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Access type: UnknownAuthor: search.filters.author.Mariana Dittborn

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    Item type:Publication,
    Opioid analgesics prescribing in Latin America: systematic review and meta-analysis
    (BMJ, 2025-11-15)
    Ofelia Leiva
    ;
    Mariana Dittborn
    ;
    Pamela Turrillas
    ;
    Emeka Chukwusa
    ;
    Kennedy Nkhoma
      3
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    Item type:Publication,
    Permissibility of euthanasia: a response from LATAM
    (BMJ, 2024-12-31)
    Mariana Dittborn
    ;
    Daniela P Rojas
    ;
    Sofía P Salas
    Scopus© Citations 1  2
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    Opioid prescribing for cancer pain in Latin America: systematic review
    (2024)
    ofelia Leiva
    ;
    Emeka Chukwusa
    ;
    Kennedy Nkhoma
    ;
    Mariana Dittborn
    ;
    Pamela Turrillas
    <jats:sec><jats:title>Objective</jats:title><jats:p>To explore opioid prescribing patterns for cancer pain in Latin America (LA).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Relevant databases, including MEDLINE, EMBASE, PubMed, LILACS and Scielo, were searched from inception to June 2023. Empirical studies of opioid prescription patterns in adult palliative care patients with cancer pain were included. Methodological quality was assessed using the Effective Public Health Practice Project tool. Data were analysed using narrative synthesis. Descriptive statistical analyses were conducted using SPSS V.28 (IBM). Categorical variables were summarised using frequencies and percentages and continuous variables as means or medians.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Seventeen studies from six countries were included. Ten were observational, while seven were experimental, including five randomised controlled trials (RCT) and two non-RCT. Most were low or moderate methodological quality. Out of 7809 patients, morphine (54%) and tramadol (18%) were the most prescribed opioids. The median of morphine equivalent daily dose was 26 mg (IQR 26–41).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Latin America shows lower opioid consumption rates compared with high-income countries for control pain management (CPM). More rigorous research on CPM in LA is needed. Additionally, a comprehensive review of opioid prescription patterns, including non-cancer diagnoses, is necessary.</jats:p></jats:sec>
      2
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    Clinical ethics support services in paediatric practice: protocol for a mixed studies systematic review on structures, interventions and outcomes
    (2022)
    Mariana Dittborn
    ;
    Bernardita Portales
    ;
    Joe Brierley
    <jats:sec><jats:title>Introduction</jats:title><jats:p>Clinical ethics support services (CESS) have been developing worldwide with growing interest in evaluating their quality. Paediatric-specific CESSs (p-CESS) have received little attention, and evidence from adult services might not be generalisable. Evidence on service models and practices is crucial to inform further research and debate on quality evaluation and minimum standards for p-CESSs. We aim to systematically identify, appraise and synthesise evidence for p-CESS structures, processes and outcomes.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>We will conduct a mixed-studies systematic review including peer-reviewed empirical studies published in English or Spanish language providing data on the evaluation and/or impact on any aspect of p-CESS. We will search seven electronic databases: MEDLINE, Philosopher’s Index, EMBASE, PsycINFO, LILACS, Web of Science and CINHAL, without filters applied. Search terms will be related to “clinical ethics support” AND “paediatrics” AND “structure/process/outcome”. Reference and citation list of included studies will be handsearched. A 10% random sample of retrieved titles/abstracts and all full texts will be independently dual-screened. We will conduct narrative and thematic synthesis for quantitative and qualitative data, respectively, following sequential explanatory synthesis guided by Donabedian’s framework of structure, process and outcomes. Quality will be assessed using the Mixed-Methods Appraisal Tool (2018). The review will be reported using the adapted Preferred Reporting Items for Systematic Reviews and Meta-Analyses for reporting systematic reviews of qualitative and quantitative evidence template. Stakeholders will be involved twice in the review process; prior to data extraction and synthesis and after preliminary results.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>As a systematic review of published data, no ethical approval is necessary. Results will be published in a relevant academic peer-reviewed journal.</jats:p></jats:sec><jats:sec><jats:title>PROSPERO registration number</jats:title><jats:p>CRD42021280978.</jats:p></jats:sec>
      9
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    Scopus© Citations 8  1
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      6Scopus© Citations 3