Saudi Cultural Missions Theses & Dissertations
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Item Restricted Effectiveness of Adherence to Home Non-Invasive Ventilation (NIV) upon Hospitalisation Rate and Mortality of Chronic Obstructive Pulmonary Disease Patients with Chronic Hypercapnic Respiratory Failure: A Structured Literature Review.(Glasgow Caledonian University, 2024-08) Alomari, Osama; Sharp, KathrynIntroduction: Chronic Obstructive Pulmonary Disease (COPD) with Chronic Hypercapnic Respiratory Failure (CHRF) has a significant impact on hospitalisation rate and mortality. Non-invasive ventilation (NIV) is a clinically established home-based intervention; however, its impact on hospitalisation rate and mortality remains undetermined. Review Aim: This review aims to investigate existing literature to establish the impact of adherence to home NIV on reducing hospitalisation rate and mortality among patients with COPD and CHRF. Method: Between May 2024 and June 2024, this review conducted a systematic literature search of the primary medical databases (MEDLINE, Cochrane Library, CINAHL and Embase). A quality assessment was conducted using the Newcastle-Ottawa Quality Assessment tool and the National Heart, Lung, and Blood Institute (NIH) quality assessment tool. Findings: Six observational studies, involving 10,206 participants, analysed the impact of adherence to home NIV on hospitalisation rate and mortality. Five studies were considered to be high quality and one was moderate quality. Adherence to home NIV for at least four hours per day was associated with a significant reduction in hospitalisation rate and mortality. Conclusion: Adherence to home NIV significantly reduces hospitalisation rate and mortality among COPD patients with CHRF. These findings recommend the adoption of home NIV as a standard care practice for this population and emphasise the importance of patient compliance to maximise the therapeutic benefits of NIV. This review recommends that future research conducts additional randomised control trials (RCTs) to reinforce its initial findings.16 0Item Restricted EVALUATION OF NON-ADHERENCE IN CLINICAL TRIALS OF ANTIDEPRESSANTS FOR MAJOR DEPRESSION DISORDER: A SYSTEMATIC REVIEW AND METAANALYSIS.(Saudi Digital Library, 0022-10-03) Alrasheedi, Maram; Williams, SianMajor depression disorder is a serious mental issue which affects the physical and mental well-being of affected persons. Hence, there is a need to develop antidepressants to treat major depression disorder. However, medicine non-adherence is a major challenge in major depression disorder drug development. Similarly, medication adherence is an essential aspect of the success of antidepressant development. Adherence/non-adherence data informs the interpretation of antidepressant clinical results, reducing clinical risks and realising antidepressant benefits in clinical trials. However, adherence prevalence is a crucial aspect of clinical research, existing evidence points to underreporting adherence assessment methods and outcomes in published clinical trials. Also, RCTs that report adherence measures and outcomes fail to provide adequate methodology regarding adherence measures and outcomes. To improve the completeness and quality of the information in antidepressant clinical trials, this research examined medication adherence prevalence in RCTs, measures of adherence/non-adherence, and clinical and cost impacts of non-adherence. A systematic review and meta-analysis methodology was adopted. Meta-analysis findings affirm that medication adherence prevalence in clinical trials for antidepressant development is 72.2%, translating to a 27.8% non-adherence level. Qualitative findings from the studies established direct and indirect non-adherence measures of adherence, including self-report measures and the use of questionnaires. Impacts of non-adherence include disease relapse and recurrence (clinical impact) and increased clinical trial costs. Keywords: Major depression disorder, Antidepressant clinical trials, Non-adherence, Adherence, Adherence prevalence.34 0