Peer Review #2 of "Patient-centered care interventions to reduce the inappropriate prescription and use of benzodiazepines and z-drugs: a systematic review (v0.1)"

BackgroundBenzodiazepines (BZDs) and z-drugs are effective drugs, but they are prescribed excessively worldwide. International guidelines recommend a maximum treatment duration of 4 weeks. Although these drugs are effective in the short-term, long-term BZD therapy is associated with considerable adverse effects, the development of tolerance and, finally, addiction. However, there are different interventions in terms of patient-centered care that aim to reduce the use of BZDs and z-drugs as well as assist health care professionals (HCPs) in preventing the inappropriate prescription of BZDs.AimThe aim of this systematic review was to identify interventions that promote patient-centered treatments for inappropriate BZD and z-drug use and to analyze their effectiveness in reducing the inappropriate use of these drugs.MethodsTo identify relevant studies, the PubMed, EMBASE, PsycINFO, Psyndex, and Cochrane Library databases were searched. Studies with controlled designs focusing on adult patients were included. Trials with chronically or mentally ill patients were excluded if long-term BZD and z-drug use was indicated. Study extraction was performed based on the Cochrane Form for study extraction. To assess the quality of the studies, we used a tool based on the Cochrane Collaboration’s tool for assessing the risk of bias in randomized trials.ResultsWe identified 7,068 studies and selected 20 for systematic review. Nine interventions focused on patients, nine on HCPs, and two on both patients and HCPs. Intervention types ranged from simple to multifaceted. Patient-centered interventions that provided patient information effectively increased the appropriate use of BZDs. The educational approaches for HCPs that aimed to achieve appropriate prescription reported inconsistent results. The methods that combined informing patients and HCPs led to a significant reduction in BZD use.ConclusionsThis is the first review of studies focused on patient-centered approaches to reducing the inappropriate prescription and use of BZDs and z-drugs. The patient-centered dimension of patient information was responsible for a decrease in BZD and z-drug consumption. Further, in some studies, the patient-centered dimensions responsible for reducing the prescription and use of BZDs and z-drugs were the clinician’s essential characteristics and clinician-patient communication.

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A Systematic Review of Surveys for Measuring Patient-centered Care in the Hospital Setting

Medical Care ◽

10.1097/mlr.0000000000001474 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Sara C. Handley ◽

Sydney Bell ◽

Ingrid M. Nembhard

Keyword(s):

Systematic Review ◽

Hospital Setting ◽

Patient Centered Care ◽

Patient Centered ◽

Centered Care

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EXAMINING THE EFFECT OF PATIENT-CENTERED CARE ON PATIENT OUTCOMES: A SYSTEMATIC REVIEW

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2015.07.053 ◽

2015 ◽

Vol 31 (10) ◽

pp. S18-S19

Author(s):

S.M. Fredericks ◽

J. Lapum ◽

G. Hui

Keyword(s):

Systematic Review ◽

Patient Outcomes ◽

Patient Centered Care ◽

Patient Centered ◽

Centered Care

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Patient-centered care pathways: what does it mean? An integrative conceptual framework to meet the need of an international consensus: a qualitative systematic review protocol

10.31219/osf.io/c6asn ◽

2021 ◽

Author(s):

Jean-Baptiste Gartner ◽

Kassim Said Abasse ◽

Ghita Ben Zagguou ◽

Frédéric Bergeron ◽

Paolo Landa ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Care Delivery ◽

Care Pathway ◽

Patient Centered Care ◽

Patient Centered ◽

International Consensus ◽

Patient Journey ◽

Centered Care ◽

Health Care Delivery Systems

Background: Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more qualitative and efficient ways to deliver care. This study is conducted to provide a clear definition of the patient-centered care pathway and its characteristics to meet the need for an international consensus. Methods: This qualitative systematic review aims to perform a systematic synthesis of published evidence concerning (1) the definition of the patient trajectory, patient pathway or patient journey and (2) their characteristics. With a consulting librarian, a comprehensive and systematic search in three databases was conducted (PUBMED, Embase, ABI/Inform), from 1995 to 2020 without language criteria. Eligibility criteria guiding data selection will follow the PICo mnemonic criteria consisting of (1) Population : all types of patients managed by health care delivery systems for an acute or chronic condition regardless of age or condition, (2) Phenomena : studies that contribute to the definition and conceptualization of the concepts of care trajectory, care pathway and patient journey resulting in a theoretical and conceptual contribution, and (3) Context : health care providers include all providers of primary, secondary, tertiary, and quaternary care in any geographic area. Two reviewers will independently screen, select, extract data and make a critical assessment of the methodology used with the JBI Qualitative Assessment and Review Instrument (JBI QARI).Discussion: This systematic review will provide much-needed knowledge regarding patient-centered pathways. The results will benefit clinicians, decision makers, and researchers by giving them a clear and integrated definition and understanding of the patient-centered care pathways and their characteristics to finally meet the need for an international consensus.

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A Systematic Review of Educational Interventions and Their Impact on Empathy and Compassion of Undergraduate Medical Students

Frontiers in Medicine ◽

10.3389/fmed.2021.758377 ◽

2021 ◽

Vol 8 ◽

Author(s):

Prianna Menezes ◽

Salman Y. Guraya ◽

Shaista Salman Guraya

Keyword(s):

Systematic Review ◽

Medical Students ◽

Well Being ◽

Educational Interventions ◽

Patient Centered Care ◽

Technology Enhanced Learning ◽

Long Term Effects ◽

Undergraduate Medical Students ◽

Patient Centered ◽

Centered Care

Introduction: A compassionate and patient-centered care leads to improved clinical outcomes. Promoting empathy and compassion of medical students is a forerunner of their well-being, emotional stability, and a patient-centered care. However, there is slender evidence about best educational interventions that can inculcate empathy and compassion skills. Our objective was to conduct a systematic review of research evaluating the associations between spectrum, effectiveness, frequency of teaching modalities and their outcomes on compassion and empathy to highlight best practices.Methods: We searched the Web of Science, PubMed, Scopus, and EBSCO Host on 22nd July 2020. We adapted our search strategy from a previously published systematic review on education for compassion and empathy. Selected studies were required to have used unique educational interventions for promoting empathy and compassion of medical students. The research questions were based on Participants (medical students), Intervention (empathy and/or compassion related teaching), Comparison, and Outcome.Results: We analyzed 24 articles from the initial yield of 2,861. Twenty-two were quantitative studies with a mean of 12.8 on MERSQI. Twelve were randomized controlled trials while 5 measured outcomes with single group pre- and post-tests. There was no association found between duration, frequency and complexity of an educational intervention and its effectiveness. Twenty used multimodality curricula, and of those 18 reported statistically significant positive improvement in empathy, while 3 of 4 single modality were effective. Only three studies looked for long-term effects of educational interventions. Fourteen studies evaluated Kirkpatrick's level one (self-reported knowledge), 2 level three (behavior), and 6 level four (patient outcomes). We identified six major educational constructs of teaching empathy and compassion; communication, mindfulness, early clinical exposure, technology-enhanced learning, comics and arts and culture.Discussion: Our review couldn't identify a standard teaching construct in place and highlighted that different teaching tools carry similar impact in promoting compassion and empathy and a sustainable program rather than a single training activity is essential.

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