Impacts of social support on the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis.
Impacts of social support on the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis.
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社会支持对耐药结核病治疗结果的影响：系统评价和荟萃分析
DOI：
10.1136/bmjopen-2020-036985
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发表时间：
2020-10-08
期刊：
影响因子：
2.9
通讯作者：
Sun Q
中科院分区：
文献类型：
--
作者：
Wen S;Yin J;Sun Q
目的探讨社会支持对耐药结核病（DR-TB）患者治疗成功率和失访率的影响。我们检索了Pubmed、Web of Science、Embase、Scopus和Medline数据库，直至2020年6月18日，以寻找报告耐药结核患者社会支持和治疗结局的干预性或混合方法研究。两名独立评审员提取数据，并与第三名评审员达成共识解决分歧。采用随机效应Meta分析方法，计算社会支持对治疗效果改善作用的OR和95%CI，并对异质性和偏倚风险进行评估。低收入和中等收入国家。受试者为耐药结核病患者。治疗成功定义为治愈和治疗完成的组合，LTFU是指连续两个月或更长时间中断治疗。结果在173篇文献中，162篇通过独立综述排除（kappa=0.87），10篇纳入8个国家1621例耐药结核患者的研究纳入定性分析。在这些研究中，最常引入的社会支持是物质支持（10项研究），其次是信息支持（8项研究），情感支持（7项研究）和陪伴支持（4项研究）。7项报告了干预组和对照组治疗结局的研究符合荟萃分析的条件。当物质支持整合到社会支持包中时，发现治疗成功率（OR：2.58; 95%CI：1.80至3.69）得到了令人鼓舞的改善，并且未观察到异质性（I1为0%，Q检验p=0.72）。当材料支持可用时，也观察到LTFU率降低（OR：0.17; 95% CI：0.05 - 0.55），但发现显著异质性（I2为80%，Q检验p=0.002）。结论物质支持结合其他社会支持干预措施对提高耐药结核病患者治疗成功率是可行和有效的。PROSPERO注册号CRD 42019140824。
Objective To assess the effectiveness of social support on treatment success promotion or lost to follow-up (LTFU) reduction for patients with drug-resistant tuberculosis (DR-TB). Design We searched Pubmed, Web of Science, Embase, Scopus and Medline databases until 18 June 2020 for interventional or mixed-method studies which reported social support and treatment outcomes of DR-TB patients. Two independent reviewers extracted data and disagreements were resolved by consensus with a third reviewer. Random-effects meta-analysis was performed to calculate the OR and 95% CI for the effects of social support on the improvement of treatment outcomes and the heterogeneity and risk of bias were assessed. Setting Low-income and middle-income countries. Participants DR-TB patients. Outcomes Treatment success is defined as the combination of the cured and treatment completion, and LTFU is measured as treatment being interrupted for two consecutive months or more. Results Among 173 articles selected for full-text review, 162 were excluded through independent review (kappa=0.87) and 10 studies enrolling 1621 DR-TB patients in eight countries were included for qualitative analysis. In these studies, the most frequently introduced social support was material support (10 studies), followed by informational (eight studies), emotional (seven studies) and companionship support (four studies). Seven studies that reported treatment outcomes in both intervention arm and control arm are qualified for meta-analysis. An encouraging improvement on treatment success rate (OR: 2.58; 95% CI: 1.80 to 3.69) was found when material support was integrated into social support packages and no heterogeneity was observed (I1 of 0%, Q test p=0.72). Reduction on LTFU rate (OR: 0.17; 95% CI: 0.05 to 0.55) was also noted when material support was available but substantial heterogeneity was found (I2 of 80%, Q test p=0.002). Conclusion Material support appeared feasible and effective to improve treatment success for DR-TB patients combined with other social support interventions. PROSPERO registration number CRD42019140824.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
--
作者：
Kundu, Debashish;Katre, Vijendra;Parmar, Malik
通讯作者：
Parmar, Malik
DOI：
10.1016/j.ijtb.2017.05.003
发表时间：
2018-01-01
期刊：
The Indian journal of tuberculosis
影响因子：
--
作者：
Deshmukh, R D;Dhande, D J;Parmar, M
通讯作者：
Parmar, M
影响因子：
8.1
作者：
Kibret KT;Moges Y;Memiah P;Biadgilign S
通讯作者：
Biadgilign S
影响因子：
168.9
作者：
Ismail, K;Winkley, K;Rabe-Hesketh, S
通讯作者：
Rabe-Hesketh, S