scholarly journals Group Medical Care: A Systematic Review of Health Service Performance

2021 ◽  
Vol 18 (23) ◽  
pp. 12726
Author(s):  
Shayna D. Cunningham ◽  
Ryan A. Sutherland ◽  
Chloe W. Yee ◽  
Jordan L. Thomas ◽  
Joan K. Monin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Medical Care ◽  
Patient Experience ◽  
Health Conditions ◽  
Controlled Trials ◽  
Group Visits ◽  
Individual Care ◽  
Care Models

Group care models, in which patients with similar health conditions receive medical services in a shared appointment, have increasingly been adopted in a variety of health care settings. Applying the Triple Aim framework, we examined the potential of group medical care to optimize health system performance through improved patient experience, better health outcomes, and the reduced cost of health care. A systematic review of English language articles was conducted using the Cochrane Controlled Trials Register (CENTRAL), MEDLINE/PubMed, Scopus, and Embase. Studies based on data from randomized control trials (RCTs) conducted in the US and analyzed using an intent-to-treat approach to test the effect of group visits versus standard individual care on at least one Triple Aim domain were included. Thirty-one studies met the inclusion criteria. These studies focused on pregnancy (n = 9), diabetes (n = 15), and other chronic health conditions (n = 7). Compared with individual care, group visits have the potential to improve patient experience, health outcomes, and costs for a diversity of health conditions. Although findings varied between studies, no adverse effects were associated with group health care delivery in these randomized controlled trials. Group care models may contribute to quality improvements, better health outcomes, and lower costs for select health conditions.

How Does Mindfulness Affect Cognition? A Reflection on Confounding Issues Surrounding Mindfulness-based Intervention Research Targeting Cognitive Outcomes

2018 ◽  
Author(s):  
David R Vago ◽  
Resh Gupta ◽  
Sara Lazar
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Cognitive Functioning ◽  
Cognitive Processes ◽  
Methodological Quality ◽  
Cognitive Outcomes ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Existing Data

One potential pathway by which mindfulness-based meditation improves health outcomes is through changes in cognitive functioning. A systematic review of randomized controlled trials of mindfulness-based interventions (MBIs) was conducted with a focus on assessing the state of the evidence for effects on cognitive processes and associated assays. Here, we comment on confounding issues surrounding the reporting of these and related findings, including 1) criteria that appropriately define an MBI; 2) limitations of assays used to measure cognition; and 3) methodological quality of MBI trials and reporting of findings. Because these issues contribute to potentially distorted interpretations of existing data, we offer constructive means for interpretation and recommendations for moving the field of mindfulness research forward regarding the effects on cognition.

scholarly journals Effectiveness of chronic care models: opportunities for improving healthcare practice and health outcomes: a systematic review

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Carol Davy ◽  
Jonathan Bleasel ◽  
Hueiming Liu ◽  
Maria Tchan ◽  
Sharon Ponniah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Chronic Care ◽  
Healthcare Practice ◽  
Care Models

scholarly journals Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta-analysis of controlled trials

2018 ◽  
Vol 57 (4) ◽  
pp. 453-472 ◽  
Author(s):  
Charlotte Paterson ◽  
Thanos Karatzias ◽  
Adele Dickson ◽  
Sean Harper ◽  
Nadine Dougall ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Care ◽  
Meta Analysis ◽  
Psychological Therapy ◽  
Controlled Trials

scholarly journals Improving the Prescription of Oral Anticoagulants in Atrial Fibrillation: A Systematic Review

2019 ◽  
Vol 119 (02) ◽  
pp. 294-307 ◽  
Author(s):  
Ruth Pritchett ◽  
Danai Bem ◽  
Grace Turner ◽  
G. Thomas ◽  
Joanne Clarke ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Medical Care ◽  
Stroke Prevention ◽  
Assessment Tool ◽  
Peer Group ◽  
Oral Anticoagulants ◽  
Controlled Trials ◽  
Computerized Decision Support ◽  
Appropriate Prescription

