Systematic reviews of antihypertensive drugs: A review of publication trends, characteristics, and quality.
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ABSTRACT:
SUBMITTER: Esam H
PROVIDER: S-EPMC8678774 | biostudies-literature | 2021 May
REPOSITORIES: biostudies-literature
Publications
Systematic reviews of antihypertensive drugs: A review of publication trends, characteristics, and quality.
Esam Hariprasad H Kanukula Raju R Dhurjati Rupasvi R Aerram Rupa R Chevireddy Sindhujareddy S Bhaumik Soumyadeep S Atkins Emily E Huffman Mark D MD Rodgers Anthony A Salam Abdul A
Journal of clinical hypertension (Greenwich, Conn.) 20210302 5
This review presents publication trends, characteristics, and quality of systematic reviews (SRs) of randomized controlled trials (RCTs) of antihypertensive drugs (AHTDs). Between 1985 and 2017, 1,173 SRs were published, and in the last 20 years, 10, 35, and 116 were published in the year 1996, 2006, and 2016, respectively. Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers were the most common class of drugs studied. Fourteen percent of the SRs were prospectively register ...[more]
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Project description:BackgroundSystematic reviews (SRs) worldwide suffer from methodological deficiencies, potentially biasing intervention decisions, and Peruvian SRs are no exception. Evaluating SRs led by Peruvian researchers is a crucial step to enhance quality and transparency in decision-making and to identify topics where SRs are either scarce or prioritized for research.ObjectiveTo describe the characteristics and assess the methodological quality of SRs with Peruvian first authors.MethodsWe conducted a scoping review within the Scopus database on January 5, 2023. We aimed to identify published SRs of interventions in which the first author had a Peruvian affiliation, published between 2013 and 2022. We evaluated the methodological quality of these SRs using the AMSTAR 2 tool. We assessed the factors associated with the AMSTAR 2 score using adjusted mean differences (aMD), including their 95 % confidence intervals (95 % CI).ResultsWe identified 95 eligible SRs, with a clear upward trend. SRs were primarily published in Q1 (43.2 %) and Q2 (23.2 %) journals, predominantly affiliated with institutions in Lima (90.5 %). Areas like infectious diseases (20.0 %) and dentistry (18.9 %) were most frequent. AMSTAR 2 assessments highlighted deficiencies, with few SRs reporting prior protocols (37.9 %), comprehensive search strategies (23.2 %), explanations for excluded studies (20.0 %), adequate descriptions of included studies (38.3 %), or funding sources (19.1 %). Notably, SRs in Q4 journals (aMD: -19.7, 95 % CI: -33.8 to -5.5) and those on surgical interventions (aMD: -22.6, 95 % CI: -34.7 to -10.4) had lower AMSTAR 2 scores.ConclusionsAlthough Peruvian-led SRs are increasingly being published, critical deficiencies are common, especially in reporting protocols, search strategies, study descriptions, and funding sources. Addressing these gaps is pivotal for enhancing the credibility and utility of these SRs in informing decision-making.
| S-EPMC11403479 | biostudies-literature
Project description:BackgroundWe systematically reviewed Mendelian randomization (MR) studies and summarized evidence on the potential effects of different antihypertensive drugs on health.MethodsWe searched PubMed and Embase for MR studies evaluating the effects of antihypertensive drug classes on health outcomes until 22 May 2024. We extracted data on study characteristics and findings, assessed study quality, and compared the evidence with that from randomized controlled trials (RCTs).ResultsWe identified 2643 studies in the search, of which 37 studies were included. These studies explored a wide range of health outcomes including cardiovascular diseases and their risk factors, psychiatric and neurodegenerative diseases, cancer, immune function and infection, and other outcomes. There is strong evidence supporting the protective effects of genetically proxied antihypertensive drugs on cardiovascular diseases. We found strong protective effects of angiotensin-converting enzyme (ACE) inhibitors on diabetes whereas beta-blockers showed adverse effects. ACE inhibitors might increase the risk of psoriasis, schizophrenia, and Alzheimer's disease but did not affect COVID-19. There is strong evidence that ACE inhibitors and calcium channel blockers (CCBs) are beneficial for kidney and immune function, and CCBs showed a safe profile for disorders of pregnancy. Most studies have high quality. RCT evidence supports the beneficial effects of ACE inhibitors and CCBs on stroke, diabetes, and kidney function. However, there is a lack of reliable RCTs to confirm the associations with other diseases.ConclusionsEvidence of the benefits and off-target effects of antihypertensive drugs contribute to clinical decision-making, pharmacovigilance, and the identification of drug repurposing opportunities.
