scholarly journals Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review

10.2196/20359 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e20359 ◽  
Author(s):  
Clemens Kruse ◽  
Joanna Fohn ◽  
Nakia Wilson ◽  
Evangelina Nunez Patlan ◽  
Stephanie Zipp ◽  
...  

Background Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. Objective This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. Methods This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. Results Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). Conclusions The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. Trial Registration PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162. International Registered Report Identifier (IRRID) RR2-10.2196/15490

2020 ◽  
Author(s):  
Clemens Kruse ◽  
Joanna Fohn ◽  
Nakia Wilson ◽  
Evangelina Nunez Patlan ◽  
Stephanie Zipp ◽  
...  

BACKGROUND Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. OBJECTIVE This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. METHODS This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. RESULTS Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). CONCLUSIONS The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. CLINICALTRIAL PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162. INTERNATIONAL REGISTERED REPORT RR2-10.2196/15490


Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 971 ◽  
Author(s):  
Thara Govindaraju ◽  
Berhe Sahle ◽  
Tracy McCaffrey ◽  
John McNeil ◽  
Alice Owen

Dietary patterns may be related to quality of life (QoL) of older adults, although evidence from literature is conflicting. The demographic shifts toward ageing populations in many countries increases the importance of understanding the relationship between diet and QoL in older adults. This review was designed to investigate associations between dietary patterns and QoL in older adults. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases were searched to identify articles published in English from January 1975 to March 2018 that investigated associations between dietary patterns and QoL in older adults. Relevant studies were identified based on set inclusion and exclusion criteria, data were extracted and analysed to examine the relationships and possible implications for public health recommendations. The systematic review included 15 articles (One randomized control trial, six prospective cohorts and eight cross sectional). The studies looked at correlations between different dietary patterns and/or adherence to particular dietary patterns and self-reported QoL or self-rated health status. Excluding two studies which showed no significant association, healthy dietary patterns were associated with better self-rated health and QoL in one or more domains, and adherence to healthy dietary patterns like the Mediterranean diet were significantly associated with improvement in at least one of the QoL domains.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047191
Author(s):  
Bas Labree ◽  
Derek J Hoare ◽  
Lauren E Gascoyne ◽  
Magdalena Sereda

IntroductionTinnitus is the awareness of a sound in the ear or head in the absence of an external source. It affects around 10%–15% of people. About 20% of people with tinnitus also experience symptoms such as depression or anxiety that negatively affect their life. Transcranial direct current stimulation (tDCS) is a technique involving constant low-intensity direct current delivered via electrodes on the head. It is postulated to modulate (suppress or enhance) neural activity in the region between electrodes. As such, it represents a potential treatment option for tinnitus, as well as comorbid depression or anxiety. This systematic review will estimate the effects of tDCS on outcomes relevant to tinnitus. In addition, it will determine whether there is any relationship between stimulation parameters (electrode montage, current intensity, and length and frequency of stimulation sessions) and the effect of tDCS on these outcomes.Methods and analysisElectronic searches for peer-reviewed journal articles will be performed in the Cochrane Register of Studies online (the Cochrane Ear, Nose and Throat Disorders Group Register and CENTRAL, current issue), PubMed, EMBASE, CINAHL, LILACS, KoreaMed, IndMed, PakMediNet, CNKI, AMED, PsycINFO, Web of Science, ClinicalTrials.gov, ICTRP and Google Scholar using the following search terms: transcranial Direct Current Stimulation OR tDCS AND tinnitus OR depression OR anxiety OR quality of life OR adverse effects OR neurophys*.Searches were not limited by date. Methods are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). Randomised controlled trials will be included if they report at least one of the following outcomes: tinnitus symptom severity, anxiety or depression as measured by relevant validated instruments. Where available, data on quality of life, adverse effects and neurophysiological changes will also be reviewed. In addition to an analysis of the effect of each parameter, an analysis will be performed to uncover any interactions between parameters. Where appropriate, meta‐analyses will be performed.Ethics and disseminationThis systematic review will make use of secondary data only. As no data will be obtained from participants directly, ethical approval has not been sought. No other ethical issues are foreseen. Findings will be submitted for peer-reviewed publication and presented at academic conferences. The results of this review will inform future research.PROSPERO registration numberCRD42020185567.


2017 ◽  
Vol 22 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Bastianina Contena ◽  
Stefano Taddei

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Faiza Siddiqui ◽  
Marija Barbateskovic ◽  
Sophie Juul ◽  
Kiran Kumar Katakam ◽  
Klaus Munkholm ◽  
...  

