Effectiveness of Psychosocial Interventions Targeting Hazardous and Harmful Alcohol Use and Alcohol-Related Symptoms in Low- and Middle-Income Countries: A Systematic Review.
addiction
alcohol
intervention
low- and middle-income country
systematic review
treatment
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2020
2020
Historique:
received:
10
05
2020
accepted:
20
07
2020
entrez:
9
9
2020
pubmed:
10
9
2020
medline:
10
9
2020
Statut:
epublish
Résumé
In low- and middle-income countries (LMIC), the mismatch between the number of individuals needing and those receiving treatment for alcohol use disorders (AUD) is substantial. In order to provide suggestions for the scaling up of effective service provision we systematically reviewed the current evidence on the effectiveness of AUD-focused psychosocial interventions in LMIC. We used a systematic review methodology following the PRISMA guidelines. Twelve electronic databases listing published and grey literature were searched and only randomized-controlled trials (RCTs) were included. Where possible, effect sizes were calculated using Hedges' Twenty-one RCTs conducted in 15 different LMIC between 1992 and 2018 fulfilled inclusion criteria. Most studies employed brief one-on-one interventions facilitated by trained primary care staff. Eighty-six percent of RCTs based their interventions on the principles of motivational interviewing (MI) with the majority supplementing MI-based interventions with alcohol-tailored elements of cognitive-behavioral therapy (CBT). The remaining RCTs employed CBT-components exclusively. Just over 40% of studies included in quantitative analyses (n=17) yielded an at least medium-sized effect ( To date, a relatively small number of RCTs investigating AUD-focused treatments has been conducted in LMIC. The majority of between condition effect size estimates were small and no type of intervention can clearly be recommended over another. No RCTs were conducted in conflict-affected areas in LMIC although they would merit particular attention since AUD is often linked to trauma-related mental health disorders. More RCTs in LMIC are required and alternatives to MI-based approaches should be investigated. This systematic review summarizes properties of effective interventions and provides implications for future research.
Sections du résumé
BACKGROUND
BACKGROUND
In low- and middle-income countries (LMIC), the mismatch between the number of individuals needing and those receiving treatment for alcohol use disorders (AUD) is substantial. In order to provide suggestions for the scaling up of effective service provision we systematically reviewed the current evidence on the effectiveness of AUD-focused psychosocial interventions in LMIC.
METHODS
METHODS
We used a systematic review methodology following the PRISMA guidelines. Twelve electronic databases listing published and grey literature were searched and only randomized-controlled trials (RCTs) were included. Where possible, effect sizes were calculated using Hedges'
RESULTS
RESULTS
Twenty-one RCTs conducted in 15 different LMIC between 1992 and 2018 fulfilled inclusion criteria. Most studies employed brief one-on-one interventions facilitated by trained primary care staff. Eighty-six percent of RCTs based their interventions on the principles of motivational interviewing (MI) with the majority supplementing MI-based interventions with alcohol-tailored elements of cognitive-behavioral therapy (CBT). The remaining RCTs employed CBT-components exclusively. Just over 40% of studies included in quantitative analyses (n=17) yielded an at least medium-sized effect (
CONCLUSION
CONCLUSIONS
To date, a relatively small number of RCTs investigating AUD-focused treatments has been conducted in LMIC. The majority of between condition effect size estimates were small and no type of intervention can clearly be recommended over another. No RCTs were conducted in conflict-affected areas in LMIC although they would merit particular attention since AUD is often linked to trauma-related mental health disorders. More RCTs in LMIC are required and alternatives to MI-based approaches should be investigated. This systematic review summarizes properties of effective interventions and provides implications for future research.
Identifiants
pubmed: 32903779
doi: 10.3389/fpsyt.2020.00768
pmc: PMC7438922
doi:
Types de publication
Systematic Review
Langues
eng
Pagination
768Informations de copyright
Copyright © 2020 Preusse, Neuner and Ertl.
