Predictive value of non-consumption outcome measures in alcohol use disorder treatment
Predictive value of non-consumption outcome measures in alcohol use disorder treatment
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DOI：
10.1111/add.14553
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发表时间：
2019-06-01
期刊：
影响因子：
6
通讯作者：
Witkiewitz, Katie
中科院分区：
文献类型：
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作者：
Kirouac, Megan;Witkiewitz, Katie
背景和目的几十年来，研究人员一直呼吁，除了消费结果(如戒酒天数百分比)外，还应系统地纳入非消费结果，如与酒精相关的后果和诱惑/渴望，以评估酒精使用障碍(AUD)的治疗效果。然而，食品和药物管理局(FDA)酒精药物开发指南表明，非消费结果可能对AUD试验评估窗口内发生的变化不敏感，尽管这从未进行过直接测试。我们的目的是衡量AUD治疗效果的诊断相关、非消耗措施的预测价值。方法观察治疗前后的疗效大小。Logistic回归分析被用来检验在联合(联合药物疗法和行为干预治疗酒精依赖)研究和项目匹配(酒精中毒治疗与客户异质性匹配)中实施的非消耗性结果测量在检测治疗后12个月结果方面的预测价值。结果治疗前后效应大小显示非消费性测量在治疗过程中发生变化，诱惑/渴求、自我效能、后果和消费变量的效应大小多为中到大(中效应值为0.2DZ&0.8，大效应值为DZ>；0.8)。回归结果表明，诱惑/渴求和自我效能感在联合和匹配中预测12个月的饮酒结果，而饮酒结果在联合中预测12个月的饮酒结果。结论酒精依赖治疗后，引诱和酒精渴求的自我报告量表可能会发生改变，并可预测饮酒结果。
Background and Aims For decades, researchers have called for the systematic inclusion of non-consumption outcomes, such as alcohol-related consequences and temptation/craving, in addition to consumption outcomes (e.g. percentage of days abstinent) to evaluate alcohol use disorder (AUD) treatment efficacy. However, Food and Drug Administration (FDA) guidelines for alcohol medications development suggest that non-consumption outcomes may be insensitive to changes that occur within AUD treatment trial assessment windows, although this has never been directly tested. We aimed to measure the predictive value of diagnostically related, non-consumption measures of AUD treatment effects. Methods Pre- to post-treatment effect sizes were examined. Logistic regression analyses were used to test the predictive value of non-consumption outcome measures that were administered in the COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) Study and Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) in detecting 12-month outcomes following treatment. Results Pre- to post-treatment effect sizes suggested that non-consumption measures changed during the course of treatment; effect sizes for temptation/craving, self-efficacy, consequences and consumption variables were mostly medium to large (medium effect sizes were 0.2 dz < 0.8, large effect sizes were dz > 0.8). The regression results indicated temptation/craving and self-efficacy predicted 12-month drinking outcomes in COMBINE and MATCH, and drinking consequences predicted 12-month drinking outcomes in COMBINE. Conclusions Self-report measures of temptation and alcohol craving can change as a result of alcohol dependence treatment and can predict drinking outcomes.