Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials

Pablo Barrio, Antoni Gual Neurosciences Institute, Hospital Clinic, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer, Barcelona, Spain Issues: Patient-centered care (PCC) is increasingly accepted as an integral component of good health care, including addict...

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Main Authors: Barrio P, Gual A
Format: Article
Language:English
Published: Dove Medical Press 2016-09-01
Series:Patient Preference and Adherence
Subjects:
Online Access:https://www.dovepress.com/patient-centered-care-interventions-for-the-management-of-alcohol-use--peer-reviewed-article-PPA
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spelling doaj-d8cbf9de9abe40cbb9e53e9e52e0f1812020-11-24T22:15:16ZengDove Medical PressPatient Preference and Adherence1177-889X2016-09-01Volume 101823184528928Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trialsBarrio PGual APablo Barrio, Antoni Gual Neurosciences Institute, Hospital Clinic, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer, Barcelona, Spain Issues: Patient-centered care (PCC) is increasingly accepted as an integral component of good health care, including addiction medicine. However, its implementation has been controversial in people with alcohol use disorders. Approach: A systematic search strategy was devised to find completed randomized controlled trials enrolling adults (>18 years) with alcohol use disorders. Studies had to use a PCC approach such that they should have been individualized, respectful to the patients’ own goals, and empowering. Studies until September 2015 were searched using PubMed, Scopus, the Cochrane Library, PsychINFO, and Web of Knowledge. Key findings: In total, 40 studies enrolling 16,020 patients met the inclusion criteria. Assessment revealed two main categories of study: psychosocial (n=35 based on motivational interviewing) and pharmacological (n=5 based on an as needed dosing regimen). Psychosocial interventions were further classified according to the presence or absence of an active comparator. When no active comparator was present, studies were classified according to the number of sessions (≥1). Results from single sessions of motivational interviewing showed no clear benefit on alcohol consumption outcomes, with few studies indicating benefit of PCC versus control. Although the results for studies of multiple sessions of counseling were also mixed, many did show a significant benefit of the PCC intervention. By contrast, studies consistently demonstrated a benefit of pharmacologically supported PCC interventions, with most of the differences reaching statistical significance. Implications: PCC-based interventions may be beneficial for reducing alcohol consumption in people with alcohol use disorders. Keywords: psychosocial intervention, pharmacological intervention, motivational interviewing, as-neededhttps://www.dovepress.com/patient-centered-care-interventions-for-the-management-of-alcohol-use--peer-reviewed-article-PPAPatient centred carealcohol use disorderspsychosocialmotivational interviewing
collection DOAJ
language English
format Article
sources DOAJ
author Barrio P
Gual A
spellingShingle Barrio P
Gual A
Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials
Patient Preference and Adherence
Patient centred care
alcohol use disorders
psychosocial
motivational interviewing
author_facet Barrio P
Gual A
author_sort Barrio P
title Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials
title_short Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials
title_full Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials
title_fullStr Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials
title_full_unstemmed Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials
title_sort patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials
publisher Dove Medical Press
series Patient Preference and Adherence
issn 1177-889X
publishDate 2016-09-01
description Pablo Barrio, Antoni Gual Neurosciences Institute, Hospital Clinic, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer, Barcelona, Spain Issues: Patient-centered care (PCC) is increasingly accepted as an integral component of good health care, including addiction medicine. However, its implementation has been controversial in people with alcohol use disorders. Approach: A systematic search strategy was devised to find completed randomized controlled trials enrolling adults (>18 years) with alcohol use disorders. Studies had to use a PCC approach such that they should have been individualized, respectful to the patients’ own goals, and empowering. Studies until September 2015 were searched using PubMed, Scopus, the Cochrane Library, PsychINFO, and Web of Knowledge. Key findings: In total, 40 studies enrolling 16,020 patients met the inclusion criteria. Assessment revealed two main categories of study: psychosocial (n=35 based on motivational interviewing) and pharmacological (n=5 based on an as needed dosing regimen). Psychosocial interventions were further classified according to the presence or absence of an active comparator. When no active comparator was present, studies were classified according to the number of sessions (≥1). Results from single sessions of motivational interviewing showed no clear benefit on alcohol consumption outcomes, with few studies indicating benefit of PCC versus control. Although the results for studies of multiple sessions of counseling were also mixed, many did show a significant benefit of the PCC intervention. By contrast, studies consistently demonstrated a benefit of pharmacologically supported PCC interventions, with most of the differences reaching statistical significance. Implications: PCC-based interventions may be beneficial for reducing alcohol consumption in people with alcohol use disorders. Keywords: psychosocial intervention, pharmacological intervention, motivational interviewing, as-needed
topic Patient centred care
alcohol use disorders
psychosocial
motivational interviewing
url https://www.dovepress.com/patient-centered-care-interventions-for-the-management-of-alcohol-use--peer-reviewed-article-PPA
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