scholarly journals Effects of self-management education programmes on self-efficacy for osteoarthritis of the knee: a systematic review of randomised controlled trials

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daisuke Uritani ◽  
Hitoshi Koda ◽  
Sho Sugita
Keyword(s):  
Health Professionals ◽  
Self Efficacy ◽  
Randomised Controlled Trials ◽  
Management Education ◽  
Self Management ◽  
Controlled Trials ◽  
Face To Face ◽  
Knee Oa ◽  
Wide Range ◽  
Randomised Controlled

Abstract Background Enhancing self-efficacy to manage symptoms and functions is an important aspect of self-management for patients with knee osteoarthritis (OA). Many reports have investigated the effects of self-management education programmes for arthritis patients. However, a study that exclusively focuses on patients with OA in the same joints is required to clarify the effects of self-management programmes because individuals with knee OA experience physical and psychological difficulties different from those experienced by individuals with other arthritis diseases. Furthermore, previous studies have reported a wide range of delivery styles of self-management education programmes. This systematic review aimed to evaluate the effects of group-based and face-to-face self-management education programmes conducted by health professionals targeting self-efficacy for knee OA exclusively. Methods The MEDLINE, CENTRAL, EMBASE, CINAHL, Web of Science, and PEDro databases were searched to identify quantitative measures used in randomised controlled trials (RCTs) to assess the effects of self-management education programmes targeting self-efficacy in patients with knee OA. We included studies in which medical professional-delivered self-management education programmes were conducted in a group-based and face-to-face manner in community or outpatient settings. Results Seven RCTs from five countries were included in this review. Our retrieved studies included various types of self-management education programmes such as cognitive behavioural counselling, pain management education, physical education, weight management education, and arthritis self-efficacy management education, and control arms. They assessed various aspects of self-efficacy, including pain, physical function, arthritis symptoms excluding pain, weight management, mobility, and self-regulation. The total score of the Arthritis Self-Efficacy Scale was also measured. Some studies have reported beneficial effects of group-based and face-to-face self-management education programmes on self-efficacy for management of pain and other symptoms and for self-regulatory, knee OA. However, the results of the included studies were varied and inconsistent. Conclusions The current review only included seven studies, and there was a wide range of clinical heterogeneity among these studies. Thus, the effects of group-based and face-to-face self-management education programmes conducted by health professionals on self-efficacy for knee OA exclusively are inconclusive to date. Therefore, high-quality studies are required to provide significant information on clinicians, patients, and healthcare professionals in the future.

scholarly journals Effectiveness of chronic obstructive pulmonary disease self-management interventions in primary care settings: a systematic review

2019 ◽  
Vol 25 (3) ◽  
pp. 195 ◽  
Author(s):  
Hassan Hosseinzadeh ◽  
Mahmmoud Shnaigat
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Self Efficacy ◽  
Randomised Controlled Trials ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Primary Care Settings ◽  
Randomised Controlled

Chronic obstructive pulmonary disease (COPD) is one of the more disabling diseases and the third cause of mortality worldwide. Self-management is considered an effective strategy for controlling and managing COPD. This review aims to summarise the available evidence on the effectiveness of COPD self-management in primary care settings. Social Sciences, Citation Index, MEDLINE, CINAHL, Academic Search Complete and Scopus were searched for randomised controlled trials of COPD self-management in general practice between 2001 and 2018. Ten randomised controlled trials of COPD self-management trials conducted in primary care settings were included in this review. The identified trials have recruited stable patients; a majority having mild to moderate COPD. The trials implemented different types of interventions and measured improvements in knowledge, skills and behaviours of self-management, mental health, self-efficacy and endpoint outcomes such as hospitalisation and quality of life. The findings showed that COPD self-management trials had positive effects on COPD knowledge and improved self-management behaviours such as adherence to medication, physical activities and smoking cessation in some cases; however, the effect of trials on hospitalisation rate, quality of life and healthcare utilisation were not conclusive. There was also not enough evidence to suggest that the trials were efficient in improving self-efficacy, a major driver of self-management behaviours. Primary care COPD self-management trials are efficient in improving surrogate outcomes such as knowledge of and adherence to self-management behaviours; however, such improvements are less likely to be sustainable in the absence of self-efficacy. Future studies should also focus on improving endpoint self-management outcomes like hospitalisation rate and quality of life to benefit both patient and healthcare system.

