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基于社区的心血管疾病预防干预措施在减少酒精消费方面的类型及效果:一项系统评价和荟萃分析

Types and Effectiveness of Community-Based Cardiovascular Disease Preventive Interventions in Reducing Alcohol Consumption: A Systematic Review and Meta-Analysis.

作者信息

Berhe Neamin M, Hassen Hamid Y, Van Geertruyden Jean-Pierre, Ndejjo Rawlance, Musinguzi Geofrey, Bastiaens Hilde, Abrams Steven

机构信息

Department of Primary & Integrated Care, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL.

Department of Health Sciences, Société Générale de Surveillance (SGS) Life Sciences, Mechelen, BEL.

出版信息

Cureus. 2024 May 29;16(5):e61323. doi: 10.7759/cureus.61323. eCollection 2024 May.

Abstract

Cardiovascular disease (CVD) poses a global health challenge, with modifiable risk factors, notably alcohol consumption, impacting its onset and progression. This review synthesizes evidence on the types and effectiveness of community-based interventions (CBIs) aimed at reducing alcohol consumption for CVD prevention. Electronic databases were systematically searched until October 31, 2019, with updates until February 28, 2023. Given the heterogeneity in outcome measures, we narratively synthesized the effectiveness of CBIs, adhering to the synthesis without meta-analysis (SWiM) guidelines for transparent reporting. For selected homogenous studies, a random-effects meta-analysis was utilized to estimate the effects of CBIs on alcohol consumption. Twenty-two eligible studies were included, with 16 demonstrating that CBIs reduced alcohol consumption compared to controls. Meta-analysis findings revealed reductions in above moderate-level alcohol consumption (pooled odds ratio (OR)=0.50, 95% confidence interval (CI): 0.37, 0.68), number of alcohol drinks per week (standardized mean difference=-0.08, 95% CI: -0.14, -0.03), and increased odds of low-risk drinking (pooled OR=1.99, 95% CI: 1.04, 3.81) compared to the control groups. Multi-component interventions (particularly those combining health education, awareness, and promotion activities) and those interventions with a duration of 12 months or more were notably effective. The beneficial effects of CBIs focusing on achieving a reduction in alcohol consumption showed promising outcomes. Implementing such interventions, especially multicomponent interventions, could play a significant role in mitigating the increasing burden of CVDs. Future studies should also consider employing standardized and validated tools to measure alcohol consumption outcomes to enhance the consistency and comparability of findings.

摘要

心血管疾病(CVD)是一项全球性的健康挑战,可改变的风险因素,尤其是饮酒,会影响其发病和进展。本综述综合了旨在减少饮酒以预防心血管疾病的社区干预措施(CBI)的类型和效果的证据。我们系统检索了电子数据库,截至2019年10月31日,并更新至2023年2月28日。鉴于结局指标的异质性,我们按照无荟萃分析的系统综述(SWiM)指南进行透明报告,对社区干预措施的效果进行了叙述性综合分析。对于选定的同类研究,采用随机效应荟萃分析来估计社区干预措施对饮酒的影响。纳入了22项符合条件的研究,其中16项表明与对照组相比,社区干预措施减少了饮酒量。荟萃分析结果显示,与对照组相比,中度以上饮酒量减少(合并比值比(OR)=0.50,95%置信区间(CI):0.37,0.68),每周饮酒次数减少(标准化均值差=-0.08,95%CI:-0.14,-0.03),低风险饮酒的几率增加(合并OR=1.99,95%CI:1.04,3.81)。多成分干预措施(特别是那些结合健康教育、意识提升和促进活动的措施)以及持续时间为12个月或更长时间的干预措施尤为有效。专注于减少饮酒量的社区干预措施的有益效果显示出了有前景的结果。实施此类干预措施,尤其是多成分干预措施,可能在减轻心血管疾病日益增加的负担方面发挥重要作用。未来的研究还应考虑使用标准化和经过验证的工具来测量饮酒结局,以提高研究结果的一致性和可比性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6de7/11212836/81a230348f0b/cureus-0016-00000061323-i01.jpg

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