Evidence for Allied Health: new evidence and resources – July 2022

The latest evidence and resources for allied health professionals and clinical support staff, and a chance to help us improve these blogs. You can either scroll through this page or click on any of the links below to jump to the relevant section.

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Cochrane UK needs you!

Can you help us find out whether our regular evidence round-up blogs are useful and how we can make them better?

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COVID-19

Cochrane is continuing to produce new and updated reviews in response to the pandemic. We have blogged about many of them and this blog COVID-19 evidence: a Cochrane round-up brings together a large collection of evidence and resources, starting from when this evidence was first being produced in spring 2020.

Plus, we have two blogs on COVID-19 treatments:

  1. Treatments for mild COVID-19
  2. Treatments for moderate to severe COVID-19: Cochrane evidence.

Like the reviews themselves, all our blogs are updated to reflect new evidence.

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  including Coronavirus (COVID-19): infection control and prevention measures and Coronavirus (COVID-19): evidence relevant to acute and critical care which were updated in June 2022.

Cochrane Podcasts

Cochrane COVID-19 Podcasts offer short summaries of Cochrane COVID-19 reviews from the authors themselves. A good way to hear the latest Cochrane evidence in under 5 minutes each.

The collection includes the recent podcast Do blood thinners prevent people who are hospitalised with COVID-19 from developing blood clots? 

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.

Recent Cochrane Clinical Answers addresses these questions:

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Assisted reproduction

Cochrane Clinical Answer: In assisted reproductive technology, what are the effects of cleavage stage versus blastocyst stage embryo transfer?

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Asthma

Digital technologies may help people with asthma adhere better to their treatment and improve asthma control, conclude the authors of the Cochrane Review Digital interventions to improve adherence to maintenance medication in asthma (June 2022). You can find out more in this article: Featured Review: Digital technologies to help people with asthma take their medication as prescribed.

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Bronchiolitis

Cochrane Clinical Answer: How does parenteral compare with enteral fluid therapy for children hospitalized with bronchiolitis?

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Chronic obstructive pulmonary disease (COPD)

Health professional education

The authors of the Cochrane Review Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care (May 2022) conclude that “The evidence of efficacy was equivocal for educational interventions for health professionals in primary care on the proportion of COPD diagnoses confirmed with spirometry, the proportion of patients with COPD who participate in pulmonary rehabilitation, and the proportion of patients prescribed guideline‐recommended COPD respiratory medications. Educational interventions for health professionals may improve influenza vaccination rates among patients with COPD and patient satisfaction with care.”

Self-management

Cochrane Clinical Answer: What are the effects of self‐management for people with chronic obstructive pulmonary disease (COPD)?

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Dementia: remote assessment

In the blog Dementia diagnosis by phone and video: pitfalls and possibilities, Lucy Beishon, specialist trainee in geriatric medicine and NIHR Academic Clinical Lecturer in Geriatric medicine, talks about evidence from her Cochrane Review Diagnostic test accuracy of remote, multidomain cognitive assessment (telephone and video call) for dementia (April 2022), reflects on her experiences during the pandemic, and looks to the future.

During the pandemic, many of the face-to-face parts of assessing someone for dementia were replaced by telephone interviews and assessments. A Cochrane Review has shown that there are many tests available, but little evidence about their accuracy or how remote assessment compares with face-to-face. With changes in technology, we need more studies looking at how well the newer tests perform for diagnosing dementia, particularly using more modern smartphones, apps, and tablets. We need to carefully consider all the implications of remote assessments for patients, clinicians, and researchers before using them to fully replace traditional face-to-face assessments. Challenges include inequality of access to good technology and to health care which involves remote delivery.

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Discharge planning

Cochrane Clinical Answer: How does discharge planning affect outcomes in older adults with medical (non‐surgical) conditions?

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Medication reconciliation

Cochrane Clinical Answer: In adults admitted to hospital, does medication reconciliation help reduce medication errors?

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Mobility training for older people with frailty

The Cochrane Review Mobility training for increasing mobility and functioning in older people with frailty (June 2022) has high-certainty evidence that, compared to control, “mobility training improves the level of mobility” to an extent that is clinically important. The benefit was still seen six months after the intervention.

Mobility training also “likely improves the level of functioning upon completion of the intervention…[but] this benefit did not appear to be maintained six months after the intervention.”

The effect of mobility training on adverse events is uncertain.

Mobility training may make little to no difference in the number of people who are admitted to nursing care facilities at the end of the intervention, or to the number of people who fall, or to the death rate.

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Music therapy

There are two recent Cochrane Reviews on music therapy.

Key messages from Music therapy for autistic people (May 2022) are:

  • “Music therapy compared with ‘placebo’ therapy or standard care
    •  probably increases the chance of overall improvement by the end of therapy
    •  probably helps to enhance quality of life, and lessen symptom severity
    •  probably does not increase adverse events.
  • We cannot tell whether music therapy may help with social interaction, non‐verbal communication and verbal communication at the end of therapy.”

The authors also note that most of the included studies explored interventions that correspond well with music therapy in clinical practice.

Key messages from Music therapy for people with substance use disorders (May 2022) are:

  • “Music therapy as ‘add on’ treatment to standard care likely reduces substance craving and increases motivation for treatment for adults in detoxification and rehabilitation settings.
  • Music therapy lasting longer than a single session is associated with greater reductions in substance craving.
  • There is no evidence of an effect on depressive symptoms, anxiety, motivation to stay sober/clean, or retention in treatment.
  • There were no data on adverse events.”

We have a blog on a number of reviews on this topic –  Music therapies: what’s the evidence?

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Parkinson’s disease: preventing falls

The authors of the Cochrane Review Interventions for preventing falls in Parkinson’s disease (June 2022) conclude:

“Exercise interventions probably reduce the rate of falls, and probably slightly reduce the number of people falling in people with mild to moderate PD. Cholinesterase inhibitors may reduce the rate of falls, but we are uncertain if they have an effect on the number of people falling. The decision to use these medications needs to be balanced against the risk of non fall‐related adverse events, though these adverse events were predominantly mild or transient in nature.”

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Physiotherapy for adults with complex regional pain syndrome

The Cochrane Review Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II (May 2022) highlights a continued evidence gap. The authors conclude “The evidence is very uncertain about the effects of physiotherapy interventions on pain and disability in CRPS”.

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Pressure ulcers (pressure injuries)

Blog: Pressure ulcers (pressure injuries): evidence and resources. On this page, you can find Cochrane evidence on preventing and treating pressure ulcers (pressure injuries), including resources that aim to make it useful and accessible, as well as links to the reviews themselves.

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Smoking cessation

Cochrane Clinical Answer: How do heated tobacco products (HTPs) and cigarette smoking compare in terms of safety? 

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News and opportunities

A free course: How to talk about vaccines when you’re not an expert: a Lifeology and Cochrane collaboration.

 

References (pdf)

Join in the conversation on Twitter with @SarahChapman30 and @CochraneUK or leave a comment on the blog.

Please note, we cannot give medical advice and do not publish comments that link to individual pages requesting donations or to commercial sites, or appear to endorse commercial products. We welcome diverse views and encourage discussion but we ask that comments are respectful and reserve the right not to publish any we consider offensive. Cochrane UK does not fact-check – or endorse – readers’ comments, including any treatments mentioned.

Sarah and Selena have nothing to disclose.

 



Evidence for Allied Health: new evidence and resources – July 2022 by Sarah Chapman and Selena Ryan-Vig

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

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