Non-pharmacological measures for the treatment of iron deficiency anemia: A systematic review and meta-analysis

Objective: To conduct a systematic review and meta-analysis to evaluate the effectiveness of non-pharmacological measures for the treatment of iron-deficiency anemia (IDA). Data sources: MEDLINE (via PubMed), Cochrane library, SciELO/LILACS and EMBASE up to June 2021 Study selection and data extraction: We identified all randomized controlled trials (RCTs) that used non-pharmacological measures to treat IDA including iron pots/ingots, or food use were included. The outcomes of interest were hemoglobin (Hb) concentrations and prevalence of anemia. Results: 479 studies were retrieved from the databases, of which 4 duplicate records were removed. After, all titles and abstracts were reviewed, 23 articles were considered potentially relevant, and were read in full and checked for eligibility. Three articles met all inclusion criteria. We also conducted a manual search for citations and a further 8 records were identified and checked for eligibility. Eleven RCTs were included in this review. Estimates showed that the use of non-pharmacological measures was associated with a statistically significant overall increase in mean Hb (MD +0.45 g/dL, 95% CI 0.05 to 0.85, p=0.03). The effect of non-pharmacological measures on the prevalence of IDA was analyzed in only 5 RCTs. Participants in the intervention groups were 2.78 times less likely to suffer from IDA than those in the control groups, OR=2.78, 95% CI 0.93, 8.29, however without significance for the overall effect (p=0.07). Conclusion: Non-pharmacological therapies have a positive effect on iron balance, and can a useful adjunct to programs to prevent and treat IDA in at-risk populations. (PROSPERO registration number CRD42021261773).