Historique
Rapport
Evidence Map of Systematic Reviews (SRs) to inform the prevention, treatment and/or harm reduction for illicit drug use : Commissioned by the Institute for Neuroscience, Mental Health & Addiction, Canadian Institutes for Health Research (CIHR). Ottawa Methods Centre, Knowledge Synthesis Group Technical Report
Auteur(s) :
Ottawa Methods Centre, Knowledge Synthesis Group ;
GARRITTY, C. ;
ANSARI, M. ;
YAZDI, F. ;
SINGH, K. ;
GALIPEAU, J. ;
PRATT, M. ;
YOUNG, M. ;
SKIDMORE, R. ;
DANIEL, R. ;
MOHER, D. ;
GRIMSHAW, J.
Année
2011
Page(s) :
159 p.
Sous-type de document :
Revue de la littérature / Literature review
Langue(s) :
Anglais
Éditeur(s) :
Ottawa : OHRI (Ottawa Hospital Research Institute)
Refs biblio. :
143
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
DONNEE PROBANTE
;
TRAITEMENT
;
REDUCTION DES RISQUES ET DES DOMMAGES
;
PRODUIT ILLICITE
;
PREVENTION
;
INTERVENTION
;
METHODE
Résumé :
GUIDING QUESTION & PRIORITIZATION:
• The guiding objective for this mapping exercise was to determine what systematic reviews (SRs) exist to inform the prevention, treatment and/or harm reduction for illicit drug use.
• The intent was to describe the main characteristics of these published SRs that were directly focused on relevant illicit drug interventions.
EVIDENCE MAPPING
GENERAL FINDINGS:
• Included SRs were published between 1970 and 2010 by authors from across 20 countries.
• Cochrane Reviews accounted for 40% of all included reviews.
• Several of the SRs reviewed more than one intervention (prevention, treatment and/or harms reduction).
• Overall, the majority of included SRs were assessed as moderate to high quality.
FOR PREVENTION-RELATED INTERVENTIONS (7 SRS IDENTIFIED):
• Few SRs published on prevention were identified.
• Most SRs investigated school-based drug education programs to target substance use (usually not otherwise defined).
• Two Cochrane Reviews were identified.
• Overall, prevention-related SRs were primarily assessed as moderate to high quality.
FOR TREATMENT-RELATED INTERVENTIONS (108 SRS IDENTIFIED):
• Several published SRs on treatment interventions were identified including 75 SRs that reviewed somatic interventions (pharmacological and/or other), and 61 SRs that reviewed psychosocial interventions.
• Over one quarter of SRs reported on a combination of pharmacological and psychosocial interventions.
• Agonist maintenance therapies, medications to decrease withdrawal symptoms, and pharmacological interventions to treat specific dependence were the most common somatic-pharmacological interventions.
• Acupuncture was the most frequently cited somatic-'non-pharmacological' intervention.
• General behavioural therapies, specific cognitive behavioural therapy, and motivational interviewing were the psychosocial interventions most reported.
• Several SRs did not specify the targeted illicit substance(s) under review only making general reference to illicit drug use. However, when reported, the class of opioids and morphine derivatives was most common followed by specific substance use of heroin and marijuana.
• A total of 46 Cochrane Reviews were identified.
• Overall, treatment-related SRs were primarily assessed as moderate to high quality.
FOR HARMS REDUCTION-RELATED INTERVENTIONS (20 SRS IDENTIFIED):
• Of the identified SRs published on harms reduction, they primarily investigated HIV or Hepatitis C virus prevention measures, or substitution programs.
• Only one Cochrane Review was identified.
• Overall, harms reduction-related SRs were mainly assessed as moderate to high quality.
Evidence mapping is a good 'intelligence gathering exercise' for the identification of evidence pertaining to interventions for illicit drug use. The strengths of this mapping process lie in the transparent, reproducible and systematic methods used. The findings from this exercise can be used to inform priorities for research for the Institute of Neuroscience, Addiction & Mental Health's (INMHA) (and other funding agencies) by identifying areas of uncertainty and promoting the conduct of high quality relevant knowledge syntheses and/or primary studies.
• The guiding objective for this mapping exercise was to determine what systematic reviews (SRs) exist to inform the prevention, treatment and/or harm reduction for illicit drug use.
• The intent was to describe the main characteristics of these published SRs that were directly focused on relevant illicit drug interventions.
EVIDENCE MAPPING
GENERAL FINDINGS:
• Included SRs were published between 1970 and 2010 by authors from across 20 countries.
• Cochrane Reviews accounted for 40% of all included reviews.
• Several of the SRs reviewed more than one intervention (prevention, treatment and/or harms reduction).
• Overall, the majority of included SRs were assessed as moderate to high quality.
FOR PREVENTION-RELATED INTERVENTIONS (7 SRS IDENTIFIED):
• Few SRs published on prevention were identified.
• Most SRs investigated school-based drug education programs to target substance use (usually not otherwise defined).
• Two Cochrane Reviews were identified.
• Overall, prevention-related SRs were primarily assessed as moderate to high quality.
FOR TREATMENT-RELATED INTERVENTIONS (108 SRS IDENTIFIED):
• Several published SRs on treatment interventions were identified including 75 SRs that reviewed somatic interventions (pharmacological and/or other), and 61 SRs that reviewed psychosocial interventions.
• Over one quarter of SRs reported on a combination of pharmacological and psychosocial interventions.
• Agonist maintenance therapies, medications to decrease withdrawal symptoms, and pharmacological interventions to treat specific dependence were the most common somatic-pharmacological interventions.
• Acupuncture was the most frequently cited somatic-'non-pharmacological' intervention.
• General behavioural therapies, specific cognitive behavioural therapy, and motivational interviewing were the psychosocial interventions most reported.
• Several SRs did not specify the targeted illicit substance(s) under review only making general reference to illicit drug use. However, when reported, the class of opioids and morphine derivatives was most common followed by specific substance use of heroin and marijuana.
• A total of 46 Cochrane Reviews were identified.
• Overall, treatment-related SRs were primarily assessed as moderate to high quality.
FOR HARMS REDUCTION-RELATED INTERVENTIONS (20 SRS IDENTIFIED):
• Of the identified SRs published on harms reduction, they primarily investigated HIV or Hepatitis C virus prevention measures, or substitution programs.
• Only one Cochrane Review was identified.
• Overall, harms reduction-related SRs were mainly assessed as moderate to high quality.
Evidence mapping is a good 'intelligence gathering exercise' for the identification of evidence pertaining to interventions for illicit drug use. The strengths of this mapping process lie in the transparent, reproducible and systematic methods used. The findings from this exercise can be used to inform priorities for research for the Institute of Neuroscience, Addiction & Mental Health's (INMHA) (and other funding agencies) by identifying areas of uncertainty and promoting the conduct of high quality relevant knowledge syntheses and/or primary studies.
Affiliation :
Canada