| S-EPMC11580643 | biostudies-literature
Project description:BackgroundHypertension drives the global burden of cardiovascular disease and its prevalence is estimated to increase by 30% by the year 2025. Nonadherence to chronic medication regimens is common; approximately 43% to 65.5% of patients who fail to adhere to prescribed regimens are hypertensive patients. Nonadherence to medications is a potential contributing factor to the occurrence of concomitant diseases.ObjectiveThis systematic review applied a meta-analytic procedure to investigate the medication nonadherence in adult hypertensive patients.MethodsOriginal research studies, conducted on adult hypertensive patients, using the 8-item Morisky medication adherence scale (MMAS-8) to assess the medication adherence between January 2009 and March 2016 were included. Comprehensive search strategies of 3 databases and MeSH keywords were used to locate eligible literature. Study characteristics, participant demographics, and medication adherence outcomes were recorded. Effect sizes for outcomes were calculated as standardized mean differences using random-effect model to estimate overall mean effects.ResultsA total of 28 studies from 15 countries were identified, in total comprising of 13,688 hypertensive patients, were reviewed. Of 25 studies included in the meta-analysis involving 12,603 subjects, a significant number (45.2%) of the hypertensive patients and one-third (31.2%) of the hypertensive patients with comorbidities were nonadherent to medications. However, a higher proportion (83.7%) of medication nonadherence was noticed in uncontrolled blood pressure (BP) patients. Although a higher percentage (54%) of nonadherence to antihypertensive medications was noticed in females (P < 0.001), the risk of nonadherence was 1.3 times higher in males, with a relative risk of 0.883. Overall, nearly two-thirds (62.5%) of the medication nonadherence was noticed in Africans and Asians (43.5%).ConclusionNonadherence to antihypertensive medications was noticed in 45% of the subjects studied and a higher proportion of uncontrolled BP (83.7%) was nonadherent to medication. Intervention models aiming to improve adherence should be emphasized.
| S-EPMC5287944 | biostudies-literature
Project description:Hypertension continues to be an important public health concern because of its associated morbidity, mortality and economic impact on the society. It is a significant risk factor for cardiovascular, cerebrovascular and renal complications. It has been estimated that by 2025, 1.56 billion individuals will have hypertension. The increasing prevalence of hypertension and the continually increasing expense of its treatment influence the prescribing patterns among physicians and compliance to the treatment by the patients. A number of national and international guidelines for the management of hypertension have been published. Since many years ago, diuretics were considered as the first-line drugs for treatment of hypertension therapy; however, the recent guidelines by the Joint National Commission (JNC8 guidelines) recommend both calcium channel blockers as well as angiotensin-converting enzyme inhibitors as first-line drugs, in addition to diuretics. Antihypertensive drug combinations are generally used for effective long-term management and to treat comorbid conditions. This review focuses on the antihypertensive medication utilization, their cost factors, adherence to treatment by patients, and physicians' adherence to guidelines in prescribing medications in different settings including Indian scenario. The antihypertensive medication prescribing pattern studies help in monitoring, evaluation and necessary modifications to the prescribing habits to achieve rational and cost-effective treatment. Additionally, periodic updating of recommended guidelines and innovative drug formulations, and prescription monitoring studies help in rational use of antihypertensive drugs, which can be tailored to suit the patients' requirements, including those in the developing countries.
