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Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder

BACKGROUND: In Canada, low awareness of evidence-based interventions for the clinical management of alcohol use disorder exists among health care providers and people who could benefit from care. To address this gap, the Canadian Research Initiative in Substance Misuse convened a national committee...

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Autores principales: Wood, Evan, Bright, Jessica, Hsu, Katrina, Goel, Nirupa, Ross, Josey W.G., Hanson, Averill, Teed, Rand, Poulin, Ginette, Denning, Bryany, Corace, Kim, Chase, Corrina, Halpape, Katelyn, Lim, Ronald, Kealey, Tim, Rehm, Jürgen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CMA Impact Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581718/
https://www.ncbi.nlm.nih.gov/pubmed/37844924
http://dx.doi.org/10.1503/cmaj.230715
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author Wood, Evan
Bright, Jessica
Hsu, Katrina
Goel, Nirupa
Ross, Josey W.G.
Hanson, Averill
Teed, Rand
Poulin, Ginette
Denning, Bryany
Corace, Kim
Chase, Corrina
Halpape, Katelyn
Lim, Ronald
Kealey, Tim
Rehm, Jürgen
author_facet Wood, Evan
Bright, Jessica
Hsu, Katrina
Goel, Nirupa
Ross, Josey W.G.
Hanson, Averill
Teed, Rand
Poulin, Ginette
Denning, Bryany
Corace, Kim
Chase, Corrina
Halpape, Katelyn
Lim, Ronald
Kealey, Tim
Rehm, Jürgen
author_sort Wood, Evan
collection PubMed
description BACKGROUND: In Canada, low awareness of evidence-based interventions for the clinical management of alcohol use disorder exists among health care providers and people who could benefit from care. To address this gap, the Canadian Research Initiative in Substance Misuse convened a national committee to develop a guideline for the clinical management of high-risk drinking and alcohol use disorder. METHODS: Development of this guideline followed the ADAPTE process, building upon the 2019 British Columbia provincial guideline for alcohol use disorder. A national guideline committee (consisting of 36 members with diverse expertise, including academics, clinicians, people with lived and living experiences of alcohol use, and people who self-identified as Indigenous or Métis) selected priority topics, reviewed evidence and reached consensus on the recommendations. We used the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) and the Guidelines International Network’s Principles for Disclosure of Interests and Management of Conflicts to ensure the guideline met international standards for transparency, high quality and methodological rigour. We rated the final recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool; the recommendations underwent external review by 13 national and international experts and stakeholders. RECOMMENDATIONS: The guideline includes 15 recommendations that cover screening, diagnosis, withdrawal management and ongoing treatment, including psychosocial treatment interventions, pharmacotherapies and community-based programs. The guideline committee identified a need to emphasize both underused interventions that may be beneficial and common prescribing and other practice patterns that are not evidence based and that may potentially worsen alcohol use outcomes. INTERPRETATION: The guideline is intended to be a resource for physicians, policymakers and other clinical and nonclinical personnel, as well as individuals, families and communities affected by alcohol use. The recommendations seek to provide a framework for addressing a large burden of unmet treatment and care needs for alcohol use disorder within Canada in an evidence-based manner.
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spelling pubmed-105817182023-10-18 Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder Wood, Evan Bright, Jessica Hsu, Katrina Goel, Nirupa Ross, Josey W.G. Hanson, Averill Teed, Rand Poulin, Ginette Denning, Bryany Corace, Kim Chase, Corrina Halpape, Katelyn Lim, Ronald Kealey, Tim Rehm, Jürgen CMAJ Guideline BACKGROUND: In Canada, low awareness of evidence-based interventions for the clinical management of alcohol use disorder exists among health care providers and people who could benefit from care. To address this gap, the Canadian Research Initiative in Substance Misuse convened a national committee to develop a guideline for the clinical management of high-risk drinking and alcohol use disorder. METHODS: Development of this guideline followed the ADAPTE process, building upon the 2019 British Columbia provincial guideline for alcohol use disorder. A national guideline committee (consisting of 36 members with diverse expertise, including academics, clinicians, people with lived and living experiences of alcohol use, and people who self-identified as Indigenous or Métis) selected priority topics, reviewed evidence and reached consensus on the recommendations. We used the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) and the Guidelines International Network’s Principles for Disclosure of Interests and Management of Conflicts to ensure the guideline met international standards for transparency, high quality and methodological rigour. We rated the final recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool; the recommendations underwent external review by 13 national and international experts and stakeholders. RECOMMENDATIONS: The guideline includes 15 recommendations that cover screening, diagnosis, withdrawal management and ongoing treatment, including psychosocial treatment interventions, pharmacotherapies and community-based programs. The guideline committee identified a need to emphasize both underused interventions that may be beneficial and common prescribing and other practice patterns that are not evidence based and that may potentially worsen alcohol use outcomes. INTERPRETATION: The guideline is intended to be a resource for physicians, policymakers and other clinical and nonclinical personnel, as well as individuals, families and communities affected by alcohol use. The recommendations seek to provide a framework for addressing a large burden of unmet treatment and care needs for alcohol use disorder within Canada in an evidence-based manner. CMA Impact Inc. 2023-10-16 2023-10-16 /pmc/articles/PMC10581718/ /pubmed/37844924 http://dx.doi.org/10.1503/cmaj.230715 Text en © 2023 CMA Impact Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Guideline
Wood, Evan
Bright, Jessica
Hsu, Katrina
Goel, Nirupa
Ross, Josey W.G.
Hanson, Averill
Teed, Rand
Poulin, Ginette
Denning, Bryany
Corace, Kim
Chase, Corrina
Halpape, Katelyn
Lim, Ronald
Kealey, Tim
Rehm, Jürgen
Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder
title Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder
title_full Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder
title_fullStr Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder
title_full_unstemmed Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder
title_short Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder
title_sort canadian guideline for the clinical management of high-risk drinking and alcohol use disorder
topic Guideline
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581718/
https://www.ncbi.nlm.nih.gov/pubmed/37844924
http://dx.doi.org/10.1503/cmaj.230715
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