Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes.
Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes.
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将酗酒治疗与客户异质性相匹配：项目 MATCH 治疗后饮酒结果。
DOI：
10.15288/jsa.1997.58.7
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Eddie Fernando Cândido Murta
中科院分区：
文献类型：
--
作者：
F. Orsatti;P. R. Nunes;A. P. Souza;F. Martins;A. A. Oliveira;R. Nomelini;M. Michelin;Eddie Fernando Cândido Murta
目的
评估酒精依赖的客户匹配的好处，以三种不同的治疗与参考各种客户属性。
方法
进行了两项平行但独立的随机临床试验，一项是酒精依赖患者接受门诊治疗（N = 952; 72%男性），另一项是患者在住院或日间医院治疗后接受善后治疗（N = 774; 80%男性）。客户被随机分配到三个12周，手动指导，单独提供的治疗之一：认知行为应对技能疗法，动机增强疗法或跨步骤促进疗法。然后在治疗后1年内对客户进行监测。将对治疗反应的个体差异建模为潜在生长过程，并对10个主要匹配变量和16个先验指定的对比进行评价。主要的结果指标是在治疗后1年内戒酒天数百分比和每天饮酒量。
结果
客户平均参加了三分之二的治疗课程，这表明提供了大量的治疗，研究随访率超过90%的生活受试者在1年的治疗后评估。从基线到治疗后1年，被分配到这些明确定义和单独提供的心理社会治疗的客户在饮酒结果方面取得了显着和持续的改善。不同治疗类型的结果差异不大。只有一个属性，精神病的严重程度，表现出显着的属性，治疗的相互作用：在门诊研究中，客户的精神病严重程度低，有更多的禁欲天后，12步促进治疗后比认知行为治疗。对于精神病严重程度较高的患者，两种治疗都没有明显的上级优势。另外两个属性表现出时间依赖的匹配效应：门诊病人的动机和善后服务客户之间的意义寻求。客户属性的动机准备，网络支持饮酒，酒精参与，性别，精神病的严重程度和反社会的预测饮酒的结果随着时间的推移。
结论
研究结果表明，精神病的严重程度时，应考虑分配客户到门诊治疗。缺乏其他强大的匹配效果表明，除了精神病的严重程度，供应商不需要考虑这些客户的特点时，分流客户到这三个单独提供的治疗方法之一或其他，尽管他们不同的治疗理念。
OBJECTIVE
To assess the benefits of matching alcohol dependent clients to three different treatments with reference to a variety of client attributes.
METHODS
Two parallel but independent randomized clinical trials were conducted, one with alcohol dependent clients receiving outpatient therapy (N = 952; 72% male) and one with clients receiving aftercare therapy following inpatient or day hospital treatment (N = 774; 80% male). Clients were randomly assigned to one of three 12-week, manual-guided, individually delivered treatments: Cognitive Behavioral Coping Skills Therapy, Motivational Enhancement Therapy or Twelve-Step Facilitation Therapy. Clients were then monitored over a 1-year posttreatment period. Individual differences in response to treatment were modeled as a latent growth process and evaluated for 10 primary matching variables and 16 contrasts specified a priori. The primary outcome measures were percent days abstinent and drinks per drinking day during the 1-year posttreatment period.
RESULTS
Clients attended on average two-thirds of treatment sessions offered, indicating that substantial amounts of treatment were delivered, and research follow-up rates exceeded 90% of living subjects interviewed at the 1-year posttreatment assessment. Significant and sustained improvements in drinking outcomes were achieved from baseline to 1-year posttreatment by the clients assigned to each of these well-defined and individually delivered psychosocial treatments. There was little difference in outcomes by type of treatment. Only one attribute, psychiatric severity, demonstrated a significant attribute by treatment interaction: In the outpatient study, clients low in psychiatric severity had more abstinent days after 12-step facilitation treatment than after cognitive behavioral therapy. Neither treatment was clearly superior for clients with higher levels of psychiatric severity. Two other attributes showed time-dependent matching effects: motivation among outpatients and meaning-seeking among aftercare clients. Client attributes of motivational readiness, network support for drinking, alcohol involvement, gender, psychiatric severity and sociopathy were prognostic of drinking outcomes over time.
CONCLUSIONS
The findings suggest that psychiatric severity should be considered when assigning clients to outpatient therapies. The lack of other robust matching effects suggests that, aside from psychiatric severity, providers need not take these client characteristics into account when triaging clients to one or the other of these three individually delivered treatment approaches, despite their different treatment philosophies.
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将患者与治疗相匹配：概念和方法问题。
DOI：
10.15288/jsa.1986.47.122
发表时间：
1986
期刊：
Journal of studies on alcohol
影响因子：
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作者：
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通讯作者：
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影响因子：
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影响因子：
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酗酒者的类型，II。
影响因子：
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作者：
Litt,MD;Babor,TF;DelBoca,FK;Kadden,RM;Cooney,NL
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影响因子：
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