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初级保健中非药物干预措施改善有姑息治疗需求的老年患者生活质量的系统评价方案

Non-pharmacological interventions in primary care to improve the quality of life of older patients with palliative care needs: a systematic review protocol.

机构信息

Faculty of Medicine, University of Coimbra, Coimbra, Coimbra, Portugal

CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.

出版信息

BMJ Open. 2022 May 4;12(5):e060517. doi: 10.1136/bmjopen-2021-060517.

Abstract

INTRODUCTION

In the last decades, the number of older people living with chronic diseases has rapidly increased. The prevalence of palliative care needs in this population can reach 17%, making the general practitioner a cornerstone in the identification and first medical intervention delivery. Therefore, knowing the primary care interventions that effectively improve the quality of life of these patients can play an important role in the delivery of healthcare.

METHODS AND ANALYSIS

We will systematically review randomised controlled trials evaluating the effect of non-pharmacologic primary care interventions on the quality of life of older patients (≥65 years) with palliative care needs. PsycINFO, EMBASE, MEDLINE, Cochrane and CINAHL will be searched until December 2021. Screening, data extraction and quality evaluation (using the Cochrane RoB 2.0 tool) will be done by independently by two reviewers, with disagreements solved by a third reviewer. We will conduct meta-analysis if appropriate. In case of high heterogeneity, findings will be analysed by subgroup according to intervention type, main disease/symptoms and care context. Evidence will be graded using the Grading of Recommendations Assessment, Development and Evaluation approach. We will perform a sensitivity analysis based on study quality. Publication bias will be assessed using funnel plots.

ETHICS AND DISSEMINATION

Formal ethical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication, conference presentation and the press.

PROSPERO REGISTRATION NUMBER

CRD42020154216.

摘要

简介

在过去的几十年中,患有慢性病的老年人数量迅速增加。这一人群中姑息治疗需求的患病率可能达到 17%,使得全科医生成为识别和提供初步医疗干预的基石。因此,了解能够有效提高这些患者生活质量的初级保健干预措施,可以在医疗保健服务中发挥重要作用。

方法和分析

我们将系统地综述评价非药物性初级保健干预对有姑息治疗需求的老年患者(≥65 岁)生活质量影响的随机对照试验。将在 PsycINFO、EMBASE、MEDLINE、Cochrane 和 CINAHL 中检索至 2021 年 12 月。筛选、数据提取和质量评估(使用 Cochrane RoB 2.0 工具)将由两名独立的评审员进行,如果存在分歧,则由第三名评审员解决。如果合适,我们将进行荟萃分析。如果存在高度异质性,将根据干预类型、主要疾病/症状和护理环境对结果进行亚组分析。将使用推荐评估、制定与评估分级方法对证据进行分级。我们将根据研究质量进行敏感性分析。将使用漏斗图评估发表偏倚。

伦理和传播

由于不会收集原始数据,因此不需要正式的伦理批准。研究结果将通过同行评审的出版物、会议演讲和新闻发布进行传播。

PROSPERO 注册号:CRD42020154216。

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