Department of Medicine, University of Illinois Chicago, Chicago, IL 60608, United States.
Department of Obstetric and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok 10700, Thailand.
Drug Alcohol Depend. 2024 Oct 1;263:111406. doi: 10.1016/j.drugalcdep.2024.111406. Epub 2024 Aug 10.
This systematic review synthesized evidence from randomized controlled trials (RCTs) on the effects of integrated behavioral interventions for adults with alcohol use disorder (AUD).
A comprehensive search of three databases was conducted in 2022, utilizing terms related to alcohol/substance use disorders and integrated interventions. The sample included adults aged ≥18 years at low, moderate, or high risk for AUD, and had at least two other mental health conditions. Only RCTs were included and screened using Covidence. The quality of the study was evaluated using Cochrane risk of bias tool.
Across all 11 studies, the total AUD participants were 1543 aged 18 or older. Integrated intervention led to significant reductions in heavy drinking compared to usual care or other interventions. Measures included percent days of alcohol use, grams of alcohol consumed, and increased days of abstinence. Three studies compared integrated treatments with Twelve-Step Facilitation, indicating a better abstinence rate among participants in the integrated group at the end of treatment. Comparisons between delivery modes demonstrated more significant reductions in alcohol consumption with interventionists. Integrated interventions were also compared with various other treatments, including brief intervention, telephone and individual counseling, and psychological education. Participants in the integrated group showed greater improvement in alcohol consumption and depression compared to those in the standalone intervention group.
Integrated behavioral interventions effectively reduce alcohol consumption, decrease heavy drinking and promote alcohol abstinence. However, there is limited evidence to determine whether these interventions are more effective than usual care for individuals with AUD.
本系统评价综合了针对酒精使用障碍（AUD）成人的综合行为干预效果的随机对照试验（RCT）的证据。
2022 年对三个数据库进行了全面检索，使用了与酒精/物质使用障碍和综合干预相关的术语。样本包括处于低、中或高 AUD 风险的年龄≥18 岁的成年人，并且至少还有其他两种心理健康状况。仅纳入 RCT，并使用 Covidence 进行筛选。使用 Cochrane 偏倚风险工具评估研究质量。
在所有 11 项研究中，总 AUD 参与者为 1543 名年龄在 18 岁及以上的成年人。与常规护理或其他干预相比，综合干预可显著减少重度饮酒。措施包括酒精使用天数百分比、酒精消耗量和戒断天数增加。三项研究将综合治疗与十二步促进法进行了比较，表明在治疗结束时，综合组的参与者戒酒率更高。不同干预模式的比较表明，干预者干预可更显著地减少饮酒量。综合干预还与各种其他治疗方法进行了比较，包括简短干预、电话和个人咨询以及心理教育。与单独干预组相比，综合组的参与者在饮酒量和抑郁方面的改善更大。
综合行为干预可有效减少饮酒量、减少重度饮酒并促进戒酒。然而，目前尚无足够证据确定这些干预措施是否比 AUD 患者的常规护理更有效。
