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针对物质使用障碍患者的病例管理干预措施的效果:一项系统评价。

Effect of Case Management Interventions for Patients with Substance Use Disorders: A Systematic Review.

作者信息

Penzenstadler Louise, Machado Ariella, Thorens Gabriel, Zullino Daniele, Khazaal Yasser

机构信息

Geneva University Hospitals, Geneva, Switzerland.

Faculty of Medicine, Geneva University, Geneva, Switzerland.

出版信息

Front Psychiatry. 2017 Apr 6;8:51. doi: 10.3389/fpsyt.2017.00051. eCollection 2017.

Abstract

BACKGROUND

Substance use disorder (SUD) is an important health problem that requires a complex range of care because of the chronic nature of the disorder and the multiple psychosocial problems involved. Current outpatient programs often have difficulties in delivering and coordinating ongoing care and access to different health-care providers. Various case management (CM) models have been developed, first for patients in other psychiatric domains and then for patients with SUD, in order to improve treatment outcomes.

AIM

This paper aims to assess the effectiveness of CM for patients with SUD.

METHODS

We performed a systematic review of CM interventions for patients with SUD by analyzing randomized controlled studies published on the subject between 1996 and 2016 found on the electronic database PubMed.

RESULTS AND CONCLUSION

Fourteen studies were included in the analysis. Differences between studies in outcome measures, populations included, and intervention characteristics made it difficult to compare results. Most of these studies reported improvement in some of the chosen outcomes. Treatment adherence mostly improved, but substance use was reported to decrease in only a third of the studies. Overall functioning improved in about half of the studies. The heterogeneity of the results might be linked to these differences between studies. Further research is needed in the field.

摘要

背景

物质使用障碍(SUD)是一个重要的健康问题,由于该障碍的慢性性质以及所涉及的多种心理社会问题,需要一系列复杂的护理。当前的门诊项目在提供和协调持续护理以及患者接触不同医疗服务提供者方面常常存在困难。为了改善治疗效果,已经开发了各种病例管理(CM)模式,最初用于其他精神科领域的患者,随后用于患有物质使用障碍的患者。

目的

本文旨在评估病例管理对物质使用障碍患者的有效性。

方法

我们通过分析在电子数据库PubMed上检索到的1996年至2016年间发表的关于物质使用障碍患者病例管理干预措施的随机对照研究,对病例管理干预措施进行了系统评价。

结果与结论

分析纳入了14项研究。研究在结局指标、纳入人群和干预特征方面的差异使得难以比较结果。这些研究中的大多数报告了某些选定结局的改善。治疗依从性大多有所提高,但只有三分之一的研究报告物质使用有所减少。约一半的研究中整体功能有所改善。结果的异质性可能与这些研究之间的差异有关。该领域需要进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f06/5382199/525e1ab5a0c3/fpsyt-08-00051-g001.jpg

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