[AF] Newsletter Cochrane Primary Health Care Field August 2013

Mie Ago 28 15:29:26 CEST 2013

Por si os resulta de interés el último número.

Saludos
...................................................
Pedro del Río Pérez
León
pedrodelrio en uninet.edu
...................................................

 > El 28/08/2013 14:08, cochrane Primary Care escribió:
> cochrane 20th anniversary logo.jpgPHCH logo.png
>
> *Newsletter with PEARLS August 2013 *
>
> *News*
>
> **
>
> *Cochrane Library translations*
>
> Translations in French and Spanish have been available on /The Cochrane
> Library/ and on /Cochrane Summaries/ for a while, and more recently
> Croatian and Portuguese have been added. People who wish to search or
> browse in their own language can do so on /Cochrane Summaries./More
> languages are coming soon.
>
> ·French - Français <http://summaries.cochrane.org/fr/search/site>
> (http://summaries.cochrane.org/fr)
> provided by the French Cochrane Centre
>
> ·Spanish - Español
> <http://summaries.cochrane.org/es/search/site>(http://summaries.cochrane.org/es)
> provided by the Iberoamerican Cochrane Centre
>
> ·Croatian – Hrvatski <http://summaries.cochrane.org/hr/search/site>
> (http://summaries.cochrane.org/hr)
> provided by the Croatian Cochrane Branch
>
> ·Portuguese - Português
> <http://summaries.cochrane.org/pt/search/site>(http://summaries.cochrane.org/pt)
> provided by the Brazilian Cochrane Centre
>
>   If you are interested in knowing more about translations or
> contributing yourself, you can contact
>
> Ms Juliane Ried, Project Officer
>
> Cochrane Innovations
>
> juliane.ried en cochrane.org <mailto:juliane.ried en cochrane.org>
>
> Skype: juliane.ried
>
> *Cochrane anniversary wall hanging*
>
> To celebrate the Cochrane Collaboration 20^th anniversary a wall hanging
> has been created by Cochrane volunteers from many Units, Fields and
> Groups. All creative contributions for the wall hanging can be admired
> on following link:
>
> http://anniversary.cochrane.org/cochrane-wall-hanging
>
> Cochrane PHCF Wall hanging.jpg
>
> The Cochrane PHCF contribution to the wall hanging
>
> *the 'Cochrane20 Video' Series*
>
> The sixteenth video in this series, Working together in the
> Collaboration, is available at http://youtu.be/IJInSOZG6vQ
>
> The seventeenth video in this series, 'Using technology in the
> Collaboration', is available at http://youtu.be/_zXycfvjFGE.
>
> *Events*
>
> *Cochrane Colloquium PHCF meeting*
>
> The Cochrane Primary Health Care Field has scheduled an open meeting at
> the Cochrane Colloquium in Quebec on *Sunday 22 September 17.15-18.30*.
> The location of the meeting is the *Freiburg meeting room (205 C)*. In
> this open meeting the Primary Health Care Field will present and discuss
> its (recent) activities. Anyone interested in primary care and in the
> scope of the field is welcome to join and to participate in the discussion.
>
> You will find more colloquium meetings to attend at following weblink:
>
> http://colloquium.cochrane.org/meeting-list
>
> *Reminder Methods Symposium//**24 September *
>
> *Data, Outcomes, Uncertainty and Graphs: /Advances and Limitations in
> Trials, Meta-Analysis, and Novelties /*
>
> The Cochrane Methods Symposium takes place amidst the 20th anniversary
> celebrations of The Cochrane Collaboration in Quebec. The symposium will
> feature talks on topics about statistics, bias and transparency of
> research. Details and registration
> <http://www.editorial-unit.cochrane.org/methods-symposium>
>
> *Interesting new and updated reviews*
>
> The following recently published Cochrane reviews have been selected for
> your interest.
