Randomized clinical trial of matching client alcohol use disorder severity and level of cognitive functioning to treatment setting: A partial replication and extension.
Randomized clinical trial of matching client alcohol use disorder severity and level of cognitive functioning to treatment setting: A partial replication and extension.
复制标题
DOI：
10.1037/adb0000253
复制
发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Connors GJ
中科院分区：
文献类型：
--
作者：
Rychtarik RG;McGillicuddy NB;Papandonatos GD;Whitney RB;Connors GJ
在一个严格控制的临床研究环境中，研究发现，酒精使用障碍(AUD)患者从住院(IP)中获得的好处比门诊治疗更多，如果他们表现出较高的酒精问题严重性和/或认知功能低下。这项研究试图：(A)在以社区为基础的治疗中心的不受控制的环境中验证和推广这些发现，以及(B)测试住院患者的非自愿禁欲天数是否较少(例如，监禁)，以控制不同护理环境中治疗预期的差异。患有AUD的患者(N=176)被确定地分配到住院需要组(需要IP=高严重性和/或低认知功能；不需要IP=既不高严重性也不低认知功能)。在需求组中，参与者被随机分配到21天的常规住院或门诊护理，以及6个月的持续护理。在18个月内评估戒酒天数百分比(PDA)、每月戒酒时点患病率(PPA)和每天饮酒量(DDD)以及非自愿戒酒的次要结果。在严重程度高的参与者中，住院患者显著减少了DDD；门诊患者没有。无论是问题的严重性还是认知功能都不能缓和其他环境效应。在被告知预定的治疗安排后，住院患者的治疗预期高于门诊患者。高期望住院患者在整个随访过程中保持了最高的PDA，在大部分随访中具有最高的PPA，并将非自愿戒断的流行高峰推迟了6个月。酒精问题严重程度X设置对DDD的交互作用似乎很强。期望值的作用值得进一步研究。
In a tightly-controlled, clinical research environment, found that individuals with an alcohol use disorder (AUD) benefited more from inpatient (IP) than outpatient care, if they presented with high alcohol problem severity and/or low cognitive functioning. This study sought to: (a) validate and extend these findings within the uncontrolled environment of a community-based treatment center, and (b) test whether inpatients had fewer days of involuntary abstinence (e.g., incarcerations), controlling for differences in treatment expectancy across care settings. Clients (N = 176) with an AUD were deterministically assigned to inpatient-need group (Needs IP = high severity and/or low cognitive functioning; No need for IP = neither high severity nor low cognitive functioning). Within need group, participants were randomly assigned to 21 days of routine inpatient or outpatient care, plus six months of continuing care. Primary outcomes of percentage of days abstinent (PDA), monthly point prevalence abstinence (PPA), and drinks per drinking day (DDD), and the secondary outcome of involuntary abstinence were assessed over 18 months. Among high-severity participants, inpatients significantly reduced DDD; outpatients did not. Neither problem severity nor cognitive functioning moderated other setting effects. Treatment expectancy, assessed after being informed of scheduled setting, was higher among inpatients than outpatients. High-expectancy inpatients maintained the highest PDA throughout follow-up, had the highest PPA for most of follow-up, and delayed peak prevalence of involuntary abstinence by six months. The Alcohol Problem Severity X Setting interaction on DDD appears robust. The role of expectancy warrants further study.
登录
查看更多内容
DOI：
10.3102/10769986024001070
发表时间：
1999-03-01
影响因子：
2.4
作者：
Hedeker, D;Gibbons, RD;Waternaux, C
通讯作者：
Waternaux, C
DOI：
10.1097/01.alc.0000023986.42254.f5
发表时间：
2002-08-01
期刊：
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH
影响因子：
--
作者：
Anton, RF;Lieber, C;Tabakoff, B
通讯作者：
Tabakoff, B
影响因子：
3.4
作者：
Atkins, David C.;Baldwin, Scott A.;Neighbors, Clayton
通讯作者：
Neighbors, Clayton
DOI：
10.1007/s11469-011-9358-x
发表时间：
2012-10-01
影响因子：
8
作者：
Raylu, Namrata;Kaur, Inderjit
通讯作者：
Kaur, Inderjit
DOI：
10.1198/016214501753168389
发表时间：
2001-06-01
影响因子：
3.7
作者：
Olsen, MK;Schafer, JL
通讯作者：
Schafer, JL