Does patient involvement in treatment planning improve adherence, enrollment and other treatment outcome in alcohol addiction treatment? A systematic review

Hell, Morten Ellegaard; Nielsen, Anette Søgaard

doi:10.1080/16066359.2020.1723083

Cited by 14 publications

(16 citation statements)

References 35 publications

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“…“We are all in it together!” therapy has changed by necessary rules to mitigate COVID-19 spread, and patients and health care workers both are troubled by it. Just as shared decision making helps to start treatment ( Joosten, De Weert-Van Oene, Sensky, Van Der Staak, & De Jong, 2011 ), improves the working alliance ( Joosten, de Weert, Sensky, van der Staak, & de Jong, 2008 ), the adherence ( Hell & Nielsen, 2020 ; Joosten et al, 2008 ) and the efficacy ( Joosten, de Jong, de Weert-van Oene, Sensky, & van der Staak, 2009 ), this method could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the COVID-19 epidemic.…”

Section: Discussionmentioning

confidence: 99%

Psychological Impact of the Acute COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together

DeJong

Verhagen²,

Pols

et al. 2020

Basic Clin. Neurosci. J.

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Coronavirus Disease 2019 (COVID-19) results from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). it is now a pandemic that affects us all. For patients referring to the addiction care systems, this pandemic can create additional vulnerabilities. A great deal of effort has made to reorganize the care systems for patients with addiction. Our study focuses on the voice of our patients, on clues to adapt treatment, and on the impact of the pandemic on the therapeutic alliance. Methods: A qualitative design was used to develop a description and understanding of general and clinically relevant aspects of the impact of the COVID-19 pandemic. Fifteen addicted patients (11 under treatment and 4 in recovery) were interviewed by 4 interviewers according to the COREQ (consolidated criteria for reporting qualitative research). Results: COVID-19 has had a serious impact on thoughts, feelings, and behaviors. Interviewees shared their anxieties about their health and the health of their relatives. Frightening thoughts were associated with a range of negative feelings and behaviors, such as stress, anger, avoidance, and isolation. The use of psychoactive substances differed between the patients in treatment with those who are in stable recovery. In the former, all succeeded in staying abstinent. They have experienced that solidarity and connectedness were essential in sustaining their recovery. Those still in treatment were fighting against the temptation to start using again; they felt emotionally isolated and sometimes patronized by health care workers. Conclusion: The elaboration of the interviewees on the therapeutic relationship provides promising clues to optimize that relationship. Remembering this common expression, "we are all in this together", shared decision making could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the COVID-19 epidemic.

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Section: Discussionmentioning

confidence: 99%

Psychological Impact of the Acute COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together

DeJong

Verhagen²,

Pols

et al. 2020

Basic Clin. Neurosci. J.

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“…OTAT is, thus, a special form of shared decision-making (SDM, Coulter and Collins, 2011) "defined as practice in healthcare where clinicians and patients work together to decide on the best course of action" (Rose et al, 2017, p. 65) and follow different steps (such as goalsetting; Coulter and Collins, 2011). SDM in general, and OTAT in particular, have so far received little attention in addiction treatment, although they have proved promising in thealbeit fewmethodologically sound studies (Friedrichs et al, 2016;Hell and Nielsen, 2020) and projects (Joosten et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Treating patients with multiple substance use in accordance with their personal treatment goals: a new paradigm for addiction treatment

