ABSTRACT
AIMS: To review the effectiveness of workplace interventions in reducing alcohol consumption among employees. METHODS: Systematic search of science databases from inception till May 2018 for trials where an intervention was tested against a control and data presented as amount of alcohol consumed per week. Quality of trials was assessed by Cochrane risk of bias tool. Meta-analysis was performed with random-effects model and pooled mean difference (MD) was reported with 95% confidence interval. Publication bias was assessed using Egger's test. RESULTS: Seven trials with 1291 participants could be included. No outcome assessments were blinded. There was positive effect of workplace intervention on reduction of alcohol consumption with pooled MD of -2.25 [95% CI: -4.20 to -0.30]. The effect was only seen where subjects had a baseline alcohol consumption of over 15 standard drinks per week. There was no heterogeneity across the trials (I2=0%). Funnel plot was symmetrical shaped and Egger's test confirmed that there was no publication bias. Two studies found no advantages to intervention on differences on the AUDIT test. CONCLUSION: There is weak evidence for workplace interventions (varying modes) as a way of facilitating reduction in the consumption of alcohol among employees but only among the heavier consumers.
Subject(s)
Alcohol Drinking/prevention & control , Occupational Health , HumansABSTRACT
BACKGROUND: Trends in morbidity and mortality due to noncommunicable diseases (NCDs) are rising because of poor control status. Medication nonadherence is one of the most common and modifiable causes of inadequate control status. OBJECTIVES: To determine the prevalence of drug adherence among patients with NCD in rural Puducherry. METHODS: A facility-based cross-sectional study was done among 260 patients with NCD receiving treatment from rural primary health center in Puducherry during February and March 2018. Information regarding sociodemographic profile and household was collected using pretested semi-structured questionnaire. Morisky Medication Adherence Scale was done to assess the adherence. We calculated adjusted prevalence ratios (aPRs) to identify the factors associated with medication adherence. RESULTS: Among the 260 participants, 42.7% belonged to elderly age group; 66.2% were females; 44% did not have any formal education; 70% were unemployed. The majority were suffering from hypertension (71.2%) followed by diabetes (56.2%). This study found that almost one-third (32.7%) of the study participants were not properly adherent to medications. Elderly [aPR 2.51 95% confidence interval (CI): 1.70-3.70] and female participants (aPR 1.64 95% CI: 1.04-2.58) were found to have more chance being nonadherent to medications after adjusting for possible confounding variables. CONCLUSION: This study reported that almost one-third of the study participants were nonadherent to medications. Elderly age group and female gender were found to be the determinants of nonadherence. Corrective measures need to be started at patient level first by motivating and educating them regarding the importance of drug intake.
ABSTRACT
OBJECTIVE: The trial aimed to study the effectiveness of multipurpose health-worker-led exercise therapy on women patients of 30-50 years of age with chronic nonspecific low backache (LBA) in a primary health center. MATERIALS AND METHODS: The multipurpose health worker had undergone 2 days training for exercises to relief chronic nonspecific LBA in the Department of Orthopaedic, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry. Patients were allocated to either intervention arm (who received exercise therapy) or control arm (who received pharmacological therapy of analgesics). Patients with less than 3 months of pain, acute onset of pain, localized pain, or straight leg raising test positive were excluded. The pain score on three different positions (motion, sitting, and standing) was assessed on visual analogue scale before starting the exercise therapy or the pharmacological therapy and after 1 month of the exercise therapy or pharmacological therapy. STATISTICAL ANALYSIS: Data were analyzed using SPSS Software. Wilcoxon sign-rank test is used to compare the scores before and after intervention depending upon normality of distribution. Difference in difference analysis is used to compare the scores between the two groups. RESULTS: Multipurpose health-worker-led exercise therapy is found to be equally effective as compared to pharmacological therapy. Significant difference in reduction of pain score was not obtained between control and intervention arm (P value: 0.343, 0.819, and 0.335 in motion, standing, and sitting position). However, significant reduction in pain score in all the three positions was obtained in intervention (P value < 0.001, <0.001, <0.001 in motion, standing, and sitting, respectively). Therefore, it can be suggested that multipurpose health-worker-led exercise therapy may be implemented in a primary health-care setting which will help to reduce the analgesics load on the health center and prevent the adverse effect profile of the drugs on patients.
