1. Number of assessments until outcome
Does the duration matter? A systematic review of psychosocial interventions for AUD – initial results
L. Kramer Schmidt1, A. Søgaard Nielsen 1, K. Andersen 1,2
1 UCAR: Unit of Clinical Alcohol Research – University of Southern Denmark, Odense, Denmark
2 Department of Psychiatry, Odense University Hospital, Denmark
Purpose
A systematic review of the associations between reduction in drinking and number of sessions, weeks in treatment and number of research assessments/follow-ups.
Increase in percent days of abstinence
Increase in percent days of abstinence 1 2
Weeks in treat,ment
Number of sessions
Background
In different guidelines for treatment of alcohol use disorders the recommendations on duration are based on consensus decisions
There are only a few studies of the duration of psychosocial treatments. These have not found significant associations with the duration
Reviews on the subject primarily within substance use disorders. These have found slight advantage for extended treatment
(McKay 2005, McKay 2009, Blodgett et al 2013, Lenaerts et al. 2013)
Increase in percent days of abstinence
Increase in percent days of abstinence 3 4
Number of assessments until outcome
Frequency of sessions
Methods
A systematic review and meta-analysis of randomized controlled studies
Population: Adults treated for Alcohol use disorders (DSM) in an outpatient treatment facility with a maximum of 4 weeks of inpatient before outpatient treatment
Intervention: Any psychosocial intervention in the alcoholic outpatient care. Face-to-face, or telephone. Minimum 2 sessions
Comparison: Effect of treatment as a function of treatment length
Outcome: Percentage of days abstinent, percentage of days with heavy drinking, drinks per drinking day, share of participants abstinent
Results
No association between number of weeks in treatment number of sessions or the frequency of sessions and the outcome reported in percentage of days abstinent
Positive significant associations between research assessments/follow-ups and outcome reported in percentage of days abstinent until 12 assessments
These results are based on the 32 studies reporting outcome in percentage of days abstinent
Conclusions so far
Among the 32 studies in the meta-analysis we have found no association between the duration of treatment and outcome reported in percentage of days abstinent
Surprisingly the number of research assessments/follow-ups in the studies had a significant correlation with outcome
Speculations on these results are selection bias and an emphasis on the importance of check-ups when having a chronic disease 1 2 3 4
Future analysis
Meta-analysis of the remaining data according to outcome reported in percentage of days with heavy drinking, drinks per drinking day and share of participants abstinent
Qualitative analysis
Include data from the studies on the share of people refusing to participate in the study
Statistics
Multiple regression analysis of the influence on outcome of 5 different variables:
Number of weeks in treatment
Number of sessions in treatment
Frequency of sessions
Number of assessments
Time for reported outcome
Data weighted by the number of participants in the study
Acknowledgements
This project is supported by The Lundbeck Foundation, The Region of Southern Denmark and The University of Southern Denmark
Also a special thanks to Anders Bo Bojesen, the statistician on this project