scholarly journals Prevalence of polypharmacy and associated adverse health outcomes in adult patients with chronic kidney disease: protocol for a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ikechi G. Okpechi ◽  
Mohammed M. Tinwala ◽  
Shezel Muneer ◽  
Deenaz Zaidi ◽  
Feng Ye ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Adult Patients ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Inappropriate Medications

Abstract Background Polypharmacy, often defined as the concomitant use of ≥ 5 medications, has been identified as a significant global public health threat. Aging and multimorbidity are key drivers of polypharmacy and have been linked to a broad range of adverse health outcomes and mortality. Patients with chronic kidney disease (CKD) are particularly at high risk of polypharmacy and use of potentially inappropriate medications given the numerous risk factors and complications associated with CKD. The aim of this systematic review will be to assess the prevalence of polypharmacy among adult patients with CKD, and the potential association between polypharmacy and adverse health outcomes within this population. Methods/design We will search empirical databases such as MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and PsycINFO and grey literature from inception onwards (with no language restrictions) for observational studies (e.g., cross-sectional or cohort studies) reporting the prevalence of polypharmacy in adult patients with CKD (all stages including dialysis). Two reviewers will independently screen all citations, full-text articles, and extract data. Potential conflicts will be resolved through discussion. The study methodological quality will be appraised using an appropriate tool. The primary outcome will be the prevalence of polypharmacy. Secondary outcomes will include any adverse health outcomes (e.g., worsening kidney function) in association with polypharmacy. If appropriate, we will conduct random effects meta-analysis of observational data to summarize the pooled prevalence of polypharmacy and the associations between polypharmacy and adverse outcomes. Statistical heterogeneity will be estimated using Cochran’s Q and I2 index. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., sex, kidney replacement therapy, multimorbidity). Discussion Given that polypharmacy is a major and a growing public health issue, our findings will highlight the prevalence of polypharmacy, hazards associated with it, and medication thresholds associated with adverse outcomes in patients with CKD. Our study will also draw attention to the prognostic importance of improving medication practices as a key priority area to help minimize the use of inappropriate medications in patients with CKD. Systematic review registration PROSPERO registration number: [CRD42020206514].

scholarly journals Understanding the influence of socioeconomic status on the association between combinations of lifestyle factors and adverse health outcomes: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042212
Author(s):  
Hamish Foster ◽  
Peter Polz ◽  
Frances Mair ◽  
Jason Gill ◽  
Catherine A O'Donnell
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Lifestyle Factors ◽  
Lifestyle Factor ◽  
Unhealthy Lifestyle ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
The Impact

IntroductionCombinations of unhealthy lifestyle factors are strongly associated with mortality, cardiovascular disease (CVD) and cancer. It is unclear how socioeconomic status (SES) affects those associations. Lower SES groups may be disproportionately vulnerable to the effects of unhealthy lifestyle factors compared with higher SES groups via interactions with other factors associated with low SES (eg, stress) or via accelerated biological ageing. This systematic review aims to synthesise studies that examine how SES moderates the association between lifestyle factor combinations and adverse health outcomes. Greater understanding of how lifestyle risk varies across socioeconomic spectra could reduce adverse health by (1) identifying novel high-risk groups or targets for future interventions and (2) informing research, policy and interventions that aim to support healthy lifestyles in socioeconomically deprived communities.Methods and analysisThree databases will be searched (PubMed, EMBASE, CINAHL) from inception to March 2020. Reference lists, citations and grey literature will also be searched. Inclusion criteria are: (1) prospective cohort studies; (2) investigations of two key exposures: (a) lifestyle factor combinations of at least three lifestyle factors (eg, smoking, physical activity and diet) and (b) SES (eg, income, education or poverty index); (3) an assessment of the impact of SES on the association between combinations of unhealthy lifestyle factors and health outcomes; (4) at least one outcome from—mortality (all cause, CVD and cancer), CVD or cancer incidence. Two independent reviewers will screen titles, abstracts and full texts of included studies. Data extraction will focus on cohort characteristics, exposures, direction and magnitude of SES effects, methods and quality (via Newcastle-Ottawa Scale). If appropriate, a meta-analysis, pooling the effects of SES, will be performed. Alternatively, a synthesis without meta-analysis will be conducted.Ethics and disseminationEthical approval is not required. Results will be disseminated via peer-reviewed publication, professional networks, social media and conference presentations.PROSPERO registration numberCRD42020172588.

