McKay James R
University of Pennsylvania, Treatment Research Center, 3900 Chestnut Street, Philadelphia, PA 19104, USA.
Curr Psychiatry Rep. 2006 Oct;8(5):355-62. doi: 10.1007/s11920-006-0036-9.
Newer models of continuing care in the addictions are designed to improve the long-term management of substance use disorders by engaging patients into flexible, or "adaptive," treatment algorithms that change in focus and intensity as symptoms wax and wane over time. This article describes some of these newer approaches to the management of substance use disorders and presents recent research on their effectiveness. Findings suggest the following: 1) Continuing care interventions of a year or longer are more likely to show significant positive effects; 2) Continuing care treatments that are less burdensome to patients appear to promote higher rates of sustained engagement; 3) More structured and intensive continuing care may be more effective for patients with severe substance dependence and associated problems and for those who fail to achieve reasonable progress while in the initial phase of treatment; and 4) Use of medications as part of continuing care is increasing.
成瘾领域中新型的持续护理模式旨在通过让患者参与灵活的或“适应性”治疗算法来改善物质使用障碍的长期管理，这些算法会随着症状随时间的起伏而在重点和强度上发生变化。本文描述了一些管理物质使用障碍的新型方法，并介绍了关于其有效性的最新研究。研究结果表明：1）持续一年或更长时间的护理干预更有可能显示出显著的积极效果；2）对患者负担较小的持续护理治疗似乎能促进更高的持续参与率；3）对于有严重物质依赖及相关问题的患者以及在治疗初始阶段未能取得合理进展的患者，更结构化、更强化的持续护理可能更有效；4）作为持续护理一部分使用药物的情况正在增加。
