Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol.

Yasmin Akram,David Moore,Alex Copello

doi:10.1186/2046-4053-3-90

Abstract

BackgroundWorldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.MethodsExtensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded.The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted.DiscussionThis systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of family-based interventions for substance misuse.It will evaluate all the available systematic-review-level literature to report on the effectiveness of family-based psychological interventions in improving substance-related outcomes and improving health and wellbeing of substance misusers and/or their families. This will inform future treatment policies and commissioning decisions.In addition, it will identify areas of poor quality, inconsistency and gaps in the evidence base for family-based psychological interventions in substance misuse with respect to secondary evidence in order to inform future research.Systematic review registrationPROSPERO CRD42014006834

Highlights

Worldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005)
Most individuals with substance misuse have family and significant others who are affected by the problem user regardless of whether they have become estranged or remain close and even provide caring roles
Substance misuse affects both the physical and psychological wellbeing of family members resulting in greater diagnoses of depression, substance misuse and increased use of healthcare services compared to matched controls [2]

Summary

Introduction

There are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have family and significant others who are affected by the problem user regardless of whether they have become estranged or remain close and even provide caring roles. Substance misuse affects both the physical and psychological wellbeing of family members resulting in greater diagnoses of depression, substance misuse and increased use of healthcare services compared to matched controls [2]. The importance of providing support to affected family members, in addition to the key role these individuals can play in improving the substance-related outcomes for the user, has become increasingly salient [6,7]. Members are at higher risk of exposure to antisocial and criminal behaviours from the substance misuser [3], in addition to other substance-misuse-related problems such as poor mental health, unemployment, deprivation, marriage problems, domestic abuse and affected parental capacity [4,5].

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