Allara Elias, Ferri Marica, Bo Alessandra, Gasparrini Antonio, Faggiano Fabrizio
Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy School of Public Health, University of Torino, Torino, Italy.
Consequences, Responses and Best Practices Unit, European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal.
BMJ Open. 2015 Sep 3;5(9):e007449. doi: 10.1136/bmjopen-2014-007449.
To determine whether there is evidence that mass-media campaigns can be effective in reducing illicit drug consumption and the intent to consume.
Systematic review of randomised and non-randomised studies.
We searched four electronic databases (MEDLINE, EMBASE, ProQuest Dissertations & Theses A&I and CENTRAL) and further explored seven additional resources to obtain both published and unpublished materials. We appraised the quality of included studies using standardised tools. We carried out meta-analyses of randomised controlled trials and a pooled analysis of interrupted time-series and controlled before-and-after studies.
We identified 19 studies comprising 184,811 participants. Pooled analyses and narrative synthesis provided mixed evidence of effectiveness. Eight interventions evaluated with randomised controlled trials leaned towards no evidence of an effect, both on drug use (standardised mean difference (SMD) -0.02; 95% CI -0.15 to 0.12) and the intention to use drugs (SMD -0.07; 95% CI -0.19 to 0.04). Four campaigns provided some evidence of beneficial effects in preventing drug use and two interventions provided evidence of iatrogenic effects.
Studies were considerably heterogeneous in type of mass-media intervention, outcome measures, underlying theory, comparison groups and design. Such factors can contribute to explaining the observed variability in results. Owing to the risk of adverse effects, caution is needed in disseminating mass-media campaigns tackling drug use. Large studies conducted with appropriate methodology are warranted to consolidate the evidence base.
确定是否有证据表明大众媒体宣传活动能有效减少非法药物消费及消费意图。
对随机和非随机研究进行系统评价。
我们检索了四个电子数据库(MEDLINE、EMBASE、ProQuest学位论文与学术期刊文摘数据库和CENTRAL),并进一步探索了另外七种资源以获取已发表和未发表的材料。我们使用标准化工具评估纳入研究的质量。我们对随机对照试验进行了荟萃分析,并对中断时间序列和对照前后研究进行了汇总分析。
我们确定了19项研究,涉及184,811名参与者。汇总分析和叙述性综合分析提供了关于有效性的混合证据。八项通过随机对照试验评估的干预措施在药物使用(标准化均数差(SMD)-0.02;95%可信区间-0.15至0.12)和使用药物意图(SMD -0.07;95%可信区间-0.19至0.04)方面均倾向于无效果证据。四项宣传活动提供了一些预防药物使用有益效果的证据,两项干预措施提供了医源性效果的证据。
研究在大众媒体干预类型、结局测量、基础理论、对照组和设计方面存在很大差异。这些因素有助于解释观察到的结果变异性。由于存在不良反应风险,则需要谨慎传播针对药物使用的大众媒体宣传活动。有必要采用适当方法进行大型研究以巩固证据基础。