Objectives To systematically review the efficacy of multimodal nonpharmacological interventions in mild cognitive impairment (MCI). Methods An electronically search was conducted in PubMed, EMbase, The Cochrane Library, PsycINFO, Web of Science, CINAHL, VIP, CBM, WanFang Data and CNKI databases from inception to November 2017 to collect randomized controlled trials (RCTs) on multimodal nonpharmacological interventions for MCI. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software. Results A total of 12 RCTs involving 1 359 patients were included. The results of meta-analysis showed that there were no statistical differences between two groups in MMSE scores (SMD=0.33, 95%CI–0.13 to 0.78, P=0.16). However, the MoCA scores (SMD=0.52, 95%CI 0.38 to 0.67, P<0.000 01) and ADAS-Cog scores (SMD=1.13, 95%CI 0.75 to 1.51, P<0.000 01) in the multimodal nonpharmacological interventions group were better than those in the control group. Additionally, multimodal nonpharmacological interventions produced significant effects on ADL (SMD=–0.64, 95%CI –0.83 to–0.45, P<0.000 01), QOL-AD (MD=3.65, 95%CI 1.03 to 6.27, P=0.006) and depression (SMD=–0.83, 95%CI –1.41 to–0.26, P=0.005). There were no statistical differences between two groups on conversion rate to Alzheimer's disease (RR=0.27, 95%CI 0.06 to 1.26, P=0.10). Conclusions The current evidence shows that multimodal nonpharmacological interventions are feasible for patients with MCI as they have positive effects on overall cognitive abilities, daily living skills, and quality of life and depression. Nevertheless, due to the limited quantity and quality of included studies, more high quality studies are required to verify the conclusion.
ObjectivesTo assess the efficacy of non-drug interventions on improving sleep quality in ICU patients by network meta-analysis.MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on non-drug interventions on improving sleep quality in ICU patients from inception to December, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, network meta-analysis was performed by using the Stata 13.0 software.ResultsA total of 12 RCTs, involving 1 223 patients and 9 non-pharmacological interventions (music therapy, comprehensive nursing intervention, TCM emotions, music therapy+TCM emotions, Chinese medicine pillow therapy, ear acupressure, eye mask+earplugs+music, eye mask+earplugs, regular care) were included. The results of Pittsburgh sleep quality index (PSQI) showed that eye mask+earplugs, eye masks, and comprehensive nursing interventions were superior to conventional care in improving sleep quality in ICU patients, and the rankings were: eye mask+earplugs>eye mask>comprehensive nursing intervention, music therapy+TCM emotional>Chinese medicine emotional>music therapy>general care. The results of Richards-Campbell sleep scale (RCSQ) showed that eye mask+earplugs+music, Chinese medicine pillow therapy, and auricular pressure beans were superior to conventional care, and the rankings were: eye mask+earplugs+music>Chinese medicine pillow therapy>music therapy>ear acupressure beans>general care.ConclusionsThe evidence shows that in improving the sleep quality of ICU patients, eye mask + earplug, eye mask, comprehensive nursing intervention, music therapy + TCM emotional characteristics may all be effective intervention methods. It is suggested that more non-drug interventions should be carried out in the future for enhancing the sleep quality of ICU patients.
