scholarly journals Clinical and cost-effectiveness of non-medical prescribing: A systematic review of randomised controlled trials

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0193286 ◽  
Author(s):  
Timothy Noblet ◽  
John Marriott ◽  
Emma Graham-Clarke ◽  
Debra Shirley ◽  
Alison Rushton
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Randomised Controlled

scholarly journals Clinical and cost-effectiveness of non-medical prescribing: a systematic review of randomised controlled trials

Physiotherapy ◽  
2019 ◽  
Vol 105 ◽  
pp. e90-e91
Author(s):  
T. Noblet ◽  
J. Marriott ◽  
E. Graham-Clarke ◽  
D. Shirley ◽  
A. Rushton
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Randomised Controlled

scholarly journals Transcranial Magnetic Stimulation for the Treatment of Cocaine Addiction: A Systematic Review

2021 ◽  
Vol 10 (23) ◽  
pp. 5595
Author(s):  
Alezandra Torres-Castaño ◽  
Amado Rivero-Santana ◽  
Lilisbeth Perestelo-Pérez ◽  
Andrea Duarte-Díaz ◽  
Ana Toledo-Chávarri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Randomised Controlled Trials ◽  
Cocaine Addiction ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cocaine Use ◽  
Randomised Controlled

Long-term cocaine use is associated with cognitive deficits and neuro-psychiatric pathologies. Repetitive transcranial magnetic stimulation (rTMS) is an emerging therapeutic strategy relating to changes in brain activity. It stimulates the prefrontal cortex and is involved in inhibitory cognitive control, decision making and care. This systematic review aims to evaluate and synthesize the evidence on the safety, effectiveness, and cost-effectiveness of rTMS for the treatment of cocaine addiction. A systematic review of the literature was carried out. The following electronic databases were consulted from inception to October 2020: MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science. Randomised controlled trials, non-randomised controlled trials and case-series and full economic evaluations were included. Twelve studies were included. No identified study reported data on cost-effectiveness. Significant results of the efficacy of TMS have been observed in terms of the reduction of craving to consume and the number of doses consumed. No serious adverse effects have been observed. Despite the low quality of the studies, the first results were observed in terms of reduction of cocaine use and craving. In any case, this effect is considered moderate. Studies with larger sample sizes and longer follow-ups are required.

scholarly journals The effectiveness of integrating clinical pharmacists within general practice to optimise prescribing and health outcomes in primary care patients with polypharmacy: A protocol for a systematic review

2019 ◽  
Vol 2 ◽  
pp. 32
Author(s):  
Aisling Croke ◽  
Oscar James ◽  
Barbara Clyne ◽  
Frank Moriarty ◽  
Karen Cardwell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Economic ◽  
General Practice ◽  
Cost Effectiveness ◽  
Health Outcomes ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Randomised Controlled ◽  
Economic Studies

Introduction: Coordinating prescribing for patients with polypharmacy is a challenge for general practitioners. Pharmacists may improve management and outcomes for patients with polypharmacy. This systematic review aims to examine the clinical and cost-effectiveness of pharmacist interventions to optimise prescribing and improve health outcomes in patients with polypharmacy in primary care settings.  Methods: The review will be reported using the PRISMA guidelines. A comprehensive search of 10 databases from inception to present, with no language restrictions will be conducted. Studies will be included where they evaluate the clinical or cost-effectiveness of a clinical pharmacist in primary care on potentially inappropriate prescriptions using validated indicators and number of medicines. Secondary outcomes will include health related quality of life measures, health service utilisation, clinical outcomes and data relating to cost effectiveness. Randomised controlled trials, non-randomised controlled trials, controlled before-after, interrupted-time-series and health economic studies will be eligible for inclusion.  Titles, abstracts and full texts will be screened for inclusion by two reviewers. Data will be extracted using a standard form. Risk of bias in all included studies will be assessed using the Effective Practice and Organisation of Care (EPOC) criteria. Economic studies will be assessed using the Consensus Health Economic Criteria (CHEC) list as per the Cochrane Handbook for critical appraisal of methodological quality. A narrative synthesis will be performed, and the certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Where data support quantitative synthesis, a meta-analysis will be performed. Discussion: This systematic review will give an overview of the effectiveness of pharmacist interventions to improve prescribing and health outcomes in a vulnerable patient group. This will provide evidence to policy makers on strategies involving clinical pharmacists integrated within general practice, to address issues which arise in polypharmacy and multimorbidity.  PROSPERO Registration: CRD42019139679 (28/08/19)

scholarly journals The effectiveness of integrating clinical pharmacists within general practice to optimise prescribing and health outcomes in primary care patients with polypharmacy: A protocol for a systematic review

