NKR 13 Alkoholbehandling. Disulfiram for alcohol dependency

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1 NKR 13 Alkoholbehandling. Disulfiram for alcohol dependency Review information Authors Sundhedsstyrelsen 1 1 [Empty affiliation] Citation example: S. NKR 13 Alkoholbehandling. Disulfiram for alcohol dependency. Cochrane Database of Systematic Reviews [Year], Issue [Issue]. Contact person [Empty name] Dates Assessed as Up-to-date: Date of Search: Next Stage Expected: Protocol First Published: Not specified Review First Published: Not specified Last Citation Issue: Not specified What's new Date / Event Description Review Manager 5.3 1

Disulfiram for alcohol dependency. Cochrane Database of Systematic Reviews [Year], Issue [Issue].

2 History Date / Event Description Characteristics of studies Characteristics of included studies Chick 1992 Methods RCT Participants outpatients who had relapsed from earlier treatment Interventions supervised disulfiram and counselling Outcomes Notes funded by Fisons Pic Pharma devision Risk of bias table Bias Authors' judgement Support for judgement Random sequence generation (selection bias) Unclear risk not described Allocation concealment (selection bias) Low risk applied by pharmacist at participating centres Blinding of participants and personnel (performance bias) High risk not blinded Blinding of outcome assessment (detection bias) Low risk assessor blinded Incomplete outcome data (attrition bias) High risk about 1/3 stopped treatment in both groups Selective reporting (reporting bias) Low risk not detected Other bias Low risk not detected Review Manager 5.3 2

Unclear risk not described Allocation concealment (selection bias) Low risk applied by pharmacist at participating centres Blinding of participants and personnel (performance bias) High risk not

3 Fuller 1986 Methods RCT Participants men yonger than 60 years presenting for alcohol treatment, excluded if living alone Interventions disulfiram and counselling Outcomes Notes USA, NA, propably VA programme Risk of bias table Bias Authors' judgement Support for judgement Random sequence generation (selection bias) High risk randomisation list likely open Allocation concealment (selection bias) High risk numbered envelopes not described as opaque Blinding of participants and personnel (performance bias) Low risk blinded, tablets of identical type Blinding of outcome assessment (detection bias) Low risk blinded Incomplete outcome data (attrition bias) Low risk only 28 out of 202 did not complete 1 year follow-up Selective reporting (reporting bias) Low risk not detected Other bias Low risk not detected Gerrein 1973 Methods RCT Participants alcoholics in an outpatient clinic Interventions disulfiram supervised plus counselling Outcomes Notes Fisons Plc Pharma division Review Manager 5.3 3

High risk numbered envelopes not described as opaque Blinding of participants and personnel (performance bias) Low risk blinded, tablets of identical type Blinding of outcome assessment (detection

4 Risk of bias table Bias Authors' judgement Support for judgement Random sequence generation (selection bias) Unclear risk not decribed Allocation concealment (selection bias) Low risk applied by pharmacist in attending centres Blinding of participants and personnel (performance bias) High risk not blinded Blinding of outcome assessment (detection bias) Low risk assessor blinded Incomplete outcome data (attrition bias) High risk about 1/3 dropped out Selective reporting (reporting bias) Low risk not detected Other bias Low risk not detected Ulrichsen 2010 Methods RCT Participants patinets admitted for withdrawal treatment Interventions supervised disulfiram + kognitive therapy Outcomes Notes Denmark, foundation for the advancement of science Risk of bias table Bias Authors' judgement Support for judgement Random sequence generation (selection bias) Unclear risk secretary instructed to arrange envelopes in random order Allocation concealment (selection bias) Unclear risk sealed envelopes not described as opaque Blinding of participants and personnel (performance bias) High risk not blinded Blinding of outcome assessment (detection bias) High risk not blinded Incomplete outcome data (attrition bias) Low risk low number of drop-outs Review Manager 5.3 4

outcome data (attrition bias) High risk about 1/3 dropped out Selective reporting (reporting bias) Low risk not detected Other bias Low risk not detected Ulrichsen 2010 Methods RCT Participants

