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Thompson TP, Horrell J, Taylor AH, Wanner A, Husk K, Wei Y, Creanor S, Kandiyali R, Neale J, Sinclair J, Nasser M, Wallace G. Physical activity and the prevention, reduction, and treatment of alcohol and other drug use across the lifespan (The PHASE review): A systematic review. Ment Health Phys Act 2020; 19:100360. [PMID: 33020704 PMCID: PMC7527800 DOI: 10.1016/j.mhpa.2020.100360] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
The aim of this review is to systematically describe and quantify the effects of PA interventions on alcohol and other drug use outcomes, and to identify any apparent effect of PA dose and type, possible mechanisms of effect, and any other aspect of intervention delivery (e.g. key behaviour change processes), within a framework to inform the design and evaluation of future interventions. Systematic searches were designed to identify published and grey literature on the role of PA for reducing the risk of progression to alcohol and other drug use (PREVENTION), supporting individuals to reduce alcohol and other drug use for harm reduction (REDUCTION), and promote abstinence and relapse prevention during and after treatment of alcohol and other drug use (TREATMENT). Searches identified 49,518 records, with 49,342 excluded on title and abstract. We screened 176 full text articles from which we included 32 studies in 32 papers with quantitative results of relevance to this review. Meta-analysis of two studies showed a significant effect of PA on prevention of alcohol initiation (risk ratio [RR]: 0.72, 95%CI: 0.61 to 0.85). Meta-analysis of four studies showed no clear evidence for an effect of PA on alcohol consumption (Standardised Mean Difference [SMD]: 0.19, 95%, Confidence Interval -0.57 to 0.18). We were unable to quantitatively examine the effects of PA interventions on other drug use alone, or in combination with alcohol use, for prevention, reduction or treatment. Among the 19 treatment studies with an alcohol and other drug use outcome, there was a trend for promising short-term effect but with limited information about intervention fidelity and exercise dose, there was a moderate to high risk of bias. We identified no studies reporting the cost-effectiveness of interventions. More rigorous and well-designed research is needed. Our novel approach to the review provides a clearer guide to achieve this in future research questions addressed to inform policy and practice for different populations and settings.
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Affiliation(s)
- T P Thompson
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - J Horrell
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - A H Taylor
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - A Wanner
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - K Husk
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - Y Wei
- University of Plymouth, Centre for Mathematical Sciences, School of Engineering, Computing and Mathematics, Drake Circus, Plymouth, PL4 8AA, UK
| | - S Creanor
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - R Kandiyali
- Bristol University, School of Social and Community Medicine, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK
| | - J Neale
- King's College London Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, London, SE5 8BB, UK
| | - J Sinclair
- University of Southampton, Faculty of Medicine, 4-12 Terminus Terrace, Southampton, SO14 3DT, UK
| | - M Nasser
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - G Wallace
- Plymouth City Council, Public Dispensary, Catherine Street, Plymouth, PL1 2AA, UK
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Atkinson C, Penfold CM, Ness AR, Longman RJ, Thomas SJ, Hollingworth W, Kandiyali R, Leary SD, Lewis SJ. Randomized clinical trial of postoperative chewing gum versus standard care after colorectal resection. Br J Surg 2016; 103:962-70. [PMID: 27146793 PMCID: PMC5084762 DOI: 10.1002/bjs.10194] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 03/08/2016] [Accepted: 03/10/2016] [Indexed: 12/20/2022]
Abstract
Background Chewing gum may stimulate gastrointestinal motility, with beneficial effects on postoperative ileus suggested in small studies. The primary aim of this trial was to determine whether chewing gum reduces length of hospital stay (LOS) after colorectal resection. Secondary aims included examining bowel habit symptoms, complications and healthcare costs. Methods This clinical trial allocated patients randomly to standard postoperative care with or without chewing gum (sugar‐free gum for at least 10 min, four times per day on days 1–5) in five UK hospitals. The primary outcome was LOS. Cox regression was used to calculate hazard ratios for LOS. Results Data from 402 of 412 patients, of whom 199 (49·5 per cent) were allocated to chewing gum, were available for analysis. Some 40 per cent of patients in both groups had laparoscopic surgery, and all study sites used enhanced recovery programmes. Median (i.q.r.) LOS was 7 (5–11) days in both groups (P = 0·962); the hazard ratio for use of gum was 0·94 (95 per cent c.i. 0·77 to 1·15; P = 0·557). Participants allocated to gum had worse quality of life, measured using the EuroQoL 5D‐3L, than controls at 6 and 12 weeks after operation (but not on day 4). They also had more complications graded III or above according to the Dindo–Demartines–Clavien classification (16 versus 6 in the group that received standard care) and deaths (11 versus 0), but none was classed as related to gum. No other differences were observed. Conclusion Chewing gum did not alter the return of bowel function or LOS after colorectal resection. Registration number: ISRCTN55784442 (http://www.controlled-trials.com). No advantage observed
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Affiliation(s)
- C Atkinson
- Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK
| | - C M Penfold
- Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK
| | - A R Ness
- Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK
| | - R J Longman
- Department of Coloproctology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - S J Thomas
- Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK
| | - W Hollingworth
- Schools of Social and Community Medicine, University of Bristol, Bristol, UK
| | - R Kandiyali
- Schools of Social and Community Medicine, University of Bristol, Bristol, UK
| | - S D Leary
- Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK
| | - S J Lewis
- National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK.,Department of Gastroenterology, Derriford Hospital, Plymouth, UK
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