scholarly journals The effectiveness of telehealth versus face-to face interventions for anxiety disorders: A systematic review and meta-analysis

2021 ◽  
pp. 1357633X2110537
Author(s):  
Natalia Krzyzaniak ◽  
Hannah Greenwood ◽  
Anna M Scott ◽  
Ruwani Peiris ◽  
Magnolia Cardona ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anxiety Disorders ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Depression Symptom ◽  
Post Intervention ◽  
Face To Face ◽  
Compulsive Disorder ◽  
Randomised Controlled

Introduction Worldwide, it is estimated that 264 million people meet the diagnostic criteria for anxiety conditions. Effective treatment regimens consist of cognitive and behavioural therapies. During the COVID-19 pandemic, treatment delivery relied heavily on telemedicine technologies which enabled remote consultation with patients via phone or video platforms. We aim to identify, appraise and synthesise randomised controlled trials comparing telehealth to face-to-face delivery of care to individuals of any age or gender, diagnosed with anxiety disorders, and disorders with anxiety features. Methods To conduct this systematic review and meta-analysis, we searched three electronic databases, clinical trial registries and citing-cited references of included studies. Results A total of five small randomised controlled trials were includable; telehealth was conducted by video in three studies, and by telephone in two. The risk of bias for the 5 studies was low to moderate for most domains. Outcomes related to anxiety, depression symptom severity, obsessive-compulsive disorder, function, working alliance, and satisfaction were comparable between the two modes of delivery at each follow-up time point (immediately post-intervention, 3 months, 6 months and 12 months), with no significant differences reported ( p > 0.05). None of the trials reported on the costs of telehealth compared to face-to-face care. Discussion For effectively treating anxiety and related conditions, interventions delivered by telehealth appear to be as effective as the same therapy delivered in-person. However, further high-quality trials are warranted to determine the effectiveness, acceptability, feasibility, and cost-effectiveness of telehealth interventions for the management of a wider range of anxiety disorders and treatments.

scholarly journals Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials

2018 ◽  
Vol 53 (15) ◽  
pp. 940-947 ◽  
Author(s):  
Alessio Bricca ◽  
Carsten B Juhl ◽  
Martijn Steultjens ◽  
Wolfgang Wirth ◽  
Ewa M Roos
Keyword(s):  
Systematic Review ◽  
Articular Cartilage ◽  
Knee Joint ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Knee Oa ◽  
Increased Risk ◽  
Randomised Controlled ◽  
The Impact ◽  
Knee Joint Loading

ObjectiveTo investigate the impact of knee joint loading exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis (OA) by conducting a systematic review of randomised controlled trials (RCTs).DesignWe followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.Data sourcesWe performed a literature search with no restriction on publication year or language in MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials and Web of Science up to September 2017.Eligibility criteriaRCTs investigating the impact of exercise on MRI-assessed articular cartilage in people over 18 years of age.ResultsWe included nine trials, including a total of 14 comparisons of cartilage morphometry, morphology and composition outcomes, of which two included participants at increased risk of knee OA and 12 included participants with knee OA. In participants at increased risk, one study comparison reported no effect on cartilage defects and one had positive effects on glycosaminoglycans (GAG). In participants with OA, six study comparisons reported no effect on cartilage thickness, volume or defects; one reported a negative effect and one no effect on GAG; two reported a positive effect and two no effect on collagen.ConclusionsKnee joint loading exercise seems to not be harmful for articular cartilage in people at increased risk of, or with, knee OA. However, the quality of evidence was low, including some interventions studying activities considered outside the therapeutic loading spectrum to promote cartilage health.

scholarly journals Goal Attainment Scaling as an Outcome Measure for Randomised Controlled Trials: A Systematic Scoping Review

2021 ◽  
Author(s):  
Benignus Logan ◽  
Dev K Jegatheesan ◽  
Andrea K Viecelli ◽  
Elaine Pascoe ◽  
Ruth E Hubbard
Keyword(s):  
Scoping Review ◽  
Randomised Controlled Trials ◽  
Goal Attainment ◽  
Outcome Measure ◽  
Geriatric Medicine ◽  
Goal Attainment Scaling ◽  
Controlled Trials ◽  
Healthcare Settings ◽  
Wide Range ◽  
Randomised Controlled

