Planned and Unplanned Discharge from Alcohol Services in Scotland, 2004-2008

Newham, Rosemary; Russell, Christopher; Davies, John B.

doi:10.1093/alcalc/agp081

Cited by 9 publications

(6 citation statements)

References 15 publications

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“…Primary care facilities as entry point seem pragmatic, yet Nadkarni et al [ 35 ] reported a low consent rate of 23% next to a high dropout rate, which was not the case for the Treatment Camp approach with a consent rate of 89% and no dropouts during the Treatment Camp intervention. The low dropout-rate during treatment in the present study is exceptional for this patient-group [ 63 ].…”

Section: Discussionmentioning

confidence: 88%

Treating alcohol use disorder in the absence of specialized services – evaluation of the moving inpatient Treatment Camp approach in Uganda

Ertl

Groß

Mwaka³

et al. 2021

BMC Psychiatry

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Background The gap between service need and service provision for alcohol-related disorders is highest in resource-poor countries. However, in some of these contexts, local initiatives have developed pragmatic interventions that can be carried out with limited specialized personnel. In an uncontrolled treatment study, we aimed to evaluate the feasibility, acceptability, safety, costs and potential effects of an innovative locally developed community-based program (the Treatment Camp) that is based on an inpatient clinic that moves from community to community. Methods Out of 32 treatment-seeking individuals 25 took part in the one-week Treatment Camp that included detoxification and counseling components. Re-assessments took place 5 and 12 months after their participation. We explored the course of a wide range of alcohol-related indicators, using the Alcohol Use Disorders Identification Test (AUDIT) as primary outcome complemented by a timeline follow-back approach and the Obsessive Compulsive Drinking Scale. Additionally, we assessed impaired functioning, alcohol-related stigmatization, symptoms of common mental health disorders and indicators of family functioning as reported by participants’ wives and children. Results All alcohol-related measures decreased significantly after the Treatment Camp and remained stable up to the 12-month-assessment with high effect sizes ranging from 0.89 to 3.49 (Hedges’s g). Although 92% of the participants had lapsed at least once during the follow-up period, 67% classified below the usually applied AUDIT cutoff for hazardous drinking (≥ 8) and no one qualified for the dependent range (≥ 20) one year after treatment. Most secondary outcomes including impaired functioning, alcohol-related stigmatization, symptoms of depression and indicators of family functioning followed the same trajectory. Conclusions We found the Treatment Camp approach to be acceptable, feasible, safe and affordable (approx. 111 USD/patient) and we could obtain preliminary evidence of its efficacy. Due to its creative combination of inpatient treatment and monitoring by medical personnel with local mobility, the Treatment Camp appears to be more accessible and inclusive than other promising interventions for alcohol dependent individuals in resource-poor contexts. Effects of the approach seem to extend to interactions within families, including a reduction of dysfunctional and violent interactions.

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Section: Discussionmentioning

confidence: 88%

Treating alcohol use disorder in the absence of specialized services – evaluation of the moving inpatient Treatment Camp approach in Uganda

Ertl

Groß

Mwaka³

et al. 2021

BMC Psychiatry

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“…Alcohol dependence is a major global public health problem which affects 5.1% of the global population and causes up to 3.3 million deaths per year, the majority of those being related to cardiovascular diseases [ 1 ]. Although integrative multimodal acute and rehabilitative treatment regimens have been widely established to reduce the disease burden related to alcohol dependence, malcompliance and low rates of adherence to treatment are frequently compromising success of these therapies [ 2 , 3 ]. Moreover, even after completion of rehabilitation relapse poses a major problem.…”

Section: Introductionmentioning

confidence: 99%

Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – a one-year follow-up

Penzlin¹,

Barlinn

Illigens

et al. 2017

BMC Psychiatry

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BackgroundA randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. Furthermore, we sought to identify potential predictors of post-treatment abstinence.MethodsWe conducted a survey on abstinence in patients with alcohol dependence 1 year after completion of an RCT comparing HRV-biofeedback in addition to inpatient rehabilitation treatment alone (controls). Abstinence rates were compared and analysed for association with demographic data as well as psychometric and autonomic cardiac assessment before and after completion of the biofeedback training using bivariate and multivariate regression analyses.ResultsOut of 48 patients who participated in the RCT, 27 patients (9 females, ages 42.9 ± 8.6, mean ± SD) completed our one-year follow-up. When including in the analysis only patients who completed follow-up, the rate of abstinence tended to be higher in patients who underwent HRV-biofeedback 1 year earlier compared to those who received rehabilitative treatment alone (66.7% vs 50%, p = ns). This non-significant trend was also observed in the intention-to-treat analysis where patients who did not participate in the follow-up were assumed to have relapsed (46,7% biofeedback vs. 33.3% controls, p = ns). Neither cardiac autonomic function nor psychometric variables were associated with abstinence 1 year after HRV-biofeedback.ConclusionOur follow-up study provide a first indication of possible increase in long-term abstinence after HRV-biofeedback for alcohol dependence in addition to rehabilitation.Trial registrationThe original randomized controlled trial was registered in the German Clinical Trials Register (DRKS00004618). This one-year follow-up survey has not been registered.

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“…Though many factors influence continuation in treatment, these previous studies indicate that recording treatment completion is a useful predictor for progress beyond treatment. Rates of treatment noncompletion in alcohol treatment services vary remarkably in available data, from more than 50% in Scotland to approximately 10% to 20% over several years in inpatient rehabilitation programs in Germany, and are in general lower in alcohol-dependent individuals compared to participants with a substance use disorder 4,16–20…”

Section: Introductionmentioning

confidence: 99%

Risk profiles of treatment noncompletion for inpatients and outpatients undergoing alcohol disorder rehabilitation treatment

Preuss¹,

Zimmermann²,

Schultz³

et al. 2012

SAR

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BackgroundRehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion.MethodsA total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity) at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncom-pleters for any reason.ResultsA total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be married but live separated.ConclusionRates of treatment noncompletion in inpatient and outpatient rehabilitation programs correspond to results from previous research. Noncompletion is a significant correlate of relapse 1 year after treatment, and noncompleters show an elevated level of psychopathology. These findings may help rehabilitation treatment facilities to tailor specific therapies for these individuals to reduce risk for treatment noncompletion.

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Planned and Unplanned Discharge from Alcohol Services in Scotland, 2004-2008

Cited by 9 publications

References 15 publications

Treating alcohol use disorder in the absence of specialized services – evaluation of the moving inpatient Treatment Camp approach in Uganda

Treating alcohol use disorder in the absence of specialized services – evaluation of the moving inpatient Treatment Camp approach in Uganda

Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – a one-year follow-up

Risk profiles of treatment noncompletion for inpatients and outpatients undergoing alcohol disorder rehabilitation treatment

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