scholarly journals Should screening for risk of gambling-related harm be undertaken in health, care and support settings? A systematic review of the international evidence

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lindsay Blank ◽  
Susan Baxter ◽  
Helen Buckley Woods ◽  
Elizabeth Goyder
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
At Risk ◽  
Substance Abuse ◽  
Service Use ◽  
Methadone Maintenance ◽  
Grey Literature ◽  
Screening Tools ◽  
Care And Support ◽  
Related Harm

Abstract Background Gambling-related harm is an increasing recognised problem internationally. Recent years have seen an explosion in opportunities to gamble, both in person and online. Health and other care settings have the potential to act as screening sites to identify and support gamblers who may be at high risk of experiencing gambling-related harm. This study aimed to identify interventions to screen for risk of gambling-related harm in the general population which may be delivered in health, care and support settings. Methods Systematic review. Searches of key databases and grey sources since 2012 were undertaken in October 2019. Electronic database searches generated a total of 5826 unique hits. Nine studies published 2013–2019, along with thirteen grey literature documents met our eligibility criteria. The criteria were setting (health, care and support settings), participants (any attendee in help, care and support settings), interventions (screening to identify risk of harm from gambling behaviours) and outcome measures (gambling behaviours, service use). Results Three papers evaluating screening interventions delivered in general practice (repeat visits and written advice), mental health service (the use of screening tools to identify risk of harm), and substance abuse treatment (intensive outpatient treatment for substance use disorders or methadone maintenance) indicated evidence of potential effectiveness. Six papers supported the feasibility and acceptability of delivering interventions in various settings. Grey literature reports described the implementation of interventions such as training materials, and transfer of interventions developed for substance abuse populations by practitioners. Conclusions Health, care and support services offer potentially important contexts in which to identify and offer support to people who are at risk of gambling related harm. Screening interventions appear feasible and acceptable in a range of community and healthcare settings for those at risk of gambling harm. Evaluation of effectiveness and cost-effectiveness of screening in these populations should therefore be prioritised.

scholarly journals Comparison of data sources on alcohol problems: An exploratory exercise using surveys vs. national healthcare registers

2020 ◽  
pp. 145507252096802
Author(s):  
Pia Mäkelä ◽  
Kristiina Kuussaari ◽  
Airi Partanen ◽  
Elina Rautiainen
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Healthcare Service ◽  
Service Use ◽  
Basic Education ◽  
Alcohol Problems ◽  
Register Data ◽  
Data Sources ◽  
National Healthcare ◽  
Healthcare Service Use

Aims: Both survey and healthcare register data struggle as data sources to capture the phenomenon of alcohol problems. We study a large group of people for whom survey data and two types of register data are available, and examine the overlaps of similar or related measures in the different data sources to learn about potential weaknesses in each. We also examine how register-based data on the prevalence of alcohol problems change depending on which register data are used. Design: We use data from the Regional Health and Wellbeing Study (ATH) of the adult Finnish population collected in 2013 and 2014 ( n = 69,441), individually linked with data on two national healthcare registers (Care Register for Health Care; Register of Primary Health Care visits) for the survey year and previous year. Results: The prevalence of substance-abuse-related healthcare was almost two-fold if data on outpatient primary care visits were included in addition to hospitalisations. Forty-six per cent of the survey respondents self-reporting substance-abuse-related healthcare service use were identified in the registers, and 22% of all respondents with such service use according to registers reported this in the survey. Records of substance-abuse-related healthcare service use, controlled for self-reported alcohol use and self-reported substance-abuse-related service use, were found more often for men, the middle-aged, people with basic education only, and the non-employed. Conclusions: The results are suggestive of underreporting in both data sources. There is an evident need to develop recording practices in the healthcare registers regarding substance use disorders.

scholarly journals P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Services ◽  
Grey Literature ◽  
Study Data ◽  
Care Utilization ◽  
Alternative Source ◽  
Increased Risk ◽  
The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

scholarly journals “Too Grey To Be True?” Sexual Violence in Older Adults: A Critical Interpretive Synthesis of Evidence

2020 ◽  
Vol 17 (11) ◽  
pp. 4117
Author(s):  
Anne Nobels ◽  
Christophe Vandeviver ◽  
Marie Beaulieu ◽  
Adina Cismaru Inescu ◽  
Laurent Nisen ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Older Adults ◽  
Health Care ◽  
Sexual Health ◽  
Sexual Violence ◽  
Old Age ◽  
Grey Literature ◽  
Health Needs ◽  
Second Phase

Sexual violence (SV) is an important public health issue with a major impact on victims and their peers, offspring and community. However, SV in older adults is under-researched. This paper aims to establish the prevalence and nature of SV in older adults in Europe, link this with existing policies and health care workers’ response to sexual health needs in older age, and critically revise the currently used frameworks in public health research. To fill this gap in the literature, we applied a Critical Interpretative Synthesis (CIS) approach. The CIS approach uses techniques from grounded theory and processes from systematic review. It allows to critically interpret key findings from both academic as well as grey literature, engendering theory refining. In the first phase of purposive sampling, we conducted a systematic review of academic sources and included 14 references. The cut-off age used to define old age varied between 60 and 70 years old among the included studies. Subsequently we added another 14 references in the second phase of theoretical sampling. We ultimately included 16 peer-reviewed articles and 12 documents from the grey literature. The CIS results demonstrate that knowledge of SV in older adults is still limited. The current research suggests that SV in older adults rarely occurs, however, prevalence rates are likely to be underestimated because of methodological shortcomings. The complexity of SV in older adults is not acknowledged in ongoing research due to the conflation of SV with other types of violence. Information on specific risk factors and about assailants committing SV in old age is absent. Policy documents dealing with sexual and reproductive health, rights and ageing make no mention of SV in older adults. In clinical practice, the sexual health needs of older adults often remain unmet. In conclusion, our findings suggest that older adults are forgotten in prevention and response to SV. Greater awareness about this topic could contribute to a revision of current policies and health care practices, leading to more tailored care for older victims of SV.

