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Very Integrated Program (VIP): health promotion for patients with alcohol and drug use disorders

Hovhannisyan, Karen LU (2019) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2019(130).
Abstract
Treatment of patients with alcohol or drug use disorders is a complex multistage process addressing the substance addiction and co-morbidities. The risky lifestyles, including tobacco smoking, insufficient physical activity and unhealthy diet, which can aggravate health condition as well as addiction treatment itself, are very common among these patients. The complex health promotion (Very Integrated Program, VIP), addressing both the risky lifestyle and educating about the chronic diseases, can be promising for achieving better outcomes for
addiction treatment.

This thesis aims to explore the health status and lifestyle risk factors in patients with alcohol or drug use disorders in Sweden (study 1), to investigate the effect... (More)
Treatment of patients with alcohol or drug use disorders is a complex multistage process addressing the substance addiction and co-morbidities. The risky lifestyles, including tobacco smoking, insufficient physical activity and unhealthy diet, which can aggravate health condition as well as addiction treatment itself, are very common among these patients. The complex health promotion (Very Integrated Program, VIP), addressing both the risky lifestyle and educating about the chronic diseases, can be promising for achieving better outcomes for
addiction treatment.

This thesis aims to explore the health status and lifestyle risk factors in patients with alcohol or drug use disorders in Sweden (study 1), to investigate the effect of the VIP in patients with alcohol or drug use disorders (study 2). In addition, the thesis aims to explore the factors of interest associated with this intervention, such as the compliance of these patients to the VIP (study 3) and the characteristics of the patients that were successful in changing their lifestyle (study 4). The thesis consists of a comprehensive survey (study 1), two quantitative studies (studies 2 and 4), and a mix methods study (study 3).

The screening of the patients with alcohol or drug use disorders revealed that most of them had at least one lifestyle risk factor (93%) and suffer from at least one chronic disease (70%). The VIP intervention garnered no significant effect on harm reduction among these patients, their health status or quality of life (QoL), as well as on the addiction treatment outcomes, such as days in treatment or time to relapse. Surprisingly, the patients that did not receive the program had significantly more substance-free days after 12 months. The patients with higher
education, better QoL, and several lifestyle risk factors had higher chances of changing their lifestyle. The patients’ higher self-efficacy was positively associated with their compliance with the health promotion program. The patients displayed willingness for a change but also showed strong emotions associated with the process of change. (Less)
Abstract (Swedish)
Behandling av patienter med alkohol- eller drogberoende är en komplex flerstegsprocess som behandlar både substansberoende och co-morbiditeter. Riskfyllda livsstilar, inklusive tobaksrökning, otillräcklig fysisk aktivitet och ohälsosam kost, som kan förvärra hälsotillståndet och själva beroendebehandlingen, är mycket vanligt bland dessa patienter. Det komplexa hälsofrämjande programmet (Very Integrated Program, VIP), som tar upp både livsstils-riskfaktorer och utbildar om relevanta kroniska sjukdomar, kan bidra till att uppnå bättre resultat för
missbruk.

Denna avhandling syftar till att undersöka hälsostatus och livsstils-riskfaktorer hos patienter med alkohol- eller drogberoende i Sverige och att undersöka effekten av VIP... (More)
Behandling av patienter med alkohol- eller drogberoende är en komplex flerstegsprocess som behandlar både substansberoende och co-morbiditeter. Riskfyllda livsstilar, inklusive tobaksrökning, otillräcklig fysisk aktivitet och ohälsosam kost, som kan förvärra hälsotillståndet och själva beroendebehandlingen, är mycket vanligt bland dessa patienter. Det komplexa hälsofrämjande programmet (Very Integrated Program, VIP), som tar upp både livsstils-riskfaktorer och utbildar om relevanta kroniska sjukdomar, kan bidra till att uppnå bättre resultat för
missbruk.

Denna avhandling syftar till att undersöka hälsostatus och livsstils-riskfaktorer hos patienter med alkohol- eller drogberoende i Sverige och att undersöka effekten av VIP hos patienter med alkohol- eller drogberoende. Dessutom syftar avhandlingen till att utforska intressanta faktorer förknippade med denna intervention, såsom hur väl dessa patienter överensstämmer med VIP och egenskaperna hos de patienter som
lyckades ändra sin livsstil.

