School of Public Health, University of Alberta, Canada.
School of Public Health, University of Alberta, Canada.
Drug Alcohol Depend. 2021 Jan 1;218:108434. doi: 10.1016/j.drugalcdep.2020.108434. Epub 2020 Nov 23.
Mapped the sources and types of evidence available on psychosocial interventions in the treatment of opioid use disorder (OUD), with and without pharmacotherapies.
Six electronic databases were searched for research published until July 1, 2019. Included studies were coded on publication characteristics, evidence sources, treatment settings and modalities, study populations and patient characteristics, intervention(s) offered to patients, research questions addressed in experimental studies, and outcomes investigated.
We identified 305 empirical studies of 54,607 patients. Most studies (64 %; n = 194) compared psychosocial interventions to alternative treatment(s) (183 RCTs and 11 quasi-experiments) while 28 % (n = 86) used observational designs, and 8% (n = 25) used qualitative methods. Trials infrequently investigated effects of stand-alone psychosocial interventions without pharmacotherapies (20% of all RCTs). Regardless of research question or study design, program retention and illicit drug use were the most common outcomes investigated (> 81% of all studies and RCTs), typically among longstanding male heroin users attending specialty outpatient addiction services. Studies rarely examined (a) OUD treatment in general health care or prescription OUD (each < 6 % of all studies and RCTs), (b) effects of social assistance (employment, education, social support) and harm reduction (each < 6 % of studies; < 7 % of RCTs), and (c) health-related quality of life and satisfaction with care (each < 10 % and < 15 % of all studies and RCTs, respectively).
Scant evidence is available on the putative rehabilitative effects of psychosocial interventions, either as stand-alone treatments or in an adjunct role to pharmacotherapies.
本研究旨在绘制有或无药物治疗的情况下，治疗阿片类药物使用障碍（OUD）的心理社会干预措施的可用证据来源和类型。
检索了六个电子数据库，以获取截至 2019 年 7 月 1 日发表的研究。纳入的研究按出版物特征、证据来源、治疗环境和模式、研究人群和患者特征、提供给患者的干预措施、实验研究中提出的研究问题和调查的结果进行编码。
我们共确定了 305 项针对 54607 名患者的实证研究。大多数研究（64%；n=194）将心理社会干预措施与替代治疗方法进行了比较（183 项 RCT 和 11 项准实验），28%（n=86）使用观察性设计，8%（n=25）使用定性方法。试验很少调查无药物治疗的独立心理社会干预措施的效果（所有 RCT 的 20%）。无论研究问题或研究设计如何，方案保留率和非法药物使用是最常见的研究结果（所有研究和 RCT 的>81%），通常是在长期男性海洛因使用者参加专科门诊成瘾服务中。研究很少检查（a）一般医疗保健中的 OUD 治疗或处方 OUD（所有研究和 RCT 的<6%），（b）社会援助（就业、教育、社会支持）和减少伤害的效果（研究中的<6%；RCT 的<7%），以及（c）健康相关生活质量和护理满意度（所有研究和 RCT 的分别<10%和<15%）。
关于心理社会干预措施的潜在康复效果的证据很少，无论是作为独立治疗还是作为药物治疗的辅助手段。
