scholarly journals A systematic review of inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions

2021 ◽  
Author(s):  
Jack Birch ◽  
Rebecca Jones ◽  
Julia Mueller ◽  
Matthew McDonald ◽  
Rebecca Richards ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Management ◽  
Health Inequalities ◽  
Randomised Controlled Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Original Research ◽  
Controlled Trials ◽  
Management Interventions ◽  
Randomised Controlled

Background: It has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including intervention uptake, adherence and effectiveness. We conducted a systematic review to synthesise evidence on how different measures of inequality moderate the uptake of, adherence to and effectiveness of behavioural weight management interventions in adults. Methods: We updated a previous systematic literature review from the US Preventive Services Taskforce to identify trials of behavioural weight management interventions in adults that could be conducted in or recruited from primary care. Medline, Cochrane database (CENTRAL) and PsycINFO were searched. Only randomised controlled trials and cluster-randomised controlled trials were included. Two investigators independently screened articles for eligibility and conducted risk of bias assessment. We curated publication families for eligible trials. The PROGRESS-Plus acronym (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) was used to consider a comprehensive range of health inequalities. Data on trial uptake, intervention adherence, weight change, and PROGRESS-Plus related-data were extracted. Results: Data extraction in currently underway. A total of 108 studies are included in the review. Data will be synthesised narratively and through the use of Harvest Plots. A Harvest plot for each PROGRESS-Plus criterion will be presented, showing whether each trial found a negative, positive or no health inequality gradient. We will also identify potential sources of unpublished original research data on these factors which can be synthesised through a future individual participant data meta- analysis. Conclusions and implications: The review findings will contribute towards the consideration of intervention-generated inequalities by researchers, policy makers and healthcare and public health practitioners. Authors of trials included in the completed systematic review may be invited to collaborate on a future IPD meta-analysis. PROSPERO registration number: CRD42020173242

scholarly journals Non-pharmacological management of antipsychotic-induced weight gain: Systematic review and meta-analysis of randomised controlled trials

2008 ◽  
Vol 193 (2) ◽  
pp. 101-107 ◽  
Author(s):  
Mario Álvarez-Jiménez ◽  
Sarah E. Hetrick ◽  
César González-Blanch ◽  
John F. Gleeson ◽  
Patrick D. McGorry
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Specific Treatment ◽  
Antipsychotic Treatment ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Management Interventions ◽  
Randomised Controlled

BackgroundAntipsychotic-induced weight gain is a major concern in the treatment of psychosis. The efficacy of non-pharmacological interventions as well as the optimal intervention approach for this side-effect remain unclear.AimsTo determine the effectiveness of non-pharmacological interventions and specific treatment approaches to control antipsychotic-induced weight gain in patients with firstepisode or chronic schizophrenia.MethodSystematic review and meta-analysis of randomised controlled trials.ResultsTen trials were included in the meta-analysis. Adjunctive non-pharmacological interventions, either individual or group interventions, or cognitive-behavioural therapy as well as nutritional counselling were effective in reducing or attenuating antipsychotic-induced weight gain compared with treatment as usual, with treatment effects maintained over follow-up.ConclusionsNon-pharmacological weight-management interventions should be a priority, particularly during the early stages of antipsychotic treatment. Preventive approaches have the potential to be more effective, acceptable, cost-efficient and beneficial.

scholarly journals Pharmacotherapeutic Options for Managing Neuropathic Pain: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Giulia Di Stefano ◽  
Andrea Di Lionardo ◽  
Giuseppe Di Pietro ◽  
Giorgio Cruccu ◽  
Andrea Truini
Keyword(s):  
Systematic Review ◽  
Neuropathic Pain ◽  
Systematic Reviews ◽  
Randomised Controlled Trials ◽  
Fatty Acid Amide Hydrolase ◽  
Data Extraction ◽  
Meta Analysis ◽  
Acid Amide ◽  
Controlled Trials ◽  
Randomised Controlled

Despite an increasing number of available therapies, the treatment of neuropathic pain remains a major issue. Systematic reviews and meta-analyses indicate that only a minority of patients with neuropathic pain have an adequate response to pharmacological treatment and that most drugs have dose-limiting side effects. We conducted a systematic review and meta-analysis of randomised controlled trials published in the last five years. We searched for relevant papers within PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the Clinical Trials database (ClinicalTrials.gov). Two authors independently selected studies for inclusion, data extraction, and bias assessment. We identified 39 randomised controlled trials and included 16 in the meta-analysis. Trial outcomes were generally modest even for first-line drugs such as tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and gabapentinoids. Many drugs acting on new pain targets are currently under development. Clinical data are currently available for sodium channel isoform-specific antagonists, anti-nerve growth factor molecules, and fatty acid amide hydrolase inhibitors.

