Abstract
BackgroundThere is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a “usual care or no intervention” which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children.MethodsData on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model.Results28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants.ConclusionThe most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison prevention practices they wish to promote.HighlightsNetwork meta-analysis is useful for comparing multiple injury-prevention interventions.More intensive poison prevention interventions were more effective than education alone. Education and low cost/free equipment was most effective in promoting safe storage of medicines. Education, low cost/free equipment, home safety inspection and fitting was most effective in promoting safe storage of household products and poisons. Education, low cost/free equipment and home inspection were most effective in promoting possession of a poison control centre number.None of the intervention packages was more effective than the others in promoting safe storage of poisonous plants.
Highlights
Poisonings result in approximately 45,000 deaths[1] and approximately 2.4 million disability adjusted life years (DALYS) lost (GBD 2010) each year in children and young people aged 0–19 years
Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10)
The results show that home safety interventions increase safe storage of medicines with education and low cost/free equipment the most likely to be effective, with an estimated odds ratio compared to usual care of 2.51 (95% CrI: 1.01 to 6.00)
Summary
Poisonings result in approximately 45,000 deaths[1] and approximately 2.4 million disability adjusted life years (DALYS) lost (GBD 2010) each year in children and young people aged 0–19 years. More recent metaanalyses found home safety education, with or without the provision of safety equipment was effective in increasing safe storage of medicines, safe storage of non-medicinal products and increasing availability of poison control centre numbers[8]. These meta-analyses compared any intervention against a “usual care or no intervention” comparison group. The interventions comprised various combinations of education, home safety inspection, provision of free or low cost safety latches for cabinets, drawers or cupboards and fitting of safety latches Some of these interventions were aimed only at preventing poisonings, but most aimed to prevent a range of injuries and included the provision of education and other items of safety equipment. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children
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