Cochrane Database of Systematic Reviews最新文献

{"title":"Statins for adults with a first episode of venous thromboembolic disease.","authors":"Héctor José Peroni, Sabrina Rico, Camila Micaela Escobar Liquitay, Luis Garegnani","doi":"10.1002/14651858.CD016403","DOIUrl":"10.1002/14651858.CD016403","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane review (intervention). The objectives are as follows: To evaluate the benefits and harms of statins in the secondary prevention of Recurrent Venous ThromboEmbolic disease (RVTE): Deep Vein Thrombosis (DVT), Pulmonary ThromboEmbolism (PTE) and Post-Thrombotic Syndrome (PTS) in patients with a first episode of deep vein thrombosis Secondary objective To evaluate the benefits and harms of statins in the secondary prevention of RVTE, DVT, PTE and PTS in patients with or without cancer, in different sexes and in the general population aged over 70 years.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016403"},"PeriodicalIF":11.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise therapy for temporomandibular disorders.","authors":"Gul Oznur Karabicak, Ayca Araci, Mehmet Micoogullari, Kubra Zayim Gedik, Andrew R Gamble, Zekiye Karacam, Louise Mn Pearce","doi":"10.1002/14651858.CD016402","DOIUrl":"10.1002/14651858.CD016402","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane review (intervention). The objectives are as follows: Primary objective To assess the effects of exercise therapy on pain intensity, jaw function/disability, and health-related quality of life in adults with temporomandibular disorders, compared with no treatment, placebo, or other non-exercise conservative interventions. Secondary objectives To assess the effects of exercise therapy on mandibular mobility and adverse events. Additionally, to explore potential heterogeneity in treatment effects by investigating whether outcomes differ according to temporomandibular disorder subtype (e.g. myogenous, arthrogenous, or mixed).</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016402"},"PeriodicalIF":11.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Competing values, conflicting views: evidence and debate in Alzheimer's disease.","authors":"Toby Lasserson, Rupa Sarkar","doi":"10.1002/14651858.ED000180","DOIUrl":"10.1002/14651858.ED000180","url":null,"abstract":"","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"ED000180"},"PeriodicalIF":11.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Amyloid-beta-targeting monoclonal antibodies for people with mild cognitive impairment or mild dementia due to Alzheimer's disease.","authors":"Donatienne Van Weehaeghe, Andrea Varrone, Matthias Brendel, Lisbeth Marner, Antoine Verger, Nelleke Tolboom, Igor Yakushev, Francesco Fraioli, Pablo Aguiar Fernandez, Valentina Berti, Roland Wiest, Federica Agosta, Massimo Filippi","doi":"10.1002/14651858.ED000182","DOIUrl":"10.1002/14651858.ED000182","url":null,"abstract":"","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"ED000182"},"PeriodicalIF":11.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical cannabis for the treatment of insomnia.","authors":"Lucia B Varela, Joselyn Elizabeth Miño Zambrano, Brenda Maura Goncalves Costa, Guilherme Santos Marques da Silva, Camila Micaela Escobar Liquitay, Samanta Díaz Menai, Nicolás Meza, Luis I Garegnani","doi":"10.1002/14651858.CD016216.pub2","DOIUrl":"10.1002/14651858.CD016216.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Insomnia is highly prevalent and associated with substantial individual and societal burden, while existing pharmacological treatments are limited by adverse effects and concerns about long-term use. The role of medical cannabis in the treatment of insomnia remains unclear because of limited and heterogeneous evidence. Despite increasing clinical use, current guidelines do not provide clear recommendations due to uncertainty regarding its efficacy and safety. A clear synthesis of available evidence is needed to inform patients, clinicians, and policymakers about the potential benefits and harms of medical cannabis for insomnia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of medical cannabis in adults with insomnia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We used CENTRAL, MEDLINE, Embase, Global Index Medicus, and two trial registers, together with reference checking, citation searching, and contacting study authors, to identify studies for inclusion in the review. The latest search date was 5 April 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included parallel randomized controlled trials (RCTs), cross-over RCTs, and cluster RCTs in adult participants with any type of insomnia comparing medical cannabis with placebo, benzodiazepine receptor agonists, benzodiazepines, melatonin receptor agonists, antidepressants, and antipsychotics. We excluded studies that were quasi-RCTs and studies using experimental and unregistered drugs, cannabis receptor antagonists and negative allosteric modulators like rimonabant, as well as modulators that enhance endocannabinoid system activity, such as fatty acid amide hydrolase inhibitors, and synthetic cannabis, like levonantradol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were quality of sleep/satisfaction with sleep, total sleep time and adverse events. Our important outcomes included sleep onset latency, wake after sleep onset, daytime functioning, withdrawal symptoms, and quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 2 tool for parallel RCTs and the Cochrane RoB 2 tool for cross-over RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesized results for each outcome using meta-analysis where possible, using a random-effects model. Where this was not possible due to the nature of the data, we synthesized results narratively. We used GRADE to assess the certainty of evidence for our critical outcomes, daytime functioning and quality of life for the comparison of medical cannabis versus placebo.