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针对哪些人进行简短的物质使用干预最有效:一项个体参与者数据荟萃分析。

Investigating for Whom Brief Substance Use Interventions Are Most Effective: An Individual Participant Data Meta-analysis.

机构信息

Prevention Science Institute, University of Oregon, University of Oregon, 97403-6217, Eugene, OR, USA.

HEDCO Institute for Evidence-Based Educational Practice, University of Oregon, University of Oregon, 1215, 97403-1215, Eugene, OR, USA.

出版信息

Prev Sci. 2023 Nov;24(8):1459-1482. doi: 10.1007/s11121-023-01525-1. Epub 2023 May 3.

Abstract

Prior research suggests that brief interventions (BIs) for alcohol and other drug use may vary in effectiveness across patient sociodemographic factors. The objective of this individual participant data (IPD) meta-analysis was to explore for whom BIs delivered in general healthcare settings are more or less effective. We examined variability in BI effects by patient age, sex, employment, education, relationship status, and baseline severity of substance use using a two-stage IPD meta-analysis approach. All trials included in a parent aggregate data meta-analysis (k = 116) were invited to contribute IPD, and 29 trials provided patient-level data (12,074 participants). Among females, BIs led to significant reductions in binge alcohol consumption ([Formula: see text] = 0.09, 95% CI [0.03, 0.14]), frequency of alcohol consumption ([Formula: see text] = 0.10, 95% CI [0.03, 0.17]), and alcohol-related consequences ([Formula: see text] = 0.16, 95% CI [0.08, 0.25]), as well as greater substance use treatment utilization ([Formula: see text] = 0.25, 95% CI [0.21, 0.30]). BIs yielded larger reductions in frequency of alcohol consumption at 3-month follow-up for individuals with less than a high school level education ([Formula: see text] = 0.16, 95% CI [0.09, 0.22]). Given evidence demonstrating modest BI effects on alcohol use and mixed or null findings for BI effects on other drug use, BI research should continue to investigate potential drivers of effect magnitude and variation.  PROTOCOL REGISTRATION DETAILS: The protocol for this review was pre-registered in PROSPERO #CRD42018086832 and the analysis plan was pre-registered in OSF: osf.io/m48g6.

摘要

先前的研究表明,简短干预(BI)在酒精和其他药物使用方面的有效性可能因患者的社会人口统计学因素而有所不同。本项个体参与者数据(IPD)荟萃分析的目的是探讨在一般医疗保健环境中提供 BI 对哪些患者更有效或更无效。我们使用两阶段 IPD 荟萃分析方法,通过患者年龄、性别、就业、教育、婚姻状况和物质使用的基线严重程度来检查 BI 效果的变异性。邀请参加汇总数据荟萃分析的所有试验(k=116)提供 IPD,其中 29 个试验提供了患者水平数据(12074 名参与者)。在女性中,BI 导致 binge 饮酒量显著减少([Formula: see text] = 0.09,95%CI [0.03,0.14])、饮酒频率([Formula: see text] = 0.10,95%CI [0.03,0.17])和酒精相关后果([Formula: see text] = 0.16,95%CI [0.08,0.25])的减少,以及更多的物质使用治疗利用([Formula: see text] = 0.25,95%CI [0.21,0.30])。对于受教育程度低于高中学历的个体,BI 在 3 个月随访时对饮酒频率的降低幅度更大([Formula: see text] = 0.16,95%CI [0.09,0.22])。鉴于 BI 对酒精使用的影响证据表明适度,而 BI 对其他药物使用的影响结果混杂或无效,BI 研究应继续调查影响幅度和变异性的潜在驱动因素。

协议注册详情:该综述的方案已在 PROSPERO 进行了预先注册(#CRD42018086832),分析计划已在 OSF 进行了预先注册(osf.io/m48g6)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9ba/10678844/bd94672334c6/11121_2023_1525_Fig1_HTML.jpg

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