>
> *'Mediterranean' dietary pattern for the primary prevention of
> cardiovascular disease
> <http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD009825/frame.html>*
>
> **
>
> *Midwife-led continuity models versus other models of care for
> childbearing women
> <http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004667/frame.html>***
>
> **
>
> *Multimedia educational interventions for consumers about prescribed and
> over-the-counter medications
> <http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD008416/frame.html>
> (Link to Journal Club Article
> <http://www.cochranejournalclub.com/multimedia-interventions-prescribed-counter-medications-clinical/>
> Link to Podcast
> <http://www.cochrane.org/podcasts/issue-4-april-2013/multimedia-educational-interventions-consumers-about-prescribed-and-over>**)*
>
> *Interesting new titles*
>
> The following titles have been registered with the Cochrane
> Collaboration. This means that at this moment the protocol is being
> written. If you feel that this topic is of special importance and that
> you want to be of assistance in some way (e.g., peer review protocol,
> give advice etc.) please contact us at info en cochraneprimarycare.org
> <mailto:info en cochraneprimarycare.org>
>
> ·*Psychological therapies vs treatment as usual (TAU) for depression in
> older people (deregistered)*
>
> ·*Interventions for improving health literacy*
>
> ·*Health at every size (HEAS) versus conventional weight loss programmes
> for cardiovascular risk factors*
>
> ·*Opioids for the palliation of breathlessness in advanced disease and
> terminal illness*
>
> *P.E.A.R.L.S.*
>
> /practical evidence about real life situations /
>
> The New Zealand Guideline Group  fund the Cochrane Primary Care Field to
> produce the P.E.A.R.L.S. (click here
> <http://www.nzdoctor.co.nz/gp-resources/pearls/2012/february-2012.aspx>for
> the websitelink)
>
> Access http://www.cochraneprimarycare.org/to view the PEARLS online.
>
> /PEARLS are succinct summaries of Cochrane Systematic Reviews for
> primary care practitioners. They are funded by the New Zealand
> Guidelines Group.
> //PEARLS provide guidance on whether a treatment is effective or
> ineffective. PEARLS are prepared as an educational resource and do not
> replace clinician judgement in the management of individual cases.
> //The PEARLS can be used free of charge for research or teaching. No
> commercial use is allowed./
>
> **
>
> *Oral treatments effective for tinea pedis*
>
> **
>
> *Clinical question*
>
> 	
>
> How effective are oral treatments for tinea pedis?
>
> *Bottom line*
>
> 	
>
> Terbinafine and itraconazole were more effective than no treatment, and
> terbinafine appeared to give a significantly better cure rate than
> griseofulvin. In addition, terbinafine may require a shorter treatment
> period (2 weeks), which is preferable for maximising patient compliance.
> No significant difference was detected between terbinafine and
> itraconazole, fluconazole and itraconazole, fluconazole and
> ketoconazole, or between griseofulvin and ketoconazole, although the
> trials were generally small. All drugs reported adverse effects, with
> gastrointestinal effects being most commonly reported.
>
> *Caveat*
>
> 	
>
> Of the included trials, only 5 were published in recent years, with the
> other 10 trials having been published pre-1996. The quality of reporting
> of the trials was variable, and, in general, the method of generating
> the randomisation sequence and concealing allocation was not clearly
> reported, with the result that the trials were at unclear risk of bias
> for these domains. A similar omission was the lack of blinding of
> outcome assessors, especially with respect to the assessment of clinical
> signs and symptoms, as this outcome is, by its nature, subjective. Only
> 3 trials assessed the condition beyond 3 months.
>
> *Context*
>
> 	
>
> About 15% of the worldÕs population suffers from tinea pedis. Oral
> therapy is usually used for chronic conditions or when topical treatment
> has failed.
>
> *Cochrane Systematic Review*
>
> 	
>
> Bell-Syer SEM et al. Oral treatments for fungal infections of the skin
> of the foot. Cochrane Reviews, 2012, Issue 10. Article No. CD003584.DOI:
> 10.1002/14651858.CD003584.pub2.
