A systematic review of interventions for homeless alcohol-abusing adults

Adams-Guppy, Julie R.; Guppy, Andrew

doi:10.3109/09687637.2015.1044499

Cited by 7 publications

(7 citation statements)

References 60 publications

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“…Case management is likely to support the recovery process, but few studies have looked beyond substance use outcomes or included substantial follow-up periods. Also, findings from available systematic reviews are limited to narrative and global appreciations of study findings, repeatedly stressing its importance for improving individuals' overall functioning and—to a certain extent—substance use outcomes, and for enhancing linkage and retention (14, 18, 26–29). Meta-analyses offer additional opportunities to statistically synthesize data from various studies and to calculate effect sizes per study and outcome category, controlling for sample size, and various follow-up moments (30).…”

Section: Introductionmentioning

confidence: 99%

A Meta-Analysis of the Efficacy of Case Management for Substance Use Disorders: A Recovery Perspective

et al. 2019

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Background: Case management is a client-centered approach to improve the coordination and continuity of service delivery, especially for persons with substance use disorders (SUD) and multiple and complex support needs. This intervention supports individuals by helping them identify needed services, facilitate linkage with services, and promote participation and retention in services. However, it is questionable whether case management is equally effective in promoting recovery and aspects of personal functioning. The objective was to conduct an updated meta-analysis and to assess whether case management was more effective than treatment as usual (TAU) among persons with SUD for improving treatment-related (e.g., successful linkage with and retention in treatment) as well as personal functioning outcomes (e.g., substance use). Methods: This meta-analysis focuses on randomized controlled trials (RCTs) that included persons with alcohol or drug use disorders and compared case management with TAU. To be eligible, interventions had to meet core case management functions as defined in the literature. We conducted searches of the following databases to May 2017: the Cochrane Drugs and Alcohol Specialized Register, CENTRAL, PubMed, Embase, CINAHL, and Web of Science. Also, reference lists of retrieved publications were scanned for relevant (un)published studies. Results: The overall effect size for case management compared to TAU across all outcome categories and moments was small and positive (SMD = 0.18, 95% CI 0.07–0.28), but statistically significant. Effects were considerably larger for treatment tasks (SMD = 0.33, 95% CI 0.18–0.48) than for personal functioning outcomes (SMD = 0.06, 95% CI −0.02 to 0.15). The largest effect sizes were found for retention in substance abuse treatment and linkage with substance abuse services. Moderator effects of case management models and conditions were assessed, but no significant differences were observed. Conclusions: The primary results from earlier meta-analyses were supported: case management is more effective than TAU conditions for improving outcomes, but this effect is significantly larger for treatment-related tasks than for personal functioning outcomes. Case management can be an important supplement to available services for improving linkage and retention, although further research is needed to assess its potential for supporting recovery from a longitudinal perspective.

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Section: Introductionmentioning

confidence: 99%

A Meta-Analysis of the Efficacy of Case Management for Substance Use Disorders: A Recovery Perspective

et al. 2019

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“…For instance, a recent systematic review of treatment studies for adults with alcohol misuse who are experiencing homelessness found a limited evidence base, with only 17 studies meeting the inclusion criteria (Adams-Guppy and Guppy, 2016). The almost exclusive use of self-reported alcohol outcomes in these studies was raised as a potential measurement concern (Adams-Guppy and Guppy, 2016). Furthermore, alcohol misuse has long been stigmatized (Kulesza et al, 2014), and this stigma can hinder treatment seeking, treatment adherence and retention, and treatment outcomes (Carvalho et al, 2019), as well as self-report accuracy.…”

mentioning

confidence: 99%

“…Despite this greater treatment need, existing alcohol treatments may not optimally engage this population in treatment (Orwin et al, 1999; Wenzel et al, 2001; see also Collins et al, 2019). For instance, a recent systematic review of treatment studies for adults with alcohol misuse who are experiencing homelessness found a limited evidence base, with only 17 studies meeting the inclusion criteria (Adams‐Guppy and Guppy, 2016). The almost exclusive use of self‐reported alcohol outcomes in these studies was raised as a potential measurement concern (Adams‐Guppy and Guppy, 2016).…”

mentioning

confidence: 99%

Ecological Momentary Assessment of Alcohol Consumption and Its Concordance with Transdermal Alcohol Detection and Timeline Follow‐Back Self‐report Among Adults Experiencing Homelessness

