scholarly journals Non-pharmacological interventions in dementia

2004 ◽  
Vol 10 (3) ◽  
pp. 171-177 ◽  
Author(s):  
Simon Douglas ◽  
Ian James ◽  
Clive Ballard
Keyword(s):  
Randomised Controlled Trials ◽  
Best Practice ◽  
Behavioural Therapy ◽  
Controlled Trials ◽  
Second Line ◽  
Pharmacological Treatments ◽  
Pharmacological Interventions ◽  
Valid Data ◽  
Randomised Controlled ◽  
Reality Orientation

It is increasingly recognised that pharmacological treatments for dementia should be used as a second-line approach and that non-pharmacological options should, in best practice, be pursued first. This review examines current non-pharmacological approaches. It highlights the more traditional treatments such as behavioural therapy, reality orientation and validation therapy, and also examines the potential of interesting new alternative options such as cognitive therapy, aromatherapy and multisensory therapies. The current literature is explored with particular reference to recent research, especially randomised controlled trials in the area. Although many non-pharmacological treatments have reported benefits in multiple research studies, there is a need for further reliable and valid data before the efficacy of these approaches is more widely recognised.

Seksueel onaangepast gedrag bij een patiënt met dementie: literatuurreview en casusrapport

2021 ◽  
Author(s):  
C. SEAUX ◽  
K. GOEDSEELS ◽  
J. DE LEPELEIRE
Keyword(s):  
Case Studies ◽  
Randomised Controlled Trials ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Pharmacological Interventions ◽  
Drug Of Choice ◽  
Cochrane Database ◽  
History Of ◽  
Randomised Controlled

Sexually inappropriate behaviour in a patient with dementia: literature review and case report In this paper, the medical history of a 75-year-old man with dementia and sexually inappropriate behaviour (SIB) is described. An overview of the literature regarding the approach and treatment of SIB in persons with dementia was performed. PubMed, Web of Science and the Cochrane database were consulted, and thirteen articles selected. There are no randomised controlled trials available. The literature is limited to case studies and reviews of case studies. Non-pharmacological treatments are perceived to be the first step, although they are rarely studied. There is no consensus regarding a pharmacological approach. However, all studies suggest the paradigm of “start low and go slow”. A variety of drugs have been described. When starting a pharmacological treatment, it is recommended to keep in mind comorbidities and possible side-effects. Selective serotonin reuptake inhibitors (SSRIs) seem to be the preferred first line treatment if the behaviour is not too harmful. If the behaviour is intrusive, anti-androgens seem to be the drug of choice. Further research is needed: a consensus regarding the definition and the development of a screening tool could support randomised controlled trials concerning pharmacological and non-pharmacological interventions. Research concerning ethical dilemmas should, however, not be neglected.

Evidence-Based Practice: The Cochrane Collaboration, and Occupational Therapy

1998 ◽  
Vol 65 (3) ◽  
pp. 144-151 ◽  
Author(s):  
Robyn L. Hayes ◽  
John J. McGrath
Keyword(s):  
Systematic Reviews ◽  
Randomised Controlled Trials ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Cochrane Collaboration ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomised Controlled ◽  
The Cochrane Collaboration

This paper describes how occupational therapists can become involved in the Cochrane Collaboration — a well-developed tool for facilitating the involvement of health professionals and lay people in evidence-based practice. The Cochrane Collaboration is a growing international project intended to systematically locate, conduct systematic reviews (including metaanalyses) of, and disseminate information on all available randomised controlled trials of interventions in any area of health. In particular, occupational therapists can use the Cochrane Collaboration to become better informed about best practice and evaluate research in their areas of interest, and learn skills related to conducting randomised controlled trials, systematic reviews, and meta-analyses.

Non-pharmacological interventions to improve constipation amongst older adults in long-term care settings: A systematic review of randomised controlled trials

2020 ◽  
Vol 41 (6) ◽  
pp. 992-999
Author(s):  
Iria Dobarrio-Sanz ◽  
José Manuel Hernández-Padilla ◽  
María Mar López-Rodríguez ◽  
Cayetano Fernández-Sola ◽  
José Granero-Molina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Randomised Controlled Trials ◽  
Long Term Care ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Term Care ◽  
Randomised Controlled

scholarly journals Impact of pharmacological Interventions on fertility outcomes in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomised controlled trials

2021 ◽  
Author(s):  
MOHAMMED ABDALLA ◽  
Najeeb Shah ◽  
Harshal Deshmukh ◽  
Amirhossein Sahebkar ◽  
Linda Östlundh ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Randomised Controlled Trials ◽  
Polycystic Ovary ◽  
Ovulation Rate ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Ovary Syndrome ◽  
Randomised Controlled