> This review contains 15 studies involving 1438 participants.
>
> Pearls No. 381, January 2013, written by Brian R McAvoy.
>
> *Limited evidence for benefit of amitriptyline for neuropathic pain and
> fibromyalgia in adults*
>
> **
>
> *Clinical question*
>
> 	
>
> How effective is amitriptyline for neuropathic pain and fibromyalgia in
> adults?
>
> *Bottom line*
>
> 	
>
> Amitriptyline probably does not work in neuropathic pain associated with
> HIV or treatments for cancer. Amitriptyline probably does work in other
> types of neuropathic pain (painful diabetic neuropathy, post-herpetic
> neuralgia, and post-stroke pain, and in fibromyalgia), though we cannot
> be certain of this. A best estimate is that amitriptyline provides pain
> relief in about 1 in 4 (25%) more people than does placebo (NNT* = 4.6
> [95% confidence interval 3.6Ð6.6]), and about 1 in 4 (25%) more people
> than placebo report having at least 1 adverse event, probably not
> serious but disconcerting.*NNT = number needed to treat to benefit 1
> individual.
>
> *Caveat*
>
> 	
>
> There were no studies that could provide an answer that was trustworthy
> or reliable because most studies were relatively old, and used methods
> or reported results that we now recognise can make benefits seem better
> than they are.
>
> *Context*
>
> 	
>
> Amitriptyline is a tricyclic antidepressant that is widely used to treat
> chronic neuropathic pain and fibromyalgia, and is recommended in many
> guidelines. These types of pain can be treated with antidepressant drugs
> in doses below those at which the drugs act as antidepressants.
>
> *Cochrane Systematic Review*
>
> 	
>
> Moore RA et al. Amitriptyline for neuropathic pain and fibromyalgia in
> adults. Cochrane Reviews, 2012, Issue 12. Art. No.: CD008242.DOI:
> 10.1002/14651858. CD008242.pub2.
> This review contains 21 studies involving 1437 participants.
>
> Pearls No. 382, February 2013, written by Brian R McAvoy.
>
> *Psychological therapies effective for pathological and problem gambling*
>
> **
>
> *Clinical question*
>
> 	
>
> How effective are psychological therapies (cognitive behavioural therapy
> [CBT], motivational interviewing [MI], integrative therapies, and
> Twelve-step Facilitated Group Therapy) for pathological and problem
> gambling?
>
> *Bottom line*
>
> 	
>
> Data from nine studies indicated benefits of CBT in the period
> immediately following treatment. However, there were few studies across
> longer periods of time (e.g. 12 months) after treatment, and little was
> known about whether effects of CBT were lasting. Data from three studies
> of MI therapy suggested some benefits in terms of reduced gambling
> behaviour, but not necessarily other symptoms of pathological and
> problem gambling. There were also few studies that provided evidence on
> integrative therapies (two studies) and other psychological therapies
> (one study), and there was insufficient data to evaluate the efficacy of
> these therapies.
>
> *Caveat*
>
> 	
>
> A substantial amount of the evidence came from studies that suffered
> from multiple limitations, and these may have led to overestimations of
> treatment efficacy. There was variability in the nature of the
> interventions classified as CBT, and the effects of individual and group
> CBT were also combined. The data on MI therapy came from few studies and
> conclusions require further research.
>
> *Context*
>
> 	
>
> The prevalence of pathological and problem gambling has been found to
> vary internationally, with studies suggesting anywhere between 0.2% (in
> Norway) and 5.3% (in Hong Kong) of individuals affected.1 The term
> 'pathological gambling' is derived from psychiatric diagnostic systems,
> such as the Diagnostic and Statistical Manual of Mental Disorders.
> Problem gambling is also sometimes used to describe a subclinical level
> of the psychiatric disorder or alternatively, a broader category of
> severe gambling based on a continuum model of gambling-related harm.
