Tomlinson Devin C, Florimbio Autumn Rae, Lee Carol A, Ilgen Mark A, Lin Lewei A, Coughlin Lara N
Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, Michigan, USA.
Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
Alcohol Clin Exp Res (Hoboken). 2025 Apr;49(4):725-735. doi: 10.1111/acer.70022. Epub 2025 Mar 11.
Front-line treatments for alcohol use disorder (AUD) include psychotherapy and medication, and both treatments are underused. However, utilization rates of medications for alcohol use disorder (MAUD) are particularly low. The goal of the present scoping review is to characterize patient perspectives about MAUD to identify barriers to MAUD and potential areas of future work to increase access, initiation, and retention on MAUD. Searches of titles and abstracts were conducted on PubMed, EMBASE, PsycINFO, and CINAHL until March 2024 with patient perspective-, MAUD-, and alcohol-related keywords. Articles were assessed for eligibility and included in the present review if they examined adult patients' perspectives of MAUD. Fourteen studies were included in the review. The majority of patient populations assessed were individuals with AUD, and most studies evaluated MAUD in general (n = 7) or specific medications (i.e., naltrexone, n = 5; disulfiram, n = 2; acamprosate, n = 1). Important themes related to patient-perceived barriers to MAUD were identified, including a lack of awareness and misunderstanding about the effectiveness and effects of MAUD, apprehensiveness or experience with side effects, and perceived stigma of MAUD. Future work incorporating patient perspectives of MAUD into interventions and strategies may help improve MAUD uptake, including person-centered discussions factoring in unique patient perspectives about MAUD to increase patient MAUD knowledge and reduce MAUD stigma.
酒精使用障碍（AUD）的一线治疗方法包括心理治疗和药物治疗，而这两种治疗方法的使用都不足。然而，酒精使用障碍药物治疗（MAUD）的利用率尤其低。本范围综述的目的是描述患者对MAUD的看法，以确定MAUD的障碍以及未来工作的潜在领域，以增加MAUD的可及性、启动率和维持率。截至2024年3月，在PubMed、EMBASE、PsycINFO和CINAHL上使用与患者观点、MAUD和酒精相关的关键词对标题和摘要进行了检索。对文章进行了资格评估，如果文章研究了成年患者对MAUD的看法，则纳入本综述。本综述纳入了14项研究。评估的大多数患者群体是患有AUD的个体，大多数研究总体上评估了MAUD（n = 7）或特定药物（即纳曲酮，n = 5；双硫仑，n = 2；阿坎酸，n = 1）。确定了与患者感知到的MAUD障碍相关的重要主题，包括对MAUD的有效性和效果缺乏认识和误解、对副作用的担忧或经历，以及对MAUD的感知耻辱感。未来将患者对MAUD的看法纳入干预措施和策略的工作可能有助于提高MAUD的接受度，包括以患者为中心的讨论，考虑患者对MAUD的独特观点，以增加患者对MAUD的了解并减少对MAUD的耻辱感。
