METHODS: A systematic search of national and international databases of SID, MagIran, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) was conducted to find articles published from 1988 to March 2020. Random effects model was used for analysis and heterogeneity of studies was investigated using I2 index. Data analysis was then carried out using Comprehensive Meta-Analysis (Ver. 2).
RESULTS: A total of 51 articles with a total sample size of 48,195 individuals were included in the meta-analysis in all the components. The results showed that 18.9% (95% CI: 4.9-13.25%) of patients were single patients, 70.6% (95% CI: 63.5-76.8%) were married, 31.6% (95% CI: 24.5-39.7%) had low economic status, 52.1% (95% CI: 5.8-44.53%) had moderate economic status, level of education was below diploma in 33% (95% CI: 27.1-39.5%) of cases, 36.2% (95% CI: 27.3-46.1%) were smokers, and 8.8% (95% CI: 2.8-24.1%) of patients were unemployed.
CONCLUSION: The results of the present study indicate high socioeconomic inequality in RA patients in the main components of the study. Hence, to improve the aforementioned status and find causes and do the monitoring at all levels, appropriate solutions must be adopted by providing feedback to policy-makers.
KEY POINTS: • The results showed that 18.9% (95% CI: 4.9-13.25%) of patients were single patients. • 70.6% (95% CI: 63.5-76.8%) were married and 31.6% (95% CI: 24.5-39.7%) had low economic status. • 52.1% (95% CI: 5.8-44.53%) had moderate economic status; 36.2% (95% CI: 27.3-46.1%) were smokers.
METHODS: We conducted this systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Various databases were searched for CPGs and Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument was used to assess the methodological quality. We also summarized the treatments plans of CPGs across continuum of care (diagnosis and assessment, treatment initiation, pharmacotherapy and psychosocial).
RESULTS: This review included 28 CPGs of varying qualities. CPGs from high-income countries and international organizations rated high for their methodological quality. Most CPGs scored high for the scope and purpose domain and scored low for applicability domain. Recommendations for the continuum of care for OUD varied across CPGs. Buprenorphine was recommended in most of the CPGs, followed by methadone. Recommendations for psychosocial interventions also varied, with cognitive behaviour therapies and counselling or education being the common recommendations in many CPGs WHAT IS NEW AND CONCLUSION: We found most CPGs have scope and purpose and clarity of presentation. However, the methodological rigour and applicability scored low. CPGs need to frame health questions in a comprehensible manner and provide an update as evidence grows. It is important for CPG developers to consider methodological quality as a factor when developing CPG recommendations.
METHODS: This was a mixed-methods study. Gastroenterologists were surveyed electronically between September 1 and December 7, 2020, via gastroenterology and endoscopy societies of Brunei, Indonesia, Malaysia, Philippines, Singapore, and Thailand. Quantitative and qualitative data were collected. The 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to detect burnout. Quantitative data were non-parametric; non-parametric methods were used for statistical comparisons. Logistic regression was used to determine risk factors for burnout. Content analysis method was used to analyze qualitative data. Ethical approval was obtained.
RESULTS: A total of 73.0% reported that they were still significantly affected by the pandemic. Of these, 40.5% reported increased workload and 59.5% decreased workload. Statistically significant differences in weekly working hours, endoscopy, and inpatient volumes were present. No differences were observed in outpatient volumes, likely because of telemedicine. Burnout was common; however, 50.1% of gastroenterologists were unaware of or did not have access to mental health support. This, as well as depression, being a trainee, and public sector work, increased burnout risk significantly.
CONCLUSION: The effects of the pandemic are multifaceted, and burnout is common among Southeast Asian gastroenterologists. Safeguards for mental health are suboptimal, and improvements are urgently needed.