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Article ; Online: Medications for alcohol use disorder promote abstinence in alcohol-associated cirrhosis: Results from a systematic review and meta-analysis.

Gratacós-Ginès, Jordi / Bruguera, Pol / Pérez-Guasch, Martina / López-Lazcano, Ana / Borràs, Roger / Hernández-Évole, Helena / Pons-Cabrera, Maria T / Lligoña, Anna / Bataller, Ramón / Ginès, Pere / López-Pelayo, Hugo / Pose, Elisa

Hepatology (Baltimore, Md.)

2023 Volume 79, Issue 2, Page(s) 368–379

Abstract: Background and aims: The role of medications for alcohol use disorder (MAUD) in patients with cirrhosis is not well established. Evidence on the efficacy and safety of these drugs in these patients is scarce.: Approach and results: We performed a ... ...

Abstract	Background and aims: The role of medications for alcohol use disorder (MAUD) in patients with cirrhosis is not well established. Evidence on the efficacy and safety of these drugs in these patients is scarce. Approach and results: We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines on the efficacy of MAUD in patients with cirrhosis. A search was conducted in PubMed, Embase, and Scopus, including all studies until May 2022. The population was defined as patients with AUD and cirrhosis. The primary outcome was alcohol abstinence. Safety was a secondary outcome. We performed a random-effect analysis and expressed the results as relative risk of alcohol consumption. Heterogeneity was measured by I2 . Out of 4095 unique references, 8 studies on 4 different AUD treatments [baclofen (n = 6), metadoxine (n = 1), acamprosate (n = 1), and fecal microbiota transplant (n = 1)] in a total of 794 patients were included. Four were cohort studies, and 4 were RCTs. Only RCTs were included in the meta-analysis. MAUD was associated with a reduced rate of alcohol consumption [relative risk = 0.68 (CI: 0.48-0.97), P = 0.03], increasing alcohol abstinence by 32% compared to placebo or standard treatment, despite high heterogeneity ( I2 = 67%). Regarding safety, out of 165 serious adverse events in patients treated with MAUD, only 5 (3%) were possibly or probably related to study medications. Conclusion: MAUD in patients with cirrhosis is effective in promoting alcohol abstinence and has a good safety profile. Larger studies on the effects of MAUD are needed, especially in patients with advanced liver disease.
MeSH term(s)	Humans ; Alcoholism/complications ; Alcohol Drinking/adverse effects ; Acamprosate/therapeutic use ; Liver Cirrhosis, Alcoholic/drug therapy ; Liver Cirrhosis/drug therapy
Chemical Substances	Acamprosate (N4K14YGM3J)
Language	English
Publishing date	2023-08-25
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000570
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Article: Multiplatform web app (My Way Up) plus motivational interviewing for improving treatment retention in patients with onset of alcohol-related liver disease and alcohol use disorder - an example of participatory research.

Caballeria, Elsa / Balcells-Oliveró, Mercè / Bataller, Ramón / Bruguera, Pol / Cabrera, Noel / Estruch, Alexandra / Freixa, Neus / Garcia-Pañella, Óscar / Graell, Mireia / Gratacós-Gines, Jordi / Guzman, Pablo / Hernández-Rubio, Anna / Lligoña, Anna / Pérez-Guasch, Martina / Pons-Cabrera, María Teresa / Pose, Elisa / Zuluaga, Paola / López-Pelayo, Hugo

Digital health

2024 Volume 10, Page(s) 20552076241242787

Abstract: Background: With the aim of improving treatment retention in patients with the onset of alcohol-related liver disease (ArLD), we designed a blended intervention (brief motivational intervention + 'serious game' (SG)). We present the participatory design ...

Abstract	Background: With the aim of improving treatment retention in patients with the onset of alcohol-related liver disease (ArLD), we designed a blended intervention (brief motivational intervention + 'serious game' (SG)). We present the participatory design methodology and outcomes and the usability assessment of the intervention. Methods: (1) The design of the SG was based on the outcomes of two 3-h co-creation sessions with 37 participants (healthcare and technology professionals, patients, and patients' relatives). The brief face-to-face motivational intervention was based on the 5 As Model and adapted to the ArLD population. (2) Usability pilot study: 20 participants (10 ArLD patients + 10 healthcare professionals) received the intervention. System Usability Scale (SUS) and Post-Study System Usability Questionnaire (PSSUQ) were applied to assess the SG usability and patients' satisfaction with it. Weekly semi-structured interviews on the phone were conducted to identify the preferred elements in the SG and those aspects that should be improved. Results: (1) Design: an SG in the form of a gamified web app, consisting of a daily activity for six weeks and adapted brief motivational interviewing. (2) Usability pilot study: usability results were excellent for both patients and healthcare professionals (SUS median score = 85). The general usability, the quality of the information provided by the SG and the quality of the interface were very positively rated in the PSSUQ (overall median score = 2, IQR = 1-2). The best-rated aspects were the provision of feedback, the use of metaphors and the application of audiovisual material. Changes in the design, response mechanics and content were applied after the study. Conclusions: The usability and acceptability of an intervention for increasing retention to treatment in patients with recent onset of ArLD and AUD were excellent for patients and healthcare professionals. A randomized-controlled trial is required to test the efficacy of this approach.
Language	English
Publishing date	2024-05-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2819396-9
ISSN	2055-2076
ISSN	2055-2076
DOI	10.1177/20552076241242787
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Article ; Online: Elevada prevalencia del síndrome de hiperémesis cannábica en pacientes consumidores de cánnabis.

