Abufarsakh Bassema, Kappi Amani, Pemberton Kylie M, Williams Lovoria B, Okoli Chizimuzo T C
University of Kentucky College of Nursing, Lexington, Kentucky, USA.
University of Kentucky College of Education, Lexington, Kentucky, USA.
Int J Ment Health Nurs. 2023 Jun;32(3):704-726. doi: 10.1111/inm.13103. Epub 2022 Dec 19.
Assertive Community Treatment (ACT) is a multidisciplinary treatment approach to support people with severe mental illnesses (SMI) in their recovery. While the majority of ACT recipients report co-morbid substance use issues, limited reviews have evaluated the impact of receiving ACT services on substance use outcomes. The purpose of this systematic review was to evaluate the impact of ACT involvement on substance use outcomes among people with SMI. A systematic literature search was conducted including articles published prior to April 2021. Twenty-nine studies were included in this review. Of them, 15 studies implemented a controlled design (six studies demonstrated high quality) and 14 studies implemented a cohort design. From a synthesis of the reviewed studies, five areas of changes associated with substance use emerged including reduced alcohol and drug use severity, lower prevalence of alcohol and drug use, increased stage of change in substance use treatment, and fewer days of hospitalization and intoxication. Thus, future studies should examine the integration of substance use treatment services as part of ACT interventions for opportunities to enhance recovery outcomes among individuals with SMI.
积极社区治疗（ACT）是一种多学科治疗方法，旨在支持患有严重精神疾病（SMI）的人康复。虽然大多数接受ACT治疗的人报告存在共病物质使用问题，但有限的综述评估了接受ACT服务对物质使用结果的影响。本系统综述的目的是评估ACT参与对患有SMI的人的物质使用结果的影响。进行了系统的文献检索，包括2021年4月之前发表的文章。本综述纳入了29项研究。其中，15项研究采用了对照设计（6项研究显示质量较高），14项研究采用了队列设计。通过对综述研究的综合分析，出现了与物质使用相关的五个变化领域，包括酒精和药物使用严重程度降低、酒精和药物使用患病率降低、物质使用治疗的改变阶段增加以及住院和中毒天数减少。因此，未来的研究应探讨将物质使用治疗服务纳入ACT干预措施的可能性，以提高患有SMI的个体的康复效果。
