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探索治疗依从性及其与酒精问题治疗随机对照试验结局的关系:英国酒精治疗试验(UKATT)的二次分析。

Exploring treatment attendance and its relationship to outcome in a randomized controlled trial of treatment for alcohol problems: secondary analysis of the UK Alcohol Treatment Trial (UKATT).

机构信息

Department of Health Sciences, ARRC 005A, University of York, Heslington, York YO10 5DD, UK.

出版信息

Alcohol Alcohol. 2011 Sep-Oct;46(5):592-9. doi: 10.1093/alcalc/agr079. Epub 2011 Jul 5.

Abstract

AIMS

To identify client characteristics that predict attendance at treatment sessions and to investigate the effect of attendance on outcomes using data from the UK Alcohol Treatment Trial.

METHODS

Logistic regression was used to determine whether there were characteristics that could predict attendance and then continuation in treatment. Linear regression was used to explore the effects of treatment attendance on outcomes.

RESULTS

There were significant positive relationships between treatment attendance and outcomes at Month 3. At Month 12, these relationships were only significant for dependence and alcohol problems for those randomized to motivational enhancement therapy (MET). There were significant differences between groups in attendance, with MET clients more likely to attend than clients allocated to social behaviour and network therapy (SBNT). MET clients were also more likely to attend all sessions (three sessions) compared with SBNT (eight sessions). MET clients with larger social networks and those with confidence in their ability not to drink excessively were more likely to attend. SBNT clients with greater motivation to change and those with more negative short-term alcohol outcome expectancies were more likely to attend. No significant predictors were found for retention in treatment for MET. For those receiving SBNT, fewer alcohol problems were associated with continuation in treatment.

CONCLUSION

Attending more sessions was associated with better outcomes. An interpretation of these findings is that, to improve outcomes, methods should be developed and used to increase attendance rates. Different characteristics were identified that predicted attendance and continuation in treatment for MET and SBNT.

摘要

目的

确定能够预测治疗期间就诊情况的患者特征,并利用来自英国酒精治疗试验的数据来调查就诊情况对结局的影响。

方法

采用逻辑回归来确定是否存在可预测就诊情况和后续治疗的特征。采用线性回归来探讨治疗就诊对结局的影响。

结果

在第 3 个月时,治疗就诊与结局之间存在显著的正相关关系。在第 12 个月时,对于随机分配到动机增强治疗(MET)的患者,这些关系仅在依赖和酒精问题方面具有统计学意义。在就诊方面,MET 组和社会行为及网络治疗(SBNT)组之间存在显著差异,MET 组的就诊率更高。与 SBNT 组(8 次)相比,MET 组更有可能参加所有 3 次治疗。社交网络更大、对自身不酗酒能力有信心的 MET 组患者更有可能就诊。有更强的改变动机和对短期饮酒后果期望更负面的 SBNT 组患者更有可能就诊。对于 MET 组,没有发现治疗保留的显著预测因素。对于接受 SBNT 的患者,较少的酒精问题与继续治疗有关。

结论

参加更多的治疗课程与更好的结局相关。这些发现的解释是,为了改善结局,应开发并使用各种方法来提高就诊率。对于 MET 和 SBNT,确定了不同的特征可以预测就诊情况和继续治疗。

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