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1.
BMJ Open ; 14(4): e081937, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38589263

RESUMEN

INTRODUCTION: Non-communicable diseases cause 74% of global deaths, with cardiovascular diseases as the major contributor. Hypertension, a primary risk factor for cardiovascular disease, is highly prevalent in Africa. Diagnosis, treatment and control rates are notably limited in rural areas. This limitation results in increased risks of premature mortality and complications such as stroke due to socioeconomic, cultural and geographical challenges. Progress in African countries enhancing hypertension services through primary health care interventions exists. However, a comprehensive review of all primary health care interventions addressing undiagnosed and uncontrolled hypertension in rural African settings is lacking. This scoping review aims to categorise primary health care interventions targeting undiagnosed and uncontrolled hypertension in rural African adults. Intervention components will be mapped to the four stages outlined in the hypertension care cascade to develop a pilot intervention logic model for rural African adults with hypertension. METHOD AND ANALYSIS: The scoping review protocol will adhere to the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Studies considered for inclusion will include any intervention delivered by any healthcare provider in a rural African primary care setting targeting any stage of hypertension care. Eight databases will be searched without date restrictions, supplemented by grey literature and reference list searches. A two-stage screening process (title/abstract and full text) will determine evidence source eligibility. All eligible sources of evidence will be extracted, charted and evaluated using the Template for Intervention Description and Replication checklist. A pilot logic model categorising and mapping interventions to the four stages of the hypertension care cascade will be visually presented and analysed using narrative synthesis. ETHICS AND DISSEMINATION: No primary data will be collected; therefore, ethics approval is not required. Findings will be disseminated to local health authorities in Ghana and other African Regions and through national and international conferences and publications in peer-reviewed journals.


Asunto(s)
Enfermedades Cardiovasculares , Hipertensión , Adulto , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/terapia , Academias e Institutos , Ghana , Atención Primaria de Salud , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
2.
J Stud Alcohol Drugs ; 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38669136

RESUMEN

OBJECTIVE: This paper documents the methods used to assess the implementation costs of the APPRAISE alcohol brief intervention (ABI) delivered to male remand prisoners across two study sites in Scotland and North East England. METHOD: We first developed a comprehensive taxonomy of the activities constituting the APPRIASE ABI. Next, data were collected for each activity about the study staff and the subject time spent, in addition to the other resources used and unit costs. RESULTS: From the pilot data collection it was possible to construct a narrative, for both study sites, for how the intervention was delivered and the time required for each activity. The ABI was delivered by Change Grow Live and Humankind intervention staff and staff salaries were obtained from both organizations to calculate the staff delivery costs for each site. Other costs, such as the printing of materials, were estimated based on APPRAISE study records. Due to the ongoing Covid-19 restrictions and limited access to prison resources and staff, there were significant deviations from the initial study protocols. As a result, we document the costs of implementing the ABI as delivered rather than as planned. CONCLUSIONS: This paper provides the first estimates of the implementation costs of an ABI delivered in criminal justice setting in the UK. Although these costs are from a pilot implementation that was heavily impacted by the Covid-19 pandemic, this paper nonetheless provides useful, policy-relevant information on the potential costs of providing ABI to remand prisoners. It also serves as a methodological template, guidance, and proof of concept for future micro-costing studies of ABIs in criminal justice settings.

3.
Digit Health ; 9: 20552076231220241, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38130797

RESUMEN

Background: There is growing evidence to suggest that EHRs may be associated with clinician stress and burnout, which could hamper their effective use and introduce risks to patient safety. Objective: This systematic review aimed to examine the association between EHR use and clinicians' stress and burnout in hospital settings, and to identify the contributing factors influencing this relationship. Methods: The search included peer-reviewed published studies between 2000 and 2023 in English in CINAHL, Ovid Medline, Embase, and PsychINFO. Studies that provided specific data regarding clinicians' stress and/or burnout related to EHRs in hospitals were included. A quality assessment of included studies was conducted. Results: Twenty-nine studies were included (25 cross-sectional surveys, one qualitative study, and three mixed methods), which focused on physicians (n = 18), nurses (n = 10) and mixed professions (n = 3). Usability issues and the amount of time spent on the EHR were the most significant predictors, but intensity of the working environment influenced high EHR-related workload and thereby also contributed to stress and burnout. The differences in clinicians' specialties influenced the levels of stress and burnout related to EHRs. Conclusions: This systematic review showed that EHR use was a perceived contributor to clinicians' stress and burnout in hospitals, primarily driven by poor usability and excessive time spent on EHRs. Addressing these issues requires tailored EHR systems, rigorous usability testing, support for the needs of different specialities, qualitative research on EHR stressors, and expanded research in Non-Western contexts.

