手机提供的戒烟、体育活动/饮食及减少饮酒干预措施对预防非传染性疾病的有效性：随机对照试验的系统评价
The effectiveness of smoking cessation, physical activity/diet and alcohol reduction interventions delivered by mobile phones for the prevention of non-communicable diseases: A systematic review of randomised controlled trials.
作者信息
Palmer Melissa, Sutherland Jennifer, Barnard Sharmani, Wynne Aileen, Rezel Emma, Doel Andrew, Grigsby-Duffy Lily, Edwards Suzanne, Russell Sophie, Hotopf Ellie, Perel Pablo, Free Caroline
机构信息
Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
King's Centre for Global Health and Health Partnerships, King's College London, London, United Kingdom.
出版信息
PLoS One. 2018 Jan 5;13(1):e0189801. doi: 10.1371/journal.pone.0189801. eCollection 2018.
BACKGROUND
We conducted a systematic review to assess the effectiveness of smoking cessation, physical activity (PA), diet, and alcohol reduction interventions delivered by mobile technology to prevent non-communicable diseases (NCDs).
METHODS
We searched for randomised controlled trials (RCTs) of mobile-based NCD prevention interventions using MEDLINE, EMBASE, Global Health, CINAHL (Jan 1990-Jan 2016). Two authors extracted data.
FINDINGS
71 trials were included: smoking cessation (n = 18); PA (n = 15), diet (n = 3), PA and diet (n = 25); PA, diet, and smoking cessation (n = 2); and harmful alcohol consumption (n = 8). 4 trials had low risk of bias. The effect of SMS-based smoking cessation support on biochemically verified continuous abstinence was pooled relative risk [RR] 2.19 [95% CI 1.80-2.68], I2 = 0%) and on verified 7 day point prevalence of smoking cessation was pooled RR 1.51 [95% CI 1.06-2.15], I2 = 0%, with no reported adverse events. There was no difference in peak oxygen intake at 3 months in a trial of an SMS-based PA intervention. The effect of SMS-based diet and PA interventions on: incidence of diabetes was pooled RR 0.67 [95% CI 0.49, 0.90], I2 = 0.0%; end-point weight was pooled MD -0.99Kg [95% CI -3.63, 1.64] I2 = 29.4%; % change in weight was pooled MD -3.1 [95%CI -4.86- -1.3] I2 0.3%; and on triglyceride levels was pooled MD -0.19 mmol/L [95% CI -0.29, -0.08], I2 = 0.0%. The results of other pooled analyses of the effect of SMS-based diet and PA interventions were heterogenous (I2 59-90%). The effects of alcohol reduction interventions were inconclusive.
CONCLUSIONS
Smoking cessation support delivered by SMS increases quitting rates. Trials of PA interventions reporting outcomes ≥3 months showed no benefits. There were at best modest benefits of diet and PA interventions. The effects of the most promising SMS-based smoking, diet and PA interventions on morbidity and mortality in high-risk groups should be established in adequately powered RCTs.
背景
我们进行了一项系统评价，以评估通过移动技术实施的戒烟、体育活动（PA）、饮食及减少饮酒干预措施在预防非传染性疾病（NCDs）方面的有效性。
方法
我们使用MEDLINE、EMBASE、Global Health、CINAHL（1990年1月至2016年1月）检索了基于移动技术的非传染性疾病预防干预措施的随机对照试验（RCTs）。两名作者提取数据。
结果
纳入71项试验：戒烟（n = 18）；体育活动（n = 15）、饮食（n = 3）、体育活动和饮食（n = 25）；体育活动、饮食和戒烟（n = 2）；以及有害饮酒（n = 8）。4项试验偏倚风险较低。基于短信的戒烟支持对经生化验证的持续戒烟的合并相对危险度[RR]为2.19 [95%可信区间（CI）1.80 - 2.68]，I² = 0%，对经验证的7天戒烟点患病率的合并RR为1.51 [95% CI 1.06 - 2.15]，I² = 0%，且未报告不良事件。在一项基于短信的体育活动干预试验中，3个月时的峰值摄氧量无差异。基于短信的饮食和体育活动干预对以下方面的影响：糖尿病发病率的合并RR为0.67 [95% CI 0.49, 0.90]，I² = 0.0%；终点体重的合并平均差（MD）为 - 0.99kg [95% CI - 3.63, 1.64]，I² = 29.4%；体重变化百分比的合并MD为 - 3.1 [95% CI - 4.86 - - 1.3]，I² = 0.3%；甘油三酯水平的合并MD为 - 0.19 mmol/L [95% CI - 0.29, - 0.08]，I² = 0.0%。基于短信的饮食和体育活动干预效果的其他合并分析结果存在异质性（I² = 59 - 90%）。减少饮酒干预的效果尚无定论。
结论
通过短信提供的戒烟支持可提高戒烟率。报告结局≥3个月的体育活动干预试验未显示出益处。饮食和体育活动干预至多有适度益处。应在有足够样本量的随机对照试验中确定最有前景的基于短信的吸烟、饮食和体育活动干预对高危人群发病率和死亡率的影响。
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