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The impact of integrated care in community-based substance use treatment in Brazil: A longitudinal study
Health and Social Care in the Community ( IF 2.395 ) Pub Date : 2021-09-17 , DOI: 10.1111/hsc.13539
Gabriella Andrade Boska 1 , Márcia A. Ferreira de Oliveira 1 , Paulo R. Carvalho Seabra 2
Affiliation  

Integrated care (outpatient-inpatient) plays a vital function in community care for people with drug use problems. Its recent and innovative treatment model is representing a challenge for the deinstitutionalisation process. The purpose of this study was to assess the impact of integrated care using biopsychosocial indicators. We conducted a prospective longitudinal study with 122 clients from the baseline undergoing integrated care of two Psychosocial Care Centers for Alcohol and Other Drugs in São Paulo, Brazil, with three months follow-up (February 2019-January 2020). To assess the biopsychosocial indicators of the impact, we used the Substance Addiction Consequences (SAC), WHOQOL-BREF quality of life scales and the psychosocial rehabilitation axes (housing, work/income, and support network). We conducted a longitudinal analysis with linear mixed-effects models. The integrated care impacted the reduction in the days of substance use and increase of abstinence with a significant difference for cannabis (p < 0.001) and crack (p = 0.021). It reduced the substance use harms in all SAC scale dimensions (p < 0.001). Quality of life increased and remained mainly associated with the psychological size (p < 0.001). All psychosocial rehabilitation axes improved with a difference for income (p = 0.025). The increase in people's participation in treatment was relevant. The integrated care of Brazilian services has a positive impact on reducing substance use days and harms associated, improves the quality of life and contributes to the psychosocial rehabilitation of clients. Should be taken efforts to maintain long-term results.

中文翻译:

综合护理对巴西基于社区的物质使用治疗的影响:一项纵向研究

综合护理(门诊-住院)在吸毒问题人群的社区护理中发挥着至关重要的作用。其最近的创新治疗模式对去机构化进程提出了挑战。本研究的目的是使用生物心理社会指标评估综合护理的影响。我们对 122 名基线客户进行了一项前瞻性纵向研究,他们在巴西圣保罗的两个酒精和其他药物心理社会护理中心接受综合护理,并进行了三个月的随访(2019 年 2 月至 2020 年 1 月)。为了评估影响的生物心理社会指标,我们使用了物质成瘾后果 (SAC)、WHOQOL-BREF 生活质量量表和社会心理康复轴(住房、工作/收入和支持网络)。我们使用线性混合效应模型进行了纵向分析。综合护理影响了物质使用天数的减少和禁欲的增加,大麻有显着差异(p  < 0.001) 和裂纹 ( p  = 0.021)。它降低了所有 SAC 量表维度上的物质使用危害(p  < 0.001)。生活质量提高并主要与心理规模相关(p  < 0.001)。所有心理社会康复轴均因收入差异而有所改善(p  = 0.025)。人们参与治疗的增加是相关的。巴西服务的综合护理对减少药物使用天数和相关危害、提高生活质量并有助于客户的社会心理康复产生积极影响。应努力保持长期效果。
更新日期:2021-09-17
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