scholarly journals General practice pharmacists in Australia: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258674
Author(s):  
Thilini Sudeshika ◽  
Mark Naunton ◽  
Louise S. Deeks ◽  
Jackson Thomas ◽  
Gregory M. Peterson ◽  
...  

Background The inclusion of pharmacists into general practices in Australia has expanded in recent years. This systematic review aimed to synthesise the literature of qualitative and quantitative studies, and identify the knowledge gaps, related to pharmacists working in general practice in Australia. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, EBSCOhost, EMBASE, and the Cochrane Library were searched from the inception of databases to January 2021. The search was focused on studies investigating general practice pharmacists in Australia. The quality of each study was appraised using the Mixed Method Appraisal Tool criteria. The narrative synthesis approach was utilised to describe data due to the heterogeneity among study designs and measures. Results Twenty-five studies were included in this review. General practice pharmacists engaged in various non-dispensing patient care services, with medication management reviews being the primary activity reported. General practice pharmacists’ characteristics and an environment with a willingness of collaboration were the notable influencing factors for successfully including pharmacists in general practices. Factors that posed a challenge to the adoption of general practice pharmacists were lack of funding and other resources, poorly defined roles, and absence of mentoring/training. Conclusion This review has summarised the characteristics, activities, benefits, barriers, and facilitators of including pharmacists in general practices in Australia. General practice pharmacists are well accepted by stakeholders, and they can engage in a range of patient-centred activities to benefit patients. There is a need for more robust research to explore the patient and economic outcomes related to clinical activities that a pharmacist can perform in general practice, as a foundation to developing an appropriate and sustainable funding model. The findings of this review will be beneficial for pharmacists, researchers, policymakers, and readers who wish to implement the role of general practice pharmacists in the future.

Author(s):  
Soo Yeon Yang ◽  
Seon Heui Lee ◽  
Seung-Joo Chon

(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.


2018 ◽  
Vol 46 (6) ◽  
pp. 665-676 ◽  
Author(s):  
Stientje Esther Rai ◽  
Amneet Kaur Sidhu ◽  
Rohin Jayaram Krishnan

Abstract Context: Significant controversy exists surrounding the possible association between recent packed red blood cell (PRBC) transfusion and the subsequent development of necrotizing enterocolitis (NEC) in infants. Previous studies and meta-analyses reporting a statistically significant association led to a practice change to withhold enteral feeds in the peri-transfusion period in many centers in an effort to prevent NEC; however, results from more recent studies do not support the existence of an association and, thus, question the validity of this practice change. Objective: This study aimed to perform a systematic review and meta-analysis to determine whether exposure to recent PRBC transfusion (defined as within 48 h) is associated with the subsequent development of NEC stage ≥II (Bell’s criteria) in infants. Methods: Medline, Embase, CINAHL, and the Cochrane Library were searched from inception to October 7, 2015. A gray literature search was also performed. Studies comparing the risk of NEC in infants exposed and unexposed to recent PRBC transfusion were included. Thirteen studies met eligibility criteria, and 10 (n=15,675 infants) were included in the meta-analysis. Three authors independently extracted data, and meta-analysis was performed using a random effects model. Results: We found a statistically significant 45% reduction in the unadjusted odds of NEC in infants exposed to a recent PRBC transfusion (odds ratio=0.55, 95% confidence interval=0.31–0.98). Conclusion: Our results show a protective effect of recent PRBC transfusion on the subsequent development of NEC. The practice of withholding enteral feeds during the peri-transfusion period should be re-evaluated in light of these results.


2020 ◽  
Vol 10 ◽  
pp. 2235042X2090665
Author(s):  
Jordan Canning ◽  
Stefan Siebert ◽  
Bhautesh D Jani ◽  
Frances S Mair ◽  
Barbara I Nicholl

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterised by articular inflammation and systemic complications. Multimorbidity (the presence of two or more long-term health conditions) is highly prevalent in people with RA but the effect of multimorbidity on mortality and other health-related outcomes is poorly understood. Objective: To determine what is known about the effect, if any, of multimorbidity on mortality and health-related outcomes in individuals with RA. Design: Systematic review of the literature. The following electronic medical databases will be searched: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, The Cochrane Library and Scopus. Included studies will be quality appraised using the Quality in Prognostic Studies tool developed by the Cochrane Prognosis Methods Group. A narrative synthesis of findings will be undertaken and meta-analyses considered, if appropriate. This protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 guidelines, ensuring the quality of the review. Conclusions: Understanding the influence of multimorbidity on mortality and other health-related outcomes in RA will provide an important basis of knowledge with the potential to improve future clinical management of RA. PROSPERO registration number: CRD42019137756.


2018 ◽  
Vol 12 (3) ◽  
pp. 121-126
Author(s):  
Tiago Ribeiro de Oliveira ◽  
Ben Van Cleynenbreugel ◽  
Sérgio Pereira ◽  
Pedro Oliveira ◽  
Sandro Gaspar ◽  
...  