Abstract BACKGROUND: Goal Attainment Scaling (GAS) is an individualised outcome measure which can be used in research settings to assess achievement of participant-important priorities and goals. METHODS: A systematic scoping review was completed with the objective of: (1) Identifying the healthcare settings in which GAS has been used as an outcome measure. (2) Describing how GAS has been implemented by researchers in those trials. PubMed, CENTRAL, EMBASE and PsycINFO were searched without limits from their inceptions to 1 September 2021 for randomised controlled trials conducted in healthcare settings where GAS was used as an outcome measure for adults. Two reviewers independently completed both the screening and data extraction, with a third adjudicating conflicts. RESULTS: Of 1,764 articles screened, 37 studies were included. Most trials (86%) were solely undertaken in outpatient settings. They were frequently conducted within the disciplines of rehabilitation (57%), geriatric medicine (24%) and neurology (11%). Sample sizes ranged from 8 to 468, with a mean of 84 participants. GAS was a primary outcome measure in 38% of studies. There were inconsistencies between trials in the use of scales and the calculation of GAS scores. Implementation aspects such as the personnel involved, the training provided, and calibration and review mechanisms, were heterogeneously and scarcely reported. CONCLUSIONS: GAS has been used as an outcome measure across a wide range of disciplines and trial settings. However, there are inconsistencies in how it has been applied and implemented. Developing a cross-disciplinary practical guide to support a degree of standardisation in its implementation may be beneficial in increasing the reliability and comparability of trial results.

scholarly journals Embedding qualitative research in randomised controlled trials to improve recruitment: findings from two recruitment optimisation studies of orthopaedic surgical trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Arabella Scantlebury ◽  
Catriona McDaid ◽  
Stephen Brealey ◽  
Elizabeth Cook ◽  
Hemant Sharma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Health Professionals ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Surgical Trials ◽  
Link Type ◽  
Patient Pathways ◽  
Randomised Controlled ◽  
The Impact

Abstract Background Recruitment of patients is one of the main challenges when designing and conducting randomised controlled trials (RCTs). Trials of rare injuries or those that include surgical interventions pose added challenges due to the small number of potentially eligible patients and issues with patient preferences and surgeon equipoise. We explore key issues to consider when recruiting to orthopaedic surgical trials from the perspective of staff and patients with the aim of informing the development of strategies to improve recruitment in future research. Design Two qualitative process evaluations of a UK-wide orthopaedic surgical RCT (ACTIVE) and mixed methods randomised feasibility study (PRESTO). Qualitative semi-structured interviews were conducted and data was analysed thematically. Setting NHS secondary care organisations throughout the UK. Interviews were undertaken via telephone. Participants Thirty-seven health professionals including UK-based spinal and orthopaedic surgeons and individuals involved in recruitment to the ACTIVE and PRESTO studies (e.g. research nurses, surgeons, physiotherapists). Twenty-two patients including patients who agreed to participate in the ACTIVE and PRESTO studies (n=15) and patients that declined participation in the ACTIVE study (n=7) were interviewed. Results We used a mixed methods systematic review of recruiting patients to randomised controlled trials as a framework for reporting and analysing our findings. Our findings mapped onto those identified in the systematic review and highlighted the importance of equipoise, randomisation, communication, patient’s circumstances, altruism and trust in clinical and research teams. Our findings also emphasised the importance of considering how eligibility criteria are operationalised and the impact of complex patient pathways when recruiting to surgical trials. In particular, the influence of health professionals, who are not involved in trial recruitment, on patients’ treatment preferences by suggesting they would receive a certain treatment ahead of recruitment consultations should not be underestimated. Conclusions A wealth of evidence exploring factors affecting recruitment to randomised controlled trials exists. A methodological shift is now required to ensure that this evidence is used by all those involved in recruitment and to ensure that existing knowledge is translated into methods for optimising recruitment to future trials. Trial registration ACTIVE: (ISRCTN98152560). Registered on 06/03/2018. PRESTO: (ISRCTN12094890). Registered on 22/02/2018,

scholarly journals Effectiveness of community-based rehabilitation interventions incorporating outdoor mobility on ambulatory ability and falls-related self-efficacy after hip fracture: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Katie J. Sheehan ◽  
Laura Fitzgerald ◽  
Kate Lambe ◽  
Finbarr C. Martin ◽  
Sallie E. Lamb ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Self Efficacy ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
Controlled Trials ◽  
Community Based ◽  
Ambulatory Ability ◽  
Community Based Rehabilitation ◽  
Randomised Controlled