ObjectiveTo systematically review the efficacy and safety of non-pharmacological interventions for sleep disturbance in dementia, and to provide evidence for clinical practice.MethodsDatabases including CNKI, WanFang Data, VIP, PubMed, EMbase and The Cochrane Library were searched to collect randomized controlled trials (RCTs) on non-pharmacological interventions for sleep disturbance in dementia from inception to May 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 9 RCTs were included, involving 720 patients. Light therapy was the most commonly used treatment, followed by special activity and sleep education program. The results of meta-analysis showed that compared with the control intervention, light therapy could improve sleep efficiency (MD=2.21, 95%CI 1.09 to 3.33, P=0.0001) and the night-time sleep (MD=14.27, 95%CI 5.01 to 23.53, P=0.003) of patients with dementia in the community and nursing institutions, special activity could increase the night-time sleep (MD=29.74, 95%CI 20.44 to 39.04, P<0.00001), and sleep education program could also improve sleep efficiency (MD=6.19, 95%CI 5.22 to 7.16, P<0.00001) and night-time sleep (MD=33.95, 95%CI 25.40 to 42.50, P<0.00001). In addition, it was superior to obtain 120 or 60 minutes of light exposure than 30 minutes to improve the quality of sleep (RR=−2.62, 95%CI −3.56 to −1.68, P<0.001) and reduce daytime sleep (RR=−4.75, 95%CI −5.71 to −3.42, P<0.001). However, there was significant difference in incidence of adverse reactions between groups of 120 minutes and 30 minutes of light exposure (RR=2.57, 95%CI 1.44 to 4.58, P=0.001).ConclusionsThe current evidence shows that non-pharmacological intervention can improve sleep efficiency and night-time sleep in patients with dementia. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the efficacy of different non-pharmacological interventions for smoking cessation. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, VIP and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of different non-pharmacological interventions for smoking cessation from inception to November, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using Stata 15.1 software. ResultsA total of 27 RCTs involving 14 interventions were included. The results of the network meta-analysis showed that compared with conventional advice, video counseling (OR=2.34, 95%CI 1.32 to 4.15), mobile phone text message (OR=1.82, 95%CI 1.03 to 3.20), motivational interview (OR=2.00, 95%CI 1.11 to 3.59) and health education (OR=3.40, 95%CI 1.52 to 7.57) were higher in quitting rate (P<0.05). The sort results showed that health education was the most likely to be the best intervention (86.20%), followed by video consultation (74.10%). ConclusionCurrent evidence shows that the smoking cessation effects of health education, video counseling, telephone counseling, mobile phone text message and motivational interview. Among them, health education may be the best. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy of non-pharmacological interventions to reduce fear of childbirth. MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of non-pharmacological interventions to reduce fear of childbirth from inception to December 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies; then, a network meta-analysis was performed using Stata 15.0 software. ResultsA total of 19 RCTs involving 3 409 patients were included. Ten non-pharmacological interventions (prenatal education, scenario-based health education, psychological guidance, yoga training, hypnosis, mobile learning education, cognitive behavioral therapy, physical relaxation guidance, breathing guidance, and usual care) were included. The results of the reticulated meta-analysis of the Wijma Delivery Expectancy Questionnaire (W-DEQ-A) showed that the rankings of the interventions were as follows: prenatal education > yoga training > cognitive behavioral therapy > situational simulation health education > psychological guidance > physical relaxation guidance > conventional care. The results of the Wijma Experience of Childbirth Questionnaire (W-DEQ-B) mesh meta-analysis showed that the rankings of the interventions were as follows: mobile learning education > prenatal education > scenario-based health education > cognitive behavioral therapy > breathing instruction > hypnosis > psychological instruction > physical relaxation instruction > usual care. ConclusionThe current evidence suggests that prenatal education, mobile learning education, situational simulation health education, and yoga training may be effective interventions in improving maternal fear of childbirth. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the economy of non-pharmaceutical interventions (NPIs) for COVID-19. MethodsThe Web of Science, PubMed, EMbase, Cochrane Library, INAHTA, CNKI, WanFang Data and SinoMed databases were electronically searched to collect studies on health economic evaluations from 1 January 2020 to 20 August 2022. Then the included materials were reviewed, extracted and data integration analysis were conducted based on inclusion and exclusion criteria. ResultsSeventy-one academic publications were finally included, which contained 25 papers about nucleic acid testing, antigen testing and screening, 5 papers about personal protection, 12 papers about social distancing, quarantine and isolation, 11 papers about regional or national lockdown and 18 papers about multiple NPIs. The results showed that compared with no intervention, nucleic acid testing, antigen testing, screening and personal protection measures were economical. Social distancing, quarantine and isolation were also economical compared with no intervention. However, in low-income countries, movement restriction and factory shutdown may exact a heavy toll on the poorest and most vulnerable. Moreover, compared with a single long-term lockdown, multiple short-term lockdowns could be more economical, but the cost was still huge overall. ConclusionNPIs such as nucleic acid testing, antigen testing, personal protection, social distancing, quarantine, isolation and factory shutdown are economical. Although regional or national lockdown can save lives, it is not suitable for wide use. The researches on specific populations, specific variants (especially Omicron) and in the context of China need to be carried out.
