scholarly journals Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: A systematic review

2020 ◽  
Author(s):  
Babasola Okusanya ◽  
Ibitola O. Asaolu ◽  
John E. Ehiri ◽  
Linda Jepkoeach Kimaru ◽  
Abidemi Okechukwu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Hospital Admissions ◽  
Grey Literature ◽  
Emergency Department Visits ◽  
Original Research ◽  
Medical Cannabis ◽  
Analgesic Effects ◽  
The Past ◽  
Ovid Medline

Abstract Background: Medical cannabis (MC) is currently being used as an adjunct to opiates given its analgesic effects and potential to reduce opiate addiction. This review assessed if MC used in combination with opioids to treat non-cancer chronic pain would reduce opioid dosage.Methods: Four databases - Ovid (Medline), Psyc-INFO, PubMed, Web of Science, and grey literature – were searched to identify original research that assessed the effects of MC on non-cancer chronic pain in humans. The search yielded 4,316 articles and 24 reports from the databases and grey literature, respectively. Results: Nine studies involving 7,222 participants were included. There was a 64%-75% reduction in opioid dosage when used in combination with MC. Use of MC for opioid substitution was reported by 32%-59.3% of patients with non-cancer chronic pain. One study reported a slight decrease in mean hospital admissions in the past calendar year (P=.53) and decreased mean emergency department visits in the past calendar year (P=.39) for patients who received MC as an adjunct to opioids in the treatment of non-cancer chronic pain compared to those who did not receive MC. Conclusions: While this review indicated the likelihood of reducing opioid dosage when used in combination with MC, the optimal MC dosage to achieve opioid dosage reduction remains unknown. More research is needed to elucidate whether MC used in combination with opioids in the treatment of non-cancer chronic pain is associated with health consequences that are yet unknown.Systematic review registration: This systematic review was not registered.

scholarly journals Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: A systematic review

2020 ◽  
Author(s):  
Babasola Okusanya ◽  
Ibitola O. Asaolu ◽  
John E. Ehiri ◽  
Linda Jepkoeach Kimaru ◽  
Abidemi Okechukwu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Dosage Reduction ◽  
Hospital Admissions ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Emergency Department Visits ◽  
Original Research ◽  
Medical Cannabis ◽  
The Past

Abstract Background: Medical cannabis (MC) is currently being used as an adjunct to opiates given its analgesic effects and potential to reduce opiate addiction. This review assessed if MC used in combination with opioids to treat non-cancer chronic pain would reduce opioid dosage.Methods: Four databases - Ovid (Medline), Psyc-INFO, PubMed, Web of Science, and grey literature – were searched to identify original research that assessed the effects of MC on non-cancer chronic pain in humans. Study eligibility included randomized controlled trials, controlled before-and-after studies, cohort studies, cross-sectional studies, and case reports. All databases were searched for articles published from inception to October 31, 2019. Cochrane’s ROBINS-I tool and the AXIS tool were used for risk of bias assessment. PRISMA guidelines was followed in reporting the systematic review.Results: Nine studies involving 7,222 participants were included. There was a 64%-75% reduction in opioid dosage when used in combination with MC. Use of MC for opioid substitution was reported by 32%-59.3% of patients with non-cancer chronic pain. One study reported a slight decrease in mean hospital admissions in the past calendar year (P=.53) and decreased mean emergency department visits in the past calendar year (P=.39) for patients who received MC as an adjunct to opioids in the treatment of non-cancer chronic pain compared to those who did not receive MC. All included studies had high risk of bias, which was mainly due to their methods. Conclusions: While this review indicated the likelihood of reducing opioid dosage when used in combination with MC, we cannot make a causal inference. Although medical cannabis’s recognized analgesic properties make it a viable option to achieve opioid dosage reduction, the evidence from this review cannot be relied upon to promote MC as an adjunct to opioids in treating non-cancer chronic pain. More so, the optimal MC dosage to achieve opioid dosage reduction remains unknown. Therefore, more research is needed to elucidate whether MC used in combination with opioids in the treatment of non-cancer chronic pain is associated with health consequences that are yet unknown.Systematic review registration: This systematic review was not registered.

scholarly journals Multicomponent interventions for enhancing primary care: a systematic review

