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BMC Primary Care
Published in: BMC Primary Care 1/2020

Open Access 01-12-2020 | Care | Research article

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

Authors: Susan A. Rombouts, James H. Conigrave, Richard Saitz, Eva Louie, Paul Haber, Kirsten C. Morley

Published in: BMC Primary Care | Issue 1/2020

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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.
Appendix
Available only for authorised users
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Metadata
Title
Evidence based models of care for the treatment of alcohol use disorder in primary health care settings: a systematic review
Authors
Susan A. Rombouts
James H. Conigrave
Richard Saitz
Eva Louie
Paul Haber
Kirsten C. Morley
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Primary Care / Issue 1/2020
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-020-01288-6

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