Körkel¹

2021

DAT

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Purpose This paper aims to present the theoretical foundation and practical approach of “open-target addiction treatment” (OTAT). Traditional treatment programmes are usually-oriented towards fixed predefined goals (abstinence, reduced consumption and harm reduction) and often focus on one substance only (e.g. alcohol). However, as a rule, people who use drugs consume several substances and sometimes additionally exhibit behavioural addictions. For many of these addictions, there is more or less motivation for change, but commonly it is not abstinence as a consistent goal. The paradigm of OTAT systematically considers multi-substance use, expects high readiness to change and is aware that commonly clients lack the willingness to abstain permanently. Design/methodology/approach The theory and practice of OTAT involve three components, namely, first, to create a systematic inventory of all psychoactive substances consumed and addictive behaviours performed, second, to clarify, which substance-related change goals clients pursue and third, to choose adequate treatment options matching the substance-specific goals of the clients. Furthermore, OTAT includes didactic tools to support working along with these three steps (e.g. a set of cards to gain an overview over the psychoactive substances used and addictive behaviours performed). Findings The systematic implementation of OTAT requires fundamentally different concepts about addiction and its treatment, specific competencies of the staff and a corresponding portfolio of interventions within the treatment facilities. Research limitations/implications Future research should focus more on patients’ goal preferences and their impact on their willingness to take up treatment and its outcomes. Practical implications To implement OTAT treatment, institutions have to undergo a systematic process of team and organizational development. Social implications OTAT has the potential to reduce the treatment gap and to serve severely addicted individuals in a more comprehensive way. Originality/value The OTAT approach has not been described in the addiction treatment literature so far.

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“…We investigated the differences in baseline variables between those participants who completed the follow-up interview (n = 325) and those who were lost to follow-up (n = 71), using Pearson's χ²test and Wilcoxon rank-sum test for continuous variables. A thorough description of baseline statistics and descriptive analyses can be found in the primary outcome report (Hell et al, 2021). All analyses are available by request to the first author.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…See the primary outcome report (Hell et al, 2021) for further description of randomization. A thorough description of power calculation is available in the protocol article (Hell et al, 2018).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…In contrast to expert-matching or clinician-led treatment matching, the Self-Match Study (Hell et al, 2018) therefore aimed to investigate if the outcome of treatment was improved when clients themselves were offered to freely choose treatment strategy from among five options. The findings from the Self-Match Study (Hell et al, 2021) showed that clients who chose their treatment from among options faired just as well as those allocated to treatment using an evidence-based algorithm . The study also showed that the clients in the self-match group chose differently among the five treatment options than what the algorithm would have proposed, leading to an overrepresentation of some therapies and under-representation of others, compared to the group of clients who received expert-based matched treatment.…”

Section: Introductionmentioning

confidence: 99%

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Personality traits and alcohol consumption: Secondary analysis of the Self‐Match Study

Hell

Müller

Horn

et al. 2022

Alcoholism Clin & Exp Res

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Background This secondary analysis of the Self‐Match Study explores whether personality traits affect the treatment outcome for alcohol use disorders (AUD). We designed the Self‐Match Study to investigate whether clients choosing between treatment options improves treatment outcomes. The primary outcome report revealed no difference in the outcome, whether treatment allocation was based on clinician matching or self‐matching. Because willingness to choose, choice of treatment method, and compliance with treatment may be related to personality, this exploratory sub‐study investigated the influence of personality traits on treatment outcome. Method We enrolled 402 consecutive clients (female 46.7%, mean age 47.4) seeking treatment at the outpatient alcohol treatment center in Odense, Denmark. Clients were randomized to treatment by expert‐match or self‐matching. Data on alcohol consumption (Timeline Follow Back), personality traits (NEO‐FFI‐3), and retention in care were collected at baseline and 6‐month follow‐up. Outcomes were compliance, sensible drinking (alcohol intake below National Recommendations), and the number of heavy drinking days at follow‐up. Results A high neuroticism score was negatively associated with treatment completion. Further, clients with a high score on neuroticism, openness, and extraversion, or a low score on conscientiousness were less likely to reduce their drinking to a sensible level at follow‐up. We also found that low scores on conscientiousness were associated with having more heavy drinking days at follow‐up. The personality traits neuroticism and openness were associated with treatment preferences. Conclusions Personality traits influence 6 months drinking outcomes for people receiving AUD treatment.

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Does patient involvement in treatment planning improve adherence, enrollment and other treatment outcome in alcohol addiction treatment? A systematic review

Cited by 14 publications

References 35 publications

Psychological Impact of the Acute COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together

Psychological Impact of the Acute COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together

Treating patients with multiple substance use in accordance with their personal treatment goals: a new paradigm for addiction treatment

Personality traits and alcohol consumption: Secondary analysis of the Self‐Match Study

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