2020 ◽  
Vol 71 (702) ◽  
pp. e10-e21
Author(s):  
Geronimo Jimenez ◽  
David Matchar ◽  
Gerald Choon-Huat Koh ◽  
Josip Car
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Hospital Admissions ◽  
Grey Literature ◽  
Emergency Department Visits ◽  
Narrative Form ◽  
Provider Satisfaction ◽  
Quadruple Aim ◽  
Literature Searches ◽  
Multicomponent Interventions

BackgroundMany countries have implemented interventions to enhance primary care to strengthen their health systems. These programmes vary widely in features included and their impact on outcomes.AimTo identify multiple-feature interventions aimed at enhancing primary care and their effects on measures of system success — that is, population health, healthcare costs and utilisation, patient satisfaction, and provider satisfaction (quadruple-aim outcomes).Design and settingSystematic review and narrative synthesis.MethodElectronic, manual, and grey-literature searches were performed for articles describing multicomponent primary care interventions, providing details of their innovation features, relationship to the ‘4Cs’ (first contact, comprehensiveness, coordination, and continuity), and impact on quadruple-aim outcomes. After abstract and full-text screening, articles were selected and their quality appraised. Results were synthesised in a narrative form.ResultsFrom 37 included articles, most interventions aimed to improve access, enhance incentives for providers, provide team-based care, and introduce technologies. The most consistent improvements related to increased primary care visits and screening/preventive services, and improved patient and provider satisfaction; mixed results were found for hospital admissions, emergency department visits, and expenditures. The available data were not sufficient to link interventions, achievement of the 4Cs, and outcomes.ConclusionMost analysed interventions improved some aspects of primary care while, simultaneously, producing non-statistically significant impacts, depending on the features of the interventions, the measured outcome(s), and the populations being studied. A critical research gap was revealed, namely, in terms of which intervention features to enhance primary care (alone or in combination) produce the most consistent benefits.

scholarly journals Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: A systematic review

2020 ◽  
Author(s):  
Babasola Okusanya ◽  
Ibitola O. Asaolu ◽  
John E. Ehiri ◽  
Linda Jepkoeach Kimaru ◽  
Abidemi Okechukwu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Opiate Addiction ◽  
Medical Cannabis ◽  
Analgesic Effects

Abstract Medical cannabis (MC) is currently being used as an adjunct to opiates given its analgesic effects and potential to reduce opiate addiction. This review assessed if MC used in combination with opioids to treat non-cancer chronic pain would reduce opioid dosage.

scholarly journals Sexual health and COVID-19: protocol for a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Navin Kumar ◽  
Kamila Janmohamed ◽  
Kate Nyhan ◽  
Laura Forastiere ◽  
Wei-Hong Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Sexual Health ◽  
Scoping Review ◽  
Current Knowledge ◽  
Grey Literature ◽  
Well Being ◽  
World Health ◽  
Original Research ◽  
Scoping Reviews

Abstract Background Global responses to the COVID-19 pandemic have exposed and exacerbated existing socioeconomic and health inequities that disproportionately affect the sexual health and well-being of many populations, including people of color, ethnic minority groups, women, and sexual and gender minority populations. Although there have been several reviews published on COVID-19 and health disparities across various populations, none has focused on sexual health. We plan to conduct a scoping review that seeks to fill several of the gaps in the current knowledge of sexual health in the COVID-19 era. Methods A scoping review focusing on sexual health and COVID-19 will be conducted. We will search (from January 2020 onwards) CINAHL, Africa-Wide Information, Web of Science Core Collection, Embase, Gender Studies Database, Gender Watch, Global Health, WHO Global Literature on Coronavirus Disease Database, WHO Global Index Medicus, PsycINFO, MEDLINE, and Sociological Abstracts. Grey literature will be identified using Disaster Lit, Google Scholar, governmental websites, and clinical trials registries (e.g., ClinicalTrial.gov, World Health Organization, International Clinical Trials Registry Platform, and International Standard Randomized Controlled Trial Number Registry). Study selection will conform to the Joanna Briggs Institute Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews. Only English language, original studies will be considered for inclusion. Two reviewers will independently screen all citations, full-text articles, and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. Discussion Original research is urgently needed to mitigate the risks of COVID-19 on sexual health. The planned scoping review will help to address this gap. Systematic review registrations Systematic Review Registration: Open Science Framework osf/io/PRX8E

A Systematic Review of Assessments and Interventions for Chronic Pain in Young Children With or at High Risk for Cerebral Palsy

