title: Continuing care for patients with alcohol use disorders: a systematic review.
abstract: BACKGROUND
  A chronic care perspective should be adopted in the treatment of patients with alcohol use disorders (AUDs). Initial treatment in a more intense psychiatric care setting should be followed by continuing care. This systematic review aims to identify effective continuing care interventions for patients with AUDs.
  
  
  METHODS
  Electronic databases were searched up to February 2013 (MEDLINE, EMBASE, CENTRAL, CINAHL and PsycINFO) to identify RCTs studying continuing care interventions for patients with AUDs. Study selection and quality appraisal was done independently by two reviewers. Drinking and treatment engagement outcomes were considered. Relative risks and mean differences were calculated with 95% confidence intervals. A statistical pooling of results was planned.
  
  
  RESULTS
  20 trials out of 15,235 identified studies met the inclusion criteria. Only six were evaluated as methodologically strong enough and included for further analysis. Interventions ranged from telephone calls and nurse follow-up to various forms of individual or couples counseling. Four trials suggested that supplementing usual continuing care with an active intervention empowering the patient, could be beneficial to drinking outcomes. Effect sizes were limited and not consistent across all outcomes. Because of heterogeneity in the interventions and outcome measures, a meta-analysis could not be performed.
  
  
  CONCLUSIONS
  For the treatment of a disease with such devastating consequences, it is remarkable how few high quality studies are available. Adding an active intervention to usual continuing care seems to improve treatment outcomes. We propose an integrated care program with different elements from the selected studies and discuss implications for further research.
authors: Academic Center for General Practice, Department of Public health and Primary Care, Katholieke Universiteit Leuven, Kapucijnenvoer 33, blok j, bus 7001, 3000 Leuven, Belgium. Electronic address: evelien.lenaerts@med.kuleuven.be.
authors: Evelien
authors: E
authors: Lenaerts
authors: Academic Center for General Practice, Department of Public health and Primary Care, Katholieke Universiteit Leuven, Kapucijnenvoer 33, blok j, bus 7001, 3000 Leuven, Belgium.
authors: Catharina
authors: C
authors: Matheï
authors: University Hospital (UZ Brussel), Psychiatric Department, Vrije Universiteit Brussel (V.U.B.), Laarbeeklaan 101, 1090 Brussels, Belgium.
authors: Frieda
authors: F
authors: Matthys
authors: University Hospital (UZ Brussel), Psychiatric Department, Vrije Universiteit Brussel (V.U.B.), Laarbeeklaan 101, 1090 Brussels, Belgium.
authors: Dieter
authors: D
authors: Zeeuws
authors: Academic Center for General Practice, Department of Public health and Primary Care, Katholieke Universiteit Leuven, Kapucijnenvoer 33, blok j, bus 7001, 3000 Leuven, Belgium.
authors: Leo
authors: L
authors: Pas
authors: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE2 4AX, United Kingdom; Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
authors: Peter
authors: P
authors: Anderson
authors: Academic Center for General Practice, Department of Public health and Primary Care, Katholieke Universiteit Leuven, Kapucijnenvoer 33, blok j, bus 7001, 3000 Leuven, Belgium.
authors: Bert
authors: B
authors: Aertgeerts
mesh_terms: D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000628:therapy*; D002986:Clinical Trials as Topic / Q000379:methods; D003266:Continuity of Patient Care / Q000639:trends*; D006801:Humans; D016896:Treatment Outcome
keywords: Aftercare; Alcohol use disorders treatment; Continuing care; Integrated care; Substance use disorders treatment