Bosah Nwosu - Academia.edu (original) (raw)

Papers by Bosah Nwosu

Research paper thumbnail of Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers’ perceptions

BMJ Open, 2012

Search strategy: We searched 19 databases covering the full range of publication years, utilised ... more Search strategy: We searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Reference lists of primary studies and related reviews were also consulted. Selection criteria: Studies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. All study designs, settings and decision makers were included. One investigator screened titles to identify candidate articles then two reviewers independently assessed the quality and the relevance of retrieved reports. Data extraction: Two reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Using a pre-established taxonomy, the barriers were organised into a framework according to their effect on knowledge, attitudes or behaviour. Results: Of 1726 articles initially identified, we selected 27 unique published studies describing at least one barrier to the uptake of evidence from systematic reviews. These studies included a total of 25 surveys and 2 qualitative studies. Overall, the majority of participants (n=10 218) were physicians (64%). The most commonly investigated barriers were lack of use (14/25), lack of awareness (12/25), lack of access (11/25), lack of familiarity (7/25), lack of usefulness (7/25), lack of motivation (4/25) and external barriers (5/25). Conclusions: This systematic review reveals that strategies to improve the uptake of evidence from reviews and meta-analyses will need to overcome a wide variety of obstacles. Our review describes the reasons why knowledge users, especially physicians, do not call on systematic reviews. This study can inform future approaches to enhancing systematic review uptake and also suggests potential avenues for future investigation.

Research paper thumbnail of EPA-0140 – Antidepressants, cbt, and their combination in depressed patients: A systematic review and meta-analysis

European Psychiatry, 2014

Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour th... more Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour therapy for the acute treatment of depression is contentious. Objective: To compare the acute outcomes of antidepressant medication, cognitive-behaviour therapy (CBT), and the combination of the two, in adult, depressed patients. Methods: Sixteen electronic databases together with reference lists were searched for randomised and other clinical trials that compared CBT, antidepressants, or their combination. Results: In the comparison between CBT and antidepressants, 8 studies met inclusion criteria. Five studies met the inclusion criteria for the second comparison between single therapy and combination therapy. In the antidepressant and CBT comparison, effect sizes favoured CBT over antidepressants with a significant advantage for CBT on some outcome measures. Combined treatment appeared more effective than antidepressants. However, combined treatment did not emerge more effective than CBT. Conclusions: Antidepressants may not be considered more efficacious than CBT for the acute treatment of depressed patients nor can combination therapy be regarded as more effective than CBT alone.

Research paper thumbnail of Correspondence to

Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review... more Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers’ perceptions

Research paper thumbnail of Citation

Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review... more Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers ' perceptions.

Research paper thumbnail of EPA-0140 – Antidepressants, cbt, and their combination in depressed patients: A systematic review and meta-analysis

European Psychiatry, 2014

Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour th... more Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour therapy for the acute treatment of depression is contentious. Objective: To compare the acute outcomes of antidepressant medication, cognitive-behaviour therapy (CBT), and the combination of the two, in adult, depressed patients. Methods: Sixteen electronic databases together with reference lists were searched for randomised and other clinical trials that compared CBT, antidepressants, or their combination. Results: In the comparison between CBT and antidepressants, 8 studies met inclusion criteria. Five studies met the inclusion criteria for the second comparison between single therapy and combination therapy. In the antidepressant and CBT comparison, effect sizes favoured CBT over antidepressants with a significant advantage for CBT on some outcome measures. Combined treatment appeared more effective than antidepressants. However, combined treatment did not emerge more effective than CBT. Conclusions: Antidepressants may not be considered more efficacious than CBT for the acute treatment of depressed patients nor can combination therapy be regarded as more effective than CBT alone.

Research paper thumbnail of Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers' perceptions

BMJ open, 2012

To review the barriers to the uptake of research evidence from systematic reviews by decision mak... more To review the barriers to the uptake of research evidence from systematic reviews by decision makers. We searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Reference lists of primary studies and related reviews were also consulted. Studies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. All study designs, settings and decision makers were included. One investigator screened titles to identify candidate articles then two reviewers independently assessed the quality and the relevance of retrieved reports. Two reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Using a pre-established taxonomy, the barriers were organised into a framework according to their effect on knowledge, attitudes or beh...