Mun

Businelle

et al. 2021

Alcoholism Clin & Exp Res

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Background: Studies of alcohol use presume valid assessment measures. To evaluate this presumption, we examined the concordance of alcohol use as measured by ecological momentary assessment (EMA) self-reports, transdermal alcohol concentration readings via the Secure Continuous Remote Alcohol Monitor (SCRAM), and retrospective self-reports via the Timeline Follow-Back (TLFB) among adults experiencing homelessness.Methods: Forty-nine adults who reported alcohol misuse (mean age = 47, SD = 9; 57% Black; 82% men) were recruited from a homeless shelter. For 4 weeks, alcohol use was assessed: (i) 5 times or more per day by EMA, (ii) every 30 minutes by a SCRAM device worn on the ankle, and (iii) by TLFB for the past month at the end of the study period. There were 1,389 days of observations of alcohol use and alcohol use intensity for 49 participants.Results: EMA and SCRAM alcohol use data agreed on 73% of days, with an interrater agreement Kappa = 0.46. A multilevel analysis of concordance of 3 measures for alcohol use yielded statistically significant correlations of 0.40 (day level) and 0.63 (person level) between EMA and SCRAM. Alcohol use was detected on 49, 38, and 33% of days by EMA, SCRAM, and TLFB, respectively. For alcohol use intensity, EMA and SCRAM resulted in statistically significant correlations of 0.46 (day level) and 0.78 (person level). The concordance of TLFB with either EMA or SCRAM was weak, especially at the day level.Conclusions: This is the first study to examine concordance of alcohol use estimates using EMA, SCRAM, and TLFB methods in adults experiencing homelessness. EMA is a valid approach to quantifying alcohol use, especially given its relatively low cost, low participant burden, and ease of use. Furthermore, any stigma associated with wearing the SCRAM or reporting alcohol use in person may be attenuated by using EMA, which may be appealing for use in studies of stigmatized and underserved populations.

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“…Bei Wohnungslosen mit geringem Bedarf ist mit CM ein Rückgang des Substanzmittelmissbrauchs zu erreichen (31,40,66), während es bei moderatem oder höherem Versorgungsbedarf keine Vorteile gegenüber TAU zu bringen scheint (40,70). ICM scheint nicht zur Veränderung des Drogenkonsums beizutragen (31,40) und wirkt bei Alkoholmissbrauch nur in Kombination mit Alkoholberatung (31). Kontingenzmanagement scheint sich in Kombination mit einem Verstärkeransatz verringernd auf die Trinkmengen auszuwirken (31).…”

Section: Psychische Gesundheit Und Substanzmittelmissbrauchunclassified

“…ICM scheint nicht zur Veränderung des Drogenkonsums beizutragen (31,40) und wirkt bei Alkoholmissbrauch nur in Kombination mit Alkoholberatung (31). Kontingenzmanagement scheint sich in Kombination mit einem Verstärkeransatz verringernd auf die Trinkmengen auszuwirken (31). Wohninterventionen oder -angebote mit Abstinenzbedingung hinsichtlich Marihuana, Kokain oder Alkohol führen entsprechenden Reviews zufolge insgesamt zu einer stärkeren Reduktion des Substanzmissbrauchs (42,71).…”

Section: Psychische Gesundheit Und Substanzmittelmissbrauchunclassified

Die gesundheitliche Versorgung von wohnungslosen Menschen mit psychischen Problemen

Franz¹,

Salize²,

Hoell³

2017

Die Psychiatrie

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Zusammenfassung Hintergrund: Wohnungslosigkeit ist ein vielerorts kaum zu übersehendes und trotzdem gesamtgesellschaftlich weitgehend ignoriertes Phänomen. Menschen mit psychischen Problemen und bestehender Abhängigkeitserkrankung finden sich überzufällig häufig in der Gruppe Wohnungsloser. Methode: Eine internationale systematische Literaturrecherche wurde mit einer deutschsprachigen Recherche in der Datenbank des Netzwerkes für Versorgungsforschung kombiniert, um aktuelle Ergebnisse von Interventionen für Wohnungslose mit psychischen Erkrankungen darzustellen. Ergebnisse: Insbesondere im anglo-amerikanischen Sprachraum werden viele gemeindenahe Ansätze wie Housing First und Assertive Community Treatment beschrieben, die gute Ergebnisse für Wohnstabilität und Lebenszufriedenheit zeigen. Gemischt sind die Ergebnisse für die psychische Gesundheit. Forschung im deutschsprachigen Raum ist vergleichsweise defizitär. Ausblick: Niedrigschwellige oder aufsuchende Angebote scheinen vorteilhaft zu sein. Doch die Befunde lassen sich aufgrund sozialrechtlicher Unterschiede nicht per se auf die hiesigen Gegebenheiten übertragen. Das Problem wird gegenwärtig durch den sozialstrukturellen Wandel mit dem Aufkommen Geflüchteter verschärft.

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A systematic review of interventions for homeless alcohol-abusing adults

Cited by 7 publications

References 60 publications

A Meta-Analysis of the Efficacy of Case Management for Substance Use Disorders: A Recovery Perspective

A Meta-Analysis of the Efficacy of Case Management for Substance Use Disorders: A Recovery Perspective

Ecological Momentary Assessment of Alcohol Consumption and Its Concordance with Transdermal Alcohol Detection and Timeline Follow‐Back Self‐report Among Adults Experiencing Homelessness

Die gesundheitliche Versorgung von wohnungslosen Menschen mit psychischen Problemen

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