Association between HTLV-1 infection and adverse health outcomes: a systematic review and meta-analysis of epidemiological studies

2020 ◽  
Vol 20 (1) ◽  
pp. 133-143 ◽  
Author(s):  
Gill Schierhout ◽  
Skye McGregor ◽  
Antoine Gessain ◽  
Lloyd Einsiedel ◽  
Marianne Martinello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Adverse Health ◽  
Adverse Health Outcomes

scholarly journals The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis

2019 ◽  
Vol 85 (11) ◽  
pp. 2464-2478 ◽  
Author(s):  
Caroline A. Walsh ◽  
Caitriona Cahir ◽  
Sarah Tecklenborg ◽  
Catherine Byrne ◽  
Michael A. Culbertson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Ageing Populations

Associations Between Potentially Inappropriate Medications and Adverse Health Outcomes in the Elderly: A Systematic Review and Meta-analysis

2019 ◽  
Vol 53 (10) ◽  
pp. 1005-1019 ◽  
Author(s):  
Xiao Xuan Xing ◽  
Chen Zhu ◽  
Hua Yu Liang ◽  
Ke Wang ◽  
Yan Qi Chu ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Adverse Drug Events ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Inclusion Criteria ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Inappropriate Medications

Background: Adverse drug outcomes in the elderly have led to the development of lists of potentially inappropriate medications (PIMs), such as the Beers criteria, and these PIMs have been studied widely; however, it is still unclear whether PIM use is predictive of adverse outcomes in older people. Objective: To qualitatively examine the associations between exposure to PIMs from the general Beers criteria and the Screening Tool of Older Persons’ Prescriptions list and adverse outcomes, such as adverse drug reactions (ADRs)/adverse drug events (ADEs), hospitalization, and mortality. Methods: Specified databases were searched from inception to February 1, 2018. Two reviewers independently selected studies that met the inclusion criteria, assessed study quality, and extracted data. Data were pooled using Stata 12.0. The outcomes were ADRs/ADEs, hospitalization, and mortality. Results: A total of 33 studies met the inclusion criteria. The combined analysis revealed a statistically significant association between ADRs/hospitalizations and PIMs (odds ratio [OR] = 1.44, 95% CI = 1.33-1.56; OR = 1.27, 95% CI = 1.20-1.35), but no statistically significant association was found between mortality and PIMs (OR = 1.04; 95% CI = 0.75-1.45). It is interesting to note that the results changed when different continents/criteria were used for the analysis. Compared with the elderly individuals exposed to 1 PIM, the risk of adverse health outcomes was much higher for those who took ≥2 PIMs. Conclusion and Relevance: We recommend that clinicians avoid prescribing PIMs for older adults whenever feasible. In addition, the observed associations should be generalized to other countries with different PIM criteria with caution.

The Adverse Health Outcomes, Economic Burden, and Public Health Implications of Unmanaged Attention Deficit Hyperactivity Disorder (ADHD): A Call to Action Resulting from CHADD Summit, Washington, DC, October 17, 2019

2021 ◽  
pp. 108705472110367
Author(s):  
Bob Cattoi ◽  
Ingrid Alpern ◽  
Jeffrey S. Katz ◽  
David Keepnews ◽  
Mary V. Solanto
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Outcomes ◽  
Health Care Providers ◽  
Economic Burden ◽  
Emotional Health ◽  
Care Providers ◽  
Health Implications ◽  
Adverse Health ◽  
Adverse Health Outcomes

Recent research has increasingly documented the adverse effects of ADHD on physical health in addition to its well-known effects on emotional health. Responding to this concern, CHADD organized a summit meeting of health care providers, governmental and other health-related organizations, and health care payers. A White Paper generated from the meeting reviewed the adverse health outcomes, economic burden and public health implications of unmanaged ADHD. Here we summarize the resulting Calls to Action to the various stakeholder groups including: increased awareness and education of providers; development of professional guidelines for diagnosis and treatment; insurance coverage of the relevant services; support of research targeting the role of ADHD in the etiology and treatment of physical illness; and public education campaigns.

Adverse Staff Health Outcomes Associated with Endoscope Reprocessing

2013 ◽  
Vol 47 (2) ◽  
pp. 172-179 ◽  
Author(s):  
Elane Gutterman ◽  
Lindsay Jorgensen ◽  
Amber Mitchell ◽  
Sherry Fua
Keyword(s):  
United States ◽  
Health Outcomes ◽  
Health Workers ◽  
The United States ◽  
Adverse Outcomes ◽  
Healthcare Personnel ◽  
Health Administration ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Pubmed Database

Abstract There are occupational challenges associated with cleaning, disinfecting, storing, and transporting flexible endoscopes. Although the Occupational Safety and Health Administration (OSHA) has set standards to protect the safety of health workers in the United States, the standards are not specific to endoscope reprocessing, and the general standards that are in place are not fully implemented. Furthermore, adverse staff outcomes may not be fully preventable. To assess the evidence for adverse outcomes in staff associated with endoscope reprocessing, a literature review was performed in the PubMed database for articles on this topic published between Jan. 1, 2007 and March 7, 2012. Eight studies were identified, mainly European, which reported numerous adverse outcomes to healthcare personnel associated with endoscope reprocessing including respiratory ailments and physical discomfort. More scientifically rigorous studies are required to comprehensively describe adverse health outcomes in personnel engaged in reprocessing, particularly in the United States, and examine whether increased automation of the reprocessing process leads to decreased adverse health outcomes for staff.

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