Evidence for Allied Health: new evidence and resources – Autumn 2020

The latest evidence and resources for allied health professionals and clinical support staff. You can either scroll through this page, or click on the topics below to jump straight to a particular section.

COVID-19

Analgesic drugs for acute soft tissue injury

Asthma

Healthcare worker safety and wellbeing

Myocardial infarction

Organisation and delivery of care

Pelvic floor muscle training

Respiratory health

Rotator cuff repair

Stroke

Coming up…

Cochrane is producing reviews and resources for the COVID-19 pandemic. We have blogged about many of them and this blog Cochrane evidence on COVID-19: a round-up brings together a large collection of evidence and resources, starting from when this evidence was first being produced in spring 2020. Like the reviews themselves, all our blogs are updated to reflect new evidence.

You may be interested in our blog Personal protective equipment (PPE) for healthcare workers: new Cochrane evidence which discusses the evidence from two Cochrane Reviews and some innovative ideas.

Take-home points • An updated review and a new rapid review on PPE have been produced as part of Cochrane’s organizational effort to meet the need for up-to-date summaries of evidence to support decision-making in combating the effects and impact of COVID-19. • These reviews contribute to the evidence base about a range of considerations in PPE use, including barriers and facilitators to healthcare workers adherence to infection prevention and control guidelines. There are some new, creative solutions being developed to address some of the issues associated with wearing PPE.

Could antimicrobial mouthwashes and nasal sprays offer protection to healthcare workers, and also patients? Three Cochrane Reviews looked for evidence on this and were published in September 2020. It is disappointing that no completed studies were found, but there are studies underway and these will be considered for future updates of the reviews.

Cochrane Special Collections

Cochrane Special Collections assemble Cochrane Reviews on important topics for the prevention and treatment of COVID-19. They are developed with experts from our global Cochrane network. They are based on World Health Organization interim guidance, and continuously updated.

You can find Coronavirus (COVID-19) Special Collections here.

Cochrane Clinical Answers

Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically-focused entry point to rigorous research from Cochrane Reviews. They are designed to be actionable and to inform point-of-care decision-making. Each CCA contains a clinical question, a short answer, and data for the outcomes from the Cochrane Review deemed most relevant to practising healthcare professionals. The evidence is displayed in a user-friendly tabulated format that includes narratives, data, and links to graphics.

You can find Cochrane Clinical Answers related to COVID-19 here.

Cochrane Rehabilitation REH-COVER (Rehabilitation – COVID-19 Evidence-based Response) action

To update the rehabilitation community on the growing evidence for the role of rehabilitation in management of COVID-19 patients, Cochrane Rehabilitation launched the REH-COVER (Rehabilitation – Covid-19 Evidence-based Response) action. 

Cochrane Review summary: Oral non-steroidal anti-inflammatory drugs compared with other oral pain killers for sprains, strains and bruises

Cochrane Clinical Answer: What are the effects of breathing exercises for adults with asthma?

Please see the above section on COVID-19 for evidence on PPE and support for wellbeing in the healthcare workforce.

Minimising workplace aggression

Featured Review: Education and training for preventing and minimizing workplace aggression directed toward healthcare workers.

Fostering resilience

Cochrane Clinical Answer: For healthcare professionals, do psychological interventions help foster resilience?

Cochrane Clinical Answer: What are the effects of early mobilization (median 6 days) for people with acute uncomplicated myocardial infarction (MI)?

Patient-initiated appointments

Cochrane Podcast: Patient-initiated appointments for people with chronic conditions managed in hospital outpatient settings.

mHealth-based technologies

mHealth‐based technology aims to provide healthcare and health education via mobile and wireless technologies.

Primary healthcare services

Cochrane Podcast: Health workers’ perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis.

mHealth-delivered education for people with heart failure

Cochrane Clinical Answer: For people with heart failure, what are the effects of mHealth‐delivered education?

Preventing urinary incontinence

A Cochrane Clinical Answer: In pregnant women, does antenatal pelvic floor muscle training help to prevent urinary incontinence?

Chest radiographs for people with acute lower respiratory tract infections

Cochrane Clinical Answer: What are the benefits and harms of chest radiographs for people with acute lower respiratory tract infection (LRTI)?

COPD

Cochrane Clinical Answers:

Do smart technology interventions facilitate self‐management for people with chronic obstructive pulmonary disease (COPD)?

Which interventions lead to increased regular physical activity for people with chronic obstructive pulmonary disease (COPD)?

