scholarly journals Prevalence of Therapeutic use of Opioids in Chronic non-Cancer Pain Patients and Associated Factors: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Helena De Sola ◽  
María Dueñas ◽  
Alejandro Salazar ◽  
Patricia Ortega-Jiménez ◽  
Inmaculada Failde
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Meta Analysis ◽  
Opioid Use ◽  
Cross Sectional ◽  
Asian Patients ◽  
Literature Searches ◽  
Cross Sectional Design ◽  
Chronic Pain Conditions

Objectives: To determine the prevalence and factors associated with the use of opioids among patients with chronic non-cancer pain (CNCP).Methods: A systematic review and meta-analysis. Comprehensive literature searches in Medline-PubMed, Embase and SCOPUS databases. Original studies published between 2009 and 2019 with a cross-sectional design were included. The quality of the studies was assessed with Critical Appraisal Checklist for Studies Reporting Prevalence Data from the Joanna Briggs Institute. Protocol registered in the International Prospective Register of Systematic Reviews with reference number: CRD42019137990.Results: Out of the 1,310 potential studies found, 25 studies fulfilled the inclusion criteria. Most of the studies were of high quality. High levels of heterogeneity were found in the studies included. In the general population, the prevalence of long-term opioid use was 2.3% (95% CI: 1.5–3.6%), the prevalence of short-term opioid use was 8.1% (95% CI: 5.6–11.6%), and among people with chronic low back pain it was 5.8% (95% CI: 0.5–45.5%). The prevalence of opioid use among patients from the health records or medical surveys was 41% (95% CI: 23.3–61.3%). Finally, in patients with musculoskeletal pain, the prevalence was 20.5% (95% CI: 12.9–30.9%) and in patients with fibromyalgia, 24.5% (95% CI: 22.9–26.2%). A higher prevalence of opioid use was observed among men, younger people, patients receiving prescriptions of different types of drugs, smokers and patients without insurance or with noncommercial insurance. In addition, non-white and Asian patients were less likely to receive opioids than non-Hispanic white patients.Conclusions: The prevalence of opioid use among patients with CNCP was higher in subjects with short or occasional use compared to those with long-term use. Men, younger people, more chronic pain conditions, and patients without insurance or with noncommercial insurance were most related to opioid use. However, non-white and Asian patients, and those treated by a physician trained in complementary medicine were less likely to use opioids.

scholarly journals The relationship between Internet use and self-concept clarity: A systematic review and meta-analysis

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Cristina Elena Petre
Keyword(s):  
Systematic Review ◽  
Internet Use ◽  
Meta Analysis ◽  
Self Concept ◽  
The Internet ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Self Evaluation ◽  
Cross Sectional Design ◽  
The Relationship

There are three hypotheses regarding the relationship between Self-Concept Clarity (SCC) and Internet use. It was argued that Internet use: 1) decreases SCC, 2) increases SCC, 3) does not relate with SCC. The present study, in the form of a systematic and meta-analytic synthesis, aimed to explore: a) the extent empirical evidence can support each hypothesis; b) how Internet use-SCC relationship was addressed across studies; c) the intensity of the Internet use –SCC relationship; d) potential moderators. Twenty-one studies (N = 8,910) met the inclusion criteria for the systematic review (i.e., being quantitative, written in English, concerned with Internet use -SCC relationship) and 11 studies (N = 3,298) met the additional criteria for meta-analysis (i.e., being correlational, using self-evaluation instruments, quantifying general Internet use and including the information needed to calculate the meta-analysis specific indicators). Results emphasized that all three hypotheses are plausible, as distinct dimensions of Internet use related differently with SCC. However, the conclusions were limited by the extensive use of cross-sectional design. For general Internet use and SCC relationship the overall effect was -0.350, p < .01. Some moderators were significant: cultural background, Internet operationalization, age homogeneity, participants rewarding. This paper outlines the complexity of SCC – Internet relationship and underlines some of the gaps that should be further addressed. Implications and limits of the study (e.g., publication bias, excluded outcomes in the meta-analysis or possible omission of moderators) are discussed.

scholarly journals Acupuncture in oncological pain relief: A systematic review of randomized clinical trials

2021 ◽  
Vol 34 ◽  
Author(s):  
Michel Marcos Dalmedico ◽  
Caroline Machado de Toledo ◽  
Paula Karina Hembecker ◽  
Juliana Londero Silva Ávila ◽  
Chayane Karla Lucena de Carvalho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cancer Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Opioid Use ◽  
Central Register ◽  
Considerable Impact ◽  
Analgesic Use

