scholarly journals The Impact of Pharmacologic and Nonpharmacologic Interventions to Improve Physical Health Outcomes in People With Dementia: A Meta-Review of Meta-Analyses of Randomized Controlled Trials

2020 ◽  
Vol 21 (10) ◽  
pp. 1410-1414.e2 ◽  
Author(s):  
Davy Vancampfort ◽  
Marco Solmi ◽  
Joseph Firth ◽  
Mathieu Vandenbulcke ◽  
Brendon Stubbs
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Physical Health Outcomes ◽  
People With Dementia ◽  
Meta Review ◽  
Meta Analyses ◽  
The Impact

Plant-based Medicines (Phytoceuticals) in the Treatment of Psychiatric Disorders: A Meta-review of Meta-analyses of Randomized Controlled Trials: Les médicaments à base de plantes (phytoceutiques) dans le traitement des troubles psychiatriques: une méta-revue des méta-analyses d’essais randomisés contrôlés

2021 ◽  
pp. 070674372097991
Author(s):  
Jerome Sarris ◽  
Wolfgang Marx ◽  
Melanie M. Ashton ◽  
Chee H. Ng ◽  
Nicole Galvao-Coelho ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Psychiatric Disorders ◽  
Publication Bias ◽  
Negative Symptoms ◽  
Depression Symptoms ◽  
Controlled Trials ◽  
Traditional Chinese Herbal Medicine ◽  
Randomized Controlled ◽  
Meta Review ◽  
Meta Analyses

Objectives: Plant-based medicines have had a long-standing history of use in psychiatric disorders. Highly quantified and standardized extracts or isolates may be termed “phytoceuticals,” in a similar way that medicinal nutrients are termed as “nutraceuticals.” Over the past 2 decades, several meta-analyses have examined the data for a range of plant-based medicines in the treatment of psychiatric disorders. The aim of this international project is to provide a “meta-review” of this top-tier evidence. Methods: We identified, synthesized, and appraised all available up to date meta-analyses... of randomized controlled trials (RCTs) reporting on the efficacy and effectiveness of individual phytoceuticals across all major psychiatric disorders. Results: Our systematic search identified 9 relevant meta-analyses of RCTs, with primary analyses including outcome data from 5,927 individuals. Supportive meta-analytic evidence was found for St John’s wort for major depressive disorder (MDD); curcumin and saffron for MDD or depression symptoms, and ginkgo for total and negative symptoms in schizophrenia. Kava was not effective in treating diagnosed anxiety disorders. We also provide details on 22 traditional Chinese herbal medicine formulas’ meta-analyses (primarily for depression studies), all of which revealed highly significant and large effect sizes. Their methodology, reporting, and potential publication bias were, however, of marked concern. The same caveat was noted for the curcumin, ginkgo, and saffron meta-analyses, which may also have significant publication bias. Conclusions: More rigorous international studies are required to validate the efficacy of these phytoceuticals before treatment recommendations can be made. In conclusion, the breadth of data tentatively supports several phytoceuticals which may be effective for mental disorders alongside pharmaceutical, psychological therapies, and standard lifestyle recommendations.

scholarly journals Mobile phone-based interventions for mental health-A systematic meta-review of 14 meta-analyses of randomized controlled trials

2021 ◽  
Author(s):  
Simon Goldberg ◽  
Sin U Lam ◽  
Otto Simonsson ◽  
John Torous ◽  
Shufang Sun
Keyword(s):  
Randomized Controlled Trials ◽  
Mobile Phone ◽  
Publication Bias ◽  
Convincing Evidence ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Suggestive Evidence ◽  
Meta Review ◽  
Meta Analyses

Mobile phone-based interventions have been proposed as a means for reducing the burden of disease associated with mental illness. While numerous randomized controlled trials and meta-analyses have investigated this possibility, evidence remains unclear. We conducted a systematic meta-review of meta-analyses examining mobile phone-based interventions tested in randomized controlled trials. We synthesized results from 14 meta-analyses representing 145 randomized controlled trials and 47,940 participants. We identified 34 effect sizes representing unique pairings of participants, intervention, comparisons, and outcome (PICO) and graded the strength of the evidence as using umbrella review methodology. We failed to find convincing evidence of efficacy (i.e., n > 1000, p < 10-6, I2 < 50%, absence of publication bias); publication bias was rarely assessed for the representative effect sizes. Eight effect sizes provided highly suggestive evidence (i.e., n > 1000, p < 10-6), including smartphone interventions outperforming inactive controls on measures of psychological symptoms and quality of life (ds = 0.32 to 0.47) and text message-based interventions outperforming non-specific controls and active controls for smoking cessation (ds = 0.31 and 0.19, respectively). The magnitude of effects and strength of evidence tended to diminish as comparison conditions became more rigorous (i.e., inactive to active, non-specific to specific). Four effect sizes provided suggestive evidence, 14 effect sizes provided weak evidence, and eight effect sizes were non-significant. Despite substantial heterogeneity, no moderators were identified. Adverse effects were not reported. Taken together, results support the potential of mobile phone-based interventions and highlight key directions to guide providers, policy makers, clinical trialists, and meta-analysts working in this area.