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included nine studies with 537 participants aged 18 to 76 years. Most studies included predominantly female populations (72.66%), focused mainly on participants with primary insomnia, although one study focused on insomnia associated with comorbidities. Three studies included patients with acute insomnia, and six included patients with chronic insomnia. One study compar","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016216"},"PeriodicalIF":11.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemodiafiltration, haemofiltration and haemodialysis for adults with kidney failure.","authors":"Robin Wm Vernooij, Giovanni Fm Strippoli, Denise Mj Veltkamp, Ionut Nistor, Jonathan C Craig, Valeria M Saglimbene, Adrian C Covic, Mariacristina Vecchio","doi":"10.1002/14651858.CD006258.pub3","DOIUrl":"https://doi.org/10.1002/14651858.CD006258.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Convective extracorporeal dialysis modalities, haemofiltration (HF), haemodiafiltration (HDF), and acetate-free biofiltration (AFB), remove excess body fluid across the dialysis membrane through an interplay of positive and negative pressures and accumulated middle- and larger-sized solutes more efficiently than haemodialysis (HD). This increased removal of larger solutes, combined with the use of ultrapure dialysis fluid in convective dialysis, is hypothesised to reduce the frequency and severity of symptoms during HD and improve long-term clinical outcomes. This is an update of a review first published in 2006 and updated in 2015.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To determine the benefits and harms of convective (HF, HDF, or AFB) versus diffusive (HD) dialysis modalities, or expanded HD (HDx), in preventing all-cause and cardiovascular death, cardiovascular morbidity, fatigue, and vascular access problems in adults with kidney failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Kidney and Transplant Specialised Register, CENTRAL, MEDLINE, Embase and two trial registers up to 3 April 2025. Additionally, handsearching of journals and conference abstract books was performed, and the references of the included studies were reviewed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) comparing convective therapy (HF, HDF, AFB) with another convective therapy or with diffusive therapy (HD or HDx) for treating adults with kidney failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical and important outcomes included all-cause and cardiovascular death, nonfatal cardiovascular events, fatigue, problems with vascular access, hospitalisation, and health-related quality of life (HRQoL).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;Two authors independently assessed the risk of bias using the Cochrane RoB 1 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We summarised treatment effects using the random-effects model and reported risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous data with 95% confidence intervals (CI). We assessed the confidence of the evidence using the GRADE approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We identified 62 eligible studies (6897 participants). In total, 54 studies (6525 participants) compared HF, HDF or AFB with HD (both high-flux and low-flux); two studies (24 participants) compared AFB with HDF; three studies (62 participants) compared HDF with HF; and four studies (163 participants) compared HDx with HDF/HD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Convective dialysis, compared with diffusive therapy, likely reduces the risk of death (any cause) (RR 0.88, 95% CI 0.80 to 0.96; I² = 0%; 15 studies, 5463 participantss; moderate-certainty evidence due to indirectness) and cardiovascular death (RR 0.78, 95% CI 0.66 to 0.92; I² = 0%; 9 studies, 4761 participants; moderate-certainty evidence due to indirectn","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD006258"},"PeriodicalIF":11.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education and training interventions for healthcare workers to prevent sexual harassment.","authors":"Therese K Dalsbø, Rakel Aasheim Greve, Ingrid L Jørgensen, Marita S Fønhus","doi":"10.1002/14651858.CD016096.pub2","DOIUrl":"10.1002/14651858.CD016096.