Pretreatment Alcohol Drinking Goals are Associated with Treatment Outcomes
Pretreatment Alcohol Drinking Goals are Associated with Treatment Outcomes
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DOI：
10.1111/acer.12137
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发表时间：
2013-10-01
影响因子：
3.2
通讯作者：
Strain, Eric C.
中科院分区：
文献类型：
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作者：
Dunn, Kelly E.;Strain, Eric C.
背景大部分接受酒精依赖治疗的患者报告非戒酒目标（例如减少饮酒）而不是戒酒，这种治疗前目标选择可能与饮酒结果和酒精相关问题相关。方法对为期 16 周的联合药物治疗和行为干预 (COMBINE) 研究进行分析，以确定自我报告的治疗前饮酒目标与饮酒结果和酒精相关问题之间的关联。报告非戒酒目标的参与者 (n=340) 与报告戒酒目标的参与者 (n=340) 在 3 个被认为有助于治疗结果的变量上进行匹配：COMBINE 实验组、性别和基线前大量饮酒天数。结果分析显示，COMBINE 实验组和饮酒目标在结果测量上没有相互作用，因此结果被折叠并作为饮酒目标组的函数进行检查。选择戒酒目标的参与者不饮酒或不大量饮酒的周数显着增加，报告的重度饮酒天数减少，报告饮酒超过 1 次的天数减少，并且从基线到干预第 16 周，每天的饮酒量更有可能减少 50%。然而，随着时间的推移，两组的饮酒天数百分比、平均每天饮酒量、重度饮酒天数和每周饮酒天数均有所减少，并且两组参与者的酒精相关问题均显着减少，心理社会功能得到改善。结论结果重复并扩展了之前检查饮酒目标与治疗结果之间关联的研究。这些数据还为将饮酒治疗目标作为研究干预中的分层变量或结果分析中的协变量的标准纳入提供了支持，并强调了需要对以非戒酒目标进行酒精治疗的患者进行额外研究的几个领域。
BackgroundA large subset of patients who enter treatment for alcohol dependence report nonabstinent drinking goals (e.g., reduction in drinking) rather than abstinence, and this pretreatment goal choice may be associated with drinking outcomes and alcohol-related problems.MethodsAn analysis of the 16-week Combined Pharmacotherapies and Behavioral Interventions (COMBINE) study was conducted to determine the association between self-reported pretreatment drinking goal and drinking outcomes and alcohol-related problems. Participants who reported a nonabstinent drinking goal (n=340) were matched with participants who reported an abstinent drinking goal (n=340) on 3 variables believed to contribute to treatment outcomes: COMBINE experimental group, gender, and number of prebaseline heavy drinking days.ResultsAnalyses revealed no interaction between the COMBINE experimental group and drinking goal on outcome measures, so results were collapsed and examined as a function of drinking goal group. Participants who chose an abstinent drinking goal had significantly more weeks with no drinking or no heavy drinking, reported fewer heavy drinking days, reported fewer days with >1 drink, and were more likely to have a50% decrease in drinks per day between baseline and week 16 of the intervention. However, both groups reported reductions over time in percent drinking days, mean drinks per day, number of heavy drinking days, and number of drinking days per week, and participants in both groups experienced significant reductions in alcohol-related problems and improvements in psychosocial functioning.ConclusionsResults replicate and expand upon previous studies examining the association between drinking goal and treatment outcome. These data also provide support for the standard inclusion of drinking treatment goal as a stratification variable in study interventions or as a covariate in outcome analyses and highlight several areas that warrant additional research regarding patients who enter alcohol treatment with a nonabstinent drinking goal.