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Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis.

ABSTRACT: OBJECTIVE:We aimed to examine whether eHealth interventions can effectively improve anthropometric and biochemical indicators of patients with metabolic syndrome (MetS). DESIGN:Systematic review and meta-analysis. METHODS:PubMed, the Web of Science, Embase, Medline, CINAHL, PsycINFO, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang and Weipu databases were comprehensively searched for papers that were published from database inception to May 2019. Articles were included if the participants were metabolic syndrome (MetS) patients, the participants received eHealth interventions, the participants in the control group received usual care or were wait listed, the outcomes included anthropometric and biochemical indicators of MetS, and the study was a randomised controlled trial (RCT) or a controlled clinical trial (CCT). The Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included articles. The meta-analysis was conducted using Review Manager V.5.3 software. RESULTS:In our review, seven RCTs and two CCTs comprising 935 MetS participants met the inclusion criteria. The results of the meta-analysis revealed that eHealth interventions resulted in significant improvements in body mass index (standardised mean difference (SMD)=-0.36, 95%?CI (-0.61 to -0.10), p<0.01), waist circumference (SMD=-0.47, 95%?CI (-0.84 to -0.09), p=0.01) and systolic blood pressure(SMD=-0.35, 95%?CI (-0.66 to -0.04), p=0.03) compared with the respective outcomes associated with the usual care or wait-listed groups. Based on the included studies, we found significant effects of the eHealth interventions on body weight. However, we did not find significant positive effects of the eHealth interventions on other metabolic parameters. CONCLUSIONS:The results indicated that eHealth interventions were beneficial for improving specific anthropometric outcomes, but did not affect biochemical indicators of MetS. Therefore, whether researchers adopt eHealth interventions should be based on the purpose of the study. More rigorous studies are needed to confirm these findings.

SUBMITTER: Chen D

PROVIDER: S-EPMC7545661 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis.

Chen Dandan D Ye Zhihong Z Shao Jing J Tang Leiwen L Zhang Hui H Wang Xiyi X Qiu Ruolin R Zhang Qi Q

BMJ open 20201008 10

<h4>Objective</h4>We aimed to examine whether eHealth interventions can effectively improve anthropometric and biochemical indicators of patients with metabolic syndrome (MetS).<h4>Design</h4>Systematic review and meta-analysis.<h4>Methods</h4>PubMed, the Web of Science, Embase, Medline, CINAHL, PsycINFO, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang and Weipu databases were comprehensively searched for papers that were published from database inception to May ...[more]

PMID: 33033085

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Project description:BackgroundIntimate partner violence (IPV) is a major public health concern. eHealth interventions may reduce exposure to violence and health-related consequences as the technology provides a safe and flexible space for the target population. However, the evidence is unclear.ObjectiveThe goal of the review is to examine the effect of eHealth interventions compared with standard care on reducing IPV, depression, and posttraumatic stress disorder (PTSD) among women exposed to IPV.MethodsWe searched EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, PsycInfo, Scopus, Global Health Library, ClinicalTrials.gov, and International Clinical Trials Registry Platform for published and unpublished trials from inception until April 2019. Trials with an eHealth intervention targeting women exposed to violence were included. We assessed risk of bias using the Cochrane Risk of Bias Tool. Trials that reported effect estimates on overall IPV; physical, sexual, and psychological violence; depression; or posttraumatic stress disorder were included in meta-analyses.ResultsA total of 14 trials were included in the review; 8 published trials, 3 unpublished trials and 3 ongoing trials. Of the 8 published trials, 2 were judged as overall low risk of bias trials. The trials reported 23 types of outcomes, and 7 of the trials had outcomes that were eligible for meta-analyses. Our pooled analyses found no effect of eHealth interventions on any of our prespecified outcomes: overall IPV (SMD -0.01; 95% CI -0.11 to 0.08; I2=0%; 5 trials, 1668 women); physical violence (SMD 0.01; 95% CI -0.22 to 0.24; I2=58%; 4 trials, 1128 women); psychological violence (SMD 0.07; 95% CI -0.12 to 0.25; I2=40%; 4 trials, 1129 women); sexual violence (MD 0.36; 95% CI -0.18 to 0.91; I2=0%; 2 trials, 1029 women); depression (SMD -0.13; 95% CI -0.37 to 0.11; I2=78%; 5 trials, 1600 women); and PTSD (MD -0.11; 95% CI -1.04 to 0.82; I2=0%; 5 trials, 1267 women).ConclusionsThere is no evidence from randomized trials of a beneficial effect of eHealth interventions on IPV. More high-quality trials are needed, and we recommend harmonizing outcome reporting in IPV trials by establishing core outcome sets.Trial registrationPROSPERO International Prospective Register of Systematic Reviews CRD42019130124; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130124.