2020 ◽  
Vol 2 ◽  
pp. 32
Author(s):  
Aisling Croke ◽  
Oscar James ◽  
Barbara Clyne ◽  
Frank Moriarty ◽  
Karen Cardwell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Economic ◽  
General Practice ◽  
Cost Effectiveness ◽  
Health Outcomes ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Randomised Controlled ◽  
Economic Studies

Introduction: Coordinating prescribing for patients with polypharmacy is a challenge for general practitioners. Pharmacists may improve management and outcomes for patients with polypharmacy. This systematic review aims to examine the clinical and cost-effectiveness of pharmacist interventions to optimise prescribing and improve health outcomes in patients with polypharmacy in primary care settings.  Methods: The review will be reported using the PRISMA guidelines. A comprehensive search of 10 databases from inception to present, with no language restrictions will be conducted. Studies will be included where they evaluate the clinical or cost-effectiveness of a clinical pharmacist in primary care on potentially inappropriate prescriptions using validated indicators and number of medicines. Secondary outcomes will include health related quality of life measures, health service utilisation, clinical outcomes and data relating to cost effectiveness. Randomised controlled trials, non-randomised controlled trials, controlled before-after, interrupted-time-series and health economic studies will be eligible for inclusion.  Titles, abstracts and full texts will be screened for inclusion by two reviewers. Data will be extracted using a standard form. Risk of bias in all included studies will be assessed using the Effective Practice and Organisation of Care (EPOC) criteria. Economic studies will be assessed using the Consensus Health Economic Criteria (CHEC) list as per the Cochrane Handbook for critical appraisal of methodological quality. A narrative synthesis will be performed, and the certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Where data support quantitative synthesis, a meta-analysis will be performed. Discussion: This systematic review will give an overview of the effectiveness of pharmacist interventions to improve prescribing and health outcomes in a vulnerable patient group. This will provide evidence to policy makers on strategies involving clinical pharmacists integrated within general practice, to address issues which arise in polypharmacy and multimorbidity.  PROSPERO Registration: CRD42019139679 (28/08/19)

scholarly journals Perioperative liberal versus restrictive fluid strategies and postoperative outcomes: a systematic review and metanalysis on randomised-controlled trials in major abdominal elective surgery

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Antonio Messina ◽  
Chiara Robba ◽  
Lorenzo Calabrò ◽  
Daniel Zambelli ◽  
Francesca Iannuzzi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Randomised Controlled Trials ◽  
Elective Surgery ◽  
Fluid Management ◽  
Risk Difference ◽  
Controlled Trials ◽  
Perioperative Fluid Management ◽  
Liberal Approach ◽  
Randomised Controlled

Abstract Background Postoperative complications impact on early and long-term patients’ outcome. Appropriate perioperative fluid management is pivotal in this context; however, the most effective perioperative fluid management is still unclear. The enhanced recovery after surgery pathways recommend a perioperative zero-balance, whereas recent findings suggest a more liberal approach could be beneficial. We conducted this trial to address the impact of restrictive vs. liberal fluid approaches on overall postoperative complications and mortality. Methods Systematic review and meta-analysis, including randomised controlled trials (RCTs). We performed a systematic literature search using MEDLINE (via Ovid), EMBASE (via Ovid) and the Cochrane Controlled Clinical trials register databases, published from 1 January 2000 to 31 December 2019. We included RCTs enrolling adult patients undergoing elective abdominal surgery and comparing the use of restrictive/liberal approaches enrolling at least 15 patients in each subgroup. Studies involving cardiac, non-elective surgery, paediatric or obstetric surgeries were excluded. Results After full-text examination, the metanalysis finally included 18 studies and 5567 patients randomised to restrictive (2786 patients; 50.0%) or liberal approaches (2780 patients; 50.0%). We found no difference in the occurrence of severe postoperative complications between restrictive and liberal subgroups [risk difference (95% CI) = 0.009 (− 0.02; 0.04); p value = 0.62; I2 (95% CI) = 38.6% (0–66.9%)]. This result was confirmed also in the subgroup of five studies having a low overall risk of bias. The liberal approach was associated with lower overall renal major events, as compared to the restrictive [risk difference (95% CI) = 0.06 (0.02–0.09); p value  = 0.001]. We found no difference in either early (p value  = 0.33) or late (p value  = 0.22) postoperative mortality between restrictive and liberal subgroups Conclusions In major abdominal elective surgery perioperative, the choice between liberal or restrictive approach did not affect overall major postoperative complications or mortality. In a subgroup analysis, a liberal as compared to a restrictive perioperative fluid policy was associated with lower overall complication renal major events, as compared to the restrictive. Trial Registration CRD42020218059; Registration: February 2020, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=218059.

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