Research paper thumbnail of Carepath for overcoming psychosis early (COPE): first 5 years of clinical operation and prospective research in the Cavan–Monaghan early intervention service

Irish Journal of Psychological Medicine, 2021

Objectives: As Ireland confronts the many challenges of broadening the introduction of early inte... more Objectives: As Ireland confronts the many challenges of broadening the introduction of early intervention services (EIS) for first episode psychosis (FEP) as national policy, this article describes Carepath for Overcoming Psychosis Early (COPE), the EIS of Cavan–Monaghan Mental Health Service, and presents prospective research findings during its first 5 years of operation. Methods: COPE was launched as a rural EIS with an embedded research protocol in early 2012, following an education programme for general practitioners (GPs). Here, operational activities are documented and research findings presented through to late 2016. Results: During this period, 115 instances of FEP were incepted into COPE, 70.4% via their GP and 29.6% via the Emergency Department. The annual rate of inception was 24.8/100,000 of population aged > 15 years and was 2.1-fold more common among men than women. Mean duration of untreated psychosis was 5.7 months and median time from first psychotic presentatio...

Research paper thumbnail of Evaluation of knowledge and attitudes among primary care physicians in Cavan-Monaghan as ‘gatekeepers-in-waiting’ for the introduction of Carepath for Overcoming Psychosis Early (COPE)

Early Intervention in Psychiatry, 2013

To investigate general practitioners&... more To investigate general practitioners' current knowledge of and attitudes towards psychosis and its management by Cavan-Monaghan Mental Health Service, Ireland, prior to their involvement in the introduction of an early intervention service. As part of a continuing medical education programme for psychosis, delivered to all 32 general practitioners practising in this region, participants were asked to complete a 29-item questionnaire designed to assess their baseline knowledge and attitudes. All 32 general practitioners participated in the study. Although 17% had received no previous psychiatric training, 93% described their knowledge of psychiatric disorders as average or above average. However, only 53% could correctly identify all of a set of psychiatric symptoms related to psychosis. Only 50% felt comfortable initiating treatment for psychotic symptoms. Whereas only 40% had heard of the early intervention model, 89% believed it to be advantageous. Easy accessibility to services and rapid assessment of patients referred were most commonly reported as helpful. However, concerns were expressed about the potential for associated increases in workload. As 'gatekeepers-in-waiting', these general practitioners will have a vital role in effective implementation of the early intervention service for psychosis. However, their knowledge needs improvement, through regular educational sessions, and this service must be responsive to their needs. In addition, general practitioners' concerns regarding the potential for increased workload must be adequately addressed in order to maintain enthusiasm and collaboration at the interface between primary care and mental health services, particularly in the context of early intervention.

Research paper thumbnail of Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers’ perceptions

BMJ Open, 2012

Search strategy: We searched 19 databases covering the full range of publication years, utilised ... more Search strategy: We searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Reference lists of primary studies and related reviews were also consulted. Selection criteria: Studies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. All study designs, settings and decision makers were included. One investigator screened titles to identify candidate articles then two reviewers independently assessed the quality and the relevance of retrieved reports. Data extraction: Two reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Using a pre-established taxonomy, the barriers were organised into a framework according to their effect on knowledge, attitudes or behaviour. Results: Of 1726 articles initially identified, we selected 27 unique published studies describing at least one barrier to the uptake of evidence from systematic reviews. These studies included a total of 25 surveys and 2 qualitative studies. Overall, the majority of participants (n=10 218) were physicians (64%). The most commonly investigated barriers were lack of use (14/25), lack of awareness (12/25), lack of access (11/25), lack of familiarity (7/25), lack of usefulness (7/25), lack of motivation (4/25) and external barriers (5/25). Conclusions: This systematic review reveals that strategies to improve the uptake of evidence from reviews and meta-analyses will need to overcome a wide variety of obstacles. Our review describes the reasons why knowledge users, especially physicians, do not call on systematic reviews. This study can inform future approaches to enhancing systematic review uptake and also suggests potential avenues for future investigation.

Research paper thumbnail of EPA-0140 – Antidepressants, cbt, and their combination in depressed patients: A systematic review and meta-analysis

European Psychiatry, 2014

Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour th... more Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour therapy for the acute treatment of depression is contentious. Objective: To compare the acute outcomes of antidepressant medication, cognitive-behaviour therapy (CBT), and the combination of the two, in adult, depressed patients. Methods: Sixteen electronic databases together with reference lists were searched for randomised and other clinical trials that compared CBT, antidepressants, or their combination. Results: In the comparison between CBT and antidepressants, 8 studies met inclusion criteria. Five studies met the inclusion criteria for the second comparison between single therapy and combination therapy. In the antidepressant and CBT comparison, effect sizes favoured CBT over antidepressants with a significant advantage for CBT on some outcome measures. Combined treatment appeared more effective than antidepressants. However, combined treatment did not emerge more effective than CBT. Conclusions: Antidepressants may not be considered more efficacious than CBT for the acute treatment of depressed patients nor can combination therapy be regarded as more effective than CBT alone.