scholarly journals Inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions: systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039518
Author(s):  
Jack Michael Birch ◽  
Simon J Griffin ◽  
Michael P Kelly ◽  
Amy L Ahern
Keyword(s):  
Systematic Review ◽  
Weight Management ◽  
Health Inequalities ◽  
Meta Analysis ◽  
The United States ◽  
Primary Data ◽  
Original Research ◽  
Individual Participant Data ◽  
Management Interventions ◽  
Individual Participant

IntroductionIt has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including intervention uptake, adherence and effectiveness. We will synthesise evidence on how different measures of inequality moderate the uptake, adherence and effectiveness of behavioural weight management interventions in adults.Methods and analysisWe will update a previous systematic literature review from the United States Preventive Services Taskforce to identify trials of behavioural weight management interventions in adults aged 18 years and over that were, or could feasibly be, conducted in or recruited from primary care. Medline, Cochrane database (CENTRAL) and PsycINFO will be searched. Only randomised controlled trials (RCTs) and cluster-RCTs will be included. Two investigators will independently screen articles for eligibility and conduct risk of bias assessment. We will curate publication families for eligible trials. The PROGRESS-Plus acronym (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) will be used to consider a comprehensive range of health inequalities. Data on trial uptake, intervention adherence, weight change and PROGRESS-Plus-related data will be extracted. Data will be synthesised narratively. We will present a Harvest plot for each PROGRESS-Plus criterion and whether each trial found a negative, positive or no health inequality gradient. We will also identify potential sources of unpublished original research data on these factors which can be synthesised through a future individual participant data meta-analysis.Ethics and disseminationEthical approval is not required as no primary data are being collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences, and contribute to the lead author’s PhD thesis. Authors of trials included in the completed systematic review may be invited to collaborate on a future individual participant data meta-analysis.PROSPERO registration numberCRD42020173242.

Group programmes for weight loss may be more effective than one-to-one sessions

BMJ ◽  
2021 ◽  
pp. n2771
Author(s):  
Helen Saul ◽  
Deniz Gursul
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Weight Management ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Group Versus ◽  
Controlled Trials ◽  
Lifestyle Interventions ◽  
One To One ◽  
Randomised Controlled

The study Abbott S, Smith E, Tighe B, Lycett D. Group versus one-to-one multi-component lifestyle interventions for weight management: a systematic review and meta-analysis of randomised controlled trials. J Hum Nutr Diet 2021;34:485-93. To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/group-weight-loss-programmes-more-effective-than-one-to-one-sessions/

Microbial colonisation associated with conventional and self-ligating brackets: a systematic review

2021 ◽  
pp. 146531252110560
Author(s):  
Nidhi P Parmar ◽  
Gabrielle L Thompson ◽  
Nikki E Atack ◽  
Anthony J Ireland ◽  
Martyn Sherriff ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Significant Difference ◽  
Critical Appraisal Skills ◽  
Randomised Controlled ◽  
Bracket Design

Background: Decalcification and gingivitis caused by plaque accumulation around brackets are common iatrogenic effects of fixed appliances. The influence of conventional versus self-ligating bracket design on microbial colonisation is unknown. Objective: To assess the levels of microbial colonisation associated with conventional and self-ligating brackets. Search sources: Three databases were searched for publications from 2009 to 2021. Data selection: Randomised controlled trials comparing levels of microbial colonisation before and during treatment with conventional and self-ligating brackets were assessed independently and in duplicate. Data extraction: Data were extracted independently by two authors from the studies that fulfilled the inclusion criteria. Risk of bias assessments were made using the revised Cochrane risk of bias tool for randomized trials. The quality of the included studies was assessed using the Critical Appraisal Skills Programme Checklist. Results: A total of 11 randomised controlled trials were included in this systematic review. Six of the studies were found to be at low risk of bias and five presented with some concerns. The studies were considered moderate to high quality. Five trials reported no statistically significant difference in microbial colonisation between bracket types. The remaining studies showed mixed results, with some reporting increased colonisation of conventional brackets and others increased colonisation of self-ligating brackets. The heterogeneity of study methods and outcomes precluded meta-analysis. Conclusion: Of the 11 studies included in this systematic review, five found no differences in colonisation between conventional and self-ligating brackets. The remaining studies showed mixed results. The evidence is inconclusive regarding the association between bracket design and levels of microbial colonisation.

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