ObjectiveTo evaluate the efficacy of different non-pharmacological interventions on cognitive function in elderly patients with mild cognitive impairment by the network meta-analysis. MethodsThe PubMed, Embase, Cochrane Library, CINAHL, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to November 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. The network meta-analysis was then performed by using Stata 16.0 and Open BUGS 3.2.3 software. ResultsA total of 43 RCTs involving 2 986 patients were included, which involved 8 non-drug intervention methods. The best probability ranking results of the network meta-analysis showed that on the simple mental state scale (MMSE) scores: rTMS > acupressure > acupuncture therapy > exercise therapy > cognitive training > multicomponent intervention > VR > conventional care > health education, and on the Montreal cognitive assessment scale (MoCA) scores: VR > exercise therapy > rTMS > acupuncture therapy > acupressure > cognitive training > health education > conventional care. Conclusion Current evidence shows that rTMS, acupressure, VR, exercise therapy and acupuncture may be effective interventions to improve cognitive function in elderly patients with mild cognitive impairment. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To evaluate the effect of different non-pharmacological interventions on the cognitive function of elderly people with cognitive decline, and provide useful reference for improving cognitive function of the elderly. Methods Computer searches of PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP Database, Wanfang Data, and China Biomedical Literature Database for randomized controlled trials on non-pharmacological interventions for aged adults with cognitive decline were conducted, all with a search time frame from database inception to October 9th, 2023. Literature screening, information extraction and bias risk assessment using RevMan 5.4 software were performed by two evaluators independently, and Stata 16.0 and R 4.3.0 software was used for network meta-analysis. Results A total of 27 articles involving 2149 elderly patients and 7 intervention protocols were included. Among the 27 articles, 8 were graded A and 19 were graded B for quality. The network meta-analysis revealed that, using the Montreal Cognitive Assessment (MoCA) as the evaluating metric, virtual reality [mean difference (MD)=6.01, 95% confidence interval (CI) (0.90, 10.75)], cognitive training [MD=4.99, 95%CI (0.56, 9.12)], and exercise training [MD=3.88, 95%CI (0.47, 7.27)] were better than community services, respectively (P<0.05), and exercise training was also better than conventional care [MD=3.05, 95%CI (0.92, 5.12), P<0.05]; using the Mini-Mental State Examination (MMSE) as the evaluation indicator, multimodal exercise [MD=3.00, 95%CI (0.89, 4.96)], cognitive training [MD=2.50, 95%CI (0.27, 4.82)], traditional Chinese exercise [MD=2.30, 95%CI (0.34, 4.28)], psychotherapy [MD=1.76, 95%CI (0.56, 2.96)], and exercise training [MD=1.36, 95%CI (0.18, 2.59)] were better than conventional care, respectively (P<0.05), and multimodal exercise [MD=3.32, 95%CI (0.62, 5.81)], cognitive training [MD=2.82, 95%CI (0.75, 4.90)], and traditional Chinese exercise [MD=2.63, 95%CI (0.08, 5.13)] were also better than community service, respectively (P<0.05). The results of the cumulative probability ranking showed that virtual reality had the highest probability of being the best intervention in terms of improving MoCA metrics (0.863), and multimodal exercise had the highest probability of being the best intervention in terms of improving MMSE metrics (0.868). Conclusion Using MoCA as an evaluation indicator, virtual reality may be the best non-pharmacological intervention; using MMSE as an evaluation indicator, multimodal exercise may be the best non-pharmacological intervention.
Objective To retrieve and summarize evidence of non-pharmacological interventions for sleep disorders in patients with osteoarthritis (OA), and to organize and evaluate the extracted evidence to provide evidence-based interventions for sleep disorders in patients with OA. Methods The relevant literature on non-pharmacological interventions for sleep disorders in patients with OA in BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, Guidelines International Network, Medlive guidelines network, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure and Wanfang was systematically searched. The search deadline was June 30th, 2024. The retrieved results were integrated and analyzed to form evidence of non pharmacological interventions for sleep disorders in patients with OA. Results A total of 13 articles were included, including 1 evidence report, 5 guidelines, 2 expert consensus papers, 3 systematic reviews, and 2 randomized controlled trials. The summarized evidence involves six aspects of sleep screening, specialist visits, assessment tools, cognitive behavioral therapy, exercise therapy, and other measures, totaling 20 pieces of evidence. Conclusion Non-pharmacological interventions for sleep disorders of patients with OA include multiple aspects, and this evidence can provide theoretical basis for developing intervention plans for sleep disorder of patients with OA, thereby improving their sleep quality and enhancing quality of life.