Background/Aims: Laparoscopy is a widespread surgical approach for many urological conditions. Achieving prof-ciency in laparoscopic surgery requires considerable effort due to the steep learning curve. Several residency programs include standardized laparoscopic training periods in their curricula. Our aim was to systematically analyze the evidence on the current status of training in laparoscopy in different residency programs in urology. Methods: We performed a systematic review of PubMed/Medline and the Cochrane library, in February 2018, according to the Preferred Reporting Items for the Systematic Review and Meta-Analyses Statement. Identified reports were reviewed according to the previously defined inclusion criteria. Eight publications, comprising a total of 985 urology residents, were selected for inclusion in this analysis. Results: There was a wide variation between training programs in terms of exposure to laparoscopy. Most residents considered that training in lap-aroscopy was inadequate during residency and had a low degree of confidence in independently performing laparo-scopic procedures by the end of the residency. Only North American residents reported high degrees of confidence in the possibility of performing laparoscopic procedures in the uture, whereas the remaining residents, namely from European countries, reported considerably lower degrees of confidence. Conclusion: There were considerable differences between national urology residency programs in terms of exposure to laparoscopy. Most residents would prefer higher exposure to laparoscopy throughout their residencies.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11713
Author(s):  
Ana Carolina Hovadick ◽  
Viviane Rodrigues Jardim ◽  
Constança Paúl ◽  
Adriana Pagano ◽  
Ilka Reis ◽  
...  

Background The family caregivers of patients on hemodialysis (HD) and peritoneal dialysis (PD) typically experience higher burden than the general population because of the nature of tasks these caregivers need to carry out as a part of homecare. This fact influences both the caregivers’ quality of life and the quality of their care toward the patient. Thus, this study aimed to review the effectiveness and limitations of interventions in improving the well-being of family caregivers of patients on HD and PD. Methodology A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, MEDLINE, VHL Regional Portal, Scopus, and Web of Science databases were searched queried for randomized controlled trials that developed interventions aimed at improving the well-being of family caregivers of patients undergoing HD and/or PD from 2009 to 2020. The study protocol was registered at the International Prospective Register of Systematic Reviews (registration no. CRD42020151161). Results Six studies met the inclusion criteria, all of which addressed caregivers of patients undergoing HD. All interventions reported in the included studies were carried out in group sessions, which addressed topics such as patient assistance and care, treatment complications, coping strategies, caregiver self-care practices, problem solving, and self-efficacy. The studies found significant improvement in the caregiver’s well-being. Conclusions Group session interventions are effective in improving the well-being of family caregivers of patients undergoing HD. In regard to PD, there is insufficient evidence to make recommendations for caregivers of patients with this treatment.


2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091570
Author(s):  
Eoghan T. Hurley ◽  
Yoshiharu Shimozono ◽  
Charles P. Hannon ◽  
Niall A. Smyth ◽  
Christopher D. Murawski ◽  
...  

Background: Plantar fasciitis is the most common cause of plantar heel pain. Several recent randomized control trials (RCTs) have been published comparing the use of platelet-rich plasma (PRP) and corticosteroids (CSs) for the treatment of plantar fasciitis. Purpose: To perform a systematic review of RCTs to compare whether PRP or CS injections result in decreased pain levels and improved patient outcomes in the treatment of plantar fasciitis. Study Design: Systematic review; Level of evidence, 1. Methods: Medline, EMBASE, and the Cochrane Library were screened according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify RCTs comparing PRP and CS injections for plantar fasciitis. The visual analog scale (VAS) pain scores and the American Orthopaedic Foot and Ankle Society (AOFAS) scores were compared between groups at 1, 1.5, 3, 6, and 12 months, where possible. Statistical analysis was performed using RevMan, and P < .05 was considered to be statistically significant. Results: A total of 9 RCTs were identified comparing 239 patients with PRP with 240 patients with CS injections. At the follow-up time points, including 1-1.5, 3, 6, and 12 months, there were statistically significant differences in VAS scores in favor of PRP ( P = .004, P < .00001, P < .00001, and P < .00001, respectively). At 1 and 3 months, there was no difference in AOFAS scores ( P = .76 and P = .35, respectively). However, at 6 and 12 months, there was a difference in AOFAS scores in favor of PRP ( P < .00001 and P < .00001, respectively). Conclusion: In patients with chronic plantar fasciitis, the current clinical evidence suggests that PRP may lead to a greater improvement in pain and functional outcome over CS injections.


Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 80
Author(s):  
D’arcy Picton-Barnes ◽  
Manikam Pillay ◽  
David Lyall

Healthcare-associated infections (HAIs) pose a significant occupational risk to medical radiation science (MRS) professionals, who have a high degree of patient contact. Current research largely focusses on HAIs in patients, with limited attention given to infectious organisms that MRS professionals are exposed to. This is a significant gap that this systematic review seeks to address by summarizing current literature to determine the infectious organisms within MRS departments, their reservoirs, and transmission modes. Reporting of this systematic review follows the preferred reporting items for systematic reviews and meta-analyses guidelines. Five databases were searched (Scopus, Medical Literature Analysis and Retrieval System Online (MEDLINE), the Cochrane Library, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) for relevant studies published between 1983 and 2018. Quality assessment was performed using checklists from the Johanna Briggs Institute. Nineteen studies were included in the review; twelve of which were set in diagnostic radiography departments, two in radiotherapy departments, and five in non-MRS departments. No studies were set in nuclear medicine departments, indicating a gap in the available literature. A total of 19 genera of infectious organisms were identified in the literature, with Staphylococcus, Escherichia, Bacillus, and Corynebacterium reported in all MRS departments. Infectious organisms were identified in all observational studies, indicating a need for better infection control methods and/or compliance training within MRS to minimize the risk of infections.


Author(s):  
Sarah Batson ◽  
Rohit Shankar ◽  
Joan Conry ◽  
Jane Boggs ◽  
Rodney Radtke ◽  
...  

AbstractVagus nerve stimulation (VNS) Therapy® is an adjunctive neurostimulation treatment for people with drug-resistant epilepsy (DRE) who are unwilling to undergo resective surgery, have had unsuccessful surgery or are unsuitable for surgery. A systematic review and meta-analysis were conducted to determine the treatment effects of VNS Therapy as an adjunct to anti-seizure medications (ASMs) for the management of adults with DRE. A literature search was performed in August 2020 of the Medline®, Medline® Epub Ahead of Print, Embase, and the Cochrane library databases. Outcomes examined included reduction in seizure frequency, seizure freedom, ASM load, discontinuations, and serious adverse events (SAEs). Comparators included best medical practice, ASMs, low-stimulation or sham VNS Therapy. Four RCTs and six comparative observational studies were identified for inclusion. Against comparators, individuals treated with VNS had a significantly better odds of experiencing a ≥ 50% reduction in seizure frequency (OR: 2.27 [95% CI 1.47, 3.51]; p = 0.0002), a ≥ 75% reduction in seizure frequency (OR: 3.56 [95% CI 1.59, 7.98]; p = 0.002) and a reduced risk for increased ASM load (risk ratio: 0.36 [95% CI 0.21, 0.62]; p = 0.0002). There was no difference in the odds of discontinuation or the rate of SAEs between VNS versus comparators. This meta-analysis demonstrated the benefits of VNS Therapy in people with DRE, which included improvement in seizure frequency without an increase in the rate of SAEs or discontinuations, thereby supporting the consideration of VNS Therapy for people who are not responding to ASMs and those unsuitable or unwilling to undergo surgery.


2021 ◽  
Author(s):  
Joan Conry ◽  
Sarah Batson ◽  
Stephen Mitchell ◽  
Rohit Shankar ◽  
Jane Boggs ◽  
...  

Abstract Vagus nerve stimulation (VNS) Therapy® is an adjunctive neurostimulation treatment for people withdrug-resistant epilepsy (DRE) who are unwilling to undergo resective surgery, have had unsuccessfulsurgery or are unsuitable for surgery. A systematic review and meta-analysis were conducted todetermine the treatment effects of VNS Therapy as an adjunct to anti-seizure medications (ASMs) forthe management of adults with DRE.A literature search was performed in August 2020 of the Medline®, Medline® Epub Ahead of Print,Embase, and the Cochrane library databases. Outcomes examined included reduction in seizurefrequency, seizure freedom, ASM load, discontinuations, and serious adverse events (SAEs).Comparators included best medical practice, ASMs, low-stimulation or sham VNS Therapy.Four RCTs and six comparative observational studies were identified for inclusion. Against comparators,individuals treated with VNS had a significantly better odds of experiencing a ≥50% reduction in seizurefrequency (OR: 2.27 [95% CI: 1.47, 3.51]; p=0.0002), a ≥75% reduction in seizure frequency (OR: 3.56[95% CI: 1.59, 7.98]; p=0.002) and a reduced risk for increased ASM load (risk ratio: 0.36 [95% CI: 0.21,0.62]; p=0.0002). There was no difference in the odds of discontinuation or the rate of SAEs betweenVNS versus comparators.This meta-analysis demonstrated the benefits of VNS Therapy in people with DRE, which includedimprovement in seizure frequency without an increase in the rate of SAEs or discontinuations, therebysupporting the consideration of VNS Therapy for people who are not responding to ASMs and thoseunsuitable or unwilling to undergo surgery.


Sign in / Sign up

Export Citation Format

Share Document