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Background and Aims: Chronic kidney disease (CKD) is a progressive condition that results in a decline in kidney function over time. There are several conditions that increase the likelihood of developing CKD, particularly diabetes and hypertension. CKD increases the risk of mortality and has a detrimental impact on quality of life (QoL). Strategies for managing CKD include controlling cardiovascular risk factors and treating complications of CKD. There is an ever‐increasing role of pharmacists in managing CKD, from the optimization of risk factors to patient education. However, currently, there is a lack of data on the effect pharmacist‐led interventions have on the clinical, economic, and humanistic outcomes. Methods: This protocol, in adherence to PRISMA‐P (Preferred Reporting Items for Systematic review and Meta‐Analysis Protocols) standards, describes a prospective systematic review and meta‐analysis of randomized controlled trials, where any intervention led by a pharmacist in CKD is used. Comparison groups will consist of usual care or non‐pharmacist‐led interventions. Literature searches will be conducted in the following databases: MEDLINE, Scopus, and Web of Science. Data pertaining to clinical (e.g., mortality), economic (e.g., healthcare‐associated costs), and humanistic (e.g., QoL) outcomes will be extracted. Risk of bias will be assessed using the United States National Heart Lung and Blood Institute quality assessment tool for controlled intervention studies. A meta‐analysis will be conducted to synthesize appropriate comparable outcomes. Results: The findings of this review will be published in a peer‐reviewed journal, where the results will be presented in lay language with appropriate infographics online and via social media. Conclusion: The findings of this review can identify gaps in the literature concerning optimizing pharmacist‐led interventions in improving outcomes. In addition, this review will establish the importance of pharmacists in managing CKD patients, and whether this may result in their increased incorporation in multidisciplinary teams. [ABSTRACT FROM AUTHOR]

Aim: To identify, appraise and synthesize the available evidence on the impact of the coronavirus disease 2019 (COVID‐19) pandemic and lockdown (LD) on glycaemic control in people with diabetes. Materials and Methods: We searched multiple databases up to 2 February 2021 for studies reporting HbA1c, time in range (TIR), average or fasting glucose, severe hypoglycaemia and diabetic ketoacidosis. Data were pooled using random effects meta‐analysis and are presented as mean difference (MD) with 95% confidence intervals (CI). This review was preregistered on PROSPERO (CRD42020179319). Results: We include 59 studies; 44 (n = 15 464) were included in quantitative syntheses and 15 were narratively synthesized. Pooled data were grouped by diabetes type. Results from 28 studies (n = 5048 type 1 diabetes [T1D] and combined diabetes participants) showed that TIR increased during LD compared with before LD (MD 2.74%, 95% CI 1.80% to 3.69%). Data from 10 studies (n = 1294 T1D participants) showed that TIR increased after LD compared with before LD (MD 5.14%, 95% CI 3.12% to 7.16%). Pooled results from 12 studies (n = 4810 T1D and type 2 diabetes participants) resulted in average glucose decreasing after LD compared with before LD (MD –6.86 mg/dl, 95% CI –8.54 to –5.18). Results for other outcomes, including HbA1c, were not statistically significantly different. Conclusions: The COVID‐19 pandemic was associated with small improvements across multiple outcomes of glycaemic control, although there was insufficient evidence to suggest that this led to changes in HbA1c. Most evidence came from people with access to diabetes technologies in high‐income countries; more research is needed in less advantaged populations. [ABSTRACT FROM AUTHOR]

Background the perceptions and experiences of care home residents and their families are important for understanding and improving the quality of emergency care. Methods we conducted a systematic review and metasynthesis to understand the perceptions and experiences of care home residents and their family members who experienced medical emergencies in a care home setting. The review protocol was registered in PROSPERO (CRD42020167018). We searched five electronic databases, MEDLINE, CINAHL, PubMed, Cochrane Library and PsycINFO, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The Critical Appraisal Skills Programme qualitative checklist was used to assess the quality of studies included in this review. Results of the 6,140 references retrieved, 10 studies from four countries (Australia, Canada, UK and USA) were included in the review and metasynthesis. All the included studies were assessed as being of good quality. Through an iterative approach, we developed six analytical themes: (i) infrastructure and process requirements in care homes to prevent and address emergencies; (ii) the decision to transfer to hospital; (iii) experiences of transfer and hospitalisation for older patients; (iv) good communication is vital for desirable outcomes; (v) legal, regulatory and ethical concerns and (vi) trusting relationships enabled residents to feel safe. Conclusions the emergency care experience for care home residents can be enhanced by ensuring resources, staff capacity and processes for high quality care and trusting relationships between staff, patients and relatives, underpinned by good communication and attention to ethical practice. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Research in diabetes‐related foot conditions (DRFC) often focuses on ulcer‐related care, whilst the patient experience and influence of sociodemographic factors are under‐researched. This systematic review investigated patient‐reported outcomes and experience in people with DRFC.Multiple databases were searched from inception to 16 August 2023. All original articles that assessed any patient‐reported outcome or experience in DRFC and reported participant ethnicity were included. Data were synthesized using a sequential contingent approach. Study quality was assessed using study design‐specific tools.Twenty‐three studies were included (11 qualitative, 11 quantitative and one mixed‐methods). DRFC had a largely negative impact on various life dimensions, including social and daily life, work, emotional and psychological well‐being, necessitating dependence on others in the form of emotional, social and/or religious support, which were experienced differently by different groups. Patient DRFC knowledge and self‐care habits were typically suboptimal, and levels of hope and feeling of control over their condition varied between groups. Outcomes varied slightly between ethnicities across studies, with some ethnicity‐specific themes identified such as beliefs about disease cause and footwear habits. Quantitative and qualitative findings were mostly congruent.DRFC profoundly and negatively impacts patient‐reported outcomes and experience, with limited evidence suggesting an influence of ethnicity. [ABSTRACT FROM AUTHOR]