Top

Published in:

Open Access 01-12-2015 | Protocol

Interventions for preventing or treating malnutrition in problem drinkers who are homeless or vulnerably housed: protocol for a systematic review

Authors: Helen Thorley, Katie Porter, Clare Fleming, Tim Jones, Joanna Kesten, Elsa Marques, Alison Richards, Jelena Savović

Published in: Systematic Reviews | Issue 1/2015

Abstract

Background

Problem alcohol drinking in homeless and vulnerably housed people can lead to malnutrition, which is associated with complications such as alcohol-related brain damage. Homeless alcohol drinkers are likely to have worse health outcomes and different nutritional needs compared with housed alcohol-drinking persons. It is not clear whether interventions to improve nutritional status in this population have been effective. The purpose of this review is to assess the effectiveness and cost-effectiveness of interventions for preventing or correcting micronutrient deficiencies and other forms of malnutrition and related comorbidities in this population.

Methods/design

A systematic search for studies of a nutrition-based intervention applied in the homeless or vulnerably housed population with problem drinking will be conducted. The following electronic databases will be systematically searched for relevant studies: MEDLINE, EMBASE, Web of Science, PsycINFO, CAB abstracts, CINAHL, Cochrane Public Health Group Register and Cochrane Drugs and Alcohol Group Register. Screening of identified abstracts for relevance and assessment of papers for inclusion will be done in duplicate. One reviewer will extract data from the studies and assess quality, and this will be checked by another reviewer. Discrepancies will be resolved by consensus. The primary outcomes are (mal)nutrition status or micronutrient deficiencies or change in (mal)nutrition status or micronutrient deficiencies, measures of liver damage and cognitive function. Secondary outcomes include comorbidities, quality of life and functional scales, resources used to deliver treatment, uptake/acceptability of the intervention and engagement with treatment services. Results will be analysed descriptively, and, if appropriate, meta-analyses will be performed.

Discussion

The results of this review should help to inform the development of effective interventions that can be implemented in the community to improve the health of homeless people who are problem drinkers.

Systematic review registration

PROSPERO CRD42015024247

Available only for authorised users

Fazel S, Khosla V, Doll H, Geddes J. The prevalence of mental disorders among the homeless in Western countries: systematic review and meta-regression analysis. PLoS Med. 2008;5(12), e225. doi:10.1371/journal.pmed.0050225.PubMedCentralCrossRefPubMed

Magura S, Nwakeze PC, Rosenblum A, Joseph H. Substance misuse and related infectious diseases in a soup kitchen population. Substance Use Misuse. 2000;35(4):551–83. doi:10.3109/10826080009147472.CrossRefPubMed

Homeless Link. The unhealthy state of homelessness: health audit results. 2014.

Choices NHS. Alcohol units - live well - NHS choices. 2015. http://www.nhs.uk/Livewell/alcohol/Pages/alcohol-units.aspx. Accessed 23/07/2015.

Department for Communities and Local Government. Rough sleeping statistics England—autumn 2014 official statistics: department for communities and local government. 2015.

Crisis. The homelessness monitor. England: Crisis; 2015.

Reeve KBE. The hidden truth about homelessness: experiences of single homelessness in England. 2011.

Coppenrath W. Problems in nutritional status among homeless populations: an introduction. Nutrition Bytes. 2001;7(1).

Darmon N, Coupel J, Deheeger M, Briend A. Dietary inadequacies observed in homeless men visiting an emergency night shelter in Paris. Public Health Nutr. 2001;4(02):155–61. doi:10.1079/PHN200053.PubMed

10.

Evans NS, Elizabeth Baxter Health Centre for the Homeless OTLRLSEPPUK, Dowler EA, Human Nutrition Unit DoPH, Policy LSoH, Tropical Medicine BSLWCBDPUK. Food, health and eating among single homeless and marginalized people in London. J Hum Nutr Diet. 2015;12:179–99. doi:10.1046/j.1365-277x.1999.00157.x.CrossRef

11.

Tse C, Tarasuk V. Nutritional assessment of charitable meal programmes serving homeless people in Toronto. Public Health Nutr. 2008;11(12):1296–305. doi:10.1017/S1368980008002577.CrossRefPubMed

12.

Bode C, Bode JC. Alcohol’s role in gastrointestinal tract disorders. Alcohol Health Res W. 1997;21(1):76–83.

13.

Bernardin F, Maheut-Bosser A, PAILLE F. Cognitive impairments in alcohol-dependent subjects. Frontiers Psychiatry. 2014;5. doi:10.3389/fpsyt.2014.00078

14.

Victor M. The effects of alcohol on the nervous system: clinical features, pathogenesis, and treatment. In: Lieber CS, editor. Medical and nutritional complications of alcoholism: mechanisms in management. New York: Plenum Publishing Corp; 1992. p. 413–57.CrossRef

15.