5 Selective reporting (reporting bias) Low risk none detected Other bias Low risk none detected Footnotes Characteristics of excluded studies Footnotes Characteristics of studies awaiting classification Footnotes Characteristics of ongoing studies Footnotes Summary of findings tables Additional tables References to studies Included studies Chick 1992 [Empty] Review Manager 5.3 5

classification Footnotes Characteristics of ongoing studies Footnotes Summary of findings

6 Fuller 1986 [Empty] Gerrein 1973 [Empty] Ulrichsen 2010 [Empty] Excluded studies Studies awaiting classification Ongoing studies Other references Additional references Other published versions of this review Data and analyses 1 Disulfiram vs control post treatment Outcome or Subgroup Studies Participants Statistical Method Effect Estimate 1.1 All cause drop-out Risk Ratio (M-H, Random, 95% CI) 1.26 [0.54, 2.92] 1.2 Number of patients abstinent Risk Ratio (M-H, Random, 95% CI) 1.45 [0.79, 2.67] 1.3 Number of days abstinent Mean Difference (IV, Random, 95% CI) [-6.64, 49.50] 1.4 Time to first drink (days) Mean Difference (IV, Random, 95% CI) [-2.84, 32.00] Review Manager 5.3 6

1 All cause drop-out 3 565 Risk Ratio (M-H, Random, 95% CI) 1.26 [0.54, 2.92] 1.2 Number of patients abstinent 3 476 Risk Ratio (M-H, Random, 95% CI) 1.45 [0.79, 2.67] 1.

7 1.5 Drinks pr week Mean Difference (IV, Fixed, 95% CI) [-38.83, 70.83] 2 Disulfiram 250 mg vs disulfiram 1 mg Outcome or Subgroup Studies Participants Statistical Method Effect Estimate 2.1 All cause drop out Risk Ratio (M-H, Fixed, 95% CI) 1.15 [0.43, 3.12] 2.2 Time to first drink (days) Mean Difference (IV, Fixed, 95% CI) [-83.26, 61.66] 2.3 No. of patients abstinent Odds Ratio (M-H, Fixed, 95% CI) 0.80 [0.49, 1.29] Figures Figure 1 (Analysis 1.1) Forest plot of comparison: 1 Disulfiram vs control post treatment, outcome: 1.1 All cause drop-out. Review Manager 5.3 7

1 All cause drop out 1 406 Risk Ratio (M-H, Fixed, 95% CI) 1.15 [0.43, 3.12] 2.

8 Figure 2 (Analysis 1.2) Forest plot of comparison: 1 Disulfiram vs control post treatment, outcome: 1.2 Number of patients abstinent. Figure 3 (Analysis 1.3) Forest plot of comparison: 1 Disulfiram vs control post treatment, outcome: 1.3 Number of days abstinent. Figure 4 (Analysis 1.4) Review Manager 5.3 8

outcome: 1.2 Number of patients abstinent. Figure 3 (Analysis 1.

9 Forest plot of comparison: 1 Disulfiram vs control post treatment, outcome: 1.4 Time to first drink (days). Figure 5 (Analysis 1.5) Forest plot of comparison: 1 Disulfiram vs control post treatment, outcome: 1.5 Drinks pr week. Figure 6 (Analysis 2.1) Forest plot of comparison: 2 Disulfiram 250 mg vs disulfiram 1 mg, outcome: 2.1 All cause drop out. Figure 7 (Analysis 2.2) Forest plot of comparison: 2 Disulfiram 250 mg vs disulfiram 1 mg, outcome: 2.2 Time to first drink (days). Review Manager 5.3 9

Figure 6 (Analysis 2.1) Forest plot of comparison: 2 Disulfiram 250 mg vs disulfiram 1 mg, outcome: 2.1 All cause drop out.

10 Forest plot of comparison: 2 Disulfiram 250 mg vs disulfiram 1 mg, outcome: 2.2 Time to first drink (days). Figure 8 (Analysis 2.3) Forest plot of comparison: 2 Disulfiram 250 mg vs disulfiram 1 mg, outcome: 2.3 No. of patients abstinent. Review Manager

Figure 8 (Analysis 2.3) mg, outcome: 2.3 No.

Familieorienteret alkoholbehandling versus Individuel alkoholbehandling for

Familieorienteret alkoholbehandling versus Individuel alkoholbehandling for alkoholafhængighed Review information Authors Sundhedsstyrelsen 1 1 Sundhedsstyrelsen Citation example: S. Familieorienteret