Research paper thumbnail of Correspondence to

Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review... more Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers’ perceptions

Research paper thumbnail of Citation

Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review... more Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers ' perceptions.

Research paper thumbnail of EPA-0140 – Antidepressants, cbt, and their combination in depressed patients: A systematic review and meta-analysis

European Psychiatry, 2014

Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour th... more Background: The comparative effectiveness of antidepressant medication and cognitive-behaviour therapy for the acute treatment of depression is contentious. Objective: To compare the acute outcomes of antidepressant medication, cognitive-behaviour therapy (CBT), and the combination of the two, in adult, depressed patients. Methods: Sixteen electronic databases together with reference lists were searched for randomised and other clinical trials that compared CBT, antidepressants, or their combination. Results: In the comparison between CBT and antidepressants, 8 studies met inclusion criteria. Five studies met the inclusion criteria for the second comparison between single therapy and combination therapy. In the antidepressant and CBT comparison, effect sizes favoured CBT over antidepressants with a significant advantage for CBT on some outcome measures. Combined treatment appeared more effective than antidepressants. However, combined treatment did not emerge more effective than CBT. Conclusions: Antidepressants may not be considered more efficacious than CBT for the acute treatment of depressed patients nor can combination therapy be regarded as more effective than CBT alone.

Research paper thumbnail of Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers' perceptions

BMJ open, 2012

To review the barriers to the uptake of research evidence from systematic reviews by decision mak... more To review the barriers to the uptake of research evidence from systematic reviews by decision makers. We searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Reference lists of primary studies and related reviews were also consulted. Studies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. All study designs, settings and decision makers were included. One investigator screened titles to identify candidate articles then two reviewers independently assessed the quality and the relevance of retrieved reports. Two reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Using a pre-established taxonomy, the barriers were organised into a framework according to their effect on knowledge, attitudes or beh...

Research paper thumbnail of Carepath for overcoming psychosis early (COPE): first 5 years of clinical operation and prospective research in the Cavan–Monaghan early intervention service

Irish Journal of Psychological Medicine, 2021

Objectives: As Ireland confronts the many challenges of broadening the introduction of early inte... more Objectives: As Ireland confronts the many challenges of broadening the introduction of early intervention services (EIS) for first episode psychosis (FEP) as national policy, this article describes Carepath for Overcoming Psychosis Early (COPE), the EIS of Cavan–Monaghan Mental Health Service, and presents prospective research findings during its first 5 years of operation. Methods: COPE was launched as a rural EIS with an embedded research protocol in early 2012, following an education programme for general practitioners (GPs). Here, operational activities are documented and research findings presented through to late 2016. Results: During this period, 115 instances of FEP were incepted into COPE, 70.4% via their GP and 29.6% via the Emergency Department. The annual rate of inception was 24.8/100,000 of population aged > 15 years and was 2.1-fold more common among men than women. Mean duration of untreated psychosis was 5.7 months and median time from first psychotic presentatio...

Research paper thumbnail of Evaluation of knowledge and attitudes among primary care physicians in Cavan-Monaghan as ‘gatekeepers-in-waiting’ for the introduction of Carepath for Overcoming Psychosis Early (COPE)

Early Intervention in Psychiatry, 2013

To investigate general practitioners&... more To investigate general practitioners' current knowledge of and attitudes towards psychosis and its management by Cavan-Monaghan Mental Health Service, Ireland, prior to their involvement in the introduction of an early intervention service. As part of a continuing medical education programme for psychosis, delivered to all 32 general practitioners practising in this region, participants were asked to complete a 29-item questionnaire designed to assess their baseline knowledge and attitudes. All 32 general practitioners participated in the study. Although 17% had received no previous psychiatric training, 93% described their knowledge of psychiatric disorders as average or above average. However, only 53% could correctly identify all of a set of psychiatric symptoms related to psychosis. Only 50% felt comfortable initiating treatment for psychotic symptoms. Whereas only 40% had heard of the early intervention model, 89% believed it to be advantageous. Easy accessibility to services and rapid assessment of patients referred were most commonly reported as helpful. However, concerns were expressed about the potential for associated increases in workload. As 'gatekeepers-in-waiting', these general practitioners will have a vital role in effective implementation of the early intervention service for psychosis. However, their knowledge needs improvement, through regular educational sessions, and this service must be responsive to their needs. In addition, general practitioners' concerns regarding the potential for increased workload must be adequately addressed in order to maintain enthusiasm and collaboration at the interface between primary care and mental health services, particularly in the context of early intervention.