Chazal Camille, Roux Charline, Kinouani Shérazade, Schuers Matthieu, Fortin Frédéric, Pereira Bruno, Blanc Olivier, Piñol-Domenech Nathalie, Brousse Georges, Vorilhon Philippe, Laporte Catherine
Department of General Practice, Université Clermont Auvergne, Clermont-Ferrand, France.
Department of General Practice, University of Bordeaux, Bordeaux F-33000, France.
Fam Pract. 2022 Nov 22;39(6):1156-1168. doi: 10.1093/fampra/cmac050.
The aim of this systematic review was to assess the effectiveness of brief interventions realized in primary care in reducing cannabis use for adolescents and emerging adults.
PubMed, CINAHL, Embase, PsycInfo, and Central (Cochrane Library) were searched until December 2020. Randomized controlled trials conducted in primary care, concerning in-person brief interventions for non-medical cannabis users aged from 12 to 25 years old were eligible for inclusion. Brief interventions had to last 30 min or less. Patients with comorbid mental health disorder or very specific populations were not included.
One thousand eighty hundred and fifty-five studies were identified through database searching; only 8 studies involving 2,199 patients were included for qualitative synthesis after double reading and data extraction. Randomized controlled trials selected were heterogeneous regarding screening tools, initial levels of cannabis use and cannabis outcomes measures. Brief interventions were all based on motivational interviewing techniques or personalized feedback. Seven studies consisted in a single session of brief intervention. Six studies involved also other substance users. No significant reduction of cannabis use after brief intervention was found for most studies, especially in the long term. A trend of decreased cannabis consequences, such as negative psychosocial repercussions, perception of cannabis use by peers, or driving under the influence of cannabis, was reported.
The current state of knowledge does not allow us to say that the brief intervention is effective in reducing cannabis use among adolescents in primary care. We found a mild positive effect on cannabis consequences after brief intervention. Mixed qualitative and quantitative studies are need to better evaluate the impact of brief intervention and his faisability. PROSPERO (International Prospective Register of Systematic Reviews): n° CRD42016033080.
本系统评价的目的是评估在初级保健中实施的简短干预措施对减少青少年和刚成年者大麻使用的有效性。
检索了截至2020年12月的PubMed、CINAHL、Embase、PsycInfo和Central(Cochrane图书馆)。在初级保健中进行的针对12至25岁非医疗大麻使用者的面对面简短干预的随机对照试验符合纳入标准。简短干预必须持续30分钟或更短时间。合并精神健康障碍的患者或非常特殊的人群不包括在内。
通过数据库检索确定了1855项研究;经过双重阅读和数据提取后,仅纳入了8项涉及2199名患者的研究进行定性综合分析。所选的随机对照试验在筛查工具、大麻使用初始水平和大麻结果测量方面存在异质性。简短干预均基于动机访谈技术或个性化反馈。7项研究包括单次简短干预。6项研究还涉及其他物质使用者。大多数研究发现,简短干预后大麻使用没有显著减少,尤其是从长期来看。报告了大麻相关后果有减少的趋势,如负面心理社会影响、同龄人对大麻使用的看法或在大麻影响下驾驶。
目前的知识水平使我们无法断言简短干预在减少初级保健中青少年大麻使用方面是有效的。我们发现简短干预后对大麻相关后果有轻微的积极影响。需要进行定性和定量混合研究,以更好地评估简短干预的影响及其可行性。国际系统评价前瞻性注册库(PROSPERO):编号CRD42016033080。