Références
PLoS One. 2014 May 27;9(5):e98299
pubmed: 24865450
BMC Psychiatry. 2013 Jul 16;13:189
pubmed: 24059784
Cochrane Database Syst Rev. 2014 Aug 21;(8):CD007025
pubmed: 25140980
Br J Addict. 1986 Feb;81(1):23-46
pubmed: 3457598
J R Coll Gen Pract. 1987 Aug;37(301):358-63
pubmed: 3448228
Alcohol Alcohol. 2010 May-Jun;45(3):263-70
pubmed: 20236990
J Consult Clin Psychol. 2008 Oct;76(5):852-62
pubmed: 18837602
Confl Health. 2012 Sep 11;6(1):7
pubmed: 22963719
Braz J Psychiatry. 2011 Sep;33(3):225-33
pubmed: 21971774
J Stud Alcohol. 1993 Jul;54(4):399-407
pubmed: 8341042
Subst Use Misuse. 2017 Sep 19;52(11):1494-1510
pubmed: 28471305
Alcohol Alcohol. 2017 Jan;52(1):56-64
pubmed: 27567270
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
J Prev Med Public Health. 2006 Jan;39(1):21-9
pubmed: 16613068
Addiction. 2015 Jun;110(6):889-90
pubmed: 25756739
Br J Addict. 1988 Jan;83(1):83-9
pubmed: 3345386
Psychol Bull. 1992 May;111(3):455-74
pubmed: 1594721
Alcohol Clin Exp Res. 2015 Mar;39(3):522-31
pubmed: 25704494
Addict Behav. 1998 Nov-Dec;23(6):785-95
pubmed: 9801716
Psychol Addict Behav. 2009 Dec;23(4):672-83
pubmed: 20025373
Asian J Psychiatr. 2015 Dec;18:75-80
pubmed: 26412051
J Subst Abuse Treat. 2015 Apr;51:1-18
pubmed: 25300577
Rev Saude Publica. 2010 Feb;44(1):53-9
pubmed: 20140329
AIDS Behav. 2011 Nov;15(8):1785-94
pubmed: 21739290
Croat Med J. 2000 Jun;41(2):173-8
pubmed: 10853047
Cogn Behav Pract. 2014 May;21(2):111-123
pubmed: 25620867
Soc Sci Med. 2013 Jun;86:17-25
pubmed: 23608090
Psychol Addict Behav. 2014 Mar;28(1):42-52
pubmed: 23647151
Trauma Violence Abuse. 2011 Jul;12(3):127-34
pubmed: 21511685
Addiction. 1993 Mar;88(3):315-35
pubmed: 8461850
Lancet. 2009 Jun 27;373(9682):2223-33
pubmed: 19560604
Ann Intern Med. 2004 Apr 6;140(7):557-68
pubmed: 15068985
Alcohol Alcohol. 2014 Jul-Aug;49(4):430-8
pubmed: 24899076
Addiction. 2011 Dec;106(12):2156-66
pubmed: 21631622
Soc Sci Med. 2002 Nov;55(9):1603-17
pubmed: 12297246
Lancet. 2017 Jan 14;389(10065):186-195
pubmed: 27988144
J Marital Fam Ther. 2008 Apr;34(2):165-76
pubmed: 18412824
Drug Alcohol Rev. 2009 May;28(3):301-23
pubmed: 19489992
J Int Assoc Provid AIDS Care. 2017 May/Jun;16(3):276-285
pubmed: 27215561
PLoS One. 2015 Oct 07;10(10):e0140041
pubmed: 26444441
Alcohol Alcohol. 2006 May-Jun;41(3):328-35
pubmed: 16547122
Lancet. 2007 Sep 15;370(9591):991-1005
pubmed: 17804058
Afr J Psychiatry (Johannesbg). 2009 Feb;12(1):52-8
pubmed: 19517048
J Gen Intern Med. 1997 May;12(5):274-83
pubmed: 9159696
BMC Public Health. 2016 Mar 03;16:218
pubmed: 26940221
Arch Intern Med. 2005 May 9;165(9):986-95
pubmed: 15883236
Subst Use Misuse. 2010 Nov;45(13):2340-55
pubmed: 20469970
Addiction. 2007 Jan;102(1):62-70
pubmed: 17207124
BMC Public Health. 2013 Jul 31;13:699
pubmed: 23902931
Cochrane Database Syst Rev. 2018 Feb 24;2:CD004148
pubmed: 29476653
Drug Alcohol Rev. 2010 Nov;29(6):631-40
pubmed: 20973848
BMC Public Health. 2015 Nov 23;15:1165
pubmed: 26597715
PLoS One. 2015 Mar 23;10(3):e0120850
pubmed: 25799590
Alcohol Res Health. 2003;27(1):52-62
pubmed: 15301400
Drug Alcohol Rev. 2005 Mar;24(2):143-55
pubmed: 16076584