| S-EPMC4808570 | biostudies-other
Project description:ObjectivesTo examine the quality of reporting of harms in systematic reviews, and to determine the need for a reporting guideline specific for reviews of harms.DesignSystematic review.Data sourcesCochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE).Review methodsDatabases were searched for systematic reviews having an adverse event as the main outcome, published from January 2008 to April 2011. Adverse events included an adverse reaction, harms, or complications associated with any healthcare intervention. Articles with a primary aim to investigate the complete safety profile of an intervention were also included. We developed a list of 37 items to measure the quality of reporting on harms in each review; data were collected as dichotomous outcomes ("yes" or "no" for each item).ResultsOf 4644 reviews identified, 309 were systematic reviews or meta-analyses primarily assessing harms (13 from CDSR; 296 from DARE). Despite a short time interval, the comparison between the years of 2008 and 2010-11 showed no difference on the quality of reporting over time (P=0.079). Titles in fewer than half the reviews (proportion of reviews 0.46 (95% confidence interval 0.40 to 0.52)) did not mention any harm related terms. Almost one third of DARE reviews (0.26 (0.22 to 0.31)) did not clearly define the adverse events reviewed, nor did they specify the study designs selected for inclusion in their methods section. Almost half of reviews (n=170) did not consider patient risk factors or length of follow-up when reviewing harms of an intervention. Of 67 reviews of complications related to surgery or other procedures, only four (0.05 (0.01 to 0.14)) reported professional qualifications of the individuals involved. The overall, unweighted, proportion of reviews with good reporting was 0.56 (0.55 to 0.57); corresponding proportions were 0.55 (0.53 to 0.57) in 2008, 0.55 (0.54 to 0.57) in 2009, and 0.57 (0.55 to 0.58) in 2010-11.ConclusionSystematic reviews compound the poor reporting of harms data in primary studies by failing to report on harms or doing so inadequately. Improving reporting of adverse events in systematic reviews is an important step towards a balanced assessment of an intervention.
| S-EPMC3898583 | biostudies-literature
Project description:IntroductionCase reports on acupuncture-related adverse events (AEs) have been consistently published in the literature. This review aims to assess the current publication status of case reports on acupuncture-related AEs and evaluate their reporting quality in order to identify areas for improvement.MethodsThis study is a systematic review (SR) of case reports. Studies describing cases for acupuncture-related AEs between 2010 and 2023 (until July) were searched in PubMed, Embase, and local databases (China and Korea), as well as by hand-searching references included in published relevant SRs. A bibliometric analysis was conducted to examine the publication trends of the included literature. The appropriateness of the acupuncture described in the cases, the causality assessment between AEs and acupuncture treatment, and the presence of necessary items from the CAse REport guidelines (CARE) checklist were narratively analyzed.ResultsA total of 169 case reports were included in this review. Over the past decade, an average of 12 case reports on acupuncture-related AEs were published annually. However, only 38.2% of the articles provided sufficient information to determine the appropriateness of the acupuncture treatment used in the reported cases, and considerable numbers of the included case reports did not suggest enough information for the assessment of a causal relationship. The majority of cases did not report the timeline (n = 164), patient perspectives (n = 157), and informed consent (n = 121) items from the CARE checklist.DiscussionAcupuncture-related AEs persist in being frequently reported in the literature. Nonetheless, the information concerning acupuncture and causality assessment within these publications is still found to be insufficient. The development of reporting guidelines for future case reports on acupuncture-related AEs is anticipated to promote an academic environment conducive to more comprehensive reporting.
| S-EPMC10569964 | biostudies-literature
Project description:BackgroundSystematic reviews should inform American Academy of Ophthalmology (AAO) Preferred Practice Pattern® (PPP) guidelines. The quality of systematic reviews related to the forthcoming Preferred Practice Pattern® guideline (PPP) Refractive Errors & Refractive Surgery is unknown. We sought to identify reliable systematic reviews to assist the AAO Refractive Errors & Refractive Surgery PPP.MethodsSystematic reviews were eligible if they evaluated the effectiveness or safety of interventions included in the 2012 PPP Refractive Errors & Refractive Surgery. To identify potentially eligible systematic reviews, we searched the Cochrane Eyes and Vision United States Satellite database of systematic reviews. Two authors identified eligible reviews and abstracted information about the characteristics and quality of the reviews independently using the Systematic Review Data Repository. We classified systematic reviews as "reliable" when they (1) defined criteria for the selection of studies, (2) conducted comprehensive literature searches for eligible studies, (3) assessed the methodological quality (risk of bias) of the included studies, (4) used appropriate methods for meta-analyses (which we assessed only when meta-analyses were reported), (5) presented conclusions that were supported by the evidence provided in the review.ResultsWe identified 124 systematic reviews related to refractive error; 39 met our eligibility criteria, of which we classified 11 to be reliable. Systematic reviews classified as unreliable did not define the criteria for selecting studies (5; 13%), did not assess methodological rigor (10; 26%), did not conduct comprehensive searches (17; 44%), or used inappropriate quantitative methods (3; 8%). The 11 reliable reviews were published between 2002 and 2016. They included 0 to 23 studies (median = 9) and analyzed 0 to 4696 participants (median = 666). Seven reliable reviews (64%) assessed surgical interventions.ConclusionsMost systematic reviews of interventions for refractive error are low methodological quality. Following widely accepted guidance, such as Cochrane or Institute of Medicine standards for conducting systematic reviews, would contribute to improved patient care and inform future research.
