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Chinese diaspora caregivers' experiences in dementia care in high-income countries: A systematic review
BACKGROUND: Chinese diaspora caregivers in high-income countries make up a large proportion of the ethnic population and usually experience significant challenges in the care of their family members with dementia. AIM: The aims of this systematic review were to gain deep insights into Chinese diaspora caregivers' experiences and factors contributing to their experiences in the care of family members living with dementia in high-income countries. METHODS: The Joanna Briggs Institute (JBI) meta-aggregative approach to qualitative studies was applied to this systematic review. The review also followed the PRISMA guidelines and was informed by the Life Course Theory. Six English databases were searched between August 2020 and September 2020. RESULTS: In total, 330 articles were screened and 16 were included in the review. The number of caregivers included in these studies was 365 across four countries. Four synthesised findings with sub-themes were identified from studies reviewed. These synthesised findings were described as: (1) motivations to take on the caregiving role; (2) receiving limited dementia care education; (3) factors affecting access and use of care services; and (4) experiencing multifaced challenges. CONCLUSION: Dementia care policies need to address disparities between caregiver support for the mainstream group and Chinese diaspora caregivers. Dementia education and care services need to consider the positive impact that filial piety and Confucianism have on Chinese diaspora caregivers and empower them to use their strengths. Dementia care services need to be culturally adapted to meet this care group's needs, preferences and expectations.
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A comprehensive clinical evaluation of first-line drugs for ALK-positive advanced non-small cell lung cancer
Background: Anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs) are mainly used in the treatment of ALK-positive advanced non-small cell lung cancer (NSCLC), but a comprehensive clinical evaluation of ALK-TKIs is lacking. Hence, a comparison of ALK-TKIs for first-line treatment of ALK-positive advanced NSCLC is essential to provide rational drug use and a basis for improving national policies and systems. Methods: According to the Guideline for the Administration of Clinical Comprehensive Evaluation of Drugs (2021) and the Technical Guideline for the Clinical Comprehensive Evaluation of Antitumor Drugs (2022), a comprehensive clinical evaluation index system of first-line treatment drugs for ALK-positive advanced NSCLC was established by literature review and expert interviews. We conducted a systematic literature review, meta-analysis, and other relevant data analyses, combined with an indicator system, to establish a quantitative and qualitative integration analysis for each indicator and each dimension of crizotinib, ceritinib, alectinib, ensartinib, brigatinib, and lorlatinib. Results: The comprehensive clinical evaluation results of all dimensions were as follows: in terms of safety, alectinib had a lower incidence of grade 3 and above adverse reactions; for effectiveness, alectinib, brigatinib, ensartinib, and lorlatinib showed better clinical efficacy, and alectinib and brigatinib have been recommended by several clinical guidelines; in terms of economy, second-generation ALK-TKIs have more cost-utility advantages, and both alectinib and ceritinib have been recommended by the UK and Canadian Health Technology Assessment (HTA) agencies; for suitability, accessibility, and innovation, alectinib has a higher degree of physician recommendations and patient compliance. Except for brigatinib and lorlatinib, all other ALK-TKIs have been admitted to the medical insurance directory; the accessibility of crizotinib, ceritinib, and alectinib is good, meeting the needs of patients. Second-and third-generation ALK-TKIs have higher blood-brain barrier permeability, stronger inhibition ability, and innovation than first-generation ALK-TKIs. Conclusions: Compared with other ALK-TKIs, alectinib performs better across six dimensions and has a higher comprehensive clinical value. The results provide better drug choice and rational use for patients with ALK-positive advanced NSCLC.
研究证据
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Evaluation of quality of pharmacoeconomic studies involved in traditional Chinese medicine in China
Objectives The pharmacoeconomic studies of traditional Chinese medicine (TCM) are still in its infancy. Assessing the quality of pharmacoeconomic studies of TCM to improve the efficiency of health resource allocation and guide the rational use of medicine. Methods Four databases were searched from inception to January 2018. The Consolidated Health Economic Evaluation Reporting Standards statement (CHEERS) and the Quality of Health Economic Studies (QHES) were used to assess the reporting quality and methodological quality. STATA 12.0 and Meta analyst 3.13 were used to analyze the related data. Results A total of 178 studies were included. The methodological evaluation of the study found that the total score of QHES was 47.85 +/- 8.09. The report quality evaluation results found that many studies did not report comprehensive information, such as lack of detailed reports on abstracts, study perspectives, time frames, discount rates, model selection, but the titles, study background and location, and health results, resource and cost estimates, analysis methods, and heterogeneity analysis are reported in more detail. Six of the ten stratification factors have statistically significant differences. Conclusion The overall quality of pharmacoeconomic studies of TCM is low, and further standardization and improvement are needed to obtain reliable study results.
期刊论文
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The collaboration and reporting quality of social welfare systematic reviews in the Campbell Collaboration online library
Background: To analyze the collaboration and reporting quality of the systematic reviews of social welfare in the Campbell collaboration online library. Methods: The Campbell collaboration online library was searched for systematic reviews of social welfare and the basic information extracted in order to assess the reporting quality of systematic reviews using a MOOSE checklist. BICOMS-2 and UCINET software were used to produce the social network, and Comprehensive Meta Analysis (Version 2) and STATA 13.0 were used to analyze the related data. Results: Fifty-seven systematic reviews of social welfare were included. Twenty-eight items of the included social welfare systematic reviews were rated as complete (≥70%). There were significant differences between ≤2013 and ≥ 2014 in five items. These differences were as follows: research published by one organization or more than one organization in one item, more than three authors or less than four authors in two items, and one country or more than one country in six items. It's completed about researches with more than one organization, three authors or more than one country. Some items were found to have a low reporting rate of studies published before 2014, by one organization, with less than four authors or one country, respectively. The social network of authors and organizations showed good collaboration. Conclusions: Some items could be further improved with regard to the rate of reporting systematic reviews of social welfare in the Campbell collaboration online library. This could improve the overall quality of social welfare systematic reviews.
期刊论文
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mHealth interventions for health system strengthening in China: A systematic review
BACKGROUND: With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. OBJECTIVE: The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation. METHODS: We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (WHO) International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for health care management were included in the study. RESULTS: A total of 1704 articles were found using the search terms, and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. CONCLUSIONS: We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated mHealth interventions to guide the development of future mHealth interventions, target disadvantaged populations with mHealth interventions, and generate appropriate evidence for scalable and sustainable models of care.
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