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Understanding low treatment seeking rates for alcohol use disorder: A narrative review of the literature and opportunities for improvement

机译:了解酒精使用障碍的低治疗寻求率:文献的叙述性综述和改进的机会

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摘要

Despite a well-documented global burden of disease attributable to alcohol use disorder (AUD), treatment seeking rates remain low. In this qualitative literature review, we address treatment seeking for AUD from a host of perspectives and summarize the literature on key factors. First, we summarize the rates of alcohol treatment seeking across various epidemiological surveys, spanning decades. Second, we discuss the definition of treatment seeking and 'what' is typically considered formal treatment. Third, we consider timing and discuss 'when' individuals are most likely to seek treatment. Fourth, we review the literature on 'who' is most likely to seek treatment, including demographic and clinical correlates. Fifth, we address the critical question of'why' so few people receive clinical services for AUD, relative to the number of individuals affected by the disorder, and review barriers to treatment seeking at the treatment- and person-levels of analysis. Finally, we identify opportunities to improve treatment seeking rates by focusing on tangible points of intervention. Specifically, we recommend a host of adaptations to models of care including efforts to make treatment more appealing across stages of AUD severity, accept a range of health-enhancing drinking goals as opposed to an abstinence-only model, educate providers and consumers about evidence-based behavioral and pharmacological treatments, and incentivize the delivery of evidence-based services.
机译:尽管有充分记录的全球疾病负担可归因于酒精使用障碍 (AUD),但寻求治疗的比率仍然很低。在这篇定性文献综述中,我们从多个角度探讨了AUD的治疗寻求,并总结了有关关键因素的文献。首先,我们总结了几十年来各种流行病学调查中寻求酒精治疗的比率。其次,我们讨论了寻求治疗的定义,以及通常被认为是正式治疗的“什么”。第三,我们考虑时机并讨论个人最有可能寻求治疗的“时间”。第四,我们回顾了关于“谁”最有可能寻求治疗的文献,包括人口统计学和临床相关性。第五,我们解决了一个关键问题,即相对于受该疾病影响的个体数量,“为什么”接受 AUD 临床服务的人如此之少,并在治疗和个人层面的分析中回顾了寻求治疗的障碍。最后,我们通过关注有形的干预点来确定提高治疗寻求率的机会。具体而言,我们建议对护理模式进行一系列调整,包括努力使治疗在AUD严重程度的各个阶段更具吸引力,接受一系列促进健康的饮酒目标,而不是仅禁欲模式,教育提供者和消费者关于循证行为和药物治疗,并激励提供循证服务。

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