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Implications of Eligibility Criteria on the Generalizability of Alcohol and Drug Treatment Outcome Research: A Study of Real-World Treatment Seekers in Sweden and in Australia
Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).ORCID iD: 0000-0002-1757-9974
Eastern Health Clinical School, MonashUniversity, Australia & Turning Point, Fitzroy, Australia.ORCID iD: 0000-0002-5076-6499
Turning Point, Fitzroy, Australia.
2016 (English)In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Clinical studies of alcohol and drug treatment outcomes frequently apply participanteligibility criteria (EC), which may exclude real-world treatment seekers, impairing the representativenessof studied samples. Some research exists on the impact of EC on alcohol treatment seekers.Little is known about drug treatment and country differences. Objectives: We tested and comparedthe degree to which commonly used EC exclude real-world treatment seekers with problem alcoholand drug use in Sweden and Australia, and compared the impact of EC on outcomes. Methods: Twolarge naturalistic and comparative service user samples were used. Respondents were recruited inStockholm County (n = 1,865; data collection 2000–2002), and Victoria and Western Australia (n =796; in 2012–2013). Follow-up interviews were conducted after 1 year. Cross-tabulations, Chi-square(χ2) tests and logistic regressions were used. Results: Percentages of the samples excluded byindividual EC ranged from 5% (lack of education/literacy) to 70% (social instability) among Swedishalcohol cases and from 2% (low alcohol problem severity) to 69% (psychiatric medication) amongAustralian counterparts; and from 2% (age 60+ years) to 82% (social instability) among Swedish drugcases and from 1% (age 60+ years) to 67% (psychiatric medication) among Australian counterparts.Country differences and differences across substances appeared independent of country effect.Co-morbid psychiatric medication, noncompliance, poly drug use, and low education EC causedpositive 1-year outcome bias; whereas female sex and old age introduced negative outcome bias.Conclusions/Importance: Commonly used EC exclude large proportions of treatment seekers. This mayimpair generalizability of clinical research, and the effects ofmany EC differ by country and drug type.

Place, publisher, year, edition, pages
2016.
Keyword [en]
Substance abuse treatment, eligibility criteria, alcohol, drugs, generalizability, clinical outcome studies
National Category
Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:su:diva-135653DOI: 10.1080/10826084.2016.1240695OAI: oai:DiVA.org:su-135653DiVA: diva2:1047476
Projects
Fellowship: Alcohol and Drug Treatment Systems Research – Comparing Sweden and Australia
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-2855
Note

Published online: 16 Nov 2016

Available from: 2016-11-17 Created: 2016-11-17 Last updated: 2016-11-17

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Storbjörk, JessicaGarfield, Joshua
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