A systematic review of the impact of brief interventions on substance use and co-morbid physical and mental health conditions

Abstract

To summarise the relevant published evidence on the health and behavioural impact of brief interventions in individuals with recognised co-morbidity. A pre-specified search strategy was applied to Medline and Embase from 1999 to 2009 inclusive. We also scanned the reference lists of key reviews in the field and carried out text-word searches of Google and Google-Scholar. Two authors independently abstracted data, assessed trial quality and recorded study outcomes. Analysis took the form of a qualitative evidence synthesis due to the heterogeneity of studies in this field. We identified 14 trials meeting our inclusion criteria. The majority of this research focused on substance use and mental health problems (n = 8) whilst the remaining trials focused on substance use and physical health problems (n = 3) and dual substance use (n = 3). The evidence-base was very heterogeneous and it was not possible to quantitatively pool the trial outcome data. There were generally positive outcomes of brief intervention targeting substance use and co-morbid physical health conditions but the evidence in the other two areas was equivocal. In the area of substance use and mental health problems, there were often significant changes reported for both intervention and control groups over time. Brief intervention tended to produce positive effects in patients with substance use and co-morbid physical health problems. However, there was a limited amount of research work in this area. The evidence of positive brief intervention effects in patients with substance use and mental health problems or dual substance use was less convincing.

Keywords:

• brief intervention
• co-morbidity
• systematic review