A population based perspective of twenty years of specialized ambulatory treatment for alcohol use disorders in publicly financed clinics. Barcelona 1996–2015

Villalbí, Joan R.; Suelves, Josep M.; Bosque-Prous, Marina; Bartrolí, Montse; Brugal, M. Teresa

doi:10.1016/j.jsat.2018.06.007

Cited by 1 publication

(6 citation statements)

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“…Regarding correlates to the trajectory groups, our results highlight the potential influence of certain treatment characteristics on treatment utilization patterns and discontinuation over time [3,42]. Being a woman was consistently associated with recurrent groups [6,19,29,40]. Women suffer from greater social stigma than men because of their substance use, are a minority in the treatment system and face additional barriers to access and continue treatment, including caregiving [65].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies found inconsistent associations between age [19,20,31,39,40], sex [1,6,19,20,31] and treatment utilization.…”

Section: Introductionmentioning

confidence: 90%

“…inpatient or outpatient), number of episodes and outcomes. Multiple readmissions are fairly common [6,[12][13][14][15][16][17][18][19], with 20% to 80% of participants reporting previous treatments [6,12,[20][21][22]. Understanding treatment trajectories can inform policy by distinguishing groups at risk of discontinuing and those who repeatedly use treatment [23], as well as their influence on current engagement and outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…People with higher education tend to report more previous treatments and longer stays [1,19,31], and unemployment has been linked to recurrence [19,31]. Being married has been associated with shorter stays in treatment [1], but increased recurrence [31].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies found inconsistent associations between age [19, 20, 31, 39, 40], sex [1, 6, 19, 20, 31] and treatment utilization. People with higher education tend to report more previous treatments and longer stays [1, 19, 31], and unemployment has been linked to recurrence [19, 31]. Being married has been associated with shorter stays in treatment [1], but increased recurrence [31].…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal trajectories of substance use disorder treatment use: A latent class growth analysis using a national cohort in Chile

Bórquez,

Cerdá,

González‐Santa Cruz

et al. 2024

Addiction

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Background and aimsLongitudinal studies have revealed that substance use treatment use is often recurrent among patients; the longitudinal patterns and characteristics of those treatment trajectories have received less attention, particularly in the global south. This study aimed to disentangle heterogeneity in treatment use among adult patients in Chile by identifying distinct treatment trajectory groups and factors associated with them.DesignNational‐level registry‐based retrospective cohort.Setting and participantsAdults admitted to publicly funded substance use disorder treatment programs in Chile from November 2009 to November 2010 and followed for 9 years (n = 6266).MeasurementsMonthly treatment use; type of treatment; ownership of the treatment center; discharge status; primary substance used; sociodemographic.FindingsA seven‐class treatment trajectory solution was chosen using latent class growth analysis. We identified three trajectory groups that did not recur and had different treatment lengths: Early discontinuation (32%), Less than a year in treatment (19.7%) and Year‐long episode, without recurrence (12.3%). We also identified a mixed trajectory group that had a long first treatment or two treatment episodes with a brief time between treatments: Long first treatment, or immediate recurrence (6.3%), and three recurrent treatment trajectory groups: Recurrent and decreasing (14.2%), Early discontinuation with recurrence (9.9%) and Recurrent after long between treatments period (5.7%). Inpatient or outpatient high intensity (vs. outpatient low intensity) at first entry increased the odds of being in the longer one‐episode groups compared with the Early discontinuation group. Women had increased odds of belonging to all the recurrent groups. Using cocaine paste (vs. alcohol) as a primary substance decreased the odds of belonging to long one‐episode groups.ConclusionsIn Chile, people in publicly funded treatment for substance use disorder show seven distinct care trajectories: three groups with different treatment lengths and no recurring episodes, a mixed group with a long first treatment or two treatment episodes with a short between‐treatment‐episodes period and three recurrent treatment groups.

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