Objective Oral anticoagulant (OAC) prescription for stroke prevention in atrial fibrillation (AF) patients frequently does not follow current guidelines, with underuse in patients at high risk of stroke and substantial overuse in those at low risk. This review aims to systematically evaluate the effectiveness of interventions to improve appropriate OAC prescription in eligible AF patients for stroke prevention. Methods Systematic review of controlled and uncontrolled studies published up to July 2017 with interventions designed to improve appropriate OAC prescription for stroke prevention in eligible AF patients (according to risk assessment tool or guidelines). Categorization of intervention types was pre-specified. The main outcome was change in proportion of eligible AF patients prescribed OACs for stroke prevention. Results Twenty studies conducted in 392 settings were included (cluster randomized controlled trials, controlled trials and uncontrolled before-after designs; n = 29,868 patients at baseline). Fifteen studies reported significant improvements in appropriate prescription of OACs in AF patients. All interventions with a persuasive element (8/8); all studies targeting health care professional (HCP) education or guideline/protocol implementation (7/7); and all medical care programs (4/4) achieved significant increases in appropriate OAC prescription. Computerized decision support interventions (3/5) and reviews of prescribing (2/4) were less likely to report significant improvements in appropriate OAC prescription. Conclusion Interventions designed to improve appropriate prescription of OACs in eligible AF patients for stroke prevention can be effective. Successful approaches include education of HCPs; implementation of local guidelines; interdisciplinary medical care programs educating both HCPs and patients and persuasive interventions utilizing peer-group experts. Protocol registration: PROSPERO (CRD42016039654).

Motivational interviewing in medical care settings: A systematic review and meta-analysis of randomized controlled trials

2013 ◽  
Vol 93 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Brad Lundahl ◽  
Teena Moleni ◽  
Brian L. Burke ◽  
Robert Butters ◽  
Derrik Tollefson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Motivational Interviewing ◽  
Medical Care ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery

2018 ◽  
Vol 36 (20) ◽  
pp. 2088-2100 ◽  
Author(s):  
Paul B. Jacobsen ◽  
Antonio P. DeRosa ◽  
Tara O. Henderson ◽  
Deborah K. Mayer ◽  
Chaya S. Moskowitz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Cochrane Library ◽  
Survivorship Care Plan ◽  
Satisfaction With Care ◽  
Survivorship Care ◽  
Care Plans

Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan (SCP) comprising a treatment summary and follow-up care plans. Among current barriers to implementation are providers’ concerns about the strength of evidence that SCPs improve outcomes. This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors. Methods Randomized and nonrandomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Data extracted by independent raters were summarized on the basis of qualitative synthesis. Results Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed. Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs. Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being); findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care. Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes. Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care.

scholarly journals The impact of eHealth group interventions on the mental, behavioral, and physical health of adults: a systematic review protocol

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Cheryl L. Currie ◽  
Richard Larouche ◽  
M. Lauren Voss ◽  
Erin K. Higa ◽  
Rae Spiwak ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Physical Health ◽  
Group Counseling ◽  
Primary Objective ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Health Conditions ◽  
Controlled Trials ◽  
The Impact

Abstract Background COVID-19 has resulted in an increased demand for eHealth services globally. There is emerging evidence for the efficacy for group eHealth interventions that support population-based mental health and wellbeing, but a systematic review is lacking. The primary objective of this systematic review is to summarize the evidence for eHealth group counseling and coaching programs for adults. A second objective is to assess, within studies selected for our primary objective, the impact of programs that encourage PA on outcomes compared to those that do not. Methods Randomized controlled trials that assess the impact of eHealth group counseling or coaching programs on mental health, health behavior, or physical health activity among community-dwelling adults will be included. We will search the following electronic databases (from January 2005 onwards): MEDLINE, PsycINFO, CINHAL, and the Central Register of Controlled Trials. The primary outcomes will be changes in mental health conditions (e.g., depression, anxiety, stress, quality of life), behavioral health conditions (e.g., substance use, smoking, sexual behavior, eating behavior, medication adherence), and physical health conditions (e.g., coping with cancer, menopausal symptoms, arthritis pain). Secondary outcomes will be changes in physical activity. Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion with a third reviewer. A narrative synthesis without meta-analysis will be conducted. The strength of the body of evidence will be assessed using GRADE. The risk of bias in individual studies will be appraised using the Cochrane Risk of Bias 2.0 tool. Potential sources of gender bias in included studies will be considered at all stages of the planned review. Discussion This review will contribute to the literature by providing evidence on the effectiveness of eHealth counseling and coaching programs delivered to adults in a group format. Systematic review registration The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020187551).

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