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All Journal Critical Medical and Surgical Nursing Journal Health Gate
Tirmidzi, Achmad
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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The Effectiveness of Nutritional Therapy in Patient with Chronic Obstructive Lung Disease: A Systematic Review of Randomized Controlled Trials Hasanudin, Hasanudin; Arif, Taufan; Authoria, Nila; Salma Yunia Rachmah, Ade; Tirmidzi, Achmad
Critical Medical and Surgical Nursing Journal Vol. 14 No. 2 (2025): SEPTEMBER 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cmsnj.v14i2.75739

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and is often complicated by malnutrition and muscle wasting, which adversely affect prognosis. Although nutritional therapy has been recommended as part of comprehensive COPD care, the effectiveness of recent interventions has not been systematically evaluated. This systematic review aimed to evaluate the impact of nutritional therapy on clinical, functional, and patient-centered outcomes in individuals with COPD.  Methods: Following the PRISMA guidelines, we searched Scopus, PubMed, EBSCO, and Nature for randomized controlled trials (RCTs) published between January 2020 and June 2025. Eligible studies included adult patients with COPD who received nutritional interventions. The risk of bias was assessed using the Cochrane RoB 2 tool. From 252 screened records, 13 RCTs involving 2,962 participants were included. Given the heterogeneity across interventions and outcomes, the findings were synthesized narratively.  Results: The interventions included oral nutritional supplements, high-energy formulas, individualized dietary counseling, vitamin D, ω-3 fatty acids, and multi-nutrient combinations. Seven studies reported significant improvements in quality of life, six demonstrated gains in weight and nutritional status, and three showed increased muscle strength. Two trials observed enhanced physical activity, whereas both vitamin D studies found no overall protective effect against exacerbations, except in patients with severe deficiencies. The risk of bias was low in eight studies and raised concerns in five. Overall, the strength of evidence was moderate, limited by heterogeneity, and inconsistent outcome reporting. Conclusion: Nutritional therapy improves nutritional status and selected clinical outcomes in patients with COPD. Standardized, adequately powered RCTs are warranted to establish optimal protocols and to confirm long-term benefits.
Cognitive Behavioral Therapy for Mental Health and Stigma Among PLWH in Low and Middle-Income Countries: A Systematic Review Hasanudin, Hasanudin; Winarni, Sri; Lema, Elizabeth Risha Murlina; Tirmidzi, Achmad; Sunari, Sunari
Health Gate Vol 4, No 2 (2026): April, 2026
Publisher : Dewan Pimpinan Daerah Persatuan Perawat Nasional Indonesia Kota Blitar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70111/hg4212

Abstract

burden of mental health disorders and HIV-related stigma, which critically hinders adherence to antiretroviral therapy (ART). Cognitive Behavioral Therapy (CBT) has emerged as a promising evidence-based psychological intervention. However, its effectiveness across diverse populations and delivery formats in LMICs has not been adequately synthesized. This systematic review aimed to evaluate the effectiveness of CBT on mental health and stigma reduction among PLWH in LMICs.  A systematic review was conducted in accordance with the PRISMA guidelines for RCT articles published in Scopus, Science Direct, and PubMed databases between January 1, 2021, to April 9, 2026. The keywords used were “Cognitive Behavioral Therapy” AND “Mental Health OR Stigma” AND “People Living with HIV” OR “Randomized Controlled Trial.” Risk of bias was assessed using the Cochrane Risk of Bias Tool version 2 (RoB 2). Seven RCTs involving 1.786 participants from six LMICs in Africa and one in South Asia were included. All studies consistently reported clinically significant reductions in depressive symptoms and internalized stigma following CBT interventions, regardless of group, individual, or self-administered delivery format, and regardless of whether the intervention was delivered by a mental health specialist or a trained non-specialist. The risk of bias assessment indicated that one study had a low risk of bias, and six studies had some concerns. CBT is an effective, flexible, and scalable intervention for improving mental health and reducing stigma among PLWH in LMICs. 
Co-Authors Ade Salma Yunia Rachmah Arif, Taufan Hasanudin Hasanudin Lema, Elizabeth Risha Murlina Nila Authoria Authoria Sri Winarni Sunari, Sunari