scholarly journals The Impact of Iron Supplementation for Treating Anemia in Patients with Chronic Kidney Disease: Results from Pairwise and Network Meta-Analyses of Randomized Controlled Trials

2020 ◽  
Vol 13 (5) ◽  
pp. 85 ◽  
Author(s):  
Marcel Adler ◽  
Francisco Herrera-Gómez ◽  
Débora Martín-García ◽  
Marie Gavid ◽  
F. Javier Álvarez ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Iron Supplementation ◽  
Controlled Trials ◽  
Total Study Population ◽  
Randomized Controlled ◽  
Meta Analyses ◽  
The Impact

After relative erythropoietin deficiency, iron deficiency is the second most important contributing factor for anemia in chronic kidney disease (CKD) patients. Iron supplementation is a crucial part of the treatment of anemia in CKD patients, and intravenous (IV) iron supplementation is considered to be superior to per os (PO) iron supplementation. The differences between the available formulations are poorly characterized. This report presents results from pairwise and network meta-analyses carried out after a comprehensive search in sources of published and unpublished studies, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations (International prospective register of systematic reviews PROSPERO reference ID: CRD42020148155). Meta-analytic calculations were performed for the outcome of non-response to iron supplementation (i.e., hemoglobin (Hgb) increase of <0.5–1.0 g/dL, or initiation/intensification of erythropoiesis-stimulating agent (ESA) therapy, or increase/change of iron supplement, or requirements of blood transfusion). A total of 34 randomized controlled trials (RCT) were identified, providing numerical data for analyses covering 93.7% (n = 10.097) of the total study population. At the network level, iron supplementation seems to have a more protective effect against the outcome of non-response before the start of dialysis than once dialysis is initiated, and some preparations seem to be more potent (e.g., ferumoxytol, ferric carboxymaltose), compared to the rest of iron supplements assessed (surface under the cumulative ranking area (SUCRA) > 0.8). This study provides parameters for adequately following-up patients requiring iron supplementation, by presenting the most performing preparations, and, indirectly, by making it possible to identify good responders among all patients treated with these medicines.

Patient Acceptance of Educational Voice Messages: A Review of Controlled Clinical Studies

2002 ◽  
Vol 41 (05) ◽  
pp. 360-369 ◽  
Author(s):  
S. A. Boren ◽  
N. Maglaveras ◽  
S. Krishna ◽  
E. A. Balas
Keyword(s):  
Health Outcomes ◽  
Randomized Controlled Trials ◽  
Preventive Care ◽  
Clinical Studies ◽  
Chronic Care ◽  
Controlled Trials ◽  
Care Education ◽  
Randomized Controlled ◽  
Computer Based ◽  
The Impact

Summary Objectives: The objective of this study was to evaluate controlled evidence on the impact of automated computer-based telephone messaging technology upon health outcomes, cost savings and acceptance by patients, caregivers and care providers. Methods: Systematic searches of electronic databases were conducted to find controlled clinical studies of automated phone messaging used in patient care. Studies were selected based on the three criteria: 1) randomized controlled trials or controlled trials; 2) patients receiving health care related education, information, advice or reminder for a specific action to be taken in their home setting; and 3) use of automated computer-based phone technology to deliver the messages. Information abstracted from studies included information about the institution, persons targeted, intervention and its effect on health outcomes, costs and acceptance by patients and caregivers. Results: A total of nineteen studies were identified for review. Sixteen studies were randomized controlled trials and three were controlled studies with no randomization. Studies were placed in two categories, preventive care education and chronic care studies. Preventive care education studies covered childhood immunizations, medication compliance, influenza vaccinations, tuberculosis and health prevention activities and chronic care studies were related to cholesterol, diabetes, hyper-tension and congestive heart failure. More than 80% of studies showed significant impact upon measurable health outcomes. Conclusions: Controlled evidence substantiates the efficacy of automated telephone communication in improving the quality of care. Educational voice messages are acceptable to patients and represent an important opportunity to enhance telemedicine and telehealth applications.

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