Evidence map›Paper›PMID 29338739›Full record

SynthesisInternational journal for equity in health2018

Interventions for preventing or treating malnutrition in homeless problem-drinkers: a systematic review.

Sharea Ijaz, Helen Thorley, Katie Porter, Clare Fleming, Tim Jones, Joanna Kesten, Loubaba Mamluk, Alison Richards, Elsa M R Marques, Jelena Savović

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in International journal for equity in health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
4.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Nutrition Status of People Experiencing Homelessness Residing in Temporary Accommodation in London.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Article
  4. Article
  5. Homelessness at the San Diego Central Library: Assessing the Potential Role of Social Workers.International journal of environmental research and public health · 2022
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Sharea IjazThe National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK. s.ijaz@bristol.ac.uk.ORCID 0000-0001-5727-1790
Helen ThorleyThe National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
Katie PorterCity Hall, Bristol, BS1 5TR, UK.
Clare FlemingCompass Health, The Compass Centre, 1 Jamaica Street, Bristol, BS2 8JP, UK.
Tim JonesThe National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
Joanna KestenThe National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
Loubaba MamlukThe National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
Alison RichardsThe National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
Elsa M R MarquesBristol Medical School, Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Bristol, UK.
Jelena SavovićThe National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
University Hospitals Bristol NHS Foundation Trust · GBBristol City Council · GBUniversity of Bristol · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExcessive drinking leads to poor absorption of nutrients and homeless problem-drinkers often have nutritionally inadequate diets. Depletion of nutrients such as vitamin B1 can lead to cognitive impairment, which can hinder efforts to reduce drinking or engage with services. This review aimed to assess effectiveness of interventions designed to prevent or treat malnutrition in homeless problem-drinkers.

methodsWe systematically searched nine electronic databases and 13 grey literature sources for studies evaluating interventions to improve nutrition in homeless populations, without regional or language restrictions. Screening for inclusion was done in duplicate. One reviewer extracted data and assessed risk of bias, and another checked the extractions. Primary outcomes were nutrition status/deficiency, liver damage, and cognitive function. Secondary outcomes included abstinence, comorbidities, resource use, acceptability and engagement with intervention. Results were synthesised narratively.

resultsWe included 25 studies (2 Randomised Controlled Trials; 15 uncontrolled before and after; 7 surveys; 1 case-control). Nine studies evaluated educational and support interventions, five food provision, and three supplement provision. Eight studies evaluated a combination of these interventions. No two interventions were the same, and all studies were at high risk of bias. Nutritional status (intake/ deficiency) were reported in 11 studies and liver function in one. Fruit and vegetable intake improved with some education and support interventions (n = 4 studies) but not others (n = 2). Vitamin supplements appeared to improve vitamin deficiency levels in the blood (n = 2). Free or subsidised meals (n = 4) and food packs (n = 1) did not always fulfil dietary needs, but were usually considered acceptable by users. Some multicomponent interventions improved nutrition (n = 3) but acceptability varied (n = 3). No study reported cost effectiveness.

conclusionsThe evidence for any one intervention for improving malnutrition in homeless problem-drinkers was based on single studies at high risk of bias. Various food and supplement provision interventions appear effective in changing nutritional status in single studies. Educational and multicomponent interventions show improved nutritional behaviour in some studies but not others. Further better quality evidence is required before these interventions can be recommended for implementation. Any future studies should seek the end user input in their design and conduct.

trial registrationRegistered with PROSPERO: CRD42015024247 .

Indexed as

Ill-Housed PersonsNutritional StatusAdultAgedAged, 80 and overAlcohol DrinkingAlcoholismFemaleHumansMaleMalnutritionMiddle AgedAlcoholAlcoholismDependenceHomelessMalnutritionMicronutrientsNutritionProblem-drinkingSupplementsSystematic reviewThiamine

Identifiers

PMID29338739
PMCPMC5771104
OpenAlexW2783248686

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.