2021 ◽  
pp. 088307382199691
Author(s):  
Lisa Letzkus ◽  
Darcy Fehlings ◽  
Lauren Ayala ◽  
Rachel Byrne ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Cerebral Palsy ◽  
High Risk ◽  
Online Survey ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Parent Report ◽  
Medical Cannabis ◽  
Nonpharmacologic Intervention

Background: Pain is common in children with cerebral palsy. The purpose of this systematic review was to evaluate the evidence regarding assessments and interventions for chronic pain in children aged ≤2 years with or at high risk for cerebral palsy. Methods: A comprehensive literature search was performed. Included articles were screened using PRISMA guidelines and quality of evidence was reviewed using best-evidence tools by independent reviewers. Using social media channels, an online survey was conducted to elicit parent preferences. Results: Six articles met criteria. Parent perception was an assessment option. Three pharmacologic interventions (gabapentin, medical cannabis, botulinum toxin type A) and 1 nonpharmacologic intervention were identified. Parent survey report parent-comfort and other nonpharmacologic interventions ranked as most preferable. Conclusion: A conditional GRADE recommendation was in favor of parent report for pain assessment. Clinical trials are sorely needed because of the lack of evidence for safety and efficacy of pharmacologic interventions.

scholarly journals Housing with support for older people: a mixed-methods systematic review protocol

2020 ◽  
Vol 3 ◽  
pp. 64
Author(s):  
Camille Coyle ◽  
Sarah Buggy ◽  
Olivia Cagney ◽  
Louise Farragher ◽  
Caitriona Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mixed Methods ◽  
Older People ◽  
Grey Literature ◽  
Qualitative And Quantitative ◽  
Ovid Medline ◽  
The Impact ◽  
People’S Perceptions

Background: The implementation of housing with support is rapidly expanding, particularly as life expectancy is increasing throughout the world. This expansion is likely to intensify in the context of coronavirus disease 2019 (COVID-19), which has revealed the risks of relying primarily on nursing homes. This mixed-methods systematic review aims to: 1) explore older people’s perceptions and experiences of housing with support and 2) examine the impact of providing housing with support for older people on their quality of life. Methods: The databases Ovid Medline, Ovid Social Policy & Practice, EBSCO CINAHL, and EBSCO SOCIndex will be searched, and grey literature will also be identified. Quality assessment will be carried out using Joanna Briggs Institute’s Critical Appraisal Checklist for Qualitative Research as well as a tool from the National Institutes of Health for observational cohort studies. This review will employ convergent parallel design; as such, qualitative and quantitative findings will be synthesised separately in the initial stage of analysis. The results from the qualitative and quantitative syntheses will then be integrated in the final stage of the analysis. Conclusion: This systematic review will synthesise the evidence regarding older people’s perceptions and experiences of housing with support and the impact of providing housing with support for older people on their quality of life.

scholarly journals P097: The characteristics and effectiveness of interventions targeting chronic pain patients in the emergency department: A systematic review and meta-analysis

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S98-S99
Author(s):  
C. O'Rielly ◽  
L. Sutherland ◽  
C. Wong
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Grey Literature ◽  
Opioid Prescription ◽  
Care Plans ◽  
Individualized Care ◽  
High Utilizers ◽  
Ed Visits

Introduction: Patients with chronic non-cancer pain (CNCP) and opioid-use disorders make up a category of patients who present a challenge to emergency department (ED) providers and healthcare administrators. Their conditions predispose them to frequent ED utilization. This problem has been compounded by a worsening opioid epidemic that has rendered clinicians apprehensive about how they approach pain care. A systematic review has not yet been performed to inform the management of CNCP patients in the ED. As such, the purpose of this project was to identify and describe the effectiveness of interventions to reduce ED visits for high-utilizers with CNCP. Methods: Included participants were high-utilizers presenting with CNCP. All study designs were eligible for inclusion if they examined an intervention aimed at reducing ED utilization. The outcomes of interest were the number of ED visits as well as the amount and type of opioids prescribed in the ED and after discharge. We searched Medline, EMBASE, CINAHL, CENTRAL, SCOPUS, Web of Science, and the grey literature from inception to June 16, 2018. Two independent investigators assessed articles for inclusion following PRISMA guidelines. Risk of bias will be assessed using the Cochrane ROBINS-I and RoB 2 tools for non-randomized and randomized trials, respectively. Results: Following review, 14 of the 5,018 identified articles were included for analysis. These articles assessed a total of 1,670 patients from both urban and rural settings. Interventions included pain protocols or policies (n = 5), individualized care plans (n = 5), ED care coordination (n = 2), a chronic pain management pathway (n = 1), and a behavioural health intervention (n = 1). Intervention effects trended towards the reduction of both ED visits and opioid prescriptions. The meta-analysis is in progress. Conclusion: Preliminary results suggest that interventions aimed at high-utilizers with CNCP can reduce ED visits and ED opioid prescription. ED opioid-restriction policies that sought to disincentivize drug-related ED visits were most successful, especially when accompanied by an electronic medical record (EMR) alert to ensure consistent application of the policy by all clinicians and administrators involved in the care of these patients. This review was limited by inconsistencies in the definition of ‘high-utilizer’ and by the lack of high-powered randomized studies.

