Stability of Drinking Reductions and Long-term Functioning Among Patients with Alcohol Use Disorder.
Stability of Drinking Reductions and Long-term Functioning Among Patients with Alcohol Use Disorder.
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DOI：
10.1007/s11606-020-06331-x
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发表时间：
2021-03
影响因子：
5.7
通讯作者：
Anton RF
中科院分区：
文献类型：
--
作者：
Witkiewitz K;Kranzler HR;Hallgren KA;Hasin DS;Aldridge AP;Zarkin GA;Mann KF;O'Malley SS;Anton RF
世界卫生组织（WHO）将酒精消费量按克数分为低、中、高和极高风险饮酒水平（RDL）。虽然戒酒被认为是酒精治疗的理想结局，但WHO RDL的降低已被提议作为酒精使用障碍（AUD）试验的主要结局。目前的研究检查了WHO RDL降低的稳定性以及RDL降低与治疗后长达3年的长期功能之间的相关性。对入组联合收割机研究和MATCH项目（两项多中心、随机化AUD临床试验）并在治疗后随访长达3年的AUD患者进行的次要数据分析（联合收割机：n = 694; MATCH：n = 806）。酒精使用是通过基于酒精的方法来测量的。我们估计了总样本中的所有模型以及在治疗期间未实现禁欲的参与者。84%的患者在治疗结束时实现了一级RDL降低，其中84.9%的患者在3年随访时保持了这种降低。68%的患者在治疗结束时实现了双节段RDL降低，其中77.7%的患者在3年随访时保持了这种降低。治疗结束时一级和二级RDL降低与治疗后3年的心理健康、生活质量（包括身体生活质量）和饮酒后果减少（p < 0.05）显著相关，与无变化或增加饮酒相比。AUD患者在治疗后可维持WHO RDL降低长达3年。WHO RDL减少的患者的功能明显优于那些没有减少饮酒的患者。这些研究结果与先前的报告一致，表明减少饮酒，戒酒，对患者的健康，福祉和功能产生有意义的改善。在线版本包含补充材料，可通过10.1007/s11606-020-06331-x获得。
The World Health Organization (WHO) categorizes alcohol consumption according to grams consumed into low-, medium-, high-, and very-high-risk drinking levels (RDLs). Although abstinence has been considered the ideal outcome of alcohol treatment, reductions in WHO RDLs have been proposed as primary outcomes for alcohol use disorder (AUD) trials. The current study examines the stability of WHO RDL reductions and the association between RDL reductions and long-term functioning for up to 3 years following treatment. Secondary data analysis of patients with AUD enrolled in the COMBINE Study and Project MATCH, two multi-site, randomized AUD clinical trials, who were followed for up to 3 years post-treatment (COMBINE: n = 694; MATCH: n = 806). Alcohol use was measured via calendar-based methods. We estimated all models in the total sample and among participants who did not achieve abstinence during treatment. One-level RDL reductions were achieved by 84% of patients at the end of treatment, with 84.9% of those individuals maintaining that reduction at a 3-year follow-up. Two-level RDL reductions were achieved by 68% of patients at the end of treatment, with 77.7% of those individuals maintaining that reduction at a 3-year follow-up. One- and two-level RDL reductions at the end of treatment were associated with significantly better mental health, quality of life (including physical quality of life), and fewer drinking consequences 3 years after treatment (p < 0.05), as compared to no change or increased drinking. AUD patients can maintain WHO RDL reductions for up to 3 years after treatment. Patients who had WHO RDL reductions functioned significantly better than those who did not reduce their drinking. These findings are consistent with prior reports suggesting that drinking reductions, short of abstinence, yield meaningful improvements in patient health, well-being, and functioning. The online version contains supplementary material available at 10.1007/s11606-020-06331-x.
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DOI：
10.1111/acer.12205
发表时间：
2013-12
期刊：
Alcoholism, clinical and experimental research
影响因子：
--
作者：
Hallgren KA;Witkiewitz K
通讯作者：
Witkiewitz K
影响因子：
64.3
作者：
Hasin, Deborah S.;Wall, Melanie;Anton, Raymond
通讯作者：
Anton, Raymond
影响因子：
4.2
作者：
Knox, Justin;Scodesb, Jennifer;Hasin, Deborah S.
通讯作者：
Hasin, Deborah S.
影响因子：
3
作者：
Yuan KH;Bentler PM
通讯作者：
Bentler PM
影响因子：
25.8
作者：
Falk, Daniel E.;O'Malley, Stephanie S.;Ramey, Tanya
通讯作者：
Ramey, Tanya