OBJECTIVE: Our study aimed to determine the clinical effects and safety of D. scandens for musculoskeletal pain treatment compared with standard regimen, nonsteroidal anti-inflammatory drugs (NSAIDs).
METHODS: International and Thai databases were searched from inception through August 2015. Comparative randomized controlled trials investigating oral D. scandens for musculoskeletal pain were included. Outcomes of interest included level of pain and adverse event. Mean changes of the outcomes from baseline were compared between D. scandens and NSAIDs by calculating mean difference.
RESULTS: From 42 articles identified, 4 studies involving a total of 414 patients were included for efficacy analysis. The effects of oral D. scandens on reducing pain score were no different from those of non-steroidal anti-inflammatory drugs at any time points (3, 7, 14 days and overall). The overall pain reduction in the D. scandens group was not inferior to treatment with NSAIDs (weighted mean difference 0.06; 95% CI: -0.20, 0.31) without evident of heterogeneity (I(2)=0.00%, p=0.768). When compared, the adverse events (AEs) of D. scandens showed no different relative risk with NSAIDs. The major adverse events were gastrointestinal symptoms.
CONCLUSION: D. scandens may be considered as an alternative for musculoskeletal pain reduction.
METHODS: Nine databases were searched through November 2017. Randomized controlled trials that reported the smoking cessation effect of V. cinerea were included. Data were extracted by two independent researchers. Study quality was assessed using the Cochrane risk of bias and JADAD score. The estimates of pooled effects were calculated as relative risk (RR) with 95% CI using a random-effects model.
RESULTS: Five trials with 347 smokers were included. V. cinerea treatment group was significantly associated with cessation rate higher than that in the control group with no evidence of heterogeneity for both continuous abstinence rate (CAR) at week 8 with risk ratio (RR): 1.69, 95% CI [1.00, 2.86]; week 12 RR: 2.18, 95% CI [1.17, 4.04]) and 7-day point prevalence abstinence rate (PAR) (week 8 RR: 1.51, 95% CI [1.01, 2.27]; week 12 RR: 1.93, 95% CI [1.24, 2.99]) at week 8 and 12, respectively. There was no significant difference of all adverse events between the treatment and the control groups.
CONCLUSION: Our study demonstrates that V. cinerea has potential efficacy for smoking cessation. Further well-design RCTs of standardized V. cinerea compared with standard treatment should be conducted to strengthen this evidence.
OBJECTIVES: This review evaluated the effectiveness of strategies for enhancing ADR reporting by healthcare professionals (HCPs).
METHODS: This systematic review was conducted following the Cochrane and the PRISMA guidelines. Five international databases were searched from inception to December 2023 and updated search to September 2024. Randomized clinical controlled trials (RCTs) and non-RCTs on enhancing ADR reporting were included. The primary outcomes were the number of overall ADR and high-quality ADR reports. Study quality was assessed using the EPOC risk of bias (ROB), and ROBIN-I for RCT, and non-RCT. All data were evaluated using a random-effects model, and heterogeneity was assessed using I2 statistic and chi-squared tests.
RESULTS: From 1,672 studies, 13 studies (10 RCTs, and 3 non-RCTs) with 28,116 participants were included. Two of 10 RCTs had low ROB while the remaining were judged as unclear and moderate ROB. Most studies were in high-income countries, and the main strategy was educating HCPs through workshops. Meta-analysis showed significant increases in overall ADR reporting through educating HCPs with a rate ratio (RR) of 5.09 (95%CI: 3.36-7.71, I2=84.5%, low certainty), and in high-quality reporting with 1.31 (95%CI:1.09-1.58, I2=0.0%, moderate certainty). Subgroup analysis indicated that educating HCPs through face-to-face workshops combined with the Tawai app (RR:10.5, 95%CI:8.74-12.61), a face-to-face workshop alone (RR:6.69, 95%CI:5.43-8.25, I2=0.0%), and repeated telephone (RR:2.59, 95%CI:1.75-3.84, I2=8.8%) significantly increased the overall number of ADR reports with moderate certainty. Email or letter communications showed no significant effect.
CONCLUSION: Educating HCPs via interactive strategies like face-to-face workshops with or without a mobile app and repeated phone calls improved ADR reporting. However, long-term, high-quality studies are needed to confirm these findings before recommending widespread implementation in clinical practice, especially in LMICs.