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Case management for persons with substance use disorders.

Hesse, Morten; Broekaert, Erich; Fridell, Mats LU ; Rapp, Richard C. and Vanderplasschen, Wouter (2007) In Cochrane Database of Systematic Reviews, The Cochrane Library 2007 The Cochrane Library 2007(4 Art. CD006265). p.1-54
Abstract
Background: Patients with alcohol and other drug use disorders (AOD) frequently have multiple social, physical, and mental health treatment needs, yet have difficulty accessing community services, including drug abuse treatment. One strategy for linking patients with AOD with relevant services is case management, where a single case manager is responsible for linking patients with multiple relevant services.

Objectives: To conduct a systematic review of all RCTs on the use of case management for helping drug abusers in or out of treatment. Outcome criteria included successful linkage with other services, illicit drug use outcomes, and a range of related outcomes.

Search strategy: We searched the Cochrane Controlled Trials... (More)
Background: Patients with alcohol and other drug use disorders (AOD) frequently have multiple social, physical, and mental health treatment needs, yet have difficulty accessing community services, including drug abuse treatment. One strategy for linking patients with AOD with relevant services is case management, where a single case manager is responsible for linking patients with multiple relevant services.

Objectives: To conduct a systematic review of all RCTs on the use of case management for helping drug abusers in or out of treatment. Outcome criteria included successful linkage with other services, illicit drug use outcomes, and a range of related outcomes.

Search strategy: We searched the Cochrane Controlled Trials Register (Cochrane Library, issue 4, 2006), MEDLINE (1966 - 2006), EMBASE (1980 - 2006), LILACS (1982 - 2006), PsycINFO (1973 - 2006), Biological Abstracts (1982 t- 2000). Reference searching; personal communication; conference abstracts; book chapters on case management.

Selection criteria: Randomized controlled studies that compared a specific model of case management with either treatment as usual or another treatment model, included only patients with at least one alcohol or drug related problem.

Data collection and analysis: Two groups of reviewers extracted the data independently. Standardized mean difference was estimated.

Main results: In total, we could extract results from 15 studies. Outcome on illicit drug use was reported from 7 studies with 2391 patients. The effect size for illicit drug use was not significant, and small (standardized mean difference (SMD)=0.12, confidence interval=-0.09,0.29, p=0.20). Substantial heterogeneity was found (I2=69.9%). Linkage to other treatment services was reported in 10 studies with 3132 patients. The effect size for linkage was moderate (SMD=0.42, 95% confidence interval=0.21 to 0.62, p<0.001), but substantial heterogeneity was found (I2=85.2%). Moderator analyses suggested that a part of the heterogeneity found in linkage studies could be explained by the presence or absence of a treatment manual for case management. A single, large trial of case management with two arms, showed that case management was superior to psychoeducation and drug counselling in reducing drug use.

Authors' conclusions: There is current evidence supporting that case management can enhance linkage with other services. However, evidence that case management reduces drug use or produce other beneficial outcome is not conclusive. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cochrane Database of Systematic Reviews, The Cochrane Library 2007
volume
The Cochrane Library 2007
issue
4 Art. CD006265
pages
1 - 54
publisher
John Wiley & Sons
external identifiers
  • Other:CD006265
  • Scopus:39149109712
DOI
10.1002/14651858.CD006265.pub2
language
English
LU publication?
yes
id
1a86ccd2-cfc8-4009-895b-4b97073c9b44 (old id 928160)
alternative location
http://www.thecochranelibrary.com
date added to LUP
2008-02-01 16:12:00
date last changed
2016-12-04 04:44:19
@misc{1a86ccd2-cfc8-4009-895b-4b97073c9b44,
  abstract     = {Background: Patients with alcohol and other drug use disorders (AOD) frequently have multiple social, physical, and mental health treatment needs, yet have difficulty accessing community services, including drug abuse treatment. One strategy for linking patients with AOD with relevant services is case management, where a single case manager is responsible for linking patients with multiple relevant services.<br/><br>
Objectives: To conduct a systematic review of all RCTs on the use of case management for helping drug abusers in or out of treatment. Outcome criteria included successful linkage with other services, illicit drug use outcomes, and a range of related outcomes.<br/><br>
Search strategy: We searched the Cochrane Controlled Trials Register (Cochrane Library, issue 4, 2006), MEDLINE (1966 - 2006), EMBASE (1980 - 2006), LILACS (1982 - 2006), PsycINFO (1973 - 2006), Biological Abstracts (1982 t- 2000). Reference searching; personal communication; conference abstracts; book chapters on case management.<br/><br>
Selection criteria: Randomized controlled studies that compared a specific model of case management with either treatment as usual or another treatment model, included only patients with at least one alcohol or drug related problem.<br/><br>
Data collection and analysis: Two groups of reviewers extracted the data independently. Standardized mean difference was estimated.<br/><br>
Main results: In total, we could extract results from 15 studies. Outcome on illicit drug use was reported from 7 studies with 2391 patients. The effect size for illicit drug use was not significant, and small (standardized mean difference (SMD)=0.12, confidence interval=-0.09,0.29, p=0.20). Substantial heterogeneity was found (I2=69.9%). Linkage to other treatment services was reported in 10 studies with 3132 patients. The effect size for linkage was moderate (SMD=0.42, 95% confidence interval=0.21 to 0.62, p&lt;0.001), but substantial heterogeneity was found (I2=85.2%). Moderator analyses suggested that a part of the heterogeneity found in linkage studies could be explained by the presence or absence of a treatment manual for case management. A single, large trial of case management with two arms, showed that case management was superior to psychoeducation and drug counselling in reducing drug use.<br/><br>
Authors' conclusions: There is current evidence supporting that case management can enhance linkage with other services. However, evidence that case management reduces drug use or produce other beneficial outcome is not conclusive.},
  author       = {Hesse, Morten and Broekaert, Erich and Fridell, Mats and Rapp, Richard C. and Vanderplasschen, Wouter},
  language     = {eng},
  number       = {4 Art.  CD006265},
  pages        = {1--54},
  publisher    = {ARRAY(0x9eec2c0)},
  series       = {Cochrane Database of Systematic Reviews, The Cochrane Library 2007},
  title        = {Case management for persons with substance use disorders.},
  url          = {http://dx.doi.org/10.1002/14651858.CD006265.pub2},
  volume       = {The Cochrane Library 2007},
  year         = {2007},
}