scholarly journals Effectiveness of Interventions To Enable Hypertension Medication Adherence In Low-And Middle-Income Countries: A Systematic Review And Meta-analysis

2021 ◽  
Author(s):  
Olivia Nakwafila ◽  
Benn Sartorius ◽  
Sphamandla Josias Nkambule ◽  
Tivani Mashamba Thompson
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Medication Adherence ◽  
Meta Analysis ◽  
Pharmacological Interventions ◽  
Middle Income ◽  
Quality Of Evidence ◽  
Middle Income Countries ◽  
Secondary Outcomes

Abstract Background: In recent decades low- and middle-income countries (LMICs) are witnessing an increase in hypertension and thus becoming a significant public health issue due to associated Cardiovascular disease (CVD) outcomes. Antihypertensive medication adherence is crucial to controlling blood pressure; therefore, this systematic review aimed to evaluate the effectiveness of non-pharmacological interventions on improving blood pressure control and medication adherence in patients with hypertension in LMICs.Methods: We searched the following databases for relevant literature published between Jan 2005 – Dec 2020: PubMed, EBSCOhost included Academic Search; CINAHL and MEDLINE complete; PubMed; WEB of Science; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews and Google Scholar. Cochrane risk of bias tool (RoB 2) was used to appraise included studies critically, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to measure the quality of evidence. We conducted a meta‑analysis using DrSimonian-Laid's random-effect model at 95% confidence intervals (CIs). The secondary outcomes of interests were synthesised descriptively as changes in BP adherence outcomes. Results: We identified 14 eligible randomised controlled trials that presented blood pressure (BP) effectiveness and medication adherence among BP patients aged between 18-75 years. The overall quality of evidence with the majority of trials was moderate. Meta weighed effect (SBP) for 12/14 studies was -4.74 (95% CI:-6.07 to -3.47) and I2 = 57%. Out of 14 eligible studies, (86%) suggested a significant improvement in the proportion of patients with controlled blood pressure (BP < 140/90mmHG) with a positive effect on secondary outcomes such as quality of life.Conclusion: Non-pharmacological interventions could be effective in managing hypertension. In recommending the need to investigate the feasibility of non-pharmacological evidence in specific LMIC settings, focus should be on an intervention strategy consisting of an educational intervention directed toward the patients, health professionals and organisation. Considering heterogeneity, randomised trials that are well-designed with larger sample sizes are encouraged in LMICs` to help policymakers make well-informed decisions on hypertension management.Systematic review Registration: PROSPERO registration number: CRD42020172954

scholarly journals The global prevalence of maternal near miss: a systematic review and meta-analysis

2019 ◽  
Vol 9 (4) ◽  
pp. 255-262
Author(s):  
Sedigheh Abdollahpour ◽  
Hamid Heidarian Miri ◽  
Talat Khadivzadeh
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Meta Analysis ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Organization

Background: Improving the maternal health is one of the world’s most challenging problems. Despite significant movements over the past decades, maternal health has been still considered as a central goal for sustainable development. Maternal near miss (MNM) cases experience long-term physical and psychological effects. To present a clear portrait of the current situation, we performed a systematic review and meta-analysis with the purpose to assess the worldwide prevalence of MNM. Methods: We conducted a systematic review on PubMed, Scopus and Web of Science electronic databases to find published papers in English, before March 2019 and regardless of the type of study. We, then, assessed the prevalence of MNM according to the World Health Organization(WHO) criteria. Finally, 49 papers were included in the study. Random effects meta-analysis was used to pool the available prevalence. The quality of studies was also evaluated. Results: The weighted pooled worldwide prevalence of MNM, was 18.67/1000 (95% CI: 16.28-21.06). Heterogeneity was explored using subgroup analyses based on the continent and the country. We used meta-regression of MNM on MD which resulted in adjusted R-squared as78.88%. Conclusion: The prevalence of MNM was considerable. Low- and middle-income countries should develop systematic approaches to improve quality of care in the facilities and to reducethe risk of MNM events, with the hope to women’s health.

scholarly journals Effects of lifestyle-related interventions on blood pressure in the low and middle income countries: systematic review and meta-analysis