Pre-operative inspiratory muscle training

Cochrane Clinical Answer: In adults undergoing cardiac and major abdominal surgery, does preoperative inspiratory muscle training help to prevent postoperative pulmonary complications?

Sleep apnea

Cochrane Clinical Answer: How do behavioral interventions compare with usual care for promoting continuous positive airway pressure (CPAP) device usage in adults with obstructive sleep apnea?

Cochrane Clinical Answer: How do mixed interventions (educational, supportive, behavioral) compare with usual care for promoting continuous positive airway pressure (CPAP) device usage in adults with obstructive sleep apnea?

Cochrane Clinical Answer: How do supportive interventions compare with usual care for promoting continuous positive airway pressure (CPAP) device usage in adults with obstructive sleep apnea?

Cochrane Clinical Answer: How do educational interventions compare with usual care for promoting continuous positive airway pressure (CPAP) device usage in adults with obstructive sleep apnea?

Ventilation

Cochrane Clinical Answer: For people with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation, how do conservative and liberal oxygen targets compare?

Patients with acute respiratory distress syndrome (ARDS) and receiving oxygen through a breathing tube in intensive care may be more likely to survive beyond 90 days if they receive higher volumes of oxygen, compared with lower volumes. Whether patients receive a higher or lower volume of oxygen may make little or no difference to the number of days ventilated; the need for inotropic support (to stabilise circulation and optimise oxygen supply); or the likelihood of needing renal replacement therapy. However the evidence is very uncertain (all very low-certainty evidence). Effects on quality of life were not reported. The evidence is very uncertain about the potential harms of higher versus lower oxygen targets (very low-certainty evidence). Cochrane Review (published September 2020); one study with 205 mechanically ventilated patients in an intensive care setting, comparing conservative oxygen therapy with liberal oxygen therapy for seven days.

Cochrane Clinical Answer: What is the accuracy of airway physical examination tests for detection of difficult face mask ventilation in adults?

Cochrane Podcast: Bedside examination tests to detect beforehand adults who are likely to be difficult to intubate

Cochrane Clinical Answer: How does rotator cuff repair with or without subacromial decompression compare with non‐operative treatment for adults with rotator cuff tears?

Stroke

Cochrane Review: Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke

Mental practice to improve arm function and arm movement in people with hemiparesis (weakness or inability to move on one side of the body) after stroke. Mental practice involves repeatedly mentally rehearsing an action or task without actually physically performing the action or task. For people with hemiparesis after stroke, adding mental practice to other physical rehabilitation treatment probably improves arm function and movement and probably reduces impairment compared to treatment without mental practice (moderate-certainty evidence). However, adding mental practice may make little or no difference to activities of daily living (low-certainty evidence). Compared with conventional therapy, mental practice may make little or no difference to impairment (low-certainty evidence). There is not enough information about how mental practice otherwise compares to conventional therapy, or about effects on quality of life or economic costs. No adverse effects were reported in any of the studies.Cochrane Review (published May 2020); 25 studies with 676 people who had hemiparesis after stroke. Studies compared mental practice in addition to another treatment versus the other treatment (with or without placebo); or compared mental practice with conventional therapy.

 

We have a blog on Living and dying well after stroke in which Scott Murray and Marilyn Kendall talk about the rich evidence from their in-depth interviews, which could guide provision of person-centred care after major stroke and support people in living and dying well. Many people have left comments below the blog, sharing their own experiences, and both the blog and the comments have valuable insights. Several stroke survivors have written or contributed to other Evidently Cochrane blogs. All our blogs on stroke are here.

The first World Evidence Based Healthcare Day will take place on 20 October 2020. This is an initiative launched by Cochrane and six other leaders in the field, to create awareness of the need for better evidence to inform healthcare policy, practice and decision making in order to improve health outcomes globally.

You can find information and resources on the World Evidence Based Healthcare Day website and look out for content on social media #WorldEBHCDay  #EvidencetoImpact.

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The next collection of evidence will be published here in January 2021. We may have new blogs and blogshots on individual reviews meanwhile.  You can find all blogs relevant to allied health here and blogshots here.

Join in the conversation on Twitter with @CochraneUK or leave a comment on the blog. Please note, we will not publish comments that link to commercial sites or appear to endorse commercial products. We welcome diverse views and encourage discussion but ask that comments are respectful and reserve the right to not publish comments we consider offensive.

References (pdf)



Evidence for Allied Health: new evidence and resources – Autumn 2020 by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

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