Leo MA, Rosman AS, Lieber CS. Differential depletion of carotenoids and tocopherol in liver disease. Hepatology (Baltimore, Md). 1993;17(6):977–86.

16.

Szabo G. Alcohol’s contribution to compromised immunity. Alcohol Health Res World. 1997;21:30–41.PubMed

17.

Sprake EF, Russell JM, Barker ME. Food choice and nutrient intake amongst homeless people. Faseb J. 2013;27.

18.

Lown LGS, Deborah A. Do soup kitchen meals contribute to suboptimal nutrient intake & obesity in the homeless population? doi:http://dx.doi.org/101080/193202482011597832. 2011. Journal of Hunger & Environmental Nutrition, Vol. 6, No. 3, July-September 2011: pp. 312–323

19.

Dachner N, Gaetz S, Poland B, Tarasuk V. An ethnographic study of meal programs for homeless and under-housed individuals in Toronto. J Health Care Poor Underserved. 2009;20(3):846–53. doi:10.1353/hpu.0.0167.CrossRefPubMed

20.

Hwang RB, Stephen W. Income and spending patterns among panhandlers. Can Med Assoc J. 2002;167(5):477–479.

21.

Burke V, Beilin LJ, Dunbar D, Kevan M. Changes in health-related behaviours and cardiovascular risk factors in young adults: associations with living with a partner. Prev Med. 2004;39(4):722–30. doi:http://dx.doi.org/10.1016/j.ypmed.2004.02.038.CrossRefPubMed

22.

Beasley LJ, Hackett AF, Maxwell SM. The dietary and health behaviour of young people aged 18–25 years living independently or in the family home in Liverpool, UK. Int J Consum Stud. 2004;28(4):355–63. doi:10.1111/j.1470-6431.2004.00394.x.CrossRef

23.

Quiroga MAD, Suzanne PM, John MN, Lauren G, Seline S. Living arrangements affect dietary quality for U.S. adults aged 50 years and older: NHANES III 1988–1994. 2000.

24.

Darmon N. A fortified street food to prevent nutritional deficiencies in homeless men in France. J Am Coll Nutr. 2009;28(2):196–202.CrossRefPubMed

25.

Yousey Y, .N CPNPPDiSLDoPSoM, Program Manager for Children With Traumatic Brain Injury JFKPUoCaD, Health Sciences Center DC, Leake J, R.N MSNSoNUoNCCCNCR, et al. Education in a homeless shelter to improve the nutrition of young children. Public Health Nurs. 2015;24:249–55. doi:10.1111/j.1525-1446.2007.00631.x.

26.

Pelham-Burn SE, Frost CJ, Russell JM, Barker ME. Improving the nutritional quality of charitable meals for homeless and vulnerable adults. A case study of food provision by a food aid organisation in the UK. Appetite. 2014;82:131–7. doi:http://dx.doi.org/10.1016/j.appet.2014.07.011.CrossRefPubMed

27.

Fitzpatrick-Lewis D, Ganann R, Krishnaratne S, Ciliska D, Kouyoumdjian F, Hwang SW. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review. BMC Public Health. 2011;11(638).

28.

Speirs V, Johnson M, Jirojwong S. A systematic review of interventions for homeless women. J Clin Nurs. 2013;22(7–8):1080–93.CrossRefPubMed

29.

Hwang SW, Tolomiczenko G, Kouyoumdjian FG, Garner RE. Interventions to improve the health of the homeless—a systematic review. Am J Prev Med. 2005;29(4):311–9.CrossRefPubMed

30.

Day E, Bentham PW, Callaghan R, Kuruvilla T, George S. Thiamine for prevention and treatment of Wernicke-Korsakoff Syndrome in people who abuse alcohol. Cochrane Database of Systematic Reviews 2013. 2015(7). doi:10.1002/14651858.CD004033.pub3.

31.

Carmen Sayon-Orea MAM-GMB-R. Alcohol consumption and body weight: a systematic review. Nutr Rev. 2011;69. doi:10.1111/j.1753-4887.2011.00403.x

32.

Effective Practice and Organisation of Care (EPOC). What study designs should be included in an EPOC review and what should they be called? Oslo: Norwegian Knowledge Centre for the Health Services; 2013.

33.

Shelter England. http://england.shelter.org.uk/get_advice/homelessness/homelessness_-_an_introduction/legal_definition_of_homelessness. Accessed 23/07/2015.

34.

Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet. 2014;384(9953):1529–40.PubMedCentralCrossRefPubMed

35.

Frieling H, Leitmeier V, Haschemi-Nassab M, Kornhuber J, Rhein M, Bleich S, et al. Reduced plasma levels of asymmetric di-methylarginine (ADMA) in patients with alcohol dependence normalize during withdrawal. Eur Neuropsychopharmacol. 2012;22(11):836–40. doi:http://dx.doi.org/10.1016/j.euroneuro.2012.03.010.CrossRefPubMed

36.