scholarly journals Double Burden of Malnutrition Among Migrants and Refugees in Developed Countries

2021 ◽  
Vol 4 ◽  
pp. 1-13
Author(s):  
Blessing Akombi-Inyang ◽  
Md. Nazmul Huda ◽  
Judith Byaruhanga ◽  
Andre Renzaho
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Developed Countries ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Double Burden ◽  
Ovid Medline ◽  
Double Burden Of Malnutrition ◽  
Meta Analyses

Background: The double burden of malnutrition (DBM) increases the risk of developing non-communicable diseases among migrant and refugee populations living in developed countries. This systematic review aims to examine the DBM among migrants and refugees in developed countries. It aims to appraise, synthesise, and summarise literature to create an evidence base that looks at multiple faces of DBM. Methods/Design: This protocol is informed by the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A systematic review of peer-reviewed quantitative, qualitative and mixed-methods studies on DBM among migrants and refugees in developed countries will be undertaken. The review will include only studies published in English. Eight bibliographic databases will be searched: Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, ProQuest, Scopus, PubMed, and web of science. Grey literature will also be searched. Studies that meet the inclusion criteria will be imported to Covidence. Screening for eligible studies will be conducted by two independent researchers. The quality of included studies will be appraised for risk of bias using validated tools. A narrative synthesis approach will be undertaken to report retrieved data. Discussion: The protocol provides insight into the scope and parameters of the systematic review to be conducted.

scholarly journals Interventions to Mitigate COVID-19 Misinformation: Protocol for a Scoping Review

2021 ◽  
Author(s):  
Navin Kumar ◽  
Nathan Walter ◽  
Kate Nyhan ◽  
Kaveh Khoshnood ◽  
Joseph D Tucker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Scoping Review ◽  
English Language ◽  
Current Knowledge ◽  
Grey Literature ◽  
Open Science ◽  
Original Research ◽  
Study Selection ◽  
Scoping Reviews ◽  
Science Framework

Abstract Background: The duration and impact of the COVID-19 pandemic depends in a large part on individual and societal actions which is influenced by the quality and salience of the information to which they are exposed. Unfortunately, COVID-19 misinformation has proliferated. To date, no systematic efforts have been made to evaluate interventions that mitigate COVID-19-related misinformation. We plan to conduct a scoping review that seeks to fill several of the gaps in the current knowledge of interventions that mitigate COVID-19-related misinformation.Methods: A scoping review focusing on interventions that mitigate COVID-19 misinformation will be conducted. We will search (from January 2020 onwards) MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science Core Collection, Africa-Wide Information, Global Health, WHO Global Literature on Coronavirus Disease Database, WHO Global Index Medicus, and Sociological Abstracts. Grey literature will be identified using Disaster Lit, Google Scholar, Open Science Framework, governmental websites and preprint servers (e.g. EuropePMC, PsyArXiv, MedRxiv, JMIR Preprints). Study selection will conform to Joanna Briggs Institute Reviewers’ Manual 2020 Methodology for JBI Scoping Reviews. Only English language, original studies will be considered for inclusion. Two reviewers will independently screen all citations, full-text articles, and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g. frequencies) and qualitative (e.g. content and thematic analysis) methods.Discussion: Original research is urgently needed to design interventions to mitigate COVID-19 misinformation. The planned scoping review will help to address this gap.Systematic Review registrations: Systematic Review Registration: Open Science Framework (osf/io/etw9d).

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