Dataset Information

Association of Patient Treatment Preference With Dropout and Clinical Outcomes in Adult Psychosocial Mental Health Interventions: A Systematic Review and Meta-analysis.

ABSTRACT: Importance:Receiving a preferred treatment has previously been associated with lower dropout rates and better clinical outcomes, but this scenario has not been investigated specifically for psychosocial interventions for patients with a mental health diagnosis. Objective:To assess the association of patient treatment preference with dropout and clinical outcomes in adult psychosocial mental health interventions via a systematic review and meta-analysis. Data Sources:The Cochrane Library, Embase, PubMed, PsychINFO, Scopus, Web of Science, Nice HDAS (Healthcare Databases Advanced Search), Google Scholar, BASE (Bielefeld Academic Search Engine), Semantic Scholar, and OpenGrey were searched from inception to July 20, 2018, and updated on June 10, 2019. Study Selection:Studies were eligible if they (1) were a randomized clinical trial; (2) involved participants older than 18 years; (3) involved participants with mental health diagnoses; (4) reported data from a group of participants who received their preferred treatment and a group who received their nonpreferred treatment or who were not given a choice; and (5) offered at least 1 psychosocial intervention. Data Extraction and Synthesis:Two researchers extracted study data for attendance, dropout, and clinical outcomes independently. Both assessed the risk of bias according to the Cochrane tool. Data were pooled using random-effects meta-analyses. Main Outcomes and Measures:The following 7 outcomes were examined: attendance, dropout, therapeutic alliance, depression and anxiety outcomes, global outcomes, treatment satisfaction, and remission. Results:A total of 7341 articles were identified, with 34 eligible for inclusion. Twenty-nine articles were included in the meta-analyses comprising 5294 participants. Receiving a preferred psychosocial mental health treatment had a medium positive association with dropout rates (relative risk, 0.62; 0.48-0.80; P?

SUBMITTER: Windle E

PROVIDER: S-EPMC6902231 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Association of Patient Treatment Preference With Dropout and Clinical Outcomes in Adult Psychosocial Mental Health Interventions: A Systematic Review and Meta-analysis.

Windle Emma E Tee Helena H Sabitova Alina A Jovanovic Nikolina N Priebe Stefan S Carr Catherine C

JAMA psychiatry 20200301 3

<h4>Importance</h4>Receiving a preferred treatment has previously been associated with lower dropout rates and better clinical outcomes, but this scenario has not been investigated specifically for psychosocial interventions for patients with a mental health diagnosis.<h4>Objective</h4>To assess the association of patient treatment preference with dropout and clinical outcomes in adult psychosocial mental health interventions via a systematic review and meta-analysis.<h4>Data sources</h4>The Coc ...[more]

PMID: 31799994

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Project description:BACKGROUND:It is presumed that pharmacological and non-pharmacological treatment of prenatal common mental disorders can mitigate associated adverse effects in offspring, yet strong evidence for the prophylactic benefits of treatment is lacking. We therefore examined the effect of prenatal treatments for common mental disorders on offspring outcomes. METHODS:For this meta-analysis, articles published up to August 31, 2017, were obtained from PubMed, PsycInfo, Embase, and Cochrane databases. Included studies needed to be randomized controlled trials (RCTs) on the effect of treatment of prenatal common mental disorders comparing an intervention to a control condition, including offspring outcome(s). Random effects models were used to calculate Hedges' g in the program Comprehensive Meta-Analysis© (version 3.0). RESULTS:Sixteen randomized controlled trials among 2778 pregnant women compared offspring outcomes between prenatal interventions and control groups. There were zero pharmacological, 13 psychological, and three other interventions (homeopathy, relaxation interventions, and short psycho-education). Birth weight (mean difference 42.88 g, g?=?0.08, 95% CI -0.06 to 0.22, p?=?0.27, n?=?11), Apgar scores (g?=?0.13, 95% CI -0.28 to 0.54, p?=?0.53, n?=?4), and gestational age (g?=?0.03, 95% CI -0.06 to 0.54, p?=?0.49, n?=?10) were not significantly affected. Other offspring outcomes could not be meta-analyzed due to the inconsistent reporting of offspring outcomes and an insufficient number of studies. CONCLUSIONS:Non-pharmacological interventions had no significant effect on birth outcomes, although this outcome should be considered with caution due to the risk of biases. No randomized controlled trial examined the effects of prenatal pharmacological treatments as compared to treatment as usual for common mental disorders on offspring outcomes. Present clinical guidelines may require more research evidence on offspring outcomes, including child development, in order to warrant the current recommendation to routinely screen and subsequently treat prenatal common mental disorders. TRIAL REGISTRATION:PROSPERO CRD42016047190.

Project description:ImportanceMultiple studies have evaluated associations between post-cochlear implant (CI) speech recognition outcomes and patient-related factors. Current literature often appears equivocal or contradictory, so little is known about the factors that contribute to successful speech recognition outcomes with CIs.ObjectiveTo use a meta-analysis to pool data from the extant literature and provide an objective summary of existing evidence on associations of patient-related factors and CI speech recognition outcomes.Data sourcesA literature search was performed using PubMed, Scopus, and CINAHL databases in January 2019 using the following search terms: cochlear implant or cochlear implants or cochlear implantation and speech recognition or word recognition or sentence recognition. Studies of postlingually deafened adult CI recipients that reported word or sentence recognition scores were included.Study selectionInclusion criteria were postlingual adult CI recipients 18 years or older with word or sentence recognition scores at minimum 6-month postimplantation. Studies that included patients undergoing revision or reimplantation surgery were excluded.Data extraction and synthesisFollowing the Preferred Reporting Items for Systemic Reviews and Meta-analyses (PRISMA) guidelines, 1809 unique articles underwent review by abstract, and 121 articles underwent full-text review, resulting in 13 articles of 1095 patients for a meta-analysis of correlations. Random-effects model was used when the heterogeneity test yielded a low P value (P < .05).Main outcomes and measuresThe planned primary outcome was the pooled correlation values between postimplant speech recognition scores and patient-related factors.ResultsOf the 1095 patients included from the 13 studies, the mean age at implantation ranged from 51.2 to 63.7 years and the mean duration of hearing loss ranged from 9.5 to 31.8 years; for the 825 patients for whom sex was reported, 421 (51.0%) were women. A weak negative correlation was observed between age at implantation and postimplant sentence recognition in quiet (r = -0.31 [95% CI, -0.41 to -0.20]). Other correlations between patient-related factors and postimplant word or sentence recognition were statistically significant, but all correlations were absent to negligible (r = 0.02-0.27).Conclusions and relevanceGiven that most associations were weak, negligible, or absent, patient-related factors often thought to affect CI speech recognition ability offer limited assistance in clinical decision-making in cochlear implantation. Additional research is needed to identify patient-related and other factors that predict CI outcomes, including speech recognition and other important variables related to success with CIs.

Dataset Information

Association of Patient Treatment Preference With Dropout and Clinical Outcomes in Adult Psychosocial Mental Health Interventions: A Systematic Review and Meta-analysis.

Publications

Association of Patient Treatment Preference With Dropout and Clinical Outcomes in Adult Psychosocial Mental Health Interventions: A Systematic Review and Meta-analysis.

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