Background: Polycystic ovary syndrome (PCOS) is an endocrine condition associated with sub-fertility, infertility and poor reproductive outcomes. Objectives: To review the effectiveness of different pharmacological interventions on fertility outcomes in women with PCOS. Search Strategy: We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library, Web of Science in April 2020 and updated the search in PubMed March 2021. Selection Criteria: Two independent reviewers selected studies, and only randomised controlled trials (RCTs) were included. Data Collection and Analysis: Thirty-four RCTs that met the eligibility criteria were used to calculate odds ratios (OR) and the 95% confidence interval (95% CI) using the random effect model. Main Results: There was a significant increase in pregnancy rate with follicular stimulating hormone (FSH) vs clomiphene citrate (CC)+ metformin (Odd Ratio(OR):4.08; 95%CI:1.12-14.83,I²=79%), Letrozole vs CC (OR: 1.58; 95%CI: 1.34-1.86, I²= 0%), metformin vs placebo(OR: 3.00; 95%CI: 1.95-4.59, I²= 0%) and with CC+ metformin vs CC (OR: 1.48; 95%CI: 1.02-2.16, I²= 39%). There were significant increases in ovulation rate with CC+ metformin vs FSH (OR: 0.09; 95%CI: 0.02-0.37, I² = 75%), CC+ metformin vs CC (OR: 2.04; 95%CI: 1.35-3.08, I² = 63%) and with Letrozole vs CC (OR: 1.60; 95%CI: 1.02-2.52, I²= 88%). A significant increase in live birth with Letrozole vs CC (OR: 1.63; 95%CI: 1.21-2.21, I² = 0%) was observed. Conclusions: CC, letrozole alone or either added to metformin, were associated with a significant increase in the pregnancy rate, ovulation rate, and live birth rate in women with PCOS. Funding: No fund for the review.

scholarly journals Effect on Neonatal Outcome of Pharmacological Interventions for Attenuation of the Maternal Haemodynamic Response to Tracheal Intubation: A Systematic Review

2018 ◽  
Vol 46 (3) ◽  
pp. 258-271 ◽  
Author(s):  
A. Aman ◽  
B. Salim ◽  
K. Munshi ◽  
S. A. Raza ◽  
F. A. Khan
Keyword(s):  
Systematic Review ◽  
Tracheal Intubation ◽  
Randomised Controlled Trials ◽  
Neonatal Outcome ◽  
Opioid Analgesics ◽  
Haemodynamic Response ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Apgar Scores ◽  
Randomised Controlled

The primary aim of this systematic review was to assess the effect on neonatal outcome of pharmacological interventions used for attenuation of the haemodynamic response to tracheal intubation in patients undergoing caesarean Section under general anaesthesia. A systematic search of randomised controlled trials from 1990 to 2015 was conducted. The primary outcome measure was the Apgar score at five minutes and secondary outcomes were umbilical arterial blood gas parameters and neurological adaptive capacity scores. Twenty-seven randomised controlled trials (1,689 patients) were included in the qualitative synthesis. Only five studies using opioids (383 patients) and five studies using non-opioid analgesics (358 patients) were subjected to meta-analysis. The Apgar score at five minutes was significantly lower in neonates of opioid-treated mothers (mean difference: −0.29, 95% confidence interval −0.56 to −0.02, P-value=0.03) compared to mothers in the control group; the umbilical arterial pH was lower and there was a higher requirement for tactile stimulation in neonates. No difference was seen in Apgar scores of neonates of mothers administered non-opioid analgesics compared to placebo. No difference was observed in other parameters between opioid- or non-opioid-treated mothers. This review suggests that opioid interventions for attenuation of the haemodynamic response to tracheal intubation in pregnant patients under general anaesthesia affect neonatal Apgar scores at five minutes in neonates but the difference did not appear to be clinically meaningful. We were unable to demonstrate any difference in safety.

scholarly journals Role of personality disorder in randomised controlled trials of pharmacological interventions for adults with mood disorders: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025145
Author(s):  
Bianca E Kavanagh ◽  
Sharon Lee Brennan-Olsen ◽  
Alyna Turner ◽  
Olivia M Dean ◽  
Michael Berk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Personality Disorder ◽  
Mood Disorders ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Randomised Controlled

IntroductionRemission rates for mood disorders, including depressive and bipolar disorders, remain relatively low despite available treatments, and many patients fail to respond adequately to these interventions. Evidence suggests that personality disorder may play a role in poor outcomes. Although personality disorders are common in patients with mood disorders, it remains unknown whether personality disorder affects treatment outcomes in mood disorders. We aim to review currently available evidence regarding the role of personality disorder on pharmacological interventions in randomised controlled trials for adults with mood disorders.Methods and analysisA systematic search of Cochrane Central Register of Controlled Clinical Trials (CENTRAL) via cochranelibrary.com, PubMed via PubMed, EMBASE via embase.com, PsycINFO via Ebsco and CINAHL Complete via Ebsco databases will be conducted to identify randomised controlled trials that have investigated pharmacological interventions in participants aged 18 years or older for mood disorders (ie, depressive disorders and bipolar spectrum disorders) and have also included assessment of personality disorder. One reviewer will screen studies against the predetermined eligibility criteria, and a second reviewer will confirm eligible studies. Data will be extracted by two independent reviewers. Methodological quality and risk of bias will be assessed using the Cochrane Risk of Bias tool. A systematic review, and if sufficient evidence is identified, a meta-analysis will be completed. Meta-analysis will be conducted using the standardised mean difference approach and reported with 95% CIs. A random effects model will be employed and statistical heterogeneity will be evaluated using the I2 statistic. Prespecified subgroup analyses will be completed.Ethics and disseminationAs this systematic review will use published data, ethics permission will not be required. The outcomes of this systematic review will be published in a relevant scientific journal and presented at a research conference.Trial registration numberCRD42018089279.

Sign in / Sign up

Export Citation Format

Share Document