Abstract Introduction: Cancer pain has a considerable impact on patients’ health and quality of life, and its treatment is essentially based on opioid use. Objective: To report the effectiveness of acupuncture in relieving cancer pain (secondary to the disease or to the corresponding therapy) or in decreasing opioid use compared to other interventions. Methods: A systematic review of randomized clinical trials was conducted following the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The trials were selected from the PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Results: The search strategy resulted in the inclusion of eight trials, of which five compared acupuncture and drug therapy and three compared acupuncture and placebo. Seven trials reported decreased pain and analgesic use. The trials showed clinical heterogeneity, making a meta-analysis unfeasible. Conclusion: The findings herein provided no robust evidence to support the routine use of acupuncture as an adjuvant therapy in the treatment of cancer pain. However, its use is promising since the results showed a trend toward decreased pain and analgesic use, thus justifying further studies in the future.

scholarly journals Risk of behaviour suggestive of opioid abuse: a protocol for a systematic review of validated assessment tools

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021948
Author(s):  
Sheila Raposo Galindo ◽  
Tatiana de Paula Santana da Silva ◽  
Manoel Henrique da Nóbrega Marinho ◽  
Carlos Eduardo de Souza Leão Ribeiro ◽  
Murilo Duarte da Costa Lima ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Meta Analysis ◽  
Opioid Abuse ◽  
Assessment Tools ◽  
Measurement Instruments ◽  
Opioid Use ◽  
Health Measurement ◽  
Registration Number ◽  
The Individual

IntroductionOpioid use patterns of individuals with non-cancer pain are influenced by the behavioural dynamics of the individual in managing and properly following the prescription. The use of assessment tools for measuring the risk of behaviour suggestive of opioid abuse is important for health professionals who provide care to individuals with non-cancer pain. The aim of the proposed review is to analyse the psychometric properties of tools for measuring the risk of behaviour suggestive of opioid abuse in adults with non-cancer pain.Methods and analysisThe review process will be based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The Consensus-Based Standards for the Selection of Health Measurement Instruments will be used to analyse the assessment tools. Two independent reviewers will perform the literature search and analysis procedures. Searches will be performed on PubMed, Web of Science, Cochrane, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases, and the ‘snowball’ strategy will be employed. The inclusion criteria will be (1) validation studies, (2) assessment tools designed exclusively for measuring the risk of behaviour suggestive of opioid abuse and (3) assessment tools designed for evaluation of adults with chronic non-cancer pain. The titles and abstracts of the studies retrieved from the databases will be analysed for the preselection of articles, which will be submitted to a full-text analysis to define the final sample. Divergence of opinion between two reviewers will be resolved by consulting a third reviewer.Ethics and disseminationThe review will offer an overview of assessment tools available for measuring the risk of behaviour suggestive of opioid abuse, which is relevant to reducing the risk of deaths due to abusive consumption and for clinical management of adults with chronic non-cancer pain.PROSPERO registration numberCRD42018081577.

scholarly journals The Relation Between Cortisol and Anthropometric Measurements Throughout Lifespan: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A30-A30
Author(s):  
Eline S van der Valk ◽  
Ozair Abawi ◽  
Mostafa Mohseni ◽  
Amir Abdelmoumen ◽  
Vincent L Wester ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Correlation Coefficients ◽  
Population Based ◽  
Population Characteristics ◽  
Central Adiposity ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Outcome Information

Abstract Introduction: Recently, cross-sectional studies report associations between long-term glucocorticoid levels in scalp hair (HairGC) and obesity. However, there is a wide variation in studied outcomes and associations, possibly caused by differences in population characteristics, e.g. age, sex, dispersion of adiposity, and used laboratory methods. The aim of this systematic review and meta-analysis was to investigate the relation between HairGC and anthropometrics and to explore possible moderators of this association. Methods: We searched the Medline, Embase, Cochrane, Web of Science, Scopus, Cinahl, PsycInfo, and Google Scholar databases for articles that relate HairGC to measures of adiposity (date 11-16-2020). Primary outcomes were correlations between hair cortisol (HairF) and cortisone (HairE), and anthropometrics: BMI, waist circumference (WC) and waist-hip-ratio (WHR). Authors were contacted to provide missing outcome information. Pooled correlation coefficients were calculated using random effects models. Assessment of heterogeneity was performed using the I2 statistic. Exploratory moderator analyses were performed with subgroup analyses and meta-regression. This systematic review was performed in accordance to the PRISMA guidelines. Results: Our systematic search identified 150 cohorts, comprising a total of 37,107 unique individuals, of which 15,033 sampled from population-based cohorts. For BMI, the pooled correlation for HairF was 0.121 (95% CI 0.083–0.158, n=26,941; I2 94.2%, p&lt;0.001) and for HairE 0.108 (95% CI 0.047–0.167, n=7,250; I2 52%, p&lt;0.01). For WC, the pooled correlation for HairF was 0.111 (95% CI 0.058–0.164, n=10,290; I2 63%, p&lt;0.01) and for HairE 0.200 (95% CI 0.137–0.264, n=2,198; I2 0%, p=0.42). For WHR, the pooled correlation for HairF was 0.102 (95% CI 0.040–0.163, n=6,865; I2 27%, p=0.14) and for HairE 0.261 (95% CI 0.195–0.330, n=1,314; I2 0%, p=0.40). A higher percentage of male participants was related to stronger correlations with WC (p&lt;0.001), but not with BMI and WHR. Mean age, mean BMI, and mean HairGC levels of the cohorts did not significantly moderate the pooled correlations, neither did the used laboratory techniques (immunoassays vs mass spectrometry-based assays). Conclusion: This unique, large meta-analysis demonstrates that long-term endogenous glucocorticoids as assessed by HairGC show small but consistent correlations to measures of obesity, despite a large heterogeneity between the included cohorts. The strongest associations were found between HairE and WC and between HairE and WHR. This suggests that glucocorticoid levels in the high-normal range, especially cortisone, may contribute to or reflect the state of specifically central adiposity, even within the general population.