Kwok TC, Lam LC, Sea MM, Goggins W, Woo J. A randomized controlled trial of dietetic interventions to prevent cognitive decline in old age hostel residents. Eur J Clin Nutr. 2012;66(10):1135–40. doi:http://dx.doi.org/10.1038/ejcn.2012.117.CrossRefPubMed

37.

Cartwright MM, Hajja W, Al-Khatib S, Hazeghazam M, Sreedhar D, Li RN, et al. Toxigenic and metabolic causes of ketosis and ketoacidotic syndromes. Crit Care Clin. 2012;28(4):601–31. doi:http://dx.doi.org/10.1016/j.ccc.2012.07.001.CrossRefPubMed

38.

Bruix J, Raoul JL, Sherman M, Mazzaferro V, Bolondi L, Craxi A, et al. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma: subanalyses of a phase III trial. J Hepatol. 2012;57(4):821–9. doi:http://dx.doi.org/10.1016/j.jhep.2012.06.014.CrossRefPubMed

39.

Shimizu F, Kanda T. Internal medicine and neurological diseases: progress in diagnosis and treatment topics: VIII. Neurological manifestation due to endocrine metabolic disease. Nippon Naika Gakkai Zasshi. 2012;101(8):2226–31.CrossRefPubMed

40.

Strohle A, Wolters M, Hahn A. Alcohol intake—a two-edged sword. Part 1: metabolism and pathogenic effects of alcohol. Med Monatsschr Pharm. 2012;35(8):281–92. quiz 93–4.PubMed

41.

Sivolap IP. Hepatoprotectors in addictive medicine. Zh Nevrol Psikhiatr Im S S Korsakova. 2012;112(5 Pt 2):49–50.PubMed

42.

Kovrazhkina EA. Demyelinating polyneuropathies in patients with diabetes mellitus and chronic alcoholic intoxication. Zh Nevrol Psikhiatr Im S S Korsakova. 2012;112(5):41–5.PubMed

43.

Anonymous. Health tips. Who needs vitamins? Mayo Clin Health Lett. 2012;30(3):3.

44.

Cunha SF, Melo DA, Braga CB, Vannucchi H, Cunha DF. Papillary atrophy of the tongue and nutritional status of hospitalized alcoholics. An Bras Dermatol. 2012;87(1):84–9.PubMed

45.

De Santis JP, Layerla DM, Barroso S, Gattamorta KA, Sanchez M, Prado GJ. Predictors of eating attitudes and behaviors among gay Hispanic men. Arch Psychiatr Nurs. 2012;26(2):111–26. doi:http://dx.doi.org/10.1016/j.apnu.2011.06.003.CrossRefPubMed

46.

Tsai J, Ford ES, Zhao G, Li C, Greenlund KJ, Croft JB. Co-occurrence of obesity and patterns of alcohol use associated with elevated serum hepatic enzymes in US adults. J Behav Med. 2012;35(2):200–10. doi:http://dx.doi.org/10.1007/s10865-011-9353-5.CrossRefPubMed

47.

Harris R, Gamboa A, Dailey Y, Ashcroft A. One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour. Cochrane Database Syst Rev. 2012;3:CD006540. doi:http://dx.doi.org/10.1002/14651858.CD006540.pub2.PubMed

48.

Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. 2011.

49.

Higgins JPT GS. Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane collaboration. 2011. www.cochrane-handbook.org. Accessed 23/07/2015.

50.

Effective Practice and Organisation of Care (EPOC). Suggested risk of bias criteria for EPOC reviews. Oslo: Norwegian Knowledge Centre for the Health Services; 2015.

51.

StataCorp. Stata statistical software: release 13. College Station, TX: StataCorp LP; 2013.

Title: Interventions for preventing or treating malnutrition in problem drinkers who are homeless or vulnerably housed: protocol for a systematic review
Authors: Helen Thorley
Katie Porter
Clare Fleming
Tim Jones
Joanna Kesten
Elsa Marques
Alison Richards
Jelena Savović
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Systematic Reviews / Issue 1/2015
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-015-0114-3

At a glance: The STEP trials

Springer Medicine

Interventions for preventing or treating malnutrition in problem drinkers who are homeless or vulnerably housed: protocol for a systematic review

Abstract

Background

Methods/design

Discussion

Systematic review registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods/design

Discussion

Systematic review registration

Please log in to get access to this content

Other articles of this Issue 1/2015

Australian Aboriginal and Torres Strait Islander-focused primary healthcare social and emotional wellbeing research: a systematic review protocol

A systematic review protocol for measuring comorbidity in inpatient rehabilitation for non-traumatic brain injury

Prognostic factors for tumor recurrence in patients with clinical stage I seminoma undergoing surveillance—protocol for a systematic review

Use of inhaled corticosteroids for the prevention and/or treatment of bronchopulmonary dysplasia in preterm infants: a systematic review protocol

Indicators and measurement tools for health system integration: a knowledge synthesis protocol

Automating data extraction in systematic reviews: a systematic review