Bruguera, Pol / López-Pelayo, Hugo / Miquel, Laia / Balcells-Oliveró, Mercè

Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

2017 Volume 28, Issue 4, Page(s) 249–251

Abstract: Objectives: Cannabinoid hyperemesis syndrome (CHS) is a recently described condition associated with chronic marijuana use. CHS is defined by the triad of chronic marijuana consumption cyclic bouts of nausea and vomiting, plus frequent hot showering. ... ...

Title translation	High prevalence of cannabinoid hyperemesis syndrome in marijuana users.
Abstract	Objectives: Cannabinoid hyperemesis syndrome (CHS) is a recently described condition associated with chronic marijuana use. CHS is defined by the triad of chronic marijuana consumption cyclic bouts of nausea and vomiting, plus frequent hot showering. Its etiology, pathogenesis, and epidemiology remain obscure. We interviewed all patients over the age of 18 years attended between February and April 2014 in an outpatient marijuana rehabilitation center. A questionnaire was used to collect sociodemographic and clinical data as well as information related to a diagnosis of CHS. Of 22 patients who met the inclusion criteria, 4 (18.2%) reported symptoms suggestive of CHS; 2 (9.1%) had all symptoms, and 2 (9.1%) had some. CHS is common. We recommend asking about symptoms that might indicate this diagnosis given that CHS generates a high level of discomfort as well as diagnostic errors and many referrals to specialists.
Language	Spanish
Publishing date	2017-02-01
Publishing country	Spain
Document type	English Abstract ; Journal Article
ZDB-ID	2127173-2
ISSN	2386-5857 ; 2386-5857
ISSN (online)	2386-5857
ISSN	2386-5857
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Ketamine associated with electroconvulsive therapy for treatment-resistant depression in the elderly: Two case reports.

Fortea, Adriana / Espinosa, Laura / Oliveras, Clara / Bruguera, Pol / Benabarre, Antoni

Revista de psiquiatria y salud mental

2017 Volume 10, Issue 2, Page(s) 125–126

Title translation	Ketamina asociada a terapia electroconvulsiva en depresión resistente al tratamiento en pacientes de edad avanzada: a propósito de 2 casos.
Language	Spanish
Publishing date	2017-04
Publishing country	Spain
Document type	Letter
ISSN	1989-4600
ISSN (online)	1989-4600
DOI	10.1016/j.rpsm.2016.12.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Detección y registro del consumo de alcohol en Urgencias.

Bruguera, Pol / Barrio, Pablo / Oliveras, Clara / Vázquez, Mireia / Soler, Victòria / Nuño, Laura / Vieta, Eduard / Gual, Antoni

Revista espanola de salud publica

2020 Volume 94

Abstract: Objective: Due to the high economic and morbimortality burden associated to alcohol use, in the last decades, public health services have developed several programs to detect and to intervene on at risk drinkers in primary care settings and emergency ... ...

Title translation	Detection and registration of alcohol use in the emergency department.
Abstract	Objective: Due to the high economic and morbimortality burden associated to alcohol use, in the last decades, public health services have developed several programs to detect and to intervene on at risk drinkers in primary care settings and emergency departments (ED). The aim of this study is to determine the proportion of detected and registered risky drinkers in an ED of Hospital Clínic de Barcelona. Methods: All patients over 18 years old, presenting to the ED and reporting risky drinking, were asked to participate. We did a descriptive analysis of the data after revising clinical records. Results: We detected 247 risky drinkers after assessing more than 2,047 patients with AUDIT-C scale. From these, 200 accepted to participate. Only 65 (32.5%) of these patients were properly detected and registered as risky drinkers, while the majority of them (122, 61%) had no record about their alcohol use in their clinical records. Conclusions: Risky drinkers are properly detected and registered in less than 35% of the patients. It is necessary to evaluate which barriers are restricting the implementation of screening programs to detect at risk drinkers.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/adverse effects ; Alcohol Drinking/epidemiology ; Alcohol Drinking/psychology ; Alcohol-Related Disorders/diagnosis ; Alcohol-Related Disorders/epidemiology ; Alcohol-Related Disorders/psychology ; Emergency Service, Hospital ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Risk Assessment ; Self Report ; Spain/epidemiology
Language	Spanish
Publishing date	2020-04-08
Publishing country	Spain
Document type	Journal Article ; Observational Study
ZDB-ID	1288657-9
ISSN	2173-9110 ; 0034-8899 ; 1135-5727
ISSN (online)	2173-9110
ISSN	0034-8899 ; 1135-5727
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 483: Show issues

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Article ; Online: Depression Following γ-Hydroxybutyrate Withdrawal: A Case Report.