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Sexual harassment is common among healthcare workers and is associated with poor mental health, job dissatisfaction, and workforce attrition. Education and training may help prevent sexual harassment, but their effectiveness in healthcare settings has not been systematically evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effectiveness of education and training interventions on knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, Scopus, ClinicalTrials.gov, and the WHO ICTRP, together with reference checking and contact with study authors, to identify eligible studies. The latest search date was March 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) involving healthcare workers comparing education or training interventions with control (no intervention, waiting list, placebo, or minimal intervention) or different types of education or training to prevent sexual harassment in healthcare settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were knowledge and skills in managing sexual harassment and the incidence of all types of sexual harassment perpetrated by patients, visitors, coworkers, and management. Important outcomes were anxiety, depression, burnout, sick leave, staff turnover, disability, and perception of the organisational climate related to harassment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 2 tool to assess risk of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome using random-effects model meta-analysis. We used GRADE to assess the certainty of evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included two studies from Taiwan with a total of 170 nurses. Most participants were young women with little work experience. The intervention group received education to prevent sexual harassment, and the comparison group received a different type of education to prevent sexual harassment. We found no studies that had a comparison group without any active educational or training components.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Education and training interventions to prevent sexual harassment compared to control (no intervention, waiting list, placebo, or minimal intervention) in healthcare workers No studies addressed this comparison. Education and training interventions to prevent sexual harassment compared to other education and training interventions for healthcare workers We found two studies reporting on education and training interventions to prevent sexual harassment compared to other education and training interventions in healthcare workers. Educational interventions to prevent sexual harassment probably increase sexual harassment p","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016096"},"PeriodicalIF":11.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home visits following hospital discharge for families with preterm and low-birthweight infants.","authors":"Solange Durao, Natasha R Gloeck, Willem A Odendaal, Ameer Hohlfeld, Amanda Brand, Sarah Gordon, Yusentha Balakrishna, Tamara Kredo","doi":"10.1002/14651858.CD016389","DOIUrl":"10.1002/14651858.CD016389","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Home visiting programmes are widely used to support families of preterm and low-birthweight (LBW) infants after hospital discharge, yet evidence on their effectiveness is limited and of variable quality, particularly in low- and middle-income countries (LMICs). A comprehensive, up-to-date review was needed to inform healthcare decisions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effectiveness of home visits following hospital discharge compared to standard of care or no home visits, for families/caregivers of preterm or LBW infants to reduce morbidity and mortality and enhance health and well-being.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, CINAHL, Scopus, Web of Science, ClinicalTrials.gov, and the WHO ICTRP, together with reference checking, to identify eligible studies. The latest search date was April 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) of preterm and LBW infants and their caregivers comparing home visits after discharge from hospital with no home visits or standard of care including home visits. There were no restrictions on language or publication status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes included all-cause mortality, neurodevelopment, morbidity, growth, breastfeeding rates, exclusive breastfeeding, and emergency hospital visits. Important outcomes were hospital readmission rates, maternal/parental emotional well-being, and maternal-infant interaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used Cochrane's RoB 2 tool to assess the risk of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome in meta-analysis where possible, using random-effects models to calculate risk ratios (RRs) for dichotomous outcomes, mean differences (MDs) or standardised mean differences (SMDs) for continuous outcomes, and hazard ratios (HRs) for time-to-event outcomes, along with 95% confidence intervals (CIs). We used GRADE to assess the certainty of evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 35 RCTs, of which 28 (12,021 infants and 10,056 mothers/caregivers) contributed data to our prespecified outcomes. Most studies were from high-income countries; however, approximately 70% of participants were from a large study in India contributing data to comparison 2. The content, timing, duration, and frequency of home visits varied widely. Twenty-one studies contributed data to meta-analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Home visits versus no home visits The effects of home visits on all-cause mortality at one year are very uncertain (RR 3.08, 95% CI 0.13 to 73.27; 1 study, 79 participants). Home visits may have little to no effect on cognitive development (SMD 0.06, 95% CI -0.17 to 0.29; 3 studies, 287 participants), and likely have little to no effect on motor development (SMD -0.02, 95% CI -0.36 to 0.33; 1 study, 127 participants). The","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016389"},"PeriodicalIF":11.