Interventions to Decrease Use in Prehospital and Emergency Care Settings Among Super-Utilizers in the United States: A Systematic Review

2019 ◽  
Vol 77 (2) ◽  
pp. 99-111 ◽  
Author(s):  
Samantha Iovan ◽  
Paula M. Lantz ◽  
Katie Allan ◽  
Mahshid Abir
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Acute Care ◽  
Emergency Care ◽  
Grey Literature ◽  
The United States ◽  
Care Utilization ◽  
Regression To The Mean ◽  
High Quality ◽  
The Impact

Interest in high users of acute care continues to grow as health care organizations look to deliver cost-effective and high-quality care to patients. Since “super-utilizers” of acute care are responsible for disproportionately high health care spending, many programs and interventions have been implemented to reduce medical care use and costs in this population. This article presents a systematic review of the peer-reviewed and grey literature on evaluations of interventions to decrease prehospital and emergency care use among U.S. super-utilizers. Forty-six distinct evaluations were included in the review. The most commonly evaluated intervention was case management. Although a number of interventions reported reductions in prehospital and emergency care utilization and costs, methodological and study design weaknesses—especially regression to the mean—were widespread and call into question reported positive findings. More high-quality research is needed to accurately assess the impact of interventions to reduce prehospital and emergency care use in the super-utilizer population.

A Systematic Review of the Impact of Healthcare Reforms on Access to Emergency Department and Elective Surgery Services

2017 ◽  
Vol 48 (1) ◽  
pp. 81-105 ◽  
Author(s):  
Sandeep Reddy ◽  
Peter Jones ◽  
Harsha Shanthanna ◽  
Raechel Damarell ◽  
John Wakerman
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
United Kingdom ◽  
Elective Surgery ◽  
Grey Literature ◽  
Unintended Consequences ◽  
Health Care Reforms ◽  
The United Kingdom ◽  
The Impact

This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant “grey” literature and websites. Included studies were checked for cited and citing papers. Primary studies corresponding to national and provincial ED and ES reforms in the four countries were considered. Only studies from Australia and the United Kingdom were eventually included, as no studies from the other two countries met the inclusion criteria. The reviewers involved in the study extracted the data independently using standardized forms. Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.

scholarly journals Screening tools to identify patients with complex health needs at risk of high use of health care services: A scoping review

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0188663 ◽  
Author(s):  
Valérie Marcoux ◽  
Maud-Christine Chouinard ◽  
Fatoumata Diadiou ◽  
Isabelle Dufour ◽  
Catherine Hudon
Keyword(s):  
Health Care ◽  
At Risk ◽  
Scoping Review ◽  
Health Care Services ◽  
Health Needs ◽  
Screening Tools ◽  
Care Services ◽  
Use Of Health Care

scholarly journals Chronic care models and opportunities for improving health care practice and outcomes in Sub-Saharan Africa: Protocol for systematic review

2020 ◽  
Author(s):  
Peter Otieno ◽  
Charles Agyemang ◽  
Razak M. Gyasi ◽  
Anthony K. Ngugi ◽  
Catherine Kyobutungi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Chronic Care ◽  
Critical Appraisal ◽  
Health Care Systems ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
Care Models ◽  
Care Systems ◽  
Sub Saharan

Abstract Background: The rising burden of chronic diseases in sub-Saharan Africa (SSA) where health care systems are least developed has led to recent calls for increased investment in chronic care models (CCM) appropriate for low-resource settings. In SSA, limited resources are often allocated to treating acute diseases thus management of chronic conditions is a major challenge for health care systems. A large diversity of CCM exist in the literature but evidence supporting their use has been derived from high income settings. This is the motivation for conducting a systematic review to identify the existing CCM and their relevance and applicability in SSA.Methods and analysis: All peer-reviewed published and grey literature on CCM will be included. PubMed/MEDLINE, Embase, Scopus, Web of Science and Global Health Cinahl, African Journals Online, Informit Online, and PsycINFO will be searched to identify relevant articles. OpenSIGLE will be reviewed for grey literature. The articles retrieved will be independently screened for inclusion by two independent investigators while a third reviewer will arbitrate the disagreements. An independent critical appraisal of retrieved studies will be performed using standardized critical appraisal checklists. The data will be extracted from the key elements of CCM. Outcome measures for the effectiveness of the models in the context of SSA will include any reported improvement to the health care service delivery or changes in the health outcomes of patients with chronic illnesses. The study findings will be reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA).Discussion: This systematic review is expected to generate crucial evidence on the applicability of CCM in SSA and unearth the CCM components that are suitable for different levels of health care delivery systems and the emerging needs of the people living with comorbidities and multimorbidities in SSA.Systematic review registration: This review is registered in PROSPERO International Prospective Register of Systematic reviews CRD42020187756.

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