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Barré T, Ramier C, Antwerpes S, Costa M, Bureau M, Maradan G, Di Beo V, Cutarella C, Leloutre J, Riccobono-Soulier O, Hedoire S, Frot E, Vernier F, Vassas-Goyard S, Dufort S, Protopopescu C, Marcellin F, Casanova D, Coste M, Carrieri P. A novel community-based therapeutic education program for reducing alcohol-related harms and stigma in people with alcohol use disorders: A quasi-experimental study (ETHER study). Drug Alcohol Rev 2023; 42:664-679. [PMID: 36721903 DOI: 10.1111/dar.13605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/07/2022] [Accepted: 12/19/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Alcohol use disorder (AUD) is associated with a significant disease burden in France, where alcohol use is deeply rooted in culture. However, the treatment gap is large because of several barriers, including stigmatisation and drinkers' apprehension about total abstinence. However, standardised and evidence-based interventions based on controlled-drinking for people with AUD are lacking. We aimed to assess the effectiveness of a novel community-based French therapeutic patient education (TPE) program for people with AUD named Choizitaconso. METHODS A before-after non-randomised quasi-experimental study, named ETHER, was designed and implemented with people living with AUD, over a period of 6 months. The primary outcome was percentage change in the number of alcohol-related harms experienced. Secondary outcomes were percentage changes in psycho-social patient-reported and community-validated outcomes. Participants in the intervention group (n = 34) benefited from the 10-week TPE program Choizitaconso, while the comparison group (n = 58) received standard care. The Kruskall-Wallis and chi-squared or Fisher's exact tests were used to compare before-after changes in variables in both groups. Linear regression models were used to test for the effect of study group on each outcome and to test for the effect of alcohol consumption as a confounder. RESULTS At 6 months, all outcomes but one either remained stable or numerically improved in both groups. Internalised stigma significantly improved in the intervention group (p = 0.026) but not in the comparison group (p = 0.207), with a significant group effect (p = 0.014). DISCUSSION AND CONCLUSIONS This study demonstrates the effectiveness of the Choizitaconso TPE program on community-validated outcomes, especially internalised stigma.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Clémence Ramier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Saskia Antwerpes
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Marie Costa
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Morgane Bureau
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Gwenaelle Maradan
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Vincent Di Beo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Christophe Cutarella
- Clinique Saint-Barnabé, Marseille, France
- Association Addictions France, Salon-de-Provence, France
| | | | | | | | - Elodie Frot
- Association Addictions France, Digne-les-Bains, France
| | | | | | - Sabine Dufort
- Association Addictions France, Digne-les-Bains, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | | | - Marion Coste
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
- Aix Marseille Univ, CNRS, AMSE, Marseille, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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Carrieri P, Barré T, Bureau M, Marcellin F, Mourad A. Stigma and care avoidance in people with unhealthy alcohol use: A call for research and action. J Hepatol 2022; 77:1221-1222. [PMID: 35714810 DOI: 10.1016/j.jhep.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Tangui Barré
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Morgane Bureau
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
| | - Abbas Mourad
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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Costa M, Barré T, Antwerpes S, Coste M, Bureau M, Ramier C, Maradan G, Riccobono-Soulier O, Vassas-Goyard S, Casanova D, Carrieri P. A Community-Based Therapeutic Education Programme for People with Alcohol Use Disorder in France: A Qualitative Study (ETHER). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159228. [PMID: 35954605 PMCID: PMC9368643 DOI: 10.3390/ijerph19159228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022]
Abstract
Therapeutic patient education (TPE) aims to help people with chronic disease strengthen their empowerment and psychosocial skills to better manage their condition. Although TPE has great potential for addiction medicine, studies on its benefits for reducing alcohol-related harms and increasing empowerment are sparse. We conducted a qualitative study of people with alcohol use disorder (AUD) who participated in the community-based TPE programme Choizitaconso to assess their perceptions and experiences of it. Semi-structured interviews were conducted with 16 participants who had completed the TPE programme at least six months previously. The interviews were transcribed and analysed using a sequential thematic analysis. We identified four general themes: (1) the context of participation: the TPE programme could be a strategy to facilitate engagement in AUD care; (2) representations and experiences: the programme helped to “normalize” participants’ relationship with alcohol use by increasing empowerment; (3) TPE strengths: improved knowledge about alcohol use, self-image, weight loss, self-stigma reduction; (4) TPE limitations: difficulty putting learning into practice after the programme ended. The Choizitaconso programme met participants’ health and psychosocial expectations, strengthening their empowerment and reducing self-stigma, thereby facilitating engagement in AUD care.
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Affiliation(s)
- Marie Costa
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
- Correspondence:
| | - Tangui Barré
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
| | - Saskia Antwerpes
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
| | - Marion Coste
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
| | - Morgane Bureau
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
| | - Clémence Ramier
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
| | - Gwenaelle Maradan
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
| | | | | | - Danielle Casanova
- Association Addictions France, 84000 Avignon, France; (O.R.-S.); (D.C.)
| | - Patrizia Carrieri
- Aix Marseille University, INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche pour le Développement), SESSTIM (Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM (Institut des Sciences de la Santé Publique), 27 Bd Jean Moulin, 13385 Marseille, France; (T.B.); (S.A.); (M.C.); (M.B.); (C.R.); (G.M.); (P.C.)
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