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P1423-P1423
Author(s):  
C. Baena ◽  
M. Olandoski ◽  
J. O. Younge ◽  
D. A. Buitrago-Lopez ◽  
S. Darweesh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Meta Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Zahra Kiani ◽  
Masoumeh Simbar ◽  
Sepideh Hajian ◽  
Farid Zayeri
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Middle Income ◽  
Infertile Women ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Prevalence Of Depression ◽  
Low And Middle Income

Abstract Background Infertile women’s mental health problems, including depression, are key fertility health issues that affect infertile women more severely than infertile men. Depression may threaten the health of individuals and reduce the quality of their lives. Considering the role and impact of depression on responses to infertility treatments, a systematic review and meta-analysis were conducted to investigate the prevalence of depression symptoms among infertile women. Methods International databases (PubMed, Cochrane Library, Web of Sciences, Scopus, Embase, and PsycINFO), national databases (SID and Magiran), and Google Scholar were searched by two independent reviewers for articles published from 2000 to April 5, 2020. The search procedure was performed in both Persian and English using keywords such as “depression,” “disorders,” “infertility,” “prevalence,” and “epidemiology.” The articles were evaluated in terms of their titles, abstracts, and full texts. The reviewers evaluated the quality of the articles using the Newcastle–Ottawa Scale, after which they analyzed the findings using STATA version 14. The I2 and Egger’s tests were performed to examine heterogeneity and publication bias, respectively. Results Thirty-two articles were subjected to the meta-analysis, and a random effects model was used in the examination given the heterogeneity of the articles. The samples in the reviewed studies encompassed a total of 9679 infertile women. The lowest and highest pooled prevalence rates were 21.01% (95% confidence interval [CI]: 15.61–34.42), as determined using the Hospital Anxiety and Depression Scale, and 52.21% (95% CI: 43.51–60.91), as ascertained using the Beck Depression Inventory, respectively. The pooled prevalence values of depression among infertile women were 44.32% (95% CI: 35.65–52.99) in low- and middle-income countries and 28.03% (95% CI: 19.61–36.44) in high-income countries. Conclusion The prevalence of depression among infertile women was higher than that among the general population of a given country. Especially in low- and middle-income countries, appropriate measures, planning, and policy that target the negative effects of depression on infertile women’s lives should be established to reduce related problems.

scholarly journals Comparative Efficacy and Acceptability of Non-pharmacological Interventions for Depression Among People Living With HIV: Protocol for a Systematic Review and Network-meta Analysis

2021 ◽  
Author(s):  
Ting Zhao ◽  
Chulei Tang ◽  
Huang Yan ◽  
Honghong Wang
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Meta Analysis ◽  
Global Network ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Comparative Efficacy ◽  
Pharmacological Interventions ◽  
Middle Income ◽  
Middle Income Countries

Abstract Background: Improving depression is critical to successful HIV treatment. Due to the adverse reactions of pharmacotherapy, treatment for depression in PLWH has increasingly turned to non-pharmacological treatments. However, the comparative efficacy and acceptability of non-pharmacological treatments for depression among PLWH in different resource contexts remain inconclusive. This protocol for a systematic review and network meta-analysis aims at evaluating the efficacy and acceptability of non-pharmacological treatments for depression among PLWH to guide future research and practice for all research settings and for low-income and middle-income countries (LMIC) only. Methods: We will include all randomized controlled trials of any non-pharmacological interventions to reduce depression in PLWH. The primary outcomes will be the efficacy (the overall mean change scores in depression) and acceptability (the proportion of participants who withdrew for any reason). We will systematically search Published studies through the related databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL) and the bibliographies. There is no restriction by language and publication year. At least two investigators will independently conduct all study selection, quality evaluation, and data extraction. We will employ a network meta-analysis to synthesize all available evidence for each outcome and obtain a comprehensive ranking of all interventions for the global network and for low-income and middle-income countries (LMICs) network only. We will employ validated local and global approaches to assess inconsistency. We will use OpenBUGS (version 3.2.3) to fit our model into the Bayesian framework. We will evaluate the strength of evidence with the GRADE system. Discussion: We will synthesize all available evidence and identify the most efficacious and acceptable non-pharmacological interventions for depression among PLWH for global network and for LMIC network only. The results of this study will be used to guide decision-making better in different resource settings.Systematic review registration: PROSPERO CRD42021244230.

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