Project description:Osteoporosis is a global health issue among the aging population. The effect of the acid or base interventions on bone health remains controversial. This study performed a systematic review and meta-analysis to investigate effects of acidic diets and alkaline supplements on bone health simultaneously. We conducted a comprehensive literature search in 5 available databases and 1 registered clinical trial system to identify randomized controlled trials (RCTs) that assessed effects of the acid-base intervention on bone health. Depending on heterogeneity across studies, the pooled effects were calculated by fixed-effects or random-effects models. The present study included 13 acidic diet intervention studies and 13 alkaline supplement studies for final quantitative assessments. The meta-analysis showed that acidic diets significantly increased net acid excretion [NAE; standardized mean difference (SMD) = 2.99; P = 0.003] and urinary calcium excretion (SMD = 0.47, P < 0.00001) but had no significant effect on bone turnover markers and bone mineral density (BMD). On the other hand, alkaline supplement intervention significantly reduced NAE (SMD = -1.29, P < 0.00001), urinary calcium excretion (SMD = -0.44, P = 0.007), bone resorption marker aminoterminal cross-linking telopeptide (NTX; SMD = -0.29, P = 0.003), and bone formation marker osteocalcin (OC; SMD = -0.23, P = 0.02), but did not affect the other bone turnover markers. Furthermore, alkaline supplements significantly increased BMD in femoral neck [mean difference (MD) = 1.62, P < 0.00001, I2 = 0%], lumbar spine (MD = 1.66, P < 0.00001, I2 = 87%), and total hip (MD = 0.98, P = 0.02, I2 = 99%). Subsequently, meta-regression analyses identified 1 study that substantially contributed to the high heterogeneity of BMD in the latter 2 sites, but sensitivity analysis suggested that this study did not affect the significant pooled effects. Despite that, the results should be interpreted with caution and need to be further validated by a larger RCT. In summary, through integrating evidence from RCTs, the present meta-analysis initially suggests that alkaline supplements may be beneficial to bone metabolism and acidic diets may not be harmful to bone health. This work may be clinically useful for both clinicians and patients with osteoporosis.

Project description:BackgroundGlobal epidemiological data indicates that despite implementation of multiple interventions and significant financial investment, the HIV/AIDS epidemic remained inadequately controlled as of 2020. E-health presents a novel approach in delivering health information and health care and has gained popularity in HIV prevention worldwide. However, evidence on the effectiveness of e-health interventions on HIV prevention among diverse populations remains inadequate. Our study aims to systematically evaluate the effectiveness of varying e-health interventions on HIV prevention, with the objective of providing data support and guidance for the development of future e-health HIV intervention strategies.MethodsA systematic search of electronic English databases, including MEDLINE through PubMed, Embase, Scopus, and Web of Science, along with three Chinese databases, including National Knowledge Infrastructure (CNKI), Chinese Wanfang Digital Periodicals (WANFANG), and Chinese Science and Technology Periodicals (VIP) database, will be conducted for the period of 1 January 1980 to 31 December 2022. Additionally, gray literature and unpublished trials in trial registers will be searched. Studies aimed at HIV prevention through e-health interventions, with full-text publications available in either English or Chinese, will be included. Study types will be limited to RCT, cluster RCT, and quasi-experiment study. The risk of bias in individual studies will be assessed following the guideline highlighted by the Cochrane Handbook for Systematic Reviews of Interventions. The outcomes will cover cognitive, behavioral, psychological, management, and biological measures of individuals involved in e-health interventions. The quality of evidence will be assessed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Ultimately, a systematic review with meta-analysis will be conducted to compare the effectiveness of e-health interventions among diverse populations.DiscussionThis systematic review seeks to establish novel insights into the effectiveness of e-health interventions in diverse populations worldwide. It will inform the design and use of e-health interventions to optimize HIV-related strategies.Systematic review registrationPROSPERO CRD42022295909.

