TY - JOUR
T1 - Outpatient psychosocial substance use treatments for young people
T2 - An overview of reviews
AU - Snowdon, Nicole
AU - Allan, Julaine
AU - Shakeshaft, Anthony
AU - Rickwood, Debra
AU - Stockings, Emily
AU - Boland, Veronica C
AU - Courtney, Ryan J
N1 - Funding Information:
This work was supported by the NSW Ministry of Health. The funding body had no role in the design, analysis or interpretation of the data.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - BACKGROUND: Systematic reviews and meta-analyses (reviews) conflict regarding the efficacy and feasibility of substance disorder treatments for young people (YP). This overview of reviews, synthesizes, and methodologically assesses reviews examining substance disorder interventions for YP in outpatient settings.METHODS: Reviews published between 1990 and March 2018 were searched using EBM Reviews, PsycINFO, Embase, Ovid Medline, and Campbell Collaboration. Reviews investigating efficacy and/or feasibility of YP substance disorder treatments in outpatient settings were included.FORTY-THREE REVIEWS MET ALL INCLUSION CRITERIA: To appraise methodological biases, 40 reviews were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and 3 were narratively assessed. One reviewer (NS) extracted study data and evaluated all 43 reviews. For inter-rater reliability, 13 (30%) reviews were extracted and appraised in duplicate by a second reviewer (JA, RC or ES). Agreement on AMSTAR2 ratings reached 100%. Agreement was moderate; κ = .52 (p < .05), 95% CI (.20, .84).RESULTS: All high quality methodological reviews (n = 6) focused on intervention efficacy and none on treatment feasibility. One (n = 1) high quality review reported evidence for an intervention. Multidimensional Family Therapy (MDFT) has possible efficacy in reducing YP substance use when compared to treatment as usual, Cognitive Behavior Therapy, Adolescent Community Reinforcement Approach and Multifamily Educational Therapy.CONCLUSIONS: Methodological and reporting quality of reviews require improvement. High quality reviews focused on intervention efficacy but treatments commonly lacked evidence. One high quality review found MDFT demonstrated promising outcomes. Reviews examining feasibility of interventions were of low methodological quality.
AB - BACKGROUND: Systematic reviews and meta-analyses (reviews) conflict regarding the efficacy and feasibility of substance disorder treatments for young people (YP). This overview of reviews, synthesizes, and methodologically assesses reviews examining substance disorder interventions for YP in outpatient settings.METHODS: Reviews published between 1990 and March 2018 were searched using EBM Reviews, PsycINFO, Embase, Ovid Medline, and Campbell Collaboration. Reviews investigating efficacy and/or feasibility of YP substance disorder treatments in outpatient settings were included.FORTY-THREE REVIEWS MET ALL INCLUSION CRITERIA: To appraise methodological biases, 40 reviews were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and 3 were narratively assessed. One reviewer (NS) extracted study data and evaluated all 43 reviews. For inter-rater reliability, 13 (30%) reviews were extracted and appraised in duplicate by a second reviewer (JA, RC or ES). Agreement on AMSTAR2 ratings reached 100%. Agreement was moderate; κ = .52 (p < .05), 95% CI (.20, .84).RESULTS: All high quality methodological reviews (n = 6) focused on intervention efficacy and none on treatment feasibility. One (n = 1) high quality review reported evidence for an intervention. Multidimensional Family Therapy (MDFT) has possible efficacy in reducing YP substance use when compared to treatment as usual, Cognitive Behavior Therapy, Adolescent Community Reinforcement Approach and Multifamily Educational Therapy.CONCLUSIONS: Methodological and reporting quality of reviews require improvement. High quality reviews focused on intervention efficacy but treatments commonly lacked evidence. One high quality review found MDFT demonstrated promising outcomes. Reviews examining feasibility of interventions were of low methodological quality.
KW - Ambulatory Care/methods
KW - Cognitive Behavioral Therapy/methods
KW - Family Therapy/methods
KW - Humans
KW - Outpatients/psychology
KW - Reproducibility of Results
KW - Review Literature as Topic
KW - Substance-Related Disorders/psychology
KW - Treatment Outcome
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U2 - 10.1016/j.drugalcdep.2019.107582
DO - 10.1016/j.drugalcdep.2019.107582
M3 - Review article
C2 - 31778903
SN - 0376-8716
VL - 205
SP - 1
EP - 13
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 107582
ER -