Abstract Background Major depression significantly impairs quality of life, increases the risk of suicide, and poses tremendous economic burden on individuals and societies. Duloxetine, a serotonin norepinephrine reuptake inhibitor, is a widely prescribed antidepressant. The effects of duloxetine have, however, not been sufficiently assessed in earlier systematic reviews and meta-analyses. Methods/design A systematic review will be performed including randomised clinical trials comparing duloxetine with ‘active’ placebo, placebo or no intervention for adults with major depressive disorder. Bias domains will be assessed, an eight-step procedure will be used to assess if the thresholds for clinical significance are crossed. We will conduct meta-analyses. Trial sequential analysis will be conducted to control random errors, and the certainty of the evidence will be assessed using GRADE. To identify relevant trials, we will search Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, PsycINFO, Science Citation Index Expanded, Social Sciences Citation Index, Conference Proceedings Citation Index—Science and Conference Proceedings Citation Index—Social Science & Humanities. We will also search Chinese databases and Google Scholar. We will search all databases from their inception to the present. Two review authors will independently extract data and perform risk of bias assessment. Primary outcomes will be the difference in mean depression scores on Hamilton Depression Rating Scale between the intervention and control groups and serious adverse events. Secondary outcomes will be suicide, suicide-attempts, suicidal ideation, quality of life and non-serious adverse events. Discussion No former systematic review has systematically assessed the beneficial and harmful effects of duloxetine taking into account both the risks of random errors and the risks of systematic errors. Our review will help clinicians weigh the benefits of prescribing duloxetine against its adverse effects and make informed decisions. Systematic review registration PROSPERO 2016 CRD42016053931


BMJ Leader ◽  
2020 ◽  
pp. leader-2019-000199
Author(s):  
Charleen Singh ◽  
Caitlin Loseth ◽  
Noordeen Shoqirat

The number of women entering medicine significantly increased over the last decades. Currently, over half of the medical students are women but less than half are applying to surgery and even less go on to surgical specialties. Even fewer women are seen in leadership roles throughout the profession of surgery and surgical residency. Our purpose of the literature review is to identify any themes, which would provide insight to the current phenomenon. We used the Preferred Reporting Items for Systemic Reviews and Meta-Analyses method for a systematic review of the literature over a 20-year period (1998–2018). Five broad themes were identified: education and recruitment, career development, impact of/on life around the globe and surgical subspecialties as areas of barriers for women entering or considering surgery. The systematic review suggests there are opportunities to improve and encourage women entering the profession of surgery as well as the quality of life for surgeons. Creating systems for mentorship across programmes, having policies to support work–life balance and recognising surgical training overlaps with childbearing years are key opportunities for improvement. Improving the current status in surgery will require direction from leadership.


2021 ◽  
Vol 147 ◽  
pp. 111287
Author(s):  
Evan Campbell ◽  
Fanny Petermann-Rocha ◽  
Paul Welsh ◽  
Carlos Celis-Morales ◽  
Jill P. Pell ◽  
...  

2019 ◽  
Vol 39 (10) ◽  
pp. 1144-1152 ◽  
Author(s):  
Meng-Chin Chen ◽  
Li-Yen Yang ◽  
Kuei-Min Chen ◽  
Hui-Fen Hsu

Acupressure is noninvasive, safe, and appropriate for use among older adults. However, there remains little evidence of the common elements that contribute to the effectiveness of acupressure in promoting the health of older adults. A systematic review using meta-analysis was designed to examine the effects of acupressure on the health promotion in older adults. Studies published between 2012 and 2017 were searched for in 11 electronic databases. Acupressure was highly effective for improving sleep quality and cognitive functioning (0.85, 95% confidence interval [CI] = [0.49, 1.22]; 1.23, 95% CI = [0.88, 1.59]). A slight to moderate effect was found in alleviating constipation (0.37, 95% CI = [0.03, 0.71]), and a moderate effect was found for alleviating pain and improving quality of life (0.71, 95% CI = [0.09, 1.32]; 0.59 95% CI = [0.36, 0.82]).


2020 ◽  
Vol 4 (3) ◽  
pp. 1-17
Author(s):  
Tamuyen P. Do ◽  
◽  
Eileen B. O’Keefe ◽  
Nicole L. Spartano ◽  
◽  
...  

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