5.
J Adv Nurs ; 79(10): 3809-3823, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37232468

RESUMEN

AIM: To explore the challenges and opportunities facing executive nurse directors in the UK and identify factors to strengthen their role and support more effective nurse leadership. DESIGN: A qualitative descriptive study using reflexive thematic analysis. METHODS: Semi-structured, telephone interviews were carried out with 15 nurse directors and 9 nominated colleagues. RESULTS: Participants described a uniquely complex role with a broader scope than any other executive board member. Seven themes were identified: preparation for the role, length of time in role, role expectations, managing complexity, status, being political and influencing. Strengthening factors included successful working relationships with other board colleagues, development of political skills and personal status, coaching and mentoring, working within a supportive team culture and having strong professional networks. CONCLUSION: Executive nurse leaders are key to the transmission of nursing values and the delivery of safety and quality in healthcare settings. To strengthen this role, the limiting factors and the recommended shared learning identified here should be recognized and addressed at an individual, organizational and professional level. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Given the pressure on all health systems to retain nurses, the role of executive nurse leaders needs to be seen as an important source of professional leadership and their value in actioning health policy into practice recognized. IMPACT: New insights have been provided into the executive nurse director role across the UK. Findings have demonstrated challenges and opportunities to strengthen the executive nurse director role. These include recognition of the need for support, preparation, networking and more realistic expectations of this unique nursing role. REPORTING METHOD: The study adhered to the Consolidated Criteria for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution.


Asunto(s)
Tutoría , Enfermeras Administradoras , Humanos , Rol de la Enfermera , Investigación Cualitativa , Liderazgo
6.
Eur J Cardiovasc Nurs ; 22(2): 201-209, 2023 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-35714048

RESUMEN

AIMS: Lifestyle interventions are an essential element in the prevention of cardiovascular disease. However, promoting a healthy lifestyle is challenging because a multitude of factors interact and influence people's decisions to adopt and maintain healthy lifestyles. The effects of these factors on Saudi cardiac patients are largely unknown. This study aimed to explore the barriers and facilitators to healthy lifestyle changes among Saudis after cardiac events. METHODS AND RESULTS: The study followed an exploratory qualitative research design, using a social ecological approach. Semi-structured interviews were conducted with 21 participants (13 men and 8 women) who had a cardiac event. Participants were purposively recruited from cardiac clinics of two hospitals in Jeddah, Saudi Arabia. Data were analysed using the qualitative framework analysis, and factors were identified as salient based on their frequency and the potential strength of their impact. Six factors were identified as influencing lifestyle behaviours in cardiac patients, categorized as 'major' factors and 'mediating' factors. The 'major' factors were sociocultural norms, family values, and religious beliefs, and the mediating factors were insufficient healthcare services, physical environment, and policy regulations. Depending upon the behaviours reported and the context, the same factor could be classified as both a barrier and a facilitator. CONCLUSION: The findings of this study can be used to inform the development of contextual-based interventions to promote the adoption of healthy lifestyles that meet the population needs and are relevant to Saudi society.


Asunto(s)
Enfermedades Cardiovasculares , Estilo de Vida , Masculino , Humanos , Femenino , Arabia Saudita , Investigación Cualitativa , Estilo de Vida Saludable
7.
J Adv Nurs ; 78(11): e132-e134, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36183154
9.
J Adv Nurs ; 78(3): 869-882, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34632610

