School of Psychology, University of Wollongong, Australia.
School of Psychology, University of Wollongong, Australia.
Drug Alcohol Depend. 2024 Sep 1;262:111376. doi: 10.1016/j.drugalcdep.2024.111376. Epub 2024 Jun 30.
Treatment completion is associated with improved alcohol and other drug (AOD) treatment outcomes. Unfortunately, treatment disengagement is common, particularly among young people. We reviewed and synthesised research on AOD treatment completion and/or early disengagement among young people.
We conducted a systematic review and meta-analysis of studies reporting on completion rates and/or early disengagement from psychosocial AOD treatment among adolescents and young adults. An overall estimated treatment completion rate was calculated using inverse-variance random effects meta-analysis, and random-effects meta-regression was used to identify between-study level moderators of completion rate. We completed a narrative review summarising literature on early treatment disengagement and within-study level correlates of treatment completion. Study quality was assessed using the EPHPP.
Of the 6158 studies screened, we retained 410 for full text review and included 98 studies in the review. Treatment completion rates were reported in 88 studies, and early disengagement rates were reported in 13. The estimated overall treatment completion rate was 59 % (95 % CI=57-61 %), with experimental studies reporting higher rates of completion than observational studies. There was limited evidence for demographic or substance-related correlates of treatment completion. Contingency management was associated with increased completion rates, as was family-based intervention.
Disengagement from AOD treatment among youth populations is common and contributes to poor treatment outcomes. Existing research has yielded little consensus on the factors associated with treatment completion. The use of contingency management strategies and involving family/social supports in treatment were identified as potential avenues for promoting ongoing treatment engagement.
完成治疗与改善酒精和其他药物（AOD）治疗结果相关。不幸的是，治疗中断很常见，尤其是在年轻人中。我们回顾和综合了关于年轻人 AOD 治疗完成和/或早期脱离的研究。
我们对报告青少年和年轻成年人接受心理社会 AOD 治疗完成率和/或早期脱离的研究进行了系统回顾和荟萃分析。使用逆方差随机效应荟萃分析计算总体估计治疗完成率，并使用随机效应荟萃回归来确定完成率的研究间水平调节因素。我们完成了一项关于早期治疗脱离的文献综述，并总结了治疗完成与研究内水平相关性的文献。使用 EPHPP 评估研究质量。
在筛选的 6158 篇论文中，我们保留了 410 篇进行全文审查，并将 98 项研究纳入综述。88 项研究报告了治疗完成率，13 项研究报告了早期脱离率。估计的总体治疗完成率为 59%（95%CI=57-61%），实验研究报告的完成率高于观察性研究。关于治疗完成的人口统计学或物质相关相关性的证据有限。条件管理与更高的完成率相关，家庭为基础的干预也是如此。
年轻人人群中 AOD 治疗的脱离很常见，导致治疗结果不佳。现有的研究对于与治疗完成相关的因素几乎没有达成共识。使用条件管理策略和让家庭/社会支持参与治疗被确定为促进持续治疗参与的潜在途径。