Abstract Summary There is limited evidence from 11 randomised controlled trials on the effect of rehabilitation interventions which incorporate outdoor mobility on ambulatory ability and/or self-efficacy after hip fracture. Outdoor mobility should be central (not peripheral) to future intervention studies targeting improvements in ambulatory ability. Purpose Determine the extent to which outdoor mobility is incorporated into rehabilitation interventions after hip fracture. Synthesise the evidence for the effectiveness of these interventions on ambulatory ability and falls-related self-efficacy. Methods Systematic search of MEDLINE, Embase, PsychInfo, CINAHL, PEDro and OpenGrey for published and unpublished randomised controlled trials (RCTs) of community-based rehabilitation interventions incorporating outdoor mobility after hip fracture from database inception to January 2021. Exclusion of protocols, pilot/feasibility studies, secondary analyses of RCTs, nonrandomised and non-English language studies. Duplicate screening for eligibility, risk of bias, and data extraction sample. Random effects meta-analysis. Statistical heterogeneity with inconsistency-value (I2). Results RCTs (n = 11) provided limited detail on target or achieved outdoor mobility intervention components. There was conflicting evidence from 2 RCTs for the effect on outdoor walking ability at 1–3 months (risk difference 0.19; 95% confidence intervals (CI): 0.21, 0.58; I2 = 92%), no effect on walking endurance at intervention end (standardised mean difference 0.05; 95% CI: − 0.26, 0.35; I2 = 36%); and suggestive (CI crosses null) of a small effect on self-efficacy at 1–3 months (standardised mean difference 0.25; 95% CI: − 0.29, 0.78; I2 = 87%) compared with routine care/sham intervention. Conclusion It was not possible to attribute any benefit observed to an outdoor mobility intervention component due to poor reporting of target or achieved outdoor mobility and/or quality of the underlying evidence. Given the low proportion of patients recovering outdoor mobility after hip fracture, future research on interventions with outdoor mobility as a central component is warranted. Trial registration PROSPERO registration: CRD42021236541

scholarly journals Self-management interventions for adolescents living with HIV: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Talitha Crowley ◽  
Anke Rohwer
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
The United States ◽  
Self Management ◽  
Controlled Trials ◽  
Hiv Viral Load ◽  
Management Interventions ◽  
Health Related ◽  
Randomised Controlled ◽  
Living With Hiv

Abstract Background Self-management interventions aim to enable people living with chronic conditions to increase control over their condition in order to achieve optimal health and may be pertinent for young people with chronic illnesses such as HIV. Our aim was to evaluate the effectiveness of self-management interventions for improving health-related outcomes of adolescents living with HIV (ALHIV) and identify the components that are most effective, particularly in low-resource settings with a high HIV burden. Methods We considered randomised controlled trials (RCTs), cluster RCTs, non-randomised controlled trials (non-RCTs) and controlled before-after (CBA) studies. We did a comprehensive search up to 1 August 2019. Two authors independently screened titles, abstracts and full texts, extracted data and assessed the risk of bias. We synthesised results in a meta-analysis where studies were sufficiently homogenous. In case of substantial heterogeneity, we synthesised results narratively. We assessed the certainty of evidence using GRADE and presented our findings as summaries in tabulated form. Results We included 14 studies, comprising 12 RCTs and two non-RCTs. Most studies were conducted in the United States, one in Thailand and four in Africa. Interventions were diverse, addressing a variety of self-management domains and including a combination of individual, group, face-to-face, cell phone or information communication technology mediated approaches. Delivery agents varied from trained counsellors to healthcare workers and peers. Self-management interventions compared to usual care for ALHIV made little to no difference to most health-related outcomes, but the evidence is very uncertain. Self-management interventions may increase adherence and decrease HIV viral load, but the evidence is very uncertain. We could not identify any particular components of interventions that were more effective for improving certain outcomes. Conclusion Existing evidence on the effectiveness of self-management interventions for improving health-related outcomes of ALHIV is very uncertain. Self-management interventions for ALHIV should take into account the individual, social and health system contexts. Intervention components need to be aligned to the desired outcomes. Systematic review registration PROSPERO CRD42019126313.

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