Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. Methods A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as 'core' or 'supplementary' reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. Results Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options.
In 1996 the BBTS introduced a certificate in Transfusion Science Practice aimed mainly at staff working in hospital transfusion laboratories who wished to have evidence of their knowledge in this field. Together with the Certificate the BBTS provided a study guide for the distance learning and a textbook, ‘Introduction to Blood Group Serology and Blood Bank Practice’. With recent changes to (state) registration and career grades as a result of Agenda for Change, the Certificate scheme was reviewed and the new Specialist Certificate in Transfusion Science Practice introduced. A new Study Guide has been issued and the latest edition of the introductory book now contains chapters on donation testing and component preparation plus up‐dated sections on immune red cell lysis. The new Specialist Certificate should now meet the requirements of a registered Health Care Scientist working in either a hospital or Blood (Transfusion) Centre wishing to attain the status of a Specialist Practitioner. The examination is very similar to that of the old Certificate except that some choice of questions have been introduced into papers three and four to reflect the wider scope of including donation testing and component production. The practical examination has now been dropped as it was not a good discriminator in terms of the overall examination. With the new ‘donation’ options it would be impossible to set a practical to assess this part of the syllabus. Competency testing has to be the responsibility of the employer. The newly formed Academic Board will be overseeing this examination, its progress and suitability. Any proposed changes would have to be approved by the Professional Affairs and Education Committee. The first of the new examinations was held in May this year and the next will be in November this year and then May 2007.
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