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Wells M, Kelly PJ, Robson D, Haynes C, Hatton E, Larance B. Systematic review of treatment completion rates and correlates among young people accessing alcohol and other drug treatment. Drug Alcohol Depend 2024; 262:111376. [PMID: 38971027 DOI: 10.1016/j.drugalcdep.2024.111376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND AND AIMS Treatment completion is associated with improved alcohol and other drug (AOD) treatment outcomes. Unfortunately, treatment disengagement is common, particularly among young people. We reviewed and synthesised research on AOD treatment completion and/or early disengagement among young people. METHODS We conducted a systematic review and meta-analysis of studies reporting on completion rates and/or early disengagement from psychosocial AOD treatment among adolescents and young adults. An overall estimated treatment completion rate was calculated using inverse-variance random effects meta-analysis, and random-effects meta-regression was used to identify between-study level moderators of completion rate. We completed a narrative review summarising literature on early treatment disengagement and within-study level correlates of treatment completion. Study quality was assessed using the EPHPP. RESULTS Of the 6158 studies screened, we retained 410 for full text review and included 98 studies in the review. Treatment completion rates were reported in 88 studies, and early disengagement rates were reported in 13. The estimated overall treatment completion rate was 59 % (95 % CI=57-61 %), with experimental studies reporting higher rates of completion than observational studies. There was limited evidence for demographic or substance-related correlates of treatment completion. Contingency management was associated with increased completion rates, as was family-based intervention. CONCLUSIONS Disengagement from AOD treatment among youth populations is common and contributes to poor treatment outcomes. Existing research has yielded little consensus on the factors associated with treatment completion. The use of contingency management strategies and involving family/social supports in treatment were identified as potential avenues for promoting ongoing treatment engagement.
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Affiliation(s)
- Megan Wells
- School of Psychology, University of Wollongong, Australia.
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Australia
| | - Davina Robson
- School of Psychology, University of Wollongong, Australia; School of Education, Faculty of Arts, Design and Architecture, University of New South Wales, Australia
| | - Chloe Haynes
- School of Psychology, University of Wollongong, Australia
| | - Emma Hatton
- School of Psychology, University of Wollongong, Australia
| | - Briony Larance
- School of Psychology, University of Wollongong, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Australia
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Zapelini do Nascimento D, Marques GM, Schuelter-Trevisol F. Potential Psychotropic Drug Interactions among Drug-dependent People. J Psychoactive Drugs 2020; 53:168-176. [PMID: 33225871 DOI: 10.1080/02791072.2020.1849878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Using psychiatric drugs to treat drug dependence and its comorbidities is very common. The objective of this study was to analyze the interactions between prescribed drugs for patients treated at a specialized mental health-care center for persons who use drugs, located in the state of Santa Catarina, Brazil. A cross-sectional study was conducted on secondary data collected from 2010 to 2018. We reviewed the medical records of patients aged 18 years or older who took psychotropic drugs and had any type of substance dependence. The analysis of psychotropic drug interactions was conducted in three databases: Medscape, Drug Interactions Checker, and Micromedex. We included 1,022 of the 2,322 patients attending the care center during the study period. Psychotropic drug interactions were found in 779 (76.4%) study participants, and they presented 2,292 (100%) interactions, out of which 136 (6.0%) had minor clinical risk, 537 (23.4%) had moderate risk, and 1,619 (70.6%) had major risk for the patient, totaling 172 incompatible combinations between two psychotropic drugs. Of the total number of interactions, 128 were pharmacokinetic and 44 were pharmacodynamic. The high number of psychotropic drug interactions is a serious public health issue. Psychopharmacological treatment should be carefully addressed to be safe for the patient.
