Update on Alcohol and Health：在酒精和健康更新

《Update on Alcohol and Health：在酒精和健康更新》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、UpdateonAlcoholandHealthAlcoholandHealth:CurrentEvidenceJuly-August20061www.alcoholandhealth.orgStudiesonAssessmentsandInterventions2www.alcoholandhealth.orgCombiningMedicationWithSpecialistBehavioralInterventionforAlcoholism:theCOMBINEStudyAntonRF,etal.JAMA.20

2、06;295(17):2003–2017.3www.alcoholandhealth.orgObjectives/MethodsTostudytheeffectsofpharmacotherapywithbehavioralinterventionforalcoholdependence1383recentlyabstinentpatientswithalcoholismrandomizedto1of9treatmentsfor16weeks:Placebo;Naltrexone(100mgperday),acampro

3、sate(3gperday),orboth;orCombinedbehavioralintervention(CBI)alone,withactivepills,orwithplacebo4www.alcoholandhealth.orgObjectives/Methods(cont.)CBI:OfferedbyaspecialistIncludedelementsofcognitivebehavioraltherapy,motivationalinterviewing,and12-stepfacilitationUpt

4、o2050-minutesessions“Medicalmanagement”(MM)providedtoallbutCBIalonegroup9counselingandeducationsessions(45-minuteinitialsessionand≈20-minutefollow-upsessions)ProvidedbyageneralisthealthcareprofessionalFocusedonmedicationsideeffects,adherence,andalcoholabstinence9

5、4%follow-upat16weeks;82%ayearlater5www.alcoholandhealth.orgResultsDrinkingoutcomesimprovedsubstantiallyinallgroups.Therangeofmeanpercentdaysabstinentacrossgroupswas…23%–30%atbaseline,67%–81%at16weeks,and59%–69%ayearlater.6www.alcoholandhealth.orgResults(cont.)Nal

6、trexone/MMBetterthanplacebo/MMatincreasingpercentdaysabstinent(81%vs75%)anddelayingareturntoheavydrinking*(hazardratio0.7)AddingCBIdidnotimprovetheseoutcomesCBI/MMwithanypillsBetterthanplacebo/MMatincreasingpercentdaysabstinent(e.g.,79%versus75%)CBIalone(withoutM

7、Morpills)Lesseffectivethanplacebo/MMatincreasingdaysabstinent(67%versus74%)Acamprosate/MMDidnotsignificantlyaffectdrinkingoutcomesKeyFindingsat16Weeks*>=5standarddrinksperdayformen,>=4forwomen7www.alcoholandhealth.orgResults(cont.)Oneyearaftertreatment…drinkingou

8、tcomesdidnotsignificantlydifferamonggroups.8www.alcoholandhealth.orgConclusions/CommentsThislarge,rigorous,andcomplexstudyshowedthat...naltrexoneandspecialistc