Outcomes of an integrated care pathway for concurrent major depressive and alcohol use disorders: a multisite prospective cohort study

• Published in: BMC psychiatry 2018-06, Vol.18 (1), p.189-189, Article 189
• Main Authors: Samokhvalov, Andriy V, Probst, Charlotte, Awan, Saima, George, Tony P, Le Foll, Bernard, Voore, Peter, Rehm, Jürgen
• Format: Article
• Language: English
• Subjects: Addictions; Alcohol use; Alcohol use disorder; Alcohol-related disorders; Alcoholism; Algorithms; Care and treatment; Care pathway; Chi-square test; Clinical trials; Cognition & reasoning; Cognitive-behavioral therapy; Cohort analysis; Comorbidity; Concurrent disorders; Drinking behavior; Hospital costs; Major depressive disorder; Mathematical models; Mental depression; Mental disorders; Mental health; Patients; Pharmacotherapy; Psychiatry; Psychotherapy; Retention; Statistical analysis
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-018-1770-3

In 2013, an Integrated Care Pathway (ICP) for concurrent Major Depressive (MDD) and Alcohol Use (AUD) Disorders was developed at the Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada. The ICP was further implemented at 8 other clinical sites across Ontario (the DA VINCI Project) in 2015-2017. The goal of this study was to systematically describe and analyze the main clinical outcomes of the project. Data on a non-randomized cohort of patients receiving ICP-based treatment were collected prospectively at nine clinical sites in a variety of clinical settings. descriptive statistics, t-test, chi-square, ANOVA, generalized linear models. Two hundred forty-six patients were enrolled, 58.8% males, mean age was 45.6 years, 170 patients received treatment at academic health centres (AHC), 49 - at community hospitals (CH) and 27 - in family health teams (FHT). There were no major differences in anamnestic parameters and depression severity between the three settings, but there were differences in baseline drinking patterns between subgroups (F = 4.271, df = 2, p = 0.015). Overall completion rate was 70.7% with no significant variation between settings (χ  = 3.35, df = 2, p = 0.19). Treatment duration in AHC was the longest, and completion rates were the highest. There was a statistically significant and clinically meaningful reduction in the number of drinking days per week (1.81, t = 8.78, p