Achana Felix A, Sutton Alex J, Kendrick Denise, Wynn Persephone, Young Ben, Jones David R, Hubbard Stephanie J, Cooper Nicola J
Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom.
Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, United Kingdom.
PLoS One. 2015 Apr 20;10(3):e0121122. doi: 10.1371/journal.pone.0121122. eCollection 2015.
There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a "usual care or no intervention" which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children.
Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model.
28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants.
The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison prevention practices they wish to promote.
Network meta-analysis is useful for comparing multiple injury-prevention interventions. More intensive poison prevention interventions were more effective than education alone. Education and low cost/free equipment was most effective in promoting safe storage of medicines. Education, low cost/free equipment, home safety inspection and fitting was most effective in promoting safe storage of household products and poisons. Education, low cost/free equipment and home inspection were most effective in promoting possession of a poison control centre number. None of the intervention packages was more effective than the others in promoting safe storage of poisonous plants.
之前两项荟萃分析的证据表明，促进预防中毒行为的干预措施对于增加有儿童家庭的一系列预防中毒措施是有效的。已发表的荟萃分析将任何干预措施与“常规护理或无干预”进行了比较，这可能会限制该分析对决策者的有用性。我们旨在使用网状荟萃分析来同时评估不同干预措施在提高以下方面安全储存普及率的有效性：i）仅药品；ii）仅其他家用产品；iii）毒物（药品和非药品）；iv）有毒植物；以及v）有儿童家庭中拥有中毒控制中心（PCC）电话号码的情况。
预防中毒干预措施有效性的数据取自两项新开展的系统评价中确定的原始研究。使用随机效应网状荟萃分析模型对各研究的效应估计值进行汇总。
确定的47项原始研究中有28项纳入了分析。与常规护理干预相比，包含教育及低成本/免费设备要素的干预措施在促进药品安全储存方面最有效（优势比2.51，95%可信区间1.01至6.00），而包含教育、低成本/免费设备、家庭安全检查和配件的干预措施在促进其他家用产品安全储存（2.52，1.12至7.13）、毒物安全储存（11.10，1.60至141.50）以及拥有PCC电话号码方面最有效（38.82，2.19至687.10）。在促进有毒植物安全储存方面，没有一种干预方案比其他方案更有效。
最有效的干预措施因预防中毒措施而异，但仅靠教育并非对任何预防中毒措施都是最有效的干预。预防中毒干预措施的委托方和提供方应根据他们希望促进的预防中毒措施来调整所委托或提供的干预措施。
网状荟萃分析有助于比较多种伤害预防干预措施。更强化的预防中毒干预措施比单纯教育更有效。教育和低成本/免费设备在促进药品安全储存方面最有效。教育、低成本/免费设备、家庭安全检查和配件在促进家用产品和毒物安全储存方面最有效。教育、低成本/免费设备和家庭检查在促进拥有中毒控制中心电话号码方面最有效。在促进有毒植物安全储存方面，没有一种干预方案比其他方案更有效。
