Factors associated with alcohol use and abuse in Brazilian primary health care settings

Abstract Background Pharmacological and behavioural treatments for alcohol use disorders (AUDs) are effective but the uptake is limited. Primary care could be a key setting for identification and continuous care for AUD due to accessibility, low cost and acceptability to patients. We aimed to synthesise the literature regarding differential models of care for the management of AUD in primary health care settings. Methods We conducted a systematic review of articles published worldwide (1998-present) using the following databases; Medline, PsycINFO, Cochrane database of systematic reviews, Cochrane Central Register of Controlled Trials and Embase. The Grey Matters Tool guided the grey literature search. We selected randomised controlled trials evaluating the effectiveness of a primary care model in the management of AUD. Two researchers independently assessed and then reached agreement on the included studies. We used the Cochrane risk of bias tool 2.0 for the critical appraisal. Results Eleven studies (4186 participants) were included. We categorised the studies into ‘lower’ versus ‘higher’ intensity given the varying intensity of clinical care evaluated across the studies. Significant differences in treatment uptake were reported by most studies. The uptake of AUD medication was reported in 5 out of 6 studies that offered AUD medication. Three studies reported a significantly higher uptake of AUD medication in the intervention group. A significant reduction in alcohol use was reported in two out of the five studies with lower intensity of care, and three out of six studies with higher intensity of care. Conclusion Our results suggest that models of care in primary care settings can increase treatment uptake (e.g. psychosocial and/or pharmacotherapy) although results for alcohol-related outcomes were mixed. More research is required to determine which specific patient groups are suitable for AUD treatment in primary health care settings and to identify which models and components are most effective. Trial Registration PROSPERO: CRD42019120293.

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Distress and "problematic pregnancies" : prevalence and factors associated with depressive morbidity in women visiting perinatal primary health care settings of Dar es Salaam, Tanzania

10.26481/dis.20100226sk ◽

2010 ◽

Author(s):

S.F. Kaaya

Keyword(s):

Health Care ◽

Primary Health Care ◽

Dar Es Salaam ◽

Health Care Settings ◽

Factors Associated ◽

Primary Health ◽

Primary Health Care Settings

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Factors that facilitate diagnosis and brief intervention for risky alcohol use in Brazilian primary health care settings

Addiction Science & Clinical Practice ◽

10.1186/1940-0640-7-s1-a53 ◽

2012 ◽

Vol 7 (S1) ◽

Author(s):

Erica Cruvinel ◽

Rafaela Lisboa ◽

Michaela Amaral-Sabadini ◽

Telmo Ronzani

Keyword(s):

Health Care ◽

Primary Health Care ◽

Alcohol Use ◽

Brief Intervention ◽

Health Care Settings ◽

Primary Health ◽

Risky Alcohol ◽

Primary Health Care Settings

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Evidence-based models of care for the treatment of alcohol use disorder in primary health care settings: protocol for systematic review

Systematic Reviews ◽

10.1186/s13643-019-1157-7 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Susan A. Rombouts ◽

James Conigrave ◽

Eva Louie ◽

Paul Haber ◽

Kirsten C. Morley

Keyword(s):

Systematic Review ◽

Health Care ◽

Primary Health Care ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Critical Appraisal ◽

Models Of Care ◽

Health Care Settings ◽

Primary Health ◽

Primary Health Care Settings

Abstract Background Alcohol use disorder (AUD) is highly prevalent and accounts globally for 1.6% of disability-adjusted life years (DALYs) among females and 6.0% of DALYs among males. Effective treatments for AUDs are available but are not commonly practiced in primary health care. Furthermore, referral to specialized care is often not successful and patients that do seek treatment are likely to have developed more severe dependence. A more cost-efficient health care model is to treat less severe AUD in a primary care setting before the onset of greater dependence severity. Few models of care for the management of AUD in primary health care have been developed and with limited implementation. This proposed systematic review will synthesize and evaluate differential models of care for the management of AUD in primary health care settings. Methods We will conduct a systematic review to synthesize studies that evaluate the effectiveness of models of care in the treatment of AUD in primary health care. A comprehensive search approach will be conducted using the following databases; MEDLINE (1946 to present), PsycINFO (1806 to present), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL) (1991 to present), and Embase (1947 to present). Reference searches of relevant reviews and articles will be conducted. Similarly, a gray literature search will be done with the help of Google and the gray matter tool which is a checklist of health-related sites organized by topic. Two researchers will independently review all titles and abstracts followed by full-text review for inclusion. The planned method of extracting data from articles and the critical appraisal will also be done in duplicate. For the critical appraisal, the Cochrane risk of bias tool 2.0 will be used. Discussion This systematic review and meta-analysis aims to guide improvement of design and implementation of evidence-based models of care for the treatment of alcohol use disorder in primary health care settings. The evidence will define which models are most promising and will guide further research. Protocol registration number PROSPERO CRD42019120293.

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