Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia.
Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia.
J Stud Alcohol Drugs. 2022 May;83(3):383-391.
This study examined whether self-help group (SHG) attendance during treatment episodes in short-term residential programs increases treatment commitment among adults with substance use disorders (SUDs) in the United States.
This cross-sectional study used the 2018 Treatment Episode Data Set-Discharges (TEDS-D), made available by the Substance Abuse and Mental Health Services Administration (SAMHSA). The effect of SHG attendance frequency was examined on three outcomes: (a) treatment completion and (b) retention, analyzed by multivariable logistic regression models; and (c) time-to-dropout, estimated by Cox proportional hazards regression model.
Of the 75,252 discharges, 38% did not complete the planned treatment. SHG attendance frequency of eight times or more during the treatment episode had a significantly strong association with treatment completion and retention and time-to-dropout. Compared with individuals who did not attend any SHG, individuals attending SHG meetings eight or more times were more than three times as likely to complete treatment (odds ratio [OR] = 3.31, 95% CI [3.15, 3.49]). Similarly, SHG attendance frequency of eight or more times significantly reduced the dropout risk (adjusted hazard ratio [aHR] = 0.32, 95% CI [0.31, 0.34]). Among discharges that dropped out, we found a positive dose-response relationship between SHG attendance frequency and retention.
Our results suggest a strong association between frequent SHG attendance of 8-30 times and improvement in treatment completion and retention, as well as a reduction in early dropout within short-term residential facilities for adults with SUDs. Expanding self-help options in short-term residential settings is warranted.
本研究旨在考察美国短期住院治疗期间参加自助小组（SHG）是否会增加物质使用障碍（SUD）成人的治疗承诺。
本横断面研究使用了物质滥用和心理健康服务管理局（SAMHSA）提供的 2018 年治疗发作数据集中的出院数据（TEDS-D）。通过多变量逻辑回归模型分析了 SHG 参加频率对三个结果的影响：（a）治疗完成和（b）保留率；通过 Cox 比例风险回归模型估计了（c）辍学时间。
在 75252 例出院中，38%的人未完成计划治疗。在治疗期间参加 SHG 的频率达到 8 次或更多次与治疗完成和保留率以及辍学时间有显著的强关联。与未参加任何 SHG 的个体相比，参加 SHG 会议 8 次或更多次的个体完成治疗的可能性要高出三倍以上（优势比 [OR] = 3.31，95%置信区间 [95%CI] [3.15, 3.49]）。同样，SHG 参加频率达到 8 次或更多次也显著降低了辍学风险（调整后的危害比 [aHR] = 0.32，95%CI [0.31, 0.34]）。在辍学的出院者中，我们发现 SHG 参加频率与保留率之间存在正剂量反应关系。
我们的结果表明，在短期住院治疗环境中，参加 8-30 次的频繁 SHG 与提高治疗完成和保留率以及减少早期辍学率之间存在很强的关联。因此，有必要在短期住院环境中扩大自助选择。