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure targets in adults with hypertension.","authors":"Doreen Y Larvie, Wade Thompson, Guillaume Grenet, James Wright, Ciprian Jauca, Douglas Salzwedel, Stephen Adams, Anshula Ambasta","doi":"10.1002/14651858.CD016397","DOIUrl":"10.1002/14651858.CD016397","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane review (intervention). The objectives are as follows: Primary objective To evaluate the benefits and harms of lower targets of blood pressure (BP; i.e. BP ≤ 135/85 mmHg) versus standard targets (i.e. BP ≤ 140 to 160/90 to 100 mmHg) for total mortality and morbidity in people 18 years or older, with elevated BP. Secondary objectives To evaluate the benefits and harms of lower targets versus standard targets for achieved systolic and diastolic BP in people 18 years or older, with elevated BP. To evaluate the benefits and harms of lower targets versus standard targets for withdrawals due to adverse events in people 18 years or older with elevated BP. To assess whether the effects of lower targets versus standard targets differ according to prespecified equity-related characteristics (e.g. place of residence, race/ethnicity/culture/ancestry, sex, socioeconomic status, and social capital, plus other context-specific factors, including comorbidity burden) in people 18 years or older, with elevated BP.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016397"},"PeriodicalIF":11.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmaceutical industry information and promotional strategies aimed at prescribers.","authors":"Barbara Mintzes, Joel Lexchin, Quinn Grundy, Alice Fabbri, Geoffrey Kp Spurling, Riaz Qureshi, Lisa Bero","doi":"10.1002/14651858.CD013423.pub3","DOIUrl":"10.1002/14651858.CD013423.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;The influence of pharmaceutical company promotion on prescribing and its impacts have been subject to extensive debate. This review helps to clarify whether and how interactions between clinicians and the pharmaceutical industry influence prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Main objective: to assess the effects, using evidence from randomised trials, and the associations, using evidence from non-randomised studies, of pharmaceutical industry promotional interactions with prescribers (including provision of information, payments, gifts, and samples), compared to no interactions, on the appropriateness, quantity, and cost of prescribed medicines, and on formulary requests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, one other database, and two trial registers to January 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised trials, non-randomised trials, controlled before-after studies with at least two intervention sites and at least two control sites, interrupted time series studies with a clearly defined intervention time point and at least three data points both before and after the intervention time, and cross-sectional studies comparing exposure levels and outcomes at a single time point. We also included controlled cohort studies comparing outcomes over time, and case-control studies assessing the effects of past exposures. We included cross-sectional, cohort, and case-control studies if the data covered an entire population or a random sample of a defined population, with a response rate of at least 60%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The critical outcomes were prescribing appropriateness, quantity, and cost, and formulary requests by clinicians exposed to interactions with pharmaceutical companies compared to clinicians not exposed or with less exposure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used Cochrane's RoB 2 tool to assess bias in randomised controlled trials (RCTs), and the Joanna Briggs Institute tool for cross-sectional studies to assess bias in cross-sectional, cohort, and nested case-control studies. We used study design-specific criteria developed by the Cochrane Effective Practice and Organisation of Care (EPOC) Group to assess bias in controlled before-after studies and interrupted time series studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We grouped studies into four groups based on exposure type - advertising and education; gifts and payments; free samples; and conflict-of-interest policies - to analyse outcomes. We presented the data in harvest plots and narratively summarised the results. Due to heterogeneity, we were unable to conduct any meta-analyses. We used GRADE to assess the certainty of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 93 studies. Most studies (82/93, 88%) were conducted in the USA; 11 were conducted in the European Union or the UK. Sixty of 93 studies (65%) were cross-sectional, alon","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD013423"},"PeriodicalIF":11.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}