Transcript Journal Club Alcohol, Other Drugs, and Health: Current Evidence July–August 2015 www.aodhealth.org Featured Article Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled.

Journal Club
Alcohol, Other Drugs, and Health: Current Evidence
July–August 2015
www.aodhealth.org
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Featured Article
Specialty substance use
disorder services following
brief alcohol intervention: a
meta-analysis of
randomized controlled trials
Glass JE, et al. Addiction. 2015;110(9):1404–1415.
Study Objective
• To determine whether the “referral to
treatment” component of alcohol
screening, brief intervention, and
referral to treatment (SBIRT) is leading
to treatment.
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Study Design
• Systematic review and meta-analysis.
• Studies were randomized controlled trials (RCTs) of
brief alcohol interventions in general health care
settings among adults and adolescents.
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Assessing an Overview Article
(Systematic Reviews and Meta-Analyses)
• Are the results of the study valid?
• What are the results?
• Will the results help me in caring for
my patients?
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Are the Results of the Study Valid?
• Did the overview address a focused clinical question?
• Were the criteria used to select articles for inclusion
appropriate?
• Is it unlikely that important, relevant studies were missed?
• Was the validity of the included studies appraised?
• Were assessments of studies reproducible?
• Were the results similar from study to study?
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Did the overview address a
focused clinical question?
• Yes.
• Main outcomes:
– Post-intervention alcohol services utilization determined via selfreport or administrative data.
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Were the criteria used to select
articles for inclusion appropriate?
• Yes.
• 13 randomized controlled trials met inclusion criteria;
9 were included in the meta-analysis.
– Articles were published in English up until 2013 and available
in electronic databases.
– Studies had to have had an alcohol intervention in a general
healthcare setting.
– Participants must not have been seeking treatment.
– Studies were excluded if they did not include health services
utilization data.
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Is it unlikely that important,
relevant studies were missed?
 Yes.
 The authors searched PubMed, the Cochrane
Library, PsycINFO, and CINAHL Plus through 26
July, 2013.
 They also did a hand search of peer-reviewed and
grey papers by the references in the included
articles and contacted authors to ask if they knew
of other existing studies.
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Was the validity of the included
studies appraised?
• Yes.
– Two authors independently reviewed the
articles and performed the data extraction.
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Were assessments of studies
reproducible?
• Yes.
• The authors state their specific criteria for
grouping of studies and classifying
intervention intensity and severity of alcohol
use.
• Two authors independently reviewed papers.
• Data extraction used standardized forms
• Meetings were held to identify and resolve
discrepancies.
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Were the results similar from
study to study?
• Yes.
• The I2 statistic for the 9 studies included in
the meta-analysis was 0%, indicating no
evidence of study heterogeneity
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What Are the Results?
 What are the overall results of the
review?
 How precise were the results?
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What are the overall results of
the review?
• Referral to alcohol treatment did not lead to
treatment following alcohol SBIRT.
• Subgroup analyses yielded non-statistically
significant results.
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How precise were the results?
• For the primary outcome of receipt of alcohol
treatment following SBIRT, the pooled risk ratio
was = 1.08, 95% confidence interval = 0.92-1.28.
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Will the Results Help Me in
Caring for My Patients?
• Can the results be applied to my patient
care?
• Were all clinically important outcomes
considered?
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Can the results be applied to my
patient care?
• Yes.
– Study participants were non-treatment seeking
adults and adolescents in general healthcare
settings in 5 countries.
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Were all clinically important
outcomes considered?
• Yes.
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