Abstract
BackgroundAlcohol dependence is common and serious cause of social and physical harm. However, the optimal management of those with moderate and severe alcohol dependence in primary and community care after detoxification remains unclear. The aim of this review is to evaluate the effectiveness of interventions for maintaining abstinence in people with alcohol dependence following detoxification.MethodsWe will systematically search electronic databases and clinical trial registries for randomized controlled trials (RCTs) examining the effectiveness of pharmacological and/or psychosocial interventions for maintaining abstinence in recently detoxified, alcohol-dependent adults. The searches will be complemented by checking references and citations from included studies and other relevant systematic reviews. No limitation on language, year, or publication status will be applied. RCTs will be selected using prespecified criteria. Descriptive information, study characteristics, and results of eligible RCTs will be extracted. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed.DiscussionThis network meta-analysis aims to appraise and summarize the total evidence of therapeutic interventions for alcohol-dependent patients that require support for detoxification and can be treated in the community. The evidence will determine which combination of interventions are most promising for current practice and further investigation.Systematic review registrationPROSPERO CRD42016049779
Highlights
Alcohol dependence is common and serious cause of social and physical harm
This review will assess the comparative effectiveness of therapeutic interventions to maintain abstinence for alcohol-dependent patients following detoxification in community non-inpatient settings
There is no comprehensive systematic review of interventions across different pharmacological and psychosocial modalities to inform the clinical practice for the treatment of alcohol dependence in detoxified patients
Summary
Alcohol dependence is common and serious cause of social and physical harm. the optimal management of those with moderate and severe alcohol dependence in primary and community care after detoxification remains unclear. The negative effects of alcohol on cognitive processing and behavior contribute to psychosocial problems [2,3,4]. The consequence of these is a large cost to social and healthcare systems [5]. Many patients drop out of treatment, those exhibiting severe alcohol dependence and comorbidities. This is wasteful of resources, but clinically risky as repeated withdrawals from alcohol are associated with an increase in the severity of withdrawal symptoms and can precipitate poor outcomes [9]
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