Undersökningen av patienter med alkohol- eller drogberoende avslöjade att de flesta av dem hade minst en livsstils-riskfaktor (93%) och lider av minst en kronisk sjukdom (70%). VIP-interventionen fick ingen signifikant effekt på skadereduktion hos dessa patienter, deras hälsostatus eller livskvalitet, inte heller på resultaten av beroende-behandlingen, såsom dagar i behandling eller tid till återfall. Överraskande nog hade patienterna som inte fick programmet signifikant mer substansfria dagar efter 12 månader. Patienterna med högre utbildning, bättre livskvalitet och flera livsstils-riskfaktorer hade högre chanser att ändra sin livsstil. Patientens högre själveffektivitet var positivt associerad med deras efterlevnad av det hälsofrämjande programmet. Patienterna visade viljan för en förändring men visade också starka känslor förknippade med förändringsprocessen. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • professor Allebeck, Peter, Stockholm
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Alcohol addiction, Drug addiction, Lifestyle intervention, Smoking cessation, Dietary counselling, Physical activity, Integrated program
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2019
issue
130
pages
62 pages
publisher
Lund University, Faculty of Medicine
defense location
Lilla aulan, Jan Waldenströms gata 5, Skånes Universitetssjukhus i Malmö
defense date
2019-12-19 13:00:00
ISSN
1652-8220
ISBN
978-91-7619-859-9
project
Very Integrated Program (VIP): Health promotion for patients with alcohol and drug use disorders
language
English
LU publication?
yes
id
11400b16-dde1-4b63-96f3-6aa37d07a3c9
date added to LUP
2019-11-24 17:31:00
date last changed
2022-03-30 11:20:19
@phdthesis{11400b16-dde1-4b63-96f3-6aa37d07a3c9,
  abstract     = {{Treatment of patients with alcohol or drug use disorders is a complex multistage process addressing the substance addiction and co-morbidities. The risky lifestyles, including tobacco smoking, insufficient physical activity and unhealthy diet, which can aggravate health condition as well as addiction treatment itself, are very common among these patients. The complex health promotion (Very Integrated Program, VIP), addressing both the risky lifestyle and educating about the chronic diseases, can be promising for achieving better outcomes for<br/>addiction treatment.<br/><br/>This thesis aims to explore the health status and lifestyle risk factors in patients with alcohol or drug use disorders in Sweden (study 1), to investigate the effect of the VIP in patients with alcohol or drug use disorders (study 2). In addition, the thesis aims to explore the factors of interest associated with this intervention, such as the compliance of these patients to the VIP (study 3) and the characteristics of the patients that were successful in changing their lifestyle (study 4). The thesis consists of a comprehensive survey (study 1), two quantitative studies (studies 2 and 4), and a mix methods study (study 3).<br/><br/>The screening of the patients with alcohol or drug use disorders revealed that most of them had at least one lifestyle risk factor (93%) and suffer from at least one chronic disease (70%). The VIP intervention garnered no significant effect on harm reduction among these patients, their health status or quality of life (QoL), as well as on the addiction treatment outcomes, such as days in treatment or time to relapse. Surprisingly, the patients that did not receive the program had significantly more substance-free days after 12 months. The patients with higher<br/>education, better QoL, and several lifestyle risk factors had higher chances of changing their lifestyle. The patients’ higher self-efficacy was positively associated with their compliance with the health promotion program. The patients displayed willingness for a change but also showed strong emotions associated with the process of change.}},
  author       = {{Hovhannisyan, Karen}},
  isbn         = {{978-91-7619-859-9}},
  issn         = {{1652-8220}},
  keywords     = {{Alcohol addiction; Drug addiction; Lifestyle intervention; Smoking cessation; Dietary counselling; Physical activity; Integrated program}},
  language     = {{eng}},
  number       = {{130}},
  publisher    = {{Lund University, Faculty of Medicine}},
  school       = {{Lund University}},
  series       = {{Lund University, Faculty of Medicine Doctoral Dissertation Series}},
  title        = {{Very Integrated Program (VIP): health promotion for patients with alcohol and drug use disorders}},
  volume       = {{2019}},
  year         = {{2019}},
}