A systematic review of interventions to enhance initiation of and adherence to treatment for alcohol use disorders.

Autor: Biswal B; Addictions and related-Research Group, Sangath, Goa, India., Bora S; Addictions and related-Research Group, Sangath, Goa, India., Anand R; Addictions and related-Research Group, Sangath, Goa, India., Bhatia U; Addictions and related-Research Group, Sangath, Goa, India., Fernandes A; Addictions and related-Research Group, Sangath, Goa, India., Joshi M; Addictions and related-Research Group, Sangath, Goa, India., Nadkarni A; Addictions and related-Research Group, Sangath, Goa, India; Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK. Electronic address: abhijit.nadkarni@lshtm.ac.uk.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2024 Oct 01; Vol. 263, pp. 112429. Date of Electronic Publication: 2024 Aug 28.
DOI: 10.1016/j.drugalcdep.2024.112429
Abstrakt: Background: Alcohol use disorders (AUDs) contribute significantly to the global disease burden in terms of morbidity and mortality. While effective treatment options exist, engagement with care remains a challenge, impacting treatment outcomes and resource allocation, particularly in resource-constrained settings. In this review, we aim to systematically examine and synthesize the evidence on interventions targeting initiation of and adherence to treatment for AUDs.
Methods: A search was conducted on six electronic databases (MEDLINE, PsycINFO, Embase, Global Health, CINAHL and CENTRAL) using search terms under the following concepts: alcohol use disorders, initiation/adherence, treatments, and controlled trial study design. Due to the heterogeneity in intervention content and outcomes among the included studies, a narrative synthesis was conducted. Risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools.
Results: The search yielded 32 distinct studies testing eleven categories of interventions. 23 out of 32 studies reported effectiveness of interventions in improving at least one initiation or adherence outcome, with 11 studies reporting an improvement in at least one outcome related to drinking, and four studies reporting improvements in at least one measure of well-being or disability. Community Reinforcement Approach and Family Training (CRAFT) emerged as a prominent approach for treatment initiation, contingency management for adherence, and motivational interviewing (MI) for both treatment initiation and adherence.
Conclusion: Integrating initiation and adherence interventions into AUD treatment services holds immense potential for optimizing client outcomes and fostering overall well-being. However, generalizability of these strategies remains uncertain owing to the lack of studies conducted in low- and middle-income countries. Addressing this gap is crucial for enhancing global access to effective treatments for AUDs.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Abhijit Nadkarni reports financial support was provided by National Institute for Health and Care Research. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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