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Affiliation(s)
| | - Gabriela Moreno Marques
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Santa Catarina, Brazil
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Freitas EADO, Martins MSAS, Espinosa MM. Alcohol and tobacco experimentation among adolescents of the Midwest Region/Brazil. CIENCIA & SAUDE COLETIVA 2019; 24:1347-1357. [PMID: 31066837 DOI: 10.1590/1413-81232018244.15582017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 06/28/2017] [Indexed: 11/22/2022] Open
Abstract
This study aims to investigate the prevalence of alcohol and tobacco experimentation among adolescents of the Brazilian Midwest its association with sociodemographic factors. This is a cross-sectional study, with data from the National School Health Survey - PeNSE, carried out in 2015. The sample consisted of ninth-graders. The dependent variable was alcohol and tobacco experimentation at some point in life. A Poisson regression model was performed to identify the associated variables. The weighted estimated prevalence of alcohol and tobacco experimentation was 57.17% (95% CI: 56.20-58.14) and 22.38% (95% CI: 21.56-23.20), respectively. The prevalence of alcohol experimentation among females was higher than in males. However, regarding tobacco, males had a higher prevalence than females. Alcohol and tobacco experimentation was statistically significant with age. Public schools' administrative dependency showed a 23.99% higher prevalence than private schools concerning tobacco experimentation. We concluded that alcohol and tobacco experimentation was high among school adolescents and was shown to be associated with sociodemographic factors .
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Affiliation(s)
| | - Maria Silvia Amicucci Soares Martins
- Instituto de Saúde Coletiva , Universidade Federal de Mato Grosso (UFMT). Av. Fernando Correa da Costa s/n, Coxipó. 78060-900 Cuiabá MT Brasil .
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Galhardi CC, Matsukura TS. O cotidiano de adolescentes em um Centro de Atenção Psicossocial de Álcool e outras Drogas: realidades e desafios. CAD SAUDE PUBLICA 2018. [DOI: 10.1590/0102-311x00150816] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo objetivou compreender o cotidiano dos adolescentes em relação às drogas, no Centro de Atenção Psicossocial de Álcool e outras Drogas (CAPSad) e nos demais contextos de inserção pelos quais transitam, sob a ótica dos próprios adolescentes. Contou-se com a participação de oito adolescentes com idades entre 12 e 18 anos vinculados ao CAPSad, de um município de médio porte no interior do Estado de São Paulo, Brasil, onde o estudo foi realizado. Para a coleta de dados utilizou-se um formulário de identificação dos adolescentes e rede familiar e um roteiro de entrevista semiestruturada. Para a análise dos dados adotou-se a técnica do Discurso do Sujeito Coletivo (DSC). Os resultados evidenciam que os adolescentes vivenciam um processo de exclusão social e desengajamento em diversas esferas da vida e destaca o CAPSad como um espaço importante no dia a dia, porém ainda limitado nas ações de atenção e cuidado aos adolescentes. Este estudo acrescenta ao dar voz aos adolescentes, população que frequentemente está excluída dos serviços destinados ao acolhimento e tratamento do uso de drogas, como também ao identificar e compreender sobre as drogas e as particularidades de seus cotidianos, segundo suas próprias perspectivas, dentro e fora do serviço.
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Simões TDRDBA, Couto MCV, Miranda L, Delgado PGG. Missão e efetividade dos Consultórios na Rua: uma experiência de produção de consenso. SAÚDE EM DEBATE 2017. [DOI: 10.1590/0103-1104201711423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este é um relato da experiência de uma Oficina realizada com profissionais de Consultórios na Rua do estado do Rio de Janeiro, que inclui a apresentação do cotidiano do trabalho, discussão acerca da efetividade do cuidado oferecido e construção de consenso por meio da Técnica Delphi. A Oficina concluiu que o Consultório na Rua é um facilitador da chegada dos usuários à Atenção Básica, que o uso da redução de danos é comum a todos os serviços desse tipo, e que há algum grau de integração dos Consultórios na Rua com a saúde, a saúde mental e o intersetor, sendo essa integração, mesmo problemática, fundamental para o trabalho.
