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Therapeutics
Systematic review and meta-analysis
If pharmacotherapies for alcohol use disorders are effective, why are they underutilised?
  1. Elizabeth M Oliva1,
  2. Alex H S Harris2
  1. 1VA Palo Alto Heath Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California, USA;
  2. 2VA Palo Alto Heath Care System, Center for Innovation to Implementation (Ci2i), VA Substance Use Disorder Quality Enhancement Research Initiative, Menlo Park, California, USA
  1. Correspondence to : Dr Elizabeth M Oliva, VA Palo Alto Heath Care System, Center for Innovation to Implementation, 795 Willow Road (152 MPD), Menlo Park, CA 94025, USA; elizabeth.oliva{at}va.gov

https://doi.org/10.1136/ebmed-2014-110050

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    Commentary on: Jonas DE, Amick HR, Feltner C, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA 2014;311:1889–900.OpenUrlCrossRefPubMedWeb of Science

    Context

    Although alcohol use disorders (AUDs) are highly prevalent and often disabling, effective pharmacological treatments are underutilised, due partly to clinicians’ lack of knowledge and misperceptions about effectiveness.1 ,2 This systematic review and meta-analysis examined research literature on the efficacy of pharmacotherapies for AUDs in outpatient settings, providing an updated synthesis of effect sizes for a variety of outcomes.

    Methods

    The study reviewed pharmacotherapy studies for AUDs from January 1970 through March 2014, including randomised clinical trials (RCTs) of at least 12 weeks duration in an outpatient setting with alcohol outcomes (eg, return to any drinking, return to heavy drinking), and head-to-head prospective cohort studies with health or adverse effect outcomes. Studies using FDA-approved medications (ie, naltrexone, acamprosate and disulfiram) …

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    Footnotes

    • Contributors EMO submitted comments for the commentary and also summarised the method and findings sections.AHSH summarised the context and submitted comments for the commentary section.

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.