>
> *Cochrane Systematic Review*
>
> 	
>
> Cowlishaw S et al. Psychological therapies for pathological and problem
> gambling. Cochrane Reviews, 2012, Issue 11. Art. No.: CD008937.DOI:
> 10.1002/14651858. CD008937.pub2. This review contains 14 studies
> involving 1,245 participants.
>
> Pearls No. 383, February 2013, written by Brian R McAvoy
>
> *Computer-generated reminders influence professional practice*
>
> **
>
> *Clinical question*
>
> 	
>
> How effective are computer-generated reminders delivered on paper to
> healthcare professionals on professional practice and health care outcomes?
>
> *Bottom line*
>
> 	
>
> There was moderate quality evidence that computer-generated reminders
> delivered on paper to healthcare professionals achieved a moderate (7%)
> absolute improvement in processes of care. Median improvement in
> processes of care also differed according to the behaviour the reminder
> targeted: for instance, reminders to vaccinate improved processes of
> care by 13.1% (absolute improvement) compared with other targeted
> behaviours. Reminders to discuss issues with patients were the least
> effective.  Two characteristics emerged as significant predictors of
> improvement: providing space on the reminder for a response from the
> clinician, and providing an explanation of the reminder's content or
> advice. Reminders were not associated with significant improvements in
> health care outcomes.
>
> *Caveat*
>
> 	
>
> None of the included studies reported outcomes related to harms or
> adverse effects of the intervention, such as redundant testing or
> overdiagnosis.
>
> *Context*
>
> 	
>
> Healthcare professionals do not always provide care that is recommended
> or that reflects the latest research, partly because of information
> overload or inaccessibility. Reminders may help doctors overcome these
> problems by reminding them about important information or providing
> advice, in a more accessible and relevant format, at a particularly
> appropriate time.
>
> *Cochrane Systematic Review*
>
> 	
>
> Cochrane Systematic Review Arditi C et al. Computer-generated reminders
> delivered on paper to healthcare professionals: effects on professional
> practice and health care outcomes. Cochrane Reviews, 2012, Issue 12.
> Art. No.: CD001175.DOI: 10.1002/14651858. CD001175.pub3. This review
> contains 32 studies involving over 102,000 participants.
>
> Pearls No. 385-1, March 2013, written by Brian R McAvoy. C16
>
> *Abstracts*
>
> The actual Cochrane abstracts for the P.E.A.R.L.S are at
>
> *No. 381 **Oral treatments effective for tinea pedis*
> <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003584.pub2/abstract>**
>
> *No 382 **Limited evidence for benefit of amitriptyline for neuropathic
> pain and fibromyalgia in adults*
> <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008242.pub2/abstract>**
>
> *No 383**Psychological therapies effective for pathological and problem
> gambling*
> <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008937.pub2/abstract>**
>
> *No 385-1 **Computer-generated reminders influence professional
> practice*
> <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001175.pub3/abstract>**
>
> *Colophon*
>
> **
>
> **
>
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>
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>
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>
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>
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>
> Bruce Arroll ^1 ,  Jaap van Binsbergen ^2 , Tom Fahey ^3 , Tim Kenealy ^1 ,
>
> Floris van de Laar ^2
>
> Caroline Roos ^2
> Secretary to Cochrane Primary Health Care Field
> email: c.roos en cochraneprimarycare.org
>
>
> The Cochrane Primary Health Care Field is a collaboration between:
> ^1   New Zealand Branch of the Australasian Cochrane Centre at the
> Department of General Practice and Primary Health Care, University of
> Auckland and funded by the New Zealand Guidelines Group;
>
> ^2   Academic Department of Primary and Community Care in The
> Netherlands, The Dutch College of General Practitioners, and the
> Netherlands Institute for Health Services Research;
>
> ^3   Department of General Practice, Royal College of Surgeons in
> Ireland, Dublin.
>
>
>
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