Does patient involvement in treatment planning improve adherence, enrollment and other treatment outcome in alcohol addiction treatment? A systematic review

Introduction: Premature drop-out and lack of success from alcohol treatment is common. Within recent years, Shared Decision Making (SDM) has gained increased attention in treatment planning in health care. Results from research in SDM in addiction treatment points in different directions, hence this review focuses on alcohol addiction only. Furthermore, studies on Informed Choice is included in this review. The objective is to measure outcome results on the following four measures: (1) drinking outcome, (2) quality of life, (3) enrollment, and (4) adherence. Method: MEDLINE, PubMed and PsychInfo databases were searched. Studies included were RCT or Quasi-RCT measuring SDM or informed choice in treatment planning in alcohol addiction. The PRISMA guidelines was followed. Two researchers measured the quality of the studies. If disagreement could not be resolved by discussion, a third researcher was consulted. Results: 1203 studies were identified. Thirteen met the inclusion criteria, of which 7 were excluded. The remaining 6 studies were too heterogeneous to perform a meta-analysis, resulting in a narrative discussion of results. Discussion: The inadequate evidence limits the conclusions on our four objectives. (1) Drinking outcome, it seems that patient involvement in treatment planning does not have an effect. (2) Quality of life might be improved. (3) Enrollment might be increased. (4) Adherence was improved. Conclusion: Very few studies have been performed in this field; hence, no clear recommendation can be given to clinical practice at this point. PROSPERO Registration code: CRD42019124794