Early Treatment for Women with Alcohol Addiction (EWA) Reduces Mortality: A Randomized Controlled Trial with Long-Term Register Follow-up
Early Treatment for Women with Alcohol Addiction (EWA) Reduces Mortality: A Randomized Controlled Trial with Long-Term Register Follow-up
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DOI：
10.1093/alcalc/agq097
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发表时间：
2011-03-01
影响因子：
2.8
通讯作者：
Haver, Brit
中科院分区：
文献类型：
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作者：
Gjestad, Rolf;Franck, Johan;Haver, Brit
目的：比较随机分配到仅限女性的方案“酒精成瘾女性早期治疗”（EWA）的女性酗酒者与接受混合性别“治疗作为酒精成瘾”（TAU）的女性酗酒者的死亡率。研究方法：随机对照试验，包括2年随访个人访谈和死亡登记数据，通过27年的200名妇女首次治疗酒精使用障碍（AUD; EWA，n = 100和TAU，n = 100），谁是连续招募在1983年至1984年。来自死亡原因登记的数据用于检验与组间相互作用预测因子相关的死亡率差异，如年龄、入院时住院与门诊状态以及2年饮酒结果。结果：与接受TAU的年轻女性相比，参加EWA的年轻女性死亡率显著降低。这种差异在接受治疗后持续了近20年。对于只需要门诊治疗的妇女，EWA组的死亡率降低，即使是老年妇女。未参加2年随访的TAU妇女死亡率高于参加随访的妇女; EWA妇女没有发现这种差异。这表明两个群体的磨损机制不同。因此，以前报告的治疗效果可能被低估了。EWA是一个比TAU更全面的方案，同时也是单一性别的方案。结论：EWA是专门为满足患有AUD的妇女的广泛问题而制定的，比TAU（一个混合性别方案）更有效。不可能区分这是否部分是因为它是一个更全面的方案，以及是单一性别。
Aims: To compare the mortality of female alcoholics randomly assigned to the woman-only programme 'Early treatment for Women with Alcohol Addiction' (EWA) versus those who received mixed gender 'Treatment As Usual' (TAU). Methods: Randomized controlled trial involving 2-year follow-up by personal interview and mortality register data through 27 years of 200 women first time treated for alcohol use disorder (AUD; EWA, n = 100 and TAU, n = 100), who were consecutively recruited during 1983-1984. Data from the Causes of Death Register were used to test for mortality differences related to group interaction predictors such as age, inpatient versus outpatient status at intake and 2-year drinking outcome. Results: Significantly lower mortality was found among younger women who participated in EWA compared with those who received TAU. This difference lasted nearly 20 years after intake to treatment. For women who only needed outpatient treatment, reduced mortality was found in the EWA group, even for older women. Increased mortality was found for TAU women who did not attend the 2-year follow-up compared with those who attended; no such difference was found for EWA women. This indicates different attrition mechanisms in the two groups. Thus, previously reported treatment effects may have been underestimated. EWA was a more comprehensive programme than TAU while also being single gender. Conclusions: EWA, specifically developed to meet a broad spectrum of problems among women with AUDs, was more effective than TAU, a mixed gender programme. It was not possible to separate whether this was in part because it was a more comprehensive programme, as well as being single gender.