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Affiliation(s)
| | | | - Lilian Miranda
- Fundação Oswaldo Cruz, Brasil; Universidade Federal do Rio de Janeiro, Brasil
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Paula MLD, Jorge MSB, Lima LLD, Bezerra IC. Experiences of adolescent crack users and their relatives with psychosocial care and institucionalization. CIENCIA & SAUDE COLETIVA 2017; 22:2735-2744. [PMID: 28793087 DOI: 10.1590/1413-81232017228.22892015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 03/21/2016] [Indexed: 11/22/2022] Open
Abstract
The Drug User Comprehensive Care Policy establishes that care practices should cover biopsychosocial realms. However, evidence reveals an institutionalized practice, in which families prioritize the subject's seclusion from its context of use. This study aimed to understand the implications of psychosocial care and institutionalization in meeting the needs of adolescent crack users and their families. Eleven teenagers and six relatives narrated their experiences through in-depth interviews, which were analyzed in the light of Paul Ricoeur's Phenomenological Hermeneutics. A flow was observed in which teenagers seeking care are initially institutionalized and then referred to replacement services. Thus, there is an urgent need to strengthen the psychosocial care network so that adolescent crack users' care is offered comprehensively, ensuring respect for their fundamental rights, such as the right to freedom and to experience family or community life.
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Affiliation(s)
- Milena Lima de Paula
- Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Paranjana 1700, Itaperi. 60740-000 Fortaleza CE Brasil.
| | - Maria Salete Bessa Jorge
- Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Paranjana 1700, Itaperi. 60740-000 Fortaleza CE Brasil.
| | - Leilson Lira de Lima
- Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Paranjana 1700, Itaperi. 60740-000 Fortaleza CE Brasil.
| | - Indara Cavalcante Bezerra
- Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Paranjana 1700, Itaperi. 60740-000 Fortaleza CE Brasil.
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Silva NG, Barros S, Azevedo FCD, Batista LE, Policarpo VC. O quesito raça/cor nos estudos de caracterização de usuários de Centro de Atenção Psicossocial. SAUDE E SOCIEDADE 2017. [DOI: 10.1590/s0104-12902017164968] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este trabalho teve como objetivo apresentar, por meio de revisão narrativa da literatura científica, o perfil dos usuários atendidos em Centros de Atenção Psicossocial (CAPS), para verificar a inclusão do quesito raça/cor nessa produção. O levantamento bibliográfico foi realizado de maio a agosto de 2015 no Google Acadêmico e em bases que compõem a Biblioteca Virtual de Saúde: Medline, BDENF, Paho, Index Psicologia e Lilacs. As estratégias de busca foram: (1) “mental health services”/“serviços de saúde mental” AND “epidemiological profile”/“perfil epidemiológico” e (2) “mental health services”/“serviços de saúde mental” AND “health profile”/“perfil de saúde”. Dois revisores avaliaram títulos e resumos dos 452 artigos recuperados. A partir disso, foram excluídos os artigos repetidos e os que não tratam do perfil de usuários de CAPS, restando então 17 artigos. Desses, apenas três apresentaram dados de raça/cor, mas nenhum discutiu esses dados. Verificou-se que dois CAPS têm proporcionalmente mais negros em tratamento do que a população em geral, e evidenciou-se que o uso da variável raça/cor para caracterizar usuários dos serviços de CAPS ainda é reduzido, mesmo que seja importante marcador de cunho social - isso vai ao encontro da maneira como as desigualdades raciais no Brasil são tratadas pela sociedade: como inexistentes, o que reforça as iniquidades. Essas desigualdades têm se revelado persistentes e requerem que a política de saúde mental e a academia iniciem discussão que vá além de recomendações de conferências, para que se definam estratégias para esse enfrentamento e se produzam e reproduzam conhecimentos que possam ajudar na elaboração e implementação dessas estratégias.
