OBJECTIVE: Identify and critically evaluate systematic reviews addressing the effectiveness of interventions to reduce the number of prescriptions of potentially inappropriate medication to older patients. METHODS: This is an overview of systematic reviews. The studies were searched and selected from Medline, Cochrane Library, Embase, CINAHL, Virtual Health Library, and Web of Science databases, combining the terms aged, prescriptions, inappropriate prescribing and potentially inappropriate medication list with their entry terms and other related descriptors, published by June 2017. This study included systematic reviews with or without meta-analysis that addressed the effectiveness of any intervention or combined interventions to reduce the number of prescriptions of potentially inappropriate medications to older patients, without restriction in terms of design, language or date of publication of primary studies. AMSTAR – A MeaSurement Tool to Assess systematic Reviews – was used to evaluate the methodological quality of selected systematic reviews. Study selection and the methodological quality evaluation were performed by two independent evaluators, who resolved any divergence by consensus. The main findings were grouped into thematic categories, defined after a content analysis and discussed qualitatively as narrative synthesis. RESULTS: This study analyzed 24 systematic reviews. In terms of study design and methodological quality evaluation, most were systematic reviews of randomized controlled clinical trials and studies of moderate quality, respectively. The interventions were analyzed in five thematic categories: medication review services, pharmaceutical interventions, computerized systems, educational interventions, and others. The interventions analyzed showed good results and most of them helped reduce the number of prescriptions of potentially inappropriate medication to older patients. CONCLUSIONS: The systematic reviews included in this overview showed potential benefits of different interventions. However, it was not possible to determine the most effective intervention. Combined interventions are likely to provide better results than isolated interventions.
Dor na virilha é um problema que ocorre na área entre o abdome e as pernas, recorrente em atletas sendo a terceira maior causa de afastamentos no futebol. Métodos inadequados de treinamento, condicionamento físico, alterações estruturais, sobrecarga, fraqueza muscular e alterações articulares são considerados seus principais fatores de risco, no entanto, não há um consenso na literatura de qual forma é a mais eficaz para avaliar, tratar e prevenir. O objetivo do presente trabalho é realizar uma revisão critica de literatura identificando programas e ferramentas de maior eficácia de avaliação, reabilitação e prevenção de jogadores de futebol que apresentem como diagnóstico de dor na virilha. A busca do presente estudo foi sistematizada através de bases eletrônicas, sendo: Biblioteca virtual de saúde; Pubmed e Google Scholar. Dezesseis artigos foram encontrados, classificando os achados mais importantes da literatura; Exames de ressonância magnética mostram ser importante para estabelecer um bom diagnóstico diferencial, o questionário HAGOS parece ser uma grande ferramenta para avaliação, quantificando o estado atual do atleta, diversas técnicas envolvem para a reabilitação, cabe o terapeuta saber interceder de maneira exata, exercício de copenhagen aponta melhor maneira de evitar qualquer tipo intercorrência das várias causas de dor na virilha.
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