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Volume 3 - February 2008 >
In the News
CCNC launches petition for national license to The
Cochrane Library!
Many countries provide free access to The Cochrane
Library for their citizens; however, Canada still lacks a
national license to this rich resource. A patchwork of subscriptions
across the country leaves most professional and lay people excluded
from full access to this internationally recognized library. We
believe any Canadian should have access to the full contents of
The Cochrane Library.
Please join our request for funding by signing our petition at http://nlccl.epetitions.net by May 8, 2008.
Occupational therapists now have full access to The
Cochrane Library
The Canadian Association of Occupational Therapists is pleased to
announce provision of member access to The Cochrane Library.
Occupational therapists work to enable participation in valued
activities such as work, self-care and leisure. Members will benefit
from access to occupational therapy-specific reviews as well as
reviews from many of the Cochrane groups.
New Cochrane websites
The Cochrane Effective Practice and Organisation of
Care (EPOC) Group recently re-launched its
website at www.epoc.cochrane.org. EPOC
reviews focus on strategies to improve health professional practice
and the organization of health care services. Topics include
continuing education; informatics; financial, organizational and
regulatory practices; changes in who delivers health care, how care
is organized or where care is delivered.
The Cochrane Health Equity Field
recently launched its first website.
Concerned with inequities in health, people in this Field
encourage Cochrane reviewers to examine the effects of interventions
not only on the whole population, but upon disadvantaged people.
Topics include methodologies for reviews of interventions to reduce
inequities and priority-setting for low- and middle-income
countries.
Cochrane News
The latest issue of Cochrane
News, the international newsletter of The Cochrane
Collaboration, is now available.
Cochrane for Practice
‘Cochrane Corners’ launched
Members of the Canadian Dental Hygienists Association and the
Canadian Association of Speech Language Pathologists and
Audiologists need look no further than their association’s website
for Cochrane information. Recently launched ‘Cochrane Corners’
provide direct access to brief summaries of selected Cochrane
reviews and information about Cochrane or relevant Review Groups.
CDHA members: check Research Resources in the Members
section.
CASLPA members: check the Members only section
Finding research on child health
Although Cochrane is most known for its high quality systematic
reviews, part of Cochrane’s mandate is to search for evidence in the
form of clinical trials and other studies of interventions. The
searchable Child
Health Field’s Trial Register from Cochrane is the most
comprehensive database of published, pediatric clinical trials
available.
Cochrane for Policy
Cochrane ‘go to’ for policy makers
Important reviews related to health services delivery may be
overlooked among the hundreds of Cochrane reviews on the clinical
effectiveness of treatments. Now managers and policy makers can
access these reviews in one location. The new Cochrane-based
inventory of systematic reviews is organized by governance,
financial and delivery arrangements within health systems. Please
visit http://www.researchtopolicy.ca/search/Reviews.aspx
to search the database.
This database was developed through a partnership between
McMaster University’s Program in Policy Decision-Making and The
Canadian Cochrane Network and Centre.
Rx for Change - Improving drug prescribing
practices
Volumes of research exist about what works for effective
and efficient patient care, but this can mean changing current
practices. How change is brought about is often based on
beliefs, rather than on scientific evidence. Rx
for Change is a new searchable database of key findings from
systematic reviews of behaviour-change strategies that promote the
optimal use of medicines by both practitioners and patients.
What can you find?
- overall summaries of the effects of behaviour-change
interventions,
- summaries and quality assessments of individual reviews, and
- links to individual studies included in each review.
This database is available through a joint collaboration of the
Canadian Optimal Medication Prescribing and Utilization Service
(COMPUS), the Cochrane Effective Practice and Organisation of Care
Group (EPOC), and the Cochrane Consumers and Communication Review
Group.
Cochrane Library Spotlight - Issue 1
2008
New for 2008 - audio podcasts
of some reviews!
Chronic back pain
Antidepressants for non-specific low back
pain
Doctors commonly prescribe antidepressants for chronic low back
pain to help relieve pain, improve a person’s mood and to help
people to sleep. However, a synthesis of 10 trials showed no change
in pain relief or depression associated with low back pain in
patients treated with antidepressants or placebo.
Non-steroidal anti-inflammatory drugs (NSAIDs)
for low back pain
NSAIDs are as effective as other drugs
(paracetamol/acetaminophen, narcotic analgesics, and muscle
relaxants) for short-term relief of symptoms in patients with acute
and chronic low-back pain without sciatica. However, the risk of
side effects varies among these treatments. The new COX-2 NSAIDs are
as effective as traditional NSAIDs, but are associated with fewer
side effects, although other literature indicates some COX-2 NSAIDs
may increase cardiovascular risk.
