Now showing 1 - 4 of 4
  • Publication
    Key performance indicators for mental health and substance use disorders: a literature review and discussion paper
    (Taylor and Francis (Routledge), 2014-03) ; ; ;
    With an increasing recognition of the importance of mental and substance use disorders (MESUDS) for population health and health systems and the potential value of systems-based performance indicators in addressing this issue, we aimed to describe the development and content of key performance indicators (KPIs) for MESUDS. Publications were identified through official websites, Google searches and PubMed. Following 'PRISMA' guidelines, 25 studies were kept for qualitative synthesis and six for quantitative analysis. We describe their use in practice by comparing their application across a range of public and mixed healthcare systems. Currently, the KPI development for MESUDS adopts several methodologies, including expert opinion, literature review, stakeholder consultation, and the structured consensus method. The rationales provided for selection of particular KPIs vary greatly between systems. Systems exhibit different levels of KPI adaptability, which is reflective of dynamic changes in evidence-based practices. We noted bias in the level of KPI assessment toward system/health plan evaluation followed by program/service evaluation. Similarly, there is a large skew toward KPIs that reflect evaluation of processes. Collection of data in all systems is nearly exclusively reliant on electronic administrative/medical data. Experiences from these systems are synthesized into methodological recommendations and considerations for further research and clinical practice are provided.
      777ScopusĀ© Citations 5
  • Publication
    Genetic pre-determinants of concurrent alcohol and opioid dependence: a critical review
    Concurrent alcohol dependence poses a significant burden to health and wellbeing of people with established opioid dependence. Although previous research indicates that both genetic and environmental risk factors contribute to the development of drug or alcohol dependence, the role of genetic determinants in development of concurrent alcohol and opioid dependence has not been scrutinised. To search for genetic pre-determinants of concurrent alcohol and opioid dependence, electronic literature searches were completed using MEDLINE (PubMed) and EBSCO (Academic Search Complete) databases. Reference lists of included studies were also searched. In this discussion paper, we provide an overview of the genes (n=33) which are associated with the opioid, serotonergic, dopaminergic, GABA-ergic, cannabinoid, and metabolic systems for each dependency (i.e., alcohol or opioid) separately. The current evidence base is inconclusive regarding an exclusively genetic pre-determinant of concurrent alcohol and opioid dependence. Further search strategies and original research are needed to determine the genetic basis for concurrent alcohol and opioid dependency.
      362
  • Publication
    Psychosocial interventions for problem alcohol use in illicit drug users (Protocol)
    This is the protocol for a review and there is no abstract. The objectives are as follows:To determine the effectiveness of psychosocial interventions targeting problem alcohol use versus other treatments in illicit drug users.
      417
  • Publication
    Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users
    Background: Problem alcohol use is common among illicit drug users and is associated with adverse health outcomes. It is also an important factor in poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opiate overdose in opioid users.Objectives: To assess the effects of psychosocial interventions for problem alcohol use in illicit drug users (principally problem drug users of opiates and stimulants).Search methods: We searched the Cochrane Drugs and Alcohol Group trials register (November 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 11, November 2011), PUBMED (1966 to 2011); EMBASE (1974 to 2011); CINAHL (1982 to 2011); PsycINFO (1872 to 2011) and reference list of articles. We also searched: 1) conference proceedings (online archives only) of the Society for the Study of Addiction (SSA), International Harm Reduction Association (IHRA), International Conference on Alcohol Harm Reduction (ICAHR), and American Association for the Treatment of Opioid Dependence (AATOD); 2) online registers of clinical trials, Current Controlled Trials (CCT), Clinical Trials.org, Center Watch and International Clinical Trials Registry Platform (ICTRP).Selection criteria: Randomised controlled trials comparing psychosocial interventions with another therapy (other psychosocial treatment, including non-pharmacological therapies or placebo) in adult (over the age of 18 years) illicit drug users with concurrent problem alcohol use.Data collection and analysis: Two review authors independently assessed risk of bias and extracted data from included trials.Main results: Four studies, 594 participants, were included. Half of the trials were rated as having high or unclear risk of bias. They considered six different psychosocial interventions grouped into four comparisons: (1) cognitive-behavioural coping skills training versus 12-step facilitation (N = 41), (2) brief intervention versus treatment as usual (N = 110), (3) hepatitis health promotion versus motivational interviewing (N = 256), and (4) brief motivational intervention versus assessment-only group (N = 187). Differences between studies precluded any pooling of data. Findings are described for each trial individually:comparison 1: no significant difference; comparison 2: higher rates of decreased alcohol use at three months (risk ratio (RR) 0.32; 95% confidence interval (CI) 0.19 to 0.54) and nine months (RR 0.16; 95% CI 0.08 to 0.33) in the treatment as usual group; comparison 3 (group and individual format): no significant difference; comparison 4: more people reduced alcohol use (by seven or more days in the past 30 days at 6 months) in the brief motivational intervention compared to controls (RR 1.67; 95% CI 1.08 to 2.60).Authors' conclusions: Very little evidence exists that there is no difference in the effectiveness between different types of interventions and that brief interventions are not superior to assessment only or treatment as usual. No conclusion can be made because of the paucity of the data and the low quality of the retrieved studies.
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