SUMMARYBackground: The efficacy of interferon-a plus ribavirin treatment for patients not responding to interferon monotherapy is not well established. Aim: To assess the efficacy and safety of combination therapy with interferon-a 2a ⁄2b plus ribavirin by performing a meta-analysis of randomized clinical trials. Methods: A systematic search of electronic databases for randomized clinical trials of interferon-a 2a ⁄2b plus ribavirin was conducted independently by two investigators. Data abstraction was performed. The primary end-point was a sustained virological response. Estimates of the common odds ratio were calculated using a random effects model.
AimTo estimate the prevalence of alcohol consumption and analyse the drinking patterns among primary healthcare (PHC) providers.DesignObservational, cross-sectional, descriptive study.SettingPHC centres in the Spanish National Health System (SNHS).ParticipantsDoctors and nurses who completed an online questionnaire which explored their alcohol intake, using the Alcohol Use Disorders Identification Test (AUDIT-C) alcohol assessment tool. The study population was recruited by random sampling stratified by regions of the SNHS PHC centres.Primary and secondary outcome measuresFrequency of alcohol consumption, number of alcohol drinks on a typical day, frequency of more than six standard drinks (SDs) intake.ResultsA total of 1760 PHC providers completed the questionnaire. The frequency of alcohol consumption was: abstention (12%, 95% CI 10.4% to 13.5%); one or less SDs/month (26%, 95% CI 23.8% to 27.9%); 2–4 SDs/month (32.2%, 95% CI 29.7% to 34.1%); 2–3 SDs/week (17.9%, 95% CI 16.0% to 19.6%); four or more SDs/week (11.9%, 95% CI 10.3% to 13.3%). The number of drinks on a typical day was: none (45.6%, 95% CI 42.9% to 47.6%); 1–2 drinks (47.3%, 95% CI 23.8% to 27.9%); 3–4 drinks (6.5%, 95% CI 5.3% to 7.6%). The percentage of hazardous drinking, according to AUDIT-C criteria, was 32% (95% CI 26.7 to 37.3), with a greater frequency of intake in older professionals (p<0.001), in contrast to a higher number of drinks consumed on a typical day by younger providers (p<0.001). Intake was higher among males (p<0.001), primary care physicians (p<0.001) and resident trainers (p<0.001).ConclusionsOur study discloses the most up-to-date portrait of current alcohol consumption among Spanish PHC providers, showing a higher prevalence of alcohol intake, compared with the general population. Preventive strategies should be implemented to improve the awareness and training of PHC professionals towards alcohol consumption.
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