| S-EPMC5584039 | biostudies-literature
Project description: Not available
| S-EPMC8356304 | biostudies-literature
Project description:ObjectivesPoor worldwide rate of blood pressure control is largely due to poor adherence to antihypertensive (AHT) drug treatment. The question of whether sex affects adherence has long been debated but conflicting findings have been reported on this issue. Our objective was to evaluate sex differences in the adherence to AHT therapy.Research design and methodsStudies were identified through a systematic search of PubMed, CINAHL, PsycINFO, Web of Science and Google Scholar (through January 2020) and manual handsearching of relevant articles. Observational studies reporting adherence to AHT drugs measured by self-report or pharmacy refill prescription-based methods among men and women were included. Summarised estimates of ORs with 95% CIs were calculated using random-effects model and meta-regression models.ResultsFrom 12 849 potentially relevant publications, 82 studies (15 517 457 men and 18 537 599 women) were included. No significant between-sex differences in adherence to AHT were observed, whether all study-specific estimates were summarised (ORs 1.04, 95% CI 1.00 to 1.09, p=0.07), nor estimates were pooled according to the method for measuring adherence. Among patients aged 65 years or older, lower self-reported adherence was observed in women (ORs 0.84, 95% CI 0.72 to 0.97, p=0.02), while the main result remained unchanged according to other subgroup analyses.ConclusionsDefinitive evidence of sex differences in adherence to AHT therapy cannot be drawn. Our little knowledge about factors affecting adherence, in particular of sex effect among elderly, urgently requires high-quality studies investigating these issues.
| S-EPMC7348648 | biostudies-literature
Project description:PurposeTo evaluate the quality and characteristics of systematic reviews, including meta-analyses, in the clinical orthopaedic sports medicine literature from 2015 to 2019 and to compare the results to previous findings from a similar analysis from 2009 to 2013.MethodsAll clinical orthopaedic sports medicine and meta-analyses published from 2015 to 2019 published in The American Journal of Sports Medicine, Arthroscopy, The Journal of Bone and Joint Surgery, Knee Surgery, Sports Traumatology, Arthroscopy, and Sports Health were reviewed. These were evaluated according to guidelines from Oxford Centre for Evidence-Based Medicine, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the Assessment of Multiple Systematic Reviews tool. Results were compared to the quality of publications from 2009 to 2013.ResultsA total of 516 systematic reviews and meta-analyses were included in this study. Of these, 17.1% of studies included Level I or II evidence only, whereas 79.1% included Level IV or V studies. When compared to the previous study from 2009 to 2013, which demonstrated 32% of Level I or II evidence studies and 53% Level IV or V, there was a significant decrease in the level of evidence in the more recent study period (P < .001). The average Preferred Reporting Items for Systematic Reviews and Meta-Analyses scores were 81% and the average Assessment of Multiple Systematic Reviews scores 56%, which are declines from 87% and 73%, respectively (P < .001, P < .001).ConclusionsThere has been a significant increase in the volume of systematic reviews and meta-analyses published in orthopaedic sports medicine. This has coincided with significant declines in the level of evidence, as well as declines in methodologic and reporting quality.Clinical relevanceClinicians increasingly use systematic reviews to drive their treatment decisions. Therefore, the quality of systematic reviews in orthopaedic sports medicine merits assessment.
| S-EPMC9706954 | biostudies-literature