RESUMEN

AIMS: To explore younger adults' experiences of stroke rehabilitation to inform practice, education and future health policy. DESIGN: Qualitative analysis of digital and other media sources on public platforms. METHODS: Between March and June 2020, the experiences of younger adult stroke survivors aged 18 to 45 at the time of the stroke were collected. Data were gathered from publicly available sources, including social media, and from English-speaking users. In total, 117 accounts from 103 participants were identified from films, autobiographical books, blogs, websites, videos, Twitter and Instagram. Data analysis followed narrative and multimodal analysis with a focus on rehabilitation needs. RESULTS: Younger adult stroke survivors make sense of their experience by reflecting on how stroke has impacted their lives. Accounts reflected an emotional journey between the past self, the present self and evolving self, as well as associated challenges such as the impact on relationships and careers. The majority of accounts presented transitions as problematic, including the receipt of the initial diagnosis, or sometimes misdiagnosis, to returning home and achieving long-term rehabilitation goals. Specialist stroke nurses were considered essential in the rehabilitation process. CONCLUSION: A complex process of recovery follows stroke for younger adult stroke populations. Challenges to the rehabilitation process need to be better understood and the role of nursing highlighted in future service provision. A series of age-related challenges were highlighted that require attention to improve the care and support offered. IMPACT: This article informs clinicians, educators, and policymakers of the age-related needs of young adult stroke survivors. Focusing on the individual and the development of age-appropriate person-centred stroke care is important. The study highlights the role of stroke nursing and challenges the current policy focus on older stroke populations as well as arguing for greater awareness of age-appropriate stroke rehabilitation in younger adults following stroke.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Adolescente , Adulto , Blogging , Humanos , Persona de Mediana Edad , Sobrevivientes , Adulto Joven
10.
J Stud Alcohol Drugs ; 82(5): 638-646, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34546911

RESUMEN

OBJECTIVE: The purpose of this study was to report the "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) recommended core outcome set (COS) to improve efficacy and effectiveness trials/evaluations for alcohol brief interventions (ABIs). METHOD: A systematic review identified 2,641 outcomes in 401 ABI articles measured by 1,560 different approaches. These outcomes were classified into outcome categories, and 150 participants from 19 countries participated in a two-round e-Delphi outcome prioritization exercise. This process prioritized 15 of 93 outcome categories for discussion at a consensus meeting of key stakeholders to decide the COS. A psychometric evaluation determined how to measure the outcomes. RESULTS: Ten outcomes were voted into the COS at the consensus meeting: (a) typical frequency, (b) typical quantity, (c) frequency of heavy episodic drinking, (d) combined consumption measure summarizing alcohol use, (e) hazardous or harmful drinking (average consumption), (f) standard drinks consumed in the past week (recent, current consumption), (g) alcohol-related consequences, (h) alcohol-related injury, (i) use of emergency health care services (impact of alcohol use), and (j) quality of life. CONCLUSIONS: The ORBITAL COS is an international consensus standard for future ABI trials and evaluations. It can improve the synthesis of new findings, reduce redundant/selective reporting (i.e., reporting only some, usually significant outcomes), improve between-study comparisons, and enhance the relevance of trial and evaluation findings to decision makers. The COS is the recommended minimum and does not exclude other, additional outcomes.


Asunto(s)
Alcoholismo , Intervención en la Crisis (Psiquiatría) , Alcoholismo/epidemiología , Alcoholismo/terapia , Consenso , Humanos , Evaluación de Resultado en la Atención de Salud , Calidad de Vida , Proyectos de Investigación , Resultado del Tratamiento
11.
BMJ Open ; 11(4): e040636, 2021 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-33811049

RESUMEN

INTRODUCTION: The prevalence of at-risk drinking is far higher among those in contact with the criminal justice system (73%) than the general population (35%). However, there is little evidence on the effectiveness of alcohol brief interventions (ABIs) in reducing risky drinking among those in the criminal justice system, including the prison system and, in particular, those on remand. Building on earlier work, A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE) is a pilot study designed to assess the feasibility and acceptability of an ABI, delivered to male prisoners on remand. The findings of APPRAISE should provide the information required to design a future definitive randomised controlled trial (RCT). METHODS AND ANALYSIS: APPRAISE will use mixed methods, with two linked phases, across two prisons in the UK, recruiting 180 adult men on remand: 90 from Scotland and 90 from England. Phase I will involve a two-arm, parallel-group, individually randomised pilot study. The pilot evaluation will provide data on the likely impact of A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE), which will be used to inform a future definitive multicentre RCT. Phase II will be a process evaluation assessing how the ABI has been implemented to explore the change mechanisms underpinning the ABI (figure 1) and to assess the context within which the ABI is delivered. ETHICS AND DISSEMINATION: The APPRAISE protocol has been approved by the East of Scotland Research Ethics Committee (19/ES/0068), National Offender Management System (2019-240), Health Board Research and Development (2019/0268), Scottish Prison Service research and ethics committee, and by the University of Edinburgh's internal ethics department. The findings will be disseminated via peer-reviewed journal publications, presentations at local, national and international conferences, infographics and shared with relevant stakeholders through meetings and events. TRIAL REGISTRATION NUMBER: ISRCTN27417180.