Individual patient education for low back
pain
Patients are educated in different ways about low back pain and
what to do about it. A review of 24 trials showed that patients who
received an in-person patient education session lasting at least two
hours, in addition to their usual care, had better outcomes than
people who only received usual care. Shorter education sessions or
only providing written information did not seem to be effective.
Women
Antioxidants for preventing
pre-eclampsia
A woman may develop high blood pressure and protein in her urine
(pre-eclampsia) during pregnancy, which can be dangerous both to her
and her baby’s health. One theory suggests that pre-eclampsia is
triggered by free-radicals. However, this review reports antioxidant
supplements such vitamin C and E which can neutralize free radicals,
did not reduce the risk of pre-eclampsia in pregnant women.
Osteoporosis
Osteoporosis is an abnormal reduction in bone mass and bone
deterioration leading to increased risk of fractures. Recent
Cochrane reviews (one new and two updated) evaluate the
effectiveness of bisphosphonate drugs for this condition.
Alendronate for the primary and secondary prevention
of osteoporotic fractures in postmenopausal women
(new)
Etidronate for the primary and secondary prevention of
osteoporotic fractures in postmenopausal women
(update)
Risedronate for the primary and secondary prevention
of osteoporotic fractures in postmenopausal women
(update)
Children
Over-the-counter medications for acute cough
in children and adults in ambulatory settings
Non-prescription over-the-counter (OTC) medicines are frequently
used to treat acute cough caused by infection in the nasal passages
and throat. Trials in both children and adults show mixed results
about the effectiveness of OTC cough medicines for acute cough
indicating that there is no clear evidence to support or refute
their use.
Seniors
Hawthorn extract for treating chronic heart
failure
An extract made from the hawthorn bush is sometimes used as an
oral treatment for chronic heart failure. A Cochrane review examined
the effectiveness of this treatment. The results of 10 trials showed
hawthorn extract improved symptoms of heart failure and the function
of the heart in patients with chronic heart failure. In most of the
studies, hawthorn was used in addition to conventional
treatment.
Infection control strategies for preventing the
transmission of meticillin-resistant
Staphylococcus aureus (MRSA) in nursing homes for older
people
Nursing homes for older people provide environments where
bacteria such as meticillin-resistant Staphylococcus aureus (MRSA)
are likely to thrive. Despite this, there are no high quality
studies that look specifically at ways to reduce the risk of
transmission and infection in this setting.
Pharmacological interventions for hypertensive
emergencies
Should anti-hypertensive drugs be used in hypertensive
emergencies? A hypertensive emergency is a severe elevation in blood
pressure that can lead to organ damage. This Cochrane review showed
that there is no evidence from randomized controlled trials that
these drugs reduce mortality or morbidity in hypertensive
emergencies, despite the fact that anti-hypertensive drugs are often
used in these situations.
Health Policy
Pharmaceutical policies: effects of cap and co-payment
on rational drug
use
The proportion of health care money spent on drugs continues to
increase. If people have to pay directly for their drugs, they may
decrease their use of drugs or buy cheaper drugs. This review found
that cap and co-payment polices can decrease overall drug use and
decrease third-party spending for drugs. However, there is limited
evidence about how these polices affect overall health care spending
and health outcomes.
What’s Ahead
The Canadian Cochrane Symposium
2008
Big Sky: New Horizons for Systematic
Reviews in Health Care
March 6-7, 2008; Edmonton
Registration deadline: February 15,
2008
www.ccs2008.ca
Contact: Krystal Harvey (krystal.harvey doesnotexist@cochrane.org ualberta.ca)
16th Cochrane Colloquium
2008
Evidence in the era of
globalisation
October 3-7, 2008; Freiburg, Germany
Registration opens:
February 15, 2008
Abstract submission deadline: March 17, 2008
http://www.cochrane.de/colloquium/index_en.htm
Opportunities
The CIHR Institute of Health Services and Policy Research and
its partners are pleased to announce the latest funding
opportunities launched on December 20, 2007.
The new funding opportunities include:
- Synthesis Grant: Knowledge Translation
- Needs, Gaps and Opportunities Assessments in Health Services
and Policy
- Meetings, Planning and Dissemination Grant: Health Services
and Policy
- Strategic Training Initiative in Health Research
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