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Background: Pharmacological and behavioural treatments for alcohol use disorders (AUDs) are effective but the uptake is limited. Primary care could be a key setting for identification and continuous care for AUD due to accessibility, low cost and acceptability to patients. We aimed to synthesise the literature regarding differential models of care for the management of AUD in primary health care settings.
Methods: We conducted a systematic review of articles published worldwide (1998-present) using the following databases; Medline, PsycINFO, Cochrane database of systematic reviews, Cochrane Central Register of Controlled Trials and Embase. The Grey Matters Tool guided the grey literature search. We selected randomised controlled trials evaluating the effectiveness of a primary care model in the management of AUD. Two researchers independently assessed and then reached agreement on the included studies. We used the Cochrane risk of bias tool 2.0 for the critical appraisal.
Results: Eleven studies (4186 participants) were included. We categorised the studies into 'lower' versus 'higher' intensity given the varying intensity of clinical care evaluated across the studies. Significant differences in treatment uptake were reported by most studies. The uptake of AUD medication was reported in 5 out of 6 studies that offered AUD medication. Three studies reported a significantly higher uptake of AUD medication in the intervention group. A significant reduction in alcohol use was reported in two out of the five studies with lower intensity of care, and three out of six studies with higher intensity of care.
Conclusion: Our results suggest that models of care in primary care settings can increase treatment uptake (e.g. psychosocial and/or pharmacotherapy) although results for alcohol-related outcomes were mixed. More research is required to determine which specific patient groups are suitable for AUD treatment in primary health care settings and to identify which models and components are most effective.
Trial Registration: PROSPERO: CRD42019120293 .
Download full-text PDF |
Source |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719241 | PMC |
http://dx.doi.org/10.1186/s12875-020-01288-6 | DOI Listing |
Expert Rev Clin Pharmacol
December 2024
Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
Introduction: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly enlarging, painful ulcers with undermined borders. The management of PG is challenging due to the lack of standardized evidence-based treatments.
Areas Covered: This review examines recent efforts to establish standardized outcomes for clinical trials to facilitate the drug development process for PG.
Ann Otol Rhinol Laryngol
December 2024
Department of Otorhinolaryngology & Head-Neck Surgery, Medical College & Hospital, Kolkata; West Bengal, India.
Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; ) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.
Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.
Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window).
Ann Surg
December 2024
Center for Surgery and Public Health, Brigham and Woman's Hospital, Boston, MA USA.
Objective: To compare differences in pain, depression, function, and informal caregiving pre-and-post major elective surgery among older adults with and without serious illness; and determine if serious illness was independently associated with increasing pain, depression, assistance in activities of daily living (ADLs) and informal caregiving post-surgery.
Background: The American College of Surgeons has endorsed the integration of palliative care (PC) into surgical care in adults with serious illness but targets for PC during surgical episodes such as pain, depression, function, and informal caregiving are understudied.
Methods: We used Health and Retirement Study-linked Medicare data (2008-2018) to identify older (≥66 y) adults with and without serious illness who had major elective surgery.
J Atten Disord
December 2024
Deakin University, Melbourne, VIC, Australia.
Objectives: To determine ADHD research priorities from the perspective of ADHD professionals internationally.
Method: A two-stage modified Delphi design was used. In Stage 1 (qualitative), participants listed research questions relating to ADHD that they perceived to be most important ( = 132).
J Atten Disord
December 2024
Northern Stockholm Psychiatry, Sweden.
Objective: To evaluate care transition and medication use in young adults with ADHD in Sweden.
Method: Observational retrospective study of patients with ADHD from the Swedish National Patient Register, Prescribed Drug Register, and Cause of Death Register (2018-2020). Last contact with pediatric psychiatric care, first contact with adult psychiatric care, and medication use were described for ages 18 to 21 years, inclusive.
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