Despite the increasing burden of alcohol dependence, treatment resources in low- and middle-income countries such as India are concentrated in poorly accessible tertiary care facilities. The aim of our study was to examine the feasibility and acceptability of lay health worker-delivered home-based packages of care for alcohol dependence. We conducted an uncontrolled treatment cohort with alcohol-dependent adult males recruited in primary and secondary care. Lay health workers delivered home-detoxification and/or relapse prevention counseling. Process data were analyzed using descriptive statistics. Eleven men with alcohol dependence received home detoxification and relapse prevention counseling, and 27 men received only relapse prevention counseling. Of the 11 receiving home detoxification, one participant re-started drinking; all the rest safely completed the home detoxification. During detoxification, the pulse, blood pressure, and temperature remained within the normal range and ataxia, dehydration, disorientation, and sleep normalized over the course of the detoxification. Of the 38 who entered relapse prevention treatment, 15 (39.5%) completed treatment or had a planned discharge. The mean number of sessions was 2.4 (SD = 1.3); those who had a planned discharge received an average of 3.7 (SD 0.5) sessions, and those who dropped out received an average of 1.4 (SD 0.8) sessions. There was no significant change in daily alcohol consumption and percentage days of heavy drinking (PDHD) between baseline and follow-up in the whole cohort. The SIP score reduced significantly in the whole cohort (24.5 vs. 15.0, p = 0.002), and also reduced when segregated by treatment settings, and type of treatment package received. With appropriate adaptations, our intervention warrants further research, as it has the potential to bridge the significant treatment gap for alcohol dependence in low- and middle-income countries.

中文翻译：

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资源贫乏地区的家庭戒毒和预防酒精依赖的复发：来自印度果阿的一项探索性研究。

尽管酒精依赖的负担日益增加，但印度等中低收入国家的治疗资源却集中在交通不便的三级医疗机构中。我们研究的目的是检验由非专业卫生工作者提供的以家庭为基础的酒精依赖护理套餐的可行性和可接受性。我们与在初级和二级保健中招募的酒精依赖成年男性进行了不受控制的治疗队列。外行卫生工作者提供了家庭排毒和/或预防复发的咨询。使用描述性统计数据分析过程数据。11名酒精依赖者接受了家庭排毒和预防复发的咨询，而27名男性仅接受了预防复发的咨询。在接受家庭排毒的11位参与者中，有一位参与者重新开始饮酒；所有其他人安全地完成了家庭排毒。在排毒过程中，脉搏，血压和体温保持在正常范围内，并且在排毒过程中共济失调，脱水，迷失方向和睡眠恢复正常。在接受预防复发治疗的38名患者中，有15名（39.5％）完成了治疗或计划出院。平均会话数为2.4（SD = 1.3）；计划出院的学员平均接受3.7（SD 0.5）节，而辍学的学员则平均接受1.4（SD 0.8）节。在整个队列中，基线和随访之间的每日饮酒量和重度饮酒的百分比天数（PDHD）没有显着变化。在整个队列中，SIP得分显着降低（24.5与15.0，p = 0.002），并且在按治疗设置和所接受的治疗套餐类型分开时也减少了。通过适当的调整，我们的干预措施值得进一步研究，因为它有可能弥合中低收入国家酒精依赖的巨大治疗差距。