Klinisk behandling av rusavhengighet: Metaanalyse

Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials

Authors
Glass, J. E. Hamilton, A. M. Powell, B. J. Perron, B. E. Brown, R. T. Ilgen, M. A.
Year
2015
Journal
Addiction
Volume
110
Pages
1404-15
BACKGROUND AND AIMS: Brief alcohol interventions in medical settings are efficacious in improving self-reported alcohol consumption among those with low-severity alcohol problems. Screening, Brief Intervention and Referral to Treatment initiatives presume that brief interventions are efficacious in linking patients to higher levels of care, but pertinent evidence has not been evaluated. We estimated main and subgroup effects of brief alcohol interventions, regardless of their inclusion of a referral-specific component, in increasing the utilization of alcohol-related care. METHODS: A systematic review of English language papers published in electronic databases to 2013. We included randomized controlled trials (RCTs) of brief alcohol interventions in general health-care settings with adult and adolescent samples. We excluded studies that lacked alcohol services utilization data. Extractions of study characteristics and outcomes were standardized and conducted independently. The primary outcome was post-treatment alcohol services utilization assessed by self-report or administrative data, which we compared across intervention and control groups. RESULTS: Thirteen RCTs met inclusion criteria and nine were meta-analyzed (n=993 and n=937 intervention and control group participants, respectively). In our main analyses the pooled risk ratio (RR) was=1.08, 95% confidence interval (CI)=0.92-1.28. Five studies compared referral-specific interventions with a control condition without such interventions (pooled RR=1.08, 95% CI=0.81-1.43). Other subgroup analyses of studies with common characteristics (e.g. age, setting, severity, risk of bias) yielded non-statistically significant results. CONCLUSIONS: There is a lack of evidence that brief alcohol interventions have any efficacy for increasing the receipt of alcohol-related services. Copyright © 2015 Society for the Study of Addiction.

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Type of intervention

Early Intervention

Topic

Drugs and Gambling

Alcohol

Intervention

The organization of interventions

Brief Interventions

Age group

Adolescents (13-18 years)

Age not specified

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