entire arthroscopic SL capsuloplasty technique provides reliable results for pain relief, avoiding postoperative stiffness associated with open procedures. It is an alternative technique for patients with predynamic SL instability after failure of medical management and shall not prelude the resort to any further open procedure. Level of Evidence This is a level IV, case series.

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Health Promoting School Interventions in Latin America: A Systematic Review Protocol on the Dimensions of the RE-AIM Framework

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155558 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5558

Author(s):

Patrícia de Oliveira Bastos ◽

Ana Suelen Pedroza Cavalcante ◽

Wallingson Michael Gonçalves Pereira ◽

Victor Hugo Santos de Castro ◽

Antonio Rodrigues Ferreira Júnior ◽

...

Keyword(s):

Systematic Review ◽

Latin America ◽

Data Extraction ◽

World Health ◽

Systematic Review Protocol ◽

Level Of Evidence ◽

School Interventions ◽

Health Promoting School ◽

Health Promoting ◽

Review Protocol

Understanding the dimensions of internal and external validities (e.g., using the RE-AIM model: Reach, Effectiveness/Efficacy, Adoption, Implementation, and Maintenance) of school interventions is important to guide research and practice in this context. The aim of this systematic review protocol is to synthesize evidence on the RE-AIM dimensions in interventions based on the Health Promoting School (HPS) approach from the World Health Organization (WHO) in Latin America. Studies of interventions based on HPS-WHO that were carried out in Latin America involving the population of 5 to 18-year-olds will be eligible. Searches in nine electronic databases, a study repository, the gray literature, and the retrieved articles’ reference lists will be performed, without year or publication language limits. Study selection and data extraction will be conducted by independent researchers. Data on intervention implementation will be summarized in categories of HPS-WHO actions: (1) school curriculum, (2) changes in the social and/or physical environment of schools, and (3) actions with families and the community. A previously validated tool will be used to summarize the information on the dimensions of the RE-AIM model. The strengths and limitations of the included studies will be evaluated using the Critical Appraisal Skills Program (CASP) tool, and the confidence level of evidence will be assessed according to the GRADE CERQual tool.

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Validity and Reliability of 2-Dimensional Video-Based Assessment to Analyze Foot Strike Pattern and Step Rate During Running: A Systematic Review

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119844795 ◽

2019 ◽

Vol 11 (5) ◽

pp. 409-415 ◽

Cited By ~ 2

Author(s):

Fábio Carlos Lucas de Oliveira ◽

Anny Fredette ◽

Sherezada Ochoa Echeverría ◽

Charles Sebiyo Batcho ◽

Jean-Sébastien Roy

Keyword(s):

Systematic Review ◽

Concurrent Validity ◽

Data Extraction ◽

Intraclass Correlation ◽

Reliability And Validity ◽

Validity And Reliability ◽

Level Of Evidence ◽

Step Rate ◽

Cosmin Checklist ◽

Foot Strike

Context: Two-dimensional (2D) video-based analysis is often used by clinicians to examine the foot strike pattern (FSP) and step rate in runners. Reliability and validity of 2D video-based analysis have been questioned. Objective: To synthesize the psychometric properties of 2D video-based analysis for assessing runners’ FSP and step rate while running. Data Sources: Medline/PubMed, Science Direct, Embase, EBSCOHost/CINAHL, and Scielo were searched from their inception to August 2018. Study Selection: Studies were included if (1) they were published in English, French, Portuguese or Spanish; (2) they reported at least 1 psychometric property (validity and/or reliability) of 2D video-based analysis to assess running kinematics; and (3) they assessed FSP or step rate during running. Study Design: Systematic review. Level of Evidence: Level 2. Data Extraction: Studies were screened for methodological (MacDermid checklist) and psychometric quality (COSMIN checklist) by 2 independent raters. Results: Eight studies, with a total of 702 participants, were included. Seven studies evaluated the reliability of 2D video to assess FSP and found very good to excellent reliability (0.41 ≤ κ ≤ 1.00). Two studies reported excellent reliability for the calculation of step rate (0.75 ≤ intraclass correlation coefficient [ICC] ≤ 1.00). One study demonstrated excellent concurrent validity between 2D and 3D (gold standard) motion capture systems to determine FSP (Gwet agreement coefficient [AC] > 0.90; ICC > 0.90), and another study found excellent concurrent validity between 2D video and another device to calculate step rate (0.84 ≤ ICC ≤ 0.95). Conclusion: Strong evidence suggests that 2D video-based analysis is a reliable method for assessing FSP and quantifying step rate, regardless of the experience of the assessor. Limited evidence exists on the validity of 2D video-based analysis in determining FSP and calculating step rate during running.

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Return to Play After Isolated Meniscal Repairs in Athletes: A Systematic Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120962093 ◽

2020 ◽

Vol 8 (11) ◽

pp. 232596712096209

Author(s):

Erica R. Blanchard ◽

Christopher J. Hadley ◽

Eric D. Wicks ◽

William Emper ◽

Steven B. Cohen

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Cruciate Ligament ◽

Meniscal Repair ◽

Return To Play ◽

Meniscal Tears ◽

Arthroscopic Technique ◽

Level Of Evidence ◽

Study Results ◽

Anterior Cruciate

Background: Meniscal tears are a common knee injury. Isolated meniscal tears are less common; however, unaddressed tears can be troublesome, particularly for athletes. There is currently a lack of data in the literature on athletes returning to play after isolated meniscal repair. Purpose: To evaluate the return to play rate and time to return to play for athletes with isolated meniscal injuries. Study Design: Systematic review; Level of evidence, 4. Methods: A search of the PubMed, EMBASE, and Cochrane electronic databases was conducted to identify studies that reported the time and the rate of return to play in athletes after repair of isolated meniscal tears. Studies were excluded if there was a concomitant anterior cruciate ligament reconstruction, if there was a meniscectomy instead of a meniscal repair, or if the study was a systematic review. Quality assessment and data extraction were performed by 2 examiners. Results: Overall, 21 studies were included in this review. There were 355 athletes (358 knees) with a mean age of 22.5 years (range, 9-68 years). A sex breakdown was noted in 16 of the 21 (76.2%) studies with 224 men and 71 women. The specific repair technique was described in 259 (72.3%) knees. Of the total knees, 109 (30.4%) had an open repair, 128 (35.8%) had an inside-out arthroscopic technique repair, and 22 (6.1%) had an all-inside arthroscopic technique repair. Complications were addressed in 11 studies, with 13 out of 155 (8.4%) patients across the 11 articles having a postoperative complication. Of the total 355 patients, 295 (83.1%) returned to play, and 17 of these 21 (81.0%) articles reported the time it took for athletes to return to play, with a mean return of 8.7 months. Conclusion: The study results indicate that return to play rates after isolated meniscal repair are high, with an overall return to play rate of 83.1% and a mean return to play time of 8.7 months. However, the limited number of studies, particularly ones with larger patient numbers, highlights the need for further investigation regarding isolated meniscal repair in athletes.

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