Project description:BACKGROUND:Electronic health (eHealth) is increasingly used for self-management and service delivery of HIV-related diseases. With the publication of studies increasingly focusing on antiretroviral therapy (ART) adherence, this makes it possible to quantitatively and systematically assess the effectiveness and feasibility of eHealth interventions. OBJECTIVE:The purpose of this review was to explore the effectiveness of eHealth interventions on improving ART adherence in people living with HIV. The effects of different intervention characteristics, participant characteristics, and study characteristics were also assessed. METHODS:We systematically searched MEDLINE (via PubMed), EMBASE, the Cochrane Central Register of Controlled Trials, and 3 conference abstract databases using search terms related to HIV, ART, adherence, and eHealth interventions. We independently screened the studies, extracted the data, and assessed the study quality and then compared the information in pairs. Articles published in English that used randomized controlled trials to assess eHealth interventions to improve ART adherence of people living with HIV were identified. We extracted the data including study characteristics, participant characteristics, intervention characteristics, and outcome measures. The Cochrane risk-of-bias tool was used to assess the risk of bias and study overall quality. Odds ratios, Cohen d, and their 95% CIs were estimated using random-effects models. We also performed multiple subgroup analyses and sensitivity analyses to define any sources of heterogeneity. RESULTS:Among 3941 articles identified, a total of 19 studies (including 21 trials) met the inclusion criteria. We found 8 trials from high-income countries and 13 trials from low- and middle-income countries. Furthermore, at baseline, the health status of participants in 14 trials was healthy. Of the trials included, 7 of 21 used personality content, 12 of 21 used a 2-way communication strategy, and 7 of 21 used medical content. In the pooled analysis of 3937 participants (mean age: 35 years; 47.16%, 1857/3937 females), eHealth interventions significantly improved the ART adherence of people living with HIV (pooled Cohen d=0.25; 95% CI 0.05 to 0.46; P=.01). The interventions were also correlated with improved biochemical outcomes reported by 11 trials (pooled Cohen d=0.25; 95% CI 0.11 to 0.38; P<.001). The effect was sensitive to sample size (Q=5.56; P=.02) and study duration (Q=8.89; P=.003), but it could not be explained by other moderators. The primary meta-analysis result was stable in the 3 sensitivity analyses. CONCLUSIONS:Some of the eHealth interventions may be used as an effective method to increase the ART adherence of people living with HIV. Considering that most of the trials included a small sample size and were conducted for a short duration, these results should be interpreted with caution. Future studies need to determine the features of eHealth interventions to better improve ART adherence along with long-term effectiveness of interventions, effectiveness of real-time adherence monitoring, enhancement of study design, and influences on biochemical outcomes.

Project description:ImportanceProsocial interventions encourage voluntary actions that benefit others. Community solidarity in response to the COVID-19 pandemic, expanding mutual aid programs, and health workforce issues have accelerated prosocial health interventions.ObjectiveTo investigate the association of prosocial interventions with health outcomes in clinical trials and observational studies.Data sourcesIn this systematic review and meta-analysis informed by the Cochrane Handbook for Systematic Reviews of Interventions, 5 databases (MEDLINE [via PubMed], Embase, CINAHL, PsycInfo, and Scopus) were searched from database inception through February 23, 2023. The search included terms for altruism and prosocial behaviors, health outcomes, and study type.Study selectionIncluded studies, determined by multiple reviewers, compared health outcomes in a prosocial intervention group with a nonintervention group.Data extraction and synthesisFollowing the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline, data extraction and synthesis captured quantitative and qualitative data. To pool data from quantitative studies, random-effects meta-analyses were used to estimate the impact of prosocial interventions. To combine data from quantitative and qualitive studies, data were transformed into qualitative narratives using meta-aggregation.Main outcomes and measuresThe main outcome was whether prosocial interventions were associated with improved health outcomes. Barriers to and facilitators of implementation of these interventions were assessed.ResultsThe search identified 5229 citations; 30 studies were included in the synthesis. Studies indicated that prosocial interventions were associated with positive health outcomes for givers (17 studies [56.7]) and recipients (8 [26.7%]). Prosocial interventions included acts of kindness (12 studies [40.0%]), cash gifts (7 [23.3%]), pay-it-forward approaches (6 [20.0%]), and expressions of kindness (5 [16.7%]). Improvements were reported in depression, testing for sexually transmitted diseases, vaccine uptake, physical activity, and individual biomarkers. Data from 6 studies (20.0%) demonstrated that pay-it-forward approaches were associated with increased uptake of diagnostic tests or vaccines among vulnerable groups (moderate certainty of evidence). Data from 14 studies (46.7%) suggested that community connectedness facilitated prosocial interventions. Shared vulnerabilities among groups (eg, sexual minority individuals, older adults) may provide a context for collective mobilization to improve health in local communities.Conclusions and relevanceThis systematic review and meta-analysis found that prosocial interventions were associated with improved health outcomes among vulnerable groups and have been useful for addressing health disparities. Further research is needed to develop and evaluate prosocial interventions.

Dataset Information

Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis.

Publications

Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis.

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