Asunto(s)
Prisiones , Autoeficacia , Adulto , Inglaterra , Humanos , Masculino , Estudios Multicéntricos como Asunto , Proyectos Piloto , Ensayos Clínicos Controlados Aleatorios como Asunto , Escocia
12.
Nurs Manag (Harrow) ; 27(6): 21-27, 2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33058593

RESUMEN

The executive nurse director role is complex and there is significant variation in the expectations and responsibilities placed on it. The main function of the role is to deliver the nursing agenda and ensure that safety and quality remain the focus of the executive board. However, it is unclear what evidence exists regarding the challenges and opportunities experienced by executive nurse directors. This scoping review, undertaken as part of the Stronger Study, explores the literature published from 2009 onwards on the challenges and opportunities affecting executive nurse directors' ability to deliver the nursing agenda in the UK. Findings from the review suggest that the importance attached to the executive nurse director role is not matched by the amount of research available. Strengthening the executive nurse director role requires a stronger evidence base and an awareness of the benefits of the role.


Asunto(s)
Enfermeras Administradoras , Rol de la Enfermera , Humanos , Liderazgo , Medicina Estatal/organización & administración , Reino Unido
13.
J Adv Nurs ; 76(10): 2670-2684, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32761638

RESUMEN

AIMS: To evaluate a mHealth intervention to increase medication adherence among Iranian coronary heart disease patients. DESIGN: Quantitative-dominant mixed-methods study. DATA SOURCE: Iranian coronary heart disease patients' responses and most recent clinical documents as well as responses from Iranian cardiac nurses who participated in this study. METHODS: The study was conducted between September 2015-April 2016 drawing on the Medical Research Council's Framework. Phase one comprised of a patients' survey and focus groups with cardiac nurses. The automated short message service reminder was piloted in phase two. We recruited 78 patients and randomized to receive either 12-week daily reminders or usual care. The primary outcome was the effect on medication adherence; secondary outcomes were self-efficacy, ejection fraction, functional capacity, readmission rate and quality of life. RESULTS: Feasibility was evidenced by high ownership of mobile phones and high interest in receiving reminders. Participants in the intervention group showed significantly higher medication adherence compared with the control group. CONCLUSION: The mHealth intervention was well accepted and feasible with early evidence of effectiveness that needs to be confirmed in a fully powered future randomized clinical trial.


Asunto(s)
Investigación Biomédica , Telemedicina , Envío de Mensajes de Texto , Estudios de Factibilidad , Humanos , Irán , Cumplimiento de la Medicación , Calidad de Vida , Sistemas Recordatorios
14.
Nurs Health Sci ; 22(4): 1047-1055, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32713133

RESUMEN

Research into cardiovascular disease and its management in Indonesia, where it currently accounts for 67% of all deaths, has heavily emphasized the biomedical aspects; little is known about the individual's experience of the disease, especially for Indonesian women. This study aimed to understand how gender shapes Indonesian women's experiences of living with heart disease in their daily lives. Twenty-six women aged 30-67 years were interviewed, and the transcriptions analyzed using a qualitative framework informed by intersectional approaches to gender and culture. Three major themes emerged: (i) the effect of cardiovascular disease on women's day-to-day activities, (ii) its effects on women's family relationships, and (iii) the women's coping strategies. The inability to fulfill their required social roles as mother or wife undermined the women's sense of self, a problem particularly acute in a cultural context where responsibility for maintaining harmony in the home and society is ascribed to women. Healthcare professionals should be aware of the ethnic and cultural backgrounds of women with cardiovascular disease, in order to deliver services that meet female patients' social, spiritual, and cultural needs.


Asunto(s)
Cardiopatías/diagnóstico , Adulto , Anciano , Femenino , Cardiopatías/psicología , Humanos , Indonesia , Entrevistas como Asunto/métodos , Persona de Mediana Edad , Investigación Cualitativa , Factores Socioeconómicos
15.
J Clin Nurs ; 29(9-10): 1561-1575, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32096574

