Department of Optometry and Visual Sciences, School of Health and Psychological Sciences, University of London, Northampton Square, London EC1V 0HB, UK.
Department of Optics and Optometry, Universitat Politècnica de Catalunya, Carrer Violinista Vellsolà, 37, 08222 Terrassa, Spain.
Nutrients. 2022 Nov 3;14(21):4652. doi: 10.3390/nu14214652.
There is currently no treatment for early/intermediate Age-related Macular Degeneration (AMD) but Eye Care Professionals (ECPs) are recommended to advise patients about modifiable lifestyle factors, including dietary changes, that can slow disease progression. The aim of this review was to understand advice currently given to patients with AMD by ECPs and to evaluate evidence regarding patient compliance. A systematic review was conducted of literature published in electronic databases: CINAHL, MEDLINE, PsycINFO, PyscARTICLES, EMBASE, AMED. Methods followed PRISMA guidelines (PROSPERO registration number: CRD42020223724). Twenty-four reports were eligible for inclusion, 12 focused on ECP experience, 7 on patient experience, and 6 on impact of advice (one paper reported on the ECP and patient experience). Studies reported that a substantial proportion of patients did not recall receiving lifestyle modification advice from their ECP (57.95%, range 2-95% across patient based studies). Practitioners were most likely to provide advice about nutritional supplements (80%, range 67-93% across ECP studies), and least likely about smoking (44%, range 28-71% across ECP studies), however supplements advised did not always comply with evidence-based guidelines. The main reason for patients not following lifestyle advice was lack of provision by the ECP (54.5%, range 21-94% across studies on the impact of advice). The review highlighted a need for more studies to understand patient preferences for receiving advice and research on ECP perceived barriers to advice provision.
目前尚无治疗早期/中期年龄相关性黄斑变性（AMD）的方法，但建议眼科保健专业人员（ECP）向患者提供有关可改变的生活方式因素的建议，包括饮食改变，这些因素可以减缓疾病的进展。本综述的目的是了解 ECP 目前向 AMD 患者提供的建议，并评估有关患者依从性的证据。对电子数据库中发表的文献进行了系统综述：CINAHL、MEDLINE、PsycINFO、PyscARTICLES、EMBASE、AMED。方法遵循 PRISMA 指南（PROSPERO 注册号：CRD42020223724）。有 24 份报告符合纳入标准，其中 12 份报告侧重于 ECP 的经验，7 份报告侧重于患者的经验，6 份报告侧重于建议的影响（一份报告同时报告了 ECP 和患者的经验）。研究报告称，相当一部分患者不记得从 ECP 那里收到过生活方式改变的建议（57.95%，基于患者的研究范围为 2-95%）。医生最有可能提供有关营养补充剂的建议（80%，基于 ECP 的研究范围为 67-93%），而最不可能提供关于吸烟的建议（44%，基于 ECP 的研究范围为 28-71%），但建议的补充剂并不总是符合循证指南。患者不遵循生活方式建议的主要原因是 ECP 没有提供建议（54.5%，基于影响建议的研究范围为 21-94%）。该综述强调需要进行更多研究，以了解患者对接受建议的偏好，以及研究 ECP 对提供建议的看法。