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Pawlina MMC, Rondina RC, Espinosa MM, Botelho C. Abandonment of nicotine dependence treatment: A cohort study. SAO PAULO MED J 2016; 134:47-55. [PMID: 26786610 PMCID: PMC10496578 DOI: 10.1590/1516-3180.2015.00830309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 05/04/2015] [Accepted: 09/03/2015] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Non-adherence to treatment is one of the hindering factors in the process of smoking cessation. This study aimed to compare sociodemographic characteristics, smoking status and motivation among smokers who maintained or abandoned treatment to stop smoking, and to analyze associations between sociodemographic factors and smoking. DESIGN AND SETTING Cohort study on 216 smokers who were attended at healthcare units in Cuiabá, Mato Grosso. METHODS The instruments used were the Fagerström, URICA and CAGE questionnaires. Data from the initial evaluation was analyzed using the two-proportion test (α < 0.05). The patients were monitored for six months and those who abandoned treatment were accounted for. Bivariate analysis was conducted, using crude prevalence ratios and 5% significance level (P < 0.05), with abandonment of treatment as the outcome variable. Associations with P < 0.20 were selected for multiple robust Poisson regression (RPa). RESULTS The abandonment rate was 34.26%. Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake predominated in the dropout group. In the final model, gender (RPa 1.47; 95% CI: 1.03-2.10) and age group (RPa 3.77; 95% CI: 1.47-9.67) remained associated with abandonment. CONCLUSION Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake more frequently abandoned the treatment. Male gender and younger age group were associated with abandonment of nicotine dependence treatment.
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Affiliation(s)
| | - Regina Cássia Rondina
- PhD. Professor of Educational Psychology and Human Development, Department of Educational Psychology, Universidade Estadual Paulista (UNIP), Marília, São Paulo, Brazil.
| | - Mariano Martinez Espinosa
- PhD. Professor of Statistics, Department of Statistics and Biostatistics, Institute of Public Health, Universidade Federal de Mato Grosso (UFMT). Cuiabá, Mato Grosso, Brazil.
| | - Clóvis Botelho
- MD, PhD. Professor of Pulmonology, Department of Medicine, Universidade Federal de Mato Grosso (UFMT). Cuiabá, Mato Grosso, Brazil.
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Ribeiro DDR, Carvalho DSD. O padrão de uso de drogas por grupos em diferentes fases de tratamento nos Centros de Atenção Psicossocial Álcool e Drogas (CAPS-AD). JORNAL BRASILEIRO DE PSIQUIATRIA 2015. [DOI: 10.1590/0047-2085000000082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Analisar as características sociodemográficas e o padrão de uso de drogas em pacientes dos CAPS-AD de Curitiba, Paraná. Métodos Trata-se de um estudo observacional, transversal e descritivo em uma amostra de 268 indivíduos, 184 em início e 84 no terceiro mês de tratamento. Os questionários foram aplicados no período entre abril e setembro de 2012 e, além das variáveis sociodemográficas pesquisadas, obtiveram-se informações sobre quais substâncias eram utilizadas, tempo e frequência de uso. Para análise dos dados, utilizaram-se os programas Excel e Epi-Info. Médias e testes de qui-quadrado foram utilizados para a comparação dos grupos. Resultados Em ambos os grupos, predominaram sexo masculino, baixa escolaridade, baixa renda, ser da cor branca, residir com familiar ou amigo e possuir moradia própria. As drogas lícitas foram as mais utilizadas, e a maconha foi a droga ilícita mais utilizada na vida. O crack foi a droga mais utilizada no último ano e no último mês. Inalantes e alucinógenos foram os menos utilizados. Pacientes em terceiro mês de tratamento eram significativamente mais velhos, casados, tiveram menor uso na vida e no último mês de maconha, cocaína e crack, faziam uso mais frequente de álcool, e mais de um terço nunca tinha usado droga ilícita na vida. Conclusão Os achados deste estudo podem subsidiar o desenvolvimento de estratégias que possibilitem que grupos vulneráveis possam acessar e se manter em tratamento nos CAPS-AD.
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