Brief interventions for alcohol use disorders in low- and middle-income countries : barriers and potential solutions
Nadkarni, Abhijit (Sangath. Addictions Research Group)
Bhatia, Urvita (Oxford Brookes University. Department of Psychology, Health and Professional Development)
Bedendo, Andre (University of York. Department of Health Sciences, Faculty of Sciences)
de Paula, Tassiane Cristine Santos (Universidade Federal de São Paulo (UNIFESP). Department of Psychobiology)
de Andrade Tostes, Joanna Gonçalves (Universidade Federal de Juiz de Fora (UFJF). Department of Psychology)
Segura-Garcia, Lidia (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Tiburcio, Marcela (Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Department of Social Sciences in Health)
Andréasson, Sven (Karolinska Institutet (Estocolm, Suècia))

Fecha:	2022
Resumen:	Global alcohol consumption and harmful use of alcohol is projected to increase in the coming decades, and most of the increase will occur in low- and middle-income countries (LMICs); which calls for cost-effective measures to reduce alcohol exposure in these countries. One such evidence based measure is screening and brief intervention (BI) for alcohol problems. Some of the characteristics of BI make them a particularly appealing choice of interventions in low-resource settings. However, despite evidence of effectiveness, implementation of BI in LMICs is rare. In this paper we discuss barriers to implementation of BI in LMICs, with examples from Latin America and India. Key barriers to implementation of BI in LMICs are the lack of financial and structural resources. Specialized services for alcohol use disorders are limited or non-existent. Hence primary care is often the only possible alternative to implement BI. However, health professionals in such settings generally lack training to deal with these disorders. In our review of BI research in these countries, we find some promising results, primarily in countries from Latin America, but so far there is limited research on effectiveness. Appropriate evaluation of efficacy and effectiveness of BI is undermined by lack of generalisability and methodological limitations. No systematic and scientific efforts to explore the implementation and evaluation of BI in primary and community platforms of care have been published in India. Innovative strategies need to be deployed to overcome supply side barriers related to specialist manpower shortages in LMICs. There is a growing evidence on the effectiveness of non-specialist health workers, including lay counsellors, in delivering frontline psychological interventions for a range of disorders including alcohol use disorders in LMICs. This paper is intended to stimulate discussion among researchers, practitioners and policy-makers in LMICs because increasing access to evidence based care for alcohol use disorders in LMICs would need a concerted effort from all these stakeholders.
Nota:	Funding: Andre Bedendo is funded through grants #2018/12729-9; #2017/13831-9 by São Paulo Research Foundation (FAPESP). Urvita Bhatia is funded by a Global Challenges Research Fund studentship grant. Tassiane Paula is funded by Grant 142486/2018-3, National Council for Scientific and Technological Development (CNPQ). Joanna Tostes is funded by Foundation for Research of the State of Minas Gerais (FAPEMIG).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Brief interventions ; Alcohol use disorders ; Low- and middle- income countries ; India ; Latin America
Publicado en:	International Journal of Mental Health Systems, Vol. 16 (august 2022) , ISSN 1752-4458

DOI: 10.1186/s13033-022-00548-5
PMID: 35934695

14 p, 812.4 KB

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