Family practice
-
Review Meta Analysis
Increased risk for atypical fractures associated with bisphosphonate use.
Studies suggest an increasing occurrence of atypical femoral fractures with the use of bisphosphonates. ⋯ Results suggest there is an increased risk for atypical fractures associated with bisphosphonates and raises awareness to the potential complications related with bisphosphonates. These findings warrant the comprehensive evaluation of patients before initiating bisphosphonate therapy and highlights the need for additional medical decision analyses in future studies to compare the benefit over potential harms of bisphosphonate therapy.
-
Review Meta Analysis
Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis.
Overweight and obesity have negative health effects. Primary care clinicians are best placed to intervene in weight management. Previous reviews of weight loss interventions have included studies from specialist settings. The aim of this review was to estimate the effect of behavioural interventions delivered in primary care on body weight in overweight and obese adults. ⋯ Behavioural weight loss interventions in primary care yield very small reductions in body weight, which are unlikely to be clinically significant. More effective management strategies are needed for the treatment of overweight and obesity.
-
Review Meta Analysis
Is case management effective in reducing the risk of unplanned hospital admissions for older people? A systematic review and meta-analysis.
Case management is a collaborative practice involving coordination of care by a range of health professionals, both within the community and at the interface of primary and secondary care. It has been promoted as a way of reducing unplanned admissions in older people. ⋯ The identified trials included a range of case management interventions. Nine of the 11 trials showed no reduction of unplanned hospital admissions with case management compared with the same with usual care.
-
Review Meta Analysis
Non-steroidal anti-inflammatory drugs and chronic kidney disease progression: a systematic review.
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely regarded as one risk factor, which influences chronic kidney disease (CKD) progression. However, previous literature reviews have not quantified the risk in moderate to severe CKD patients. ⋯ The avoidance of NSAIDs in the medium term is unnecessary in patients with moderate to severe CKD, if not otherwise contraindicated. As the definition of high-dose of NSAID use remains unclear, the lowest effective dose of NSAIDs should be prescribed where indicated.
-
Review Meta Analysis
Effectiveness of oseltamivir in adults: a meta-analysis of published and unpublished clinical trials.
Oseltamivir is widely used for the treatment of influenza. Previous systematic reviews suggest that they reduce complications, but had significant methodologic limitations. ⋯ There is no evidence that oseltamivir reduces the likelihood of hospitalization, pneumonia or the combined outcome of pneumonia, otitis media and sinusitis in the ITT population.