Long‐term opioid treatment and endocrine measures in chronic non‐cancer pain patients: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Pernille D.K. Diasso ◽  
Frederiksen S. Benedikte ◽  
Susanne D. Nielsen ◽  
Katharina M. Main ◽  
Per Sjøgren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Meta Analysis ◽  
Opioid Treatment ◽  
Pain Patients

Migraine and Obesity: Is There a Relationship? A Systematic Review and Meta-Analysis of Observational Studies

2021 ◽  
Vol 20 ◽  
Author(s):  
Mahsa Hatami ◽  
Neda Soveid ◽  
Azadeh Lesani ◽  
Kurosh Djafarian ◽  
Sakineh Shab-Bidar
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Prevalence Ratio ◽  
Normal Weight ◽  
Cross Sectional ◽  
Migraine Headaches ◽  
Asian Patients ◽  
Subgroup Analyses ◽  
Pool Effect Size

Background and Objective: Many studies have evaluated the risk of migraine headache in obese persons, suggesting controversial conclusions—this systematic review and meta-analysis of the observational studies aimed to clarify the association between migraine and obesity. Methods: Scopus and PubMed electronic databases were systematically searched up to February 2019 for observational studies providing data dealing with migraine disorder in obese subjects, as well as normal-weight controls. The random-effects model was applied to assess pool effect size and inter-study heterogeneity by conducting subgroup analyses. Results: Among 1122 publications, 16 studies (10 cross-sectional, five cohort studies, and one case-control study) were detected and were included in the meta-analysis. The pooled data analysis illustrated an elevated risk of migraine headaches (Prevalence ratio estimate = 1.29, 95% CI, 1.15 -1.44; P = 0.000) in obese individuals than normal-weight persons. Subgroup analyses revealed that geographical distribution was an essential source of heterogeneity (p= 0.04). So that significantly greater migraine prevalence was found in European and Asian patients, but no statistically significant relationship was seen in American patients with obesity. Conclusions: Based on a cumulative meta-analysis of available studies indicating an association between migraine and obesity, obesity can be appropriately considered an overall risk factor for migraine headaches. Additional high-quality original studies considering frequency, severity, and duration of headache must clarify confident evidence.

scholarly journals Prevalence of endocrine disorders in obese patients: systematic review and meta-analysis

2020 ◽  
Vol 182 (1) ◽  
pp. 11-21 ◽  
Author(s):  
L T van Hulsteijn ◽  
R Pasquali ◽  
F Casanueva ◽  
M Haluzik ◽  
S Ledoux ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Free Testosterone ◽  
Cochrane Library ◽  
Total Testosterone ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Pooled Prevalence ◽  
Cross Sectional Design ◽  
Underlying Mechanisms

Objective The increasing prevalence of obesity is expected to promote the demand for endocrine testing. To facilitate evidence guided testing, we aimed to assess the prevalence of endocrine disorders in patients with obesity. The review was carried out as part of the Endocrine Work-up for the Obesity Guideline of the European Society of Endocrinology. Design Systematic review and meta-analysis of the literature. Methods A search was performed in MEDLINE, EMBASE, Web of Science and COCHRANE Library for original articles assessing the prevalence of hypothyroidism, hypercortisolism, hypogonadism (males) or hyperandrogenism (females) in patients with obesity. Data were pooled in a random-effects logistic regression model and reported with 95% confidence intervals (95% CI). Results Sixty-eight studies were included, concerning a total of 19.996 patients with obesity. The pooled prevalence of overt (newly diagnosed or already treated) and subclinical hypothyroidism was 14.0% (95% CI: 9.7–18.9) and 14.6% (95% CI: 9.2–20.9), respectively. Pooled prevalence of hypercortisolism was 0.9% (95% CI: 0.3–1.6). Pooled prevalence of hypogonadism when measuring total testosterone or free testosterone was 42.8% (95% CI: 37.6–48.0) and 32.7% (95% CI: 23.1–43.0), respectively. Heterogeneity was high for all analyses. Conclusions The prevalence of endocrine disorders in patients with obesity is considerable, although the underlying mechanisms are complex. Given the cross-sectional design of the studies included, no formal distinction between endocrine causes and consequences of obesity could be made.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

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