Cochrane Database Syst Rev. 2013 Oct 03;(10):CD001088
pubmed: 24092525
Addiction. 2013 Aug;108(8):1387-96
pubmed: 23490304
Ann Glob Health. 2014 Mar-Apr;80(2):115-21
pubmed: 24976549
Addiction. 2002 Mar;97(3):279-92
pubmed: 11964101
J Acquir Immune Defic Syndr. 2007 Apr 15;44(5):594-600
pubmed: 17325606
Addiction. 2003 Sep;98(9):1209-28
pubmed: 12930209
J Acquir Immune Defic Syndr. 2014 Dec 1;67(4):446-53
pubmed: 25197826
Addiction. 2008 Jan;103(1):42-52
pubmed: 17999707
Soc Sci Med. 2005 Jul;61(2):343-64
pubmed: 15893051
Behav Cogn Psychother. 2009 Mar;37(2):129-40
pubmed: 19364414
Subst Abuse Treat Prev Policy. 2015 Nov 14;10:46
pubmed: 26576946
Addict Behav. 2011 Aug;36(8):870-3
pubmed: 21481540
Subst Abuse Treat Prev Policy. 2015 May 27;10:22
pubmed: 26013537
Lancet. 2015 Nov 14;386(10007):1922-4
pubmed: 26386542
J Subst Abuse Treat. 1999 Oct;17(3):181-92
pubmed: 10531624
Lancet. 1997 Aug 2;350(9074):326-9
pubmed: 9251637
AIDS Behav. 2016 Mar;20(3):484-503
pubmed: 26511865
Cochrane Database Syst Rev. 2013 Nov 19;(11):CD009149
pubmed: 24249541
Disasters. 2012 Jul;36(3):533-57
pubmed: 22066703
Addict Behav. 2007 May;32(5):889-901
pubmed: 16876963
BMC Psychiatry. 2016 Jun 24;16:202
pubmed: 27342048
Alcohol Alcohol. 2014 Jan-Feb;49(1):66-78
pubmed: 24232177
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
Alcohol Alcohol. 2013 May-Jun;48(3):349-55
pubmed: 23443987
BMC Public Health. 2010 Jun 09;10:323
pubmed: 20534112
PLoS One. 2011;6(10):e23748
pubmed: 21998626
Alcohol Clin Exp Res. 2004 Apr;28(4):608-18
pubmed: 15100612
Medicine (Baltimore). 2018 Aug;97(35):e11688
pubmed: 30170370
Drug Alcohol Depend. 2015 Sep 1;154:1-13
pubmed: 26072219
J Health Popul Nutr. 2012 Mar;30(1):73-81
pubmed: 22524122
BMC Public Health. 2013 Jul 11;13:644
pubmed: 23844552
Front Psychol. 2013 Nov 26;4:863
pubmed: 24324449
Drug Alcohol Depend. 2011 Apr 1;114(2-3):87-99
pubmed: 21193271
Med J Aust. 2001 Jul 16;175(S1):S31-6
pubmed: 11556433
Addiction. 2001 Jun;96(6):835-46
pubmed: 11399215
PLoS Med. 2009 Oct;6(10):e1000170
pubmed: 19859536
Clin Psychol Rev. 1998 Sep;18(6):689-711
pubmed: 9779329
Am J Public Health. 2003 Jun;93(6):963-9
pubmed: 12773363
Front Psychiatry. 2018 Sep 21;9:433
pubmed: 30298022
PLoS One. 2016 Sep 15;11(9):e0162038
pubmed: 27632166
Ann Behav Med. 2008 Dec;36(3):270-9
pubmed: 18836789
Soc Sci Med. 2015 Dec;146:257-65
pubmed: 26521032
Bull World Health Organ. 2003;81(1):53-60
pubmed: 12640477
Drug Alcohol Rev. 2010 Jul;29(4):426-36
pubmed: 20636660
Eur Addict Res. 2003 Oct;9(4):147-56
pubmed: 12970583
J Subst Abuse Treat. 2016 May;64:29-34
pubmed: 26965174
Psychol Addict Behav. 2014 Sep;28(3):841-51
pubmed: 24933396
Child Abuse Negl. 2014 Jan;38(1):135-46
pubmed: 24239222
J Stud Alcohol Drugs. 2008 Mar;69(2):243-50
pubmed: 18299765
Soc Psychiatry Psychiatr Epidemiol. 2014 Sep;49(9):1401-25
pubmed: 24643298
AIDS Behav. 2010 Jun;14(3):669-78
pubmed: 19967441
Addiction. 2013 Apr;108(4):725-32
pubmed: 23216868
Psychol Bull. 1992 Jul;112(1):155-9
pubmed: 19565683
Alcohol Alcohol. 2007 Jul-Aug;42(4):328-32
pubmed: 17360720
Drug Alcohol Rev. 2010 Nov;29(6):584-8
pubmed: 20973840