Structured programs for the self-management of substance addiction consequences in outpatient services: A scoping review

Abstract

Structured intervention programs are an important resource for supporting people with substance addiction. Although evidence suggests that they improve health outcomes, such as specific symptoms, less is known about their impact on patients’ ability to self-manage the consequences of substance addiction. The aim of this review is to scope outpatient intervention programs focused on the self-management of substance addiction consequences. Approach. This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. MEDLINE and CINAHL (through Ebsco), Psychology & Behavioral Sciences Collection (including PsycINFO) and Web of Science were screened to identify articles published in the last 10 years. Only primary research was included. Out of 891 records, 19 were eligible for this review—12 randomized controlled trials (RCT), 6 quasi-experimental study and 1 observational study. Those studies reported group interventions (10), individual interventions (8) and 1 mixed approach. The most common interventions were based on motivational strategies, relapse prevention and definition of active plans for risky situations. 10 studies reported positive effects. The identification of structured programs may support the development of new approaches focused on empowerment and quality of life of people with substance addiction. Programs to empower patients for self-management of substance addiction consequences are often complex and rely on health professionals’ commitment. Nevertheless, they are a feasible approach that seems to benefit patients managing chronic conditions associated with substance addiction.

Acceptability and applicability of an intervention programme with substance addicts

“…Of the 6 participants, 3 had previous experience in having contributed to the development of intervention programmes for people with ABA. Concerning the interviews, participants included 5 men and 1 woman, aged between 45-63 (mean 58.4, SD=7.6); with a mean time of substance use of 27.4 years (SD=14.1) [9-43] and a mean time of permanency in the programs of 11 years (SD=8.8) [2][3][4][5][6][7][8][9][10][11]. Three were working regularly, 1 had intermittent work, 1 was retired and 1 was unemployed.…”

“…Many of these programmes differ in structure, content, target population and type of response 8 and their indiscriminate use cannot be considered adequate. When opting to create a "new" programme, the cultural characteristics of the population, the health problem, the care to be provided and accessibility must be considered.…”

Aceitabilidade e aplicabilidade de um programa de intervenção com usuários dependentes de substâncias

“…Dos 6 participantes, 3 tinham experiência prévia de ter contribuído para a elaboração de programas de intervenção junto de pessoa com CAD. Nas entrevistas os participantes foram 5 homens e 1 mulher, com idades compreendidas entre 45-63 (média 58,4 com dp=7,6); com um tempo médio de uso de substâncias de 27,4 anos (dp=14,1) e com um tempo médio de permanência nos programas de 11 anos (dp=8,8) [2][3][4][5][6][7][8][9][10][11]. Na dimensão social podemos dizer que 3 trabalhavam regularmente, 1 com trabalho esporádico, 1 reformado e 1 desempregado.…”

“…Alguns autores contextualizam os programas como uma forma de desenvolver competências sociais, adquirir confiança e devem-se constituir contextos de apoio e estimulo 7 . Muitos destes programas, são díspares na sua estrutura, conteúdo, população alvo e tipologia de resposta 8 , não se podendo considerar adequada a sua utilização indiscriminada. Quando a opção passa por criar um "novo" programa deve-se considerar as características culturais da população, o problema de saúde, os cuidados a prestar e a acessibilidade.…”