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医疗机构中针对大麻使用的简短干预措施:随机试验的系统评价和荟萃分析。

Brief Interventions for Cannabis Use in Healthcare Settings: Systematic Review and Meta-analyses of Randomized Trials.

机构信息

Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, Canada (SI, AVS, JR); Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (SI, MR, PK, AVS, OSMH, JR); Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (MR, OSMH, JR); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (PK); Mental Health and Addictions Research Program, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (PK); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (PK, AVS, JR); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (JR); and Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany (JR).

出版信息

J Addict Med. 2020 Jan/Feb;14(1):78-88. doi: 10.1097/ADM.0000000000000527.

Abstract

OBJECTIVES

The efficacy of brief interventions for cannabis use was assessed in a systematic review and meta-analyses.

METHODS

Systematic searches in academic databases were conducted, and reference lists of included studies were reviewed. Randomized trials were included that compared brief interventions with minimal control interventions for improving cannabis-specific outcomes among participants recruited from healthcare settings. Mean differences (MDs) based on change-from-baseline measurements were pooled using random-effects meta-analyses, with stratification by short term (≤3 months) and long term (>3 months).

RESULTS

Ten reports from 9 studies were included. Most studies were conducted in the United States, including participants who were adults and were recruited from primary care or emergency departments. There were no significant effects of brief interventions on cannabis-specific Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores in the short term (MD -1.27 points; 95% confidence interval [CI] -3.75, 1.21; I 84.40%). The null pattern of findings was also observed for number of days of cannabis use in the past 30 days in the short term (MD -0.22 days; 95% CI -2.27, 1.82; I 60.30%) and long term (MD -0.28 days; 95% CI -2.42, 1.86; I 60.50%). The evidence base for other outcomes not subjected to meta-analyses was limited and mixed.

CONCLUSIONS

Brief interventions did not result in reductions in cannabis-specific ASSIST scores or number of days of cannabis use, whereas the evidence base for other outcomes was limited and mixed. As such, brief interventions in healthcare settings may not be efficacious for cannabis use.

摘要

目的

本系统评价和荟萃分析评估了简短干预措施治疗大麻使用的疗效。

方法

在学术数据库中进行系统检索,并对纳入研究的参考文献进行了回顾。纳入了比较短期(≤3 个月)和长期(>3 个月)医疗保健环境中招募的参与者中,简短干预与最小对照干预在改善大麻特定结局方面的效果的随机试验。使用基于基线变化测量的随机效应荟萃分析来汇总均值差异(MD),并进行分层分析。

结果

纳入了 9 项研究的 10 项报告。大多数研究在美国进行,参与者为成年人,从初级保健或急诊部门招募。简短干预对大麻特异性酒精、吸烟和物质使用参与筛查测试(ASSIST)评分在短期(MD-1.27 分;95%置信区间 [CI]-3.75,1.21;I 84.40%)内没有显著影响。在短期(MD-0.22 天;95%CI-2.27,1.82;I 60.30%)和长期(MD-0.28 天;95%CI-2.42,1.86;I 60.50%),过去 30 天内大麻使用天数也观察到了相同的无效模式。未进行荟萃分析的其他结局的证据基础有限且混杂。

结论

简短干预并未导致大麻特异性 ASSIST 评分或大麻使用天数减少,而其他结局的证据基础有限且混杂。因此,医疗保健环境中的简短干预可能对大麻使用无效。

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