RESUMEN

AIM: To explore HIV-positive drug users' experiences of taking antiretroviral medications in Taiwan and further develop a conceptual model that can be used to understand their adherence to the long-term treatment. BACKGROUND: The global vision of ending AIDS by 2030 cannot be achieved without addressing HIV-positive drug users' experience of taking antiretroviral treatment. There remains a paucity of qualitative evidence on HIV-positive drug users' experiences of taking antiretroviral medications globally and in East Asia. Nurses play a key role in supporting HIV-positive drug users throughout their treatment process. Therefore, it is pivotal to understand HIV-positive drug users' experiences of managing long-term anti-HIV treatment. DESIGN: This qualitative study drew on a constructivist grounded theory approach to achieve the aims. Semi-structured in-depth interviews with 22 HIV-positive drug users were conducted in Taiwan between September 2015 and July 2016. Data were analysed using Charmaz's coding principles. The integration and formation of the model began with focused coding and proceeded through the subsequent analytic process. The reporting of this study was based on the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS: This study shows that integrating HIV-positive identity into sense of self laid a solid foundation for the acceptance of self and antiretroviral treatment. Valuing of antiretroviral treatment played a central role in driving their medication-taking behaviour. While valuing the treatment appeared to drive participants' behavioural change, data revealed that conscious engagement was an important element for their behaviour maintenance. CONCLUSION: The evidence from this study can extend our knowledge of the mechanisms that influence the change and maintenance of HIV-positive drug users' adherence to antiretroviral treatment. RELEVANCE TO CLINICAL PRACTICE: The Identity-Values-Conscious engagement model developed and proposed in this study can serve as a guide for the development of tailored adherence assessment and associated nursing interventions for this population.


Asunto(s)
Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Autoimagen , Adulto , Consumidores de Drogas , Femenino , Teoría Fundamentada , Infecciones por VIH/psicología , Humanos , Masculino , Cumplimiento de la Medicación/psicología , Persona de Mediana Edad , Investigación Cualitativa , Taiwán
16.
Addiction ; 115(4): 623-652, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31626354

RESUMEN

BACKGROUND AND AIMS: HIV-positive drug users' poor adherence to antiretroviral regimens can pose a significant and negative impact on individual and global health. This review aims to identify knowledge gaps and inconsistencies within the current evidence base and to measure HIV-positive drug users' adherence rates and the factors that influence their adherence. METHODS: A search of quantitative and qualitative studies in relation to HIV-positive drug users' adherence to antiretroviral treatment was performed using five databases: Applied Social Sciences Index and Abstract (ASSIA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and PsycINFO (Ovid interface). Relevant studies were retrieved based on the inclusion and exclusion criteria stated in the review. Findings were compared, contrasted and synthesized to provide a coherent account of HIV-positive drug users' adherence rates and the factors that influence their adherence. RESULTS: The proportion of HIV-positive drug users who achieved ≥ 95% adherence across the studies varied widely, from 19.3 to 83.9%. Adherence rates changed over the course of HIV treatment. The factors that influenced adherence were reported as follows: stigmatization, motivation, active drug use, accessibility and conditionality of HIV and addiction care, side effects and complexity of treatment regimens, forgetfulness and non-incorporation of dosing times into daily schedules. CONCLUSIONS: HIV-positive drug users' medication-taking is a dynamic social process that requires health professionals to assess adherence to HIV treatment on a regular basis.


Asunto(s)
Antirretrovirales/uso terapéutico , Terapia Antirretroviral Altamente Activa , Consumidores de Drogas/psicología , Infecciones por VIH/tratamiento farmacológico , Cumplimiento de la Medicación/estadística & datos numéricos , Consumidores de Drogas/estadística & datos numéricos , Humanos
18.
Eur J Cardiovasc Nurs ; 18(8): 744-752, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31328533

RESUMEN

BACKGROUND: Cardiac rehabilitation is effective in reducing mortality and morbidity, in improving life expectancy and quality of life for people with cardiovascular disease. Despite these recognised benefits, women's attendance rates in cardiac rehabilitation programmes remain suboptimal. AIMS: This paper details the study that explored factors that influence women's attendance of a phase two cardiac rehabilitation programme in Indonesia. METHODS: An exploratory qualitative research design was used in the study. Semi-structured interviews were used as the main method of data collection. Data were collected from June to September 2016. Twenty-three women aged between 30 and 66 years were interviewed. Transcribed interview data were analysed using a qualitative framework analysis. RESULTS: Three major themes were inferred from the analysis: (a) a bridge to normal; (b) connecting with others; and (c) contextual factors. The first theme is illustrated by two subthemes: 'making my heart work again' and 'performing social roles'. The second theme was illustrated by the following subthemes: 'exchanging knowledge and experience' and 'developing a give-and-take relationship'. The third theme was illustrated by three subthemes: 'recommendations from the staff', 'family support' and 'availability of health insurance'. CONCLUSION: Women's attendance in cardiac rehabilitation in Indonesia is mainly influenced by their expectations and desire to be able to resume their previous social roles in the family and society. The findings of this study can assist healthcare professionals to understand better the needs of women and the fit between women's needs and existing cardiac rehabilitation programmes. Such understanding could provide direction for more effective approaches to the cardiac rehabilitation programmes that are currently offered in Indonesia.


