A systematic review of task-sharing interventions for substance use and substance use disorder in low- and middle-income countries.

Journal: Drug and alcohol dependence

Volume: 256

Issue: 

Year of Publication: 2024

Affiliated Institutions:  Department of Psychiatry, Karu General Hospital, Federal Capital Territory, Abuja, Nigeria. Electronic address: asmauabba@gmail.com. Department of Mental Health, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria. Center for Global Mental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: Abhijit.Nadkarni@LSHTM.ac.uk.

Abstract summary 

Substance use (SU) and substance use disorders (SUDs) are associated with adverse health and socio-economic consequences. Due to the shortage of specialist healthcare providers, people with SUDs in low- and middle-income countries (LMICs) have limited access to adequate treatment. Task-sharing with non-specialist health workers (NSHWs) has the potential to improve treatment accessibility for these individuals. This review synthesizes the evidence on the effectiveness of task-sharing interventions for SU and SUDs outcomes in LMICs.PsycINFO, MEDLINE, EMBASE, Global Health and CENTRAL databases were searched to identify eligible studies. Quality assessment was conducted using the Cochrane risk of bias (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. A narrative synthesis was undertaken to analyze the data.Nineteen RCTs and two quasi-experimental studies met the eligibility criteria, and the majority had a low risk of bias rating. NSHW-delivered interventions significantly impact SU and SUDs outcomes, particularly in reducing alcohol and other substance use, cessation of smoking, and use of opioids. Multiple sessions delivered via face-to-face interactions was the most utilized method for intervention delivery. There were variations in terms of components of the intervention across studies; however, the most common intervention strategies used were a) personalized feedback, b) psychoeducation, c) motivational enhancement, d) problem-solving, and e) coping skills.Our review highlights the growing interests in leveraging NSHWs to provide interventions to people with SU and SUDs in LMICs where access to treatment is limited. However, additional research is necessary to explore the effectiveness of these interventions and identify the specific active components linked to enhancing treatment outcomes on a broader scale.

Authors & Co-authors:  Abba Hassan Asma'u A Ibrahim Abba M AM Nadkarni Abhijit A

Study Outcome 

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Statistics
Citations : 
Authors :  3
Identifiers
Doi : 10.1016/j.drugalcdep.2024.111093
SSN : 1879-0046
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Intervention;Non-specialist health worker;Substance use;Substance use disorder;Task-sharing
Study Design
Narrative Study,Cross Sectional Study,Quasi Experimental Study
Study Approach
Systemic Review
Country of Study
Publication Country
Ireland