Asunto(s)
Rehabilitación Cardiaca , Enfermedades Cardiovasculares/psicología , Cooperación del Paciente , Adulto , Anciano , Enfermedades Cardiovasculares/terapia , Femenino , Humanos , Indonesia , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida , Factores Sexuales
19.
J Stud Alcohol Drugs ; 80(3): 286-298, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31250793

RESUMEN

OBJECTIVE: The purpose of this study was to characterize recent alcohol brief intervention (ABI) efficacy and effectiveness trials, summarize outcomes, and show how variability in outcomes and reporting compromises the evidence base. METHOD: A systematic review and narrative synthesis of articles from 10 databases were undertaken (January 2000-November 2017); study selection represented recent, readily available publications. The National Institute of Care Excellence (NICE) Public Health Guideline 24 (Alcohol use disorders: prevention) informed ABI definitions. The review was conducted using Centre for Reviews and Dissemination (CRD) guidance and pre-registered on PROSPERO (CRD42016047185). Seven a priori specified domains were used to classify outcomes: biomarkers, alcohol-related outcomes, economic factors/resource use, health measures, life impact, intervention factors, and psychological/behavioral factors. RESULTS: The search identified 405 trials from 401 eligible papers. In 405 trials, 2,641 separate outcomes were measured in approximately 1,560 different ways. The most common outcomes used were the number of drinks consumed in a week and frequency of heavy episodic drinking. Biomarkers were least frequently used. The most common primary outcome was weekly drinks. By trial type, the most frequent outcome in efficacy and effectiveness trials was frequency of heavy drinking. CONCLUSIONS: Consumption outcomes predominated; however, no single outcome was found in all trials. This comprehensive outcome map and methodological detail on ABI effectiveness and efficacy trials can aid decision making in future trials. There was a diversity of instruments, time points, and outcome descriptions in methods and results sections. Compliance with reporting guidance would support data synthesis and improve trial quality. This review establishes the need for a core outcome set (COS)/minimum data standard and supports the Outcome Reporting in Brief Interventions: Alcohol initiative (ORBITAL) to improve standards in the ABI field through a COS for effectiveness and efficacy randomized trials.


Asunto(s)
Alcoholismo/terapia , Ensayos Clínicos como Asunto/estadística & datos numéricos , Ensayos Clínicos como Asunto/normas , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud/normas , Humanos , Factores de Tiempo
20.
J Stud Alcohol Drugs ; 80(3): 299-309, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31250794

RESUMEN

OBJECTIVE: Outcomes used in alcohol brief intervention trials vary considerably. Achieving consensus about key outcomes can enhance evidence synthesis and improve healthcare guidelines. This international, e-Delphi study sought to prioritize outcomes for alcohol brief intervention trials as part of a larger program of work develop an alcohol brief intervention core outcome set. METHOD: In total, 150 registrants from 19 countries, representing researchers, policymakers, and patients, participated in a two-round e-Delphi study. In Round 1, participants (n = 137) rated 86 outcomes, derived from a review of the literature and a patient and public involvement panel, by importance. In Round 2, participants (n = 114) received feedback on importance ratings for each outcome, and a reminder of their personal rating, before rating the outcomes for importance a second time. Seven additional outcomes suggested in Round 1 were added to the Round 2 questionnaire. We defined consensus a priori as 70% agreement across all stakeholder groups. RESULTS: Seven consumption outcomes met inclusion criteria: typical frequency, typical quantity, frequency of heavy drinking, alcohol-related problems, weekly drinks, at-risk drinking, and combined consumption measures. Others meeting the threshold were alcohol-related injury, quality of life, readiness to change, and intervention fidelity. CONCLUSIONS: This is the first international e-Delphi study to identify and prioritize outcomes for use in alcohol brief intervention trials. The use and reporting of outcomes in future alcohol brief intervention trials should improve evidence synthesis in systematic reviews and meta-analyses. Further work is required to refine these outcomes into a core outcome set that includes guidance for measurement of outcomes.


Asunto(s)
Alcoholismo/terapia , Consenso , Técnica Delphi , Evaluación de Resultado en la Atención de Salud/normas , Resultado del Tratamiento , Humanos , Encuestas y Cuestionarios
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