Domínguez, Iria / Bruguera, Pol / Balcells-Oliveró, Mercè / Batalla, Albert

Journal of clinical psychopharmacology

2015 Volume 35, Issue 5, Page(s) 618–619

MeSH term(s)	Adult ; Depression/etiology ; Humans ; Male ; Sodium Oxybate/administration & dosage ; Sodium Oxybate/adverse effects ; Substance Withdrawal Syndrome/physiopathology ; Substance-Related Disorders/rehabilitation
Chemical Substances	Sodium Oxybate (7G33012534)
Language	English
Publishing date	2015-10
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	604631-9
ISSN	1533-712X ; 0271-0749
ISSN (online)	1533-712X
ISSN	0271-0749
DOI	10.1097/JCP.0000000000000394
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Zs.A 1664: Show issues

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Article ; Online: Uso de metanfetamina en el contexto chemsex y sus consecuencias en la salud mental: un estudio descriptivo.

Gavín, Patricia / Arbelo, Néstor / Monràs, Miquel / Nuño, Laura / Bruguera, Pol / de la Mora, Lorena / Martínez-Rebollar, María / Laguno, Montserrat / Blanch, Jordi / Miquel, Laia

Revista espanola de salud publica

2021 Volume 95

Abstract: Objective: Chemsex is a term applicable to the use of drugs related to sex among men who have sex with men (MSM). Because it is a recent trend, there is little information about its management and consequences. The aim of the study was to describe the ... ...

Title translation	Methamphetamine use in chemsex and its consequences on mental health: a descriptive study.
Abstract	Objective: Chemsex is a term applicable to the use of drugs related to sex among men who have sex with men (MSM). Because it is a recent trend, there is little information about its management and consequences. The aim of the study was to describe the clinical profile of a sample of chemsex users who consulted for treatment. Methods: This is a longitudinal and retrospective study of 53 patients who consulted for chemsex in an addiction unit of a general hospital in Barcelona, from January 2017 to June 2019. Data was collected from electronic medical records and a descriptive analysis was performed by calculating proportions and means. Results: The most common drug used in chemsex was methamphetamine (81.1%; n=43) and 67.4% (n=29) of these used at least other two drugs. The prevalence of HIV infection was high (71.2%; n=37) and 72.1% (n=41) had psychiatric comorbidity, being the most common psychosis (37.2%; n=16). Conclusions: Methamphetamine was the most common drug chemsex user's seeked for treatment. Furthermore, there is a high prevalence of HIV diagnosis in this population. Both conditions can enhance the risk of suffering from psychosis and may explain why psychiatric comorbidity is so high in the sample.
MeSH term(s)	Homosexuality, Male/psychology ; Homosexuality, Male/statistics & numerical data ; Humans ; Longitudinal Studies ; Male ; Mental Disorders/epidemiology ; Methamphetamine/adverse effects ; Retrospective Studies ; Sexual Behavior/statistics & numerical data ; Spain/epidemiology ; Substance-Related Disorders/psychology
Chemical Substances	Methamphetamine (44RAL3456C)
Language	Spanish
Publishing date	2021-08-31
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1288657-9
ISSN	2173-9110 ; 0034-8899 ; 1135-5727
ISSN (online)	2173-9110
ISSN	0034-8899 ; 1135-5727
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mid and long-term effects of a SBIRT program for at-risk drinkers attending to an emergency department. Follow-up results from a randomized controlled trial.

Bruguera, Pol / Barrio, Pablo / Manthey, Jakob / Oliveras, Clara / López-Pelayo, Hugo / Nuño, Laura / Miquel, Laia / López-Lazcano, Ana / Blithikioti, Chrysanthi / Caballeria, Elsa / Matrai, Silvia / Rehm, Jürgen / Vieta, Eduard / Gual, Antoni

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2021 Volume 28, Issue 5, Page(s) 373–379

Abstract: Background and importance: SBIRT programs (Screening Brief Intervention and Referral to Treatment) for at-risk drinkers in emergency departments (ED) have shown to be effective, particularly at short term. In this article, we report mid and long-term ... ...

Abstract	Background and importance: SBIRT programs (Screening Brief Intervention and Referral to Treatment) for at-risk drinkers in emergency departments (ED) have shown to be effective, particularly at short term. In this article, we report mid and long-term follow-up results of a specialized SBIRT program. A short-term follow-up after 1.5 months showed encouraging results, with more than a 20% greater reduction of at-risk drinking in the intervention group and more than double of successful referrals to specialized treatment. Objective: We aimed to evaluate the mid and long-term efficacy of an SBIRT program conducted by psychiatrist specialists in addictive disorders and motivational interviewing in the ED of a tertiary hospital. Design, settings and participants: We conducted a secondary analysis of a previously published randomized controlled trial of an SBIRT program conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the AUDIT-C scale. Intervention or exposure: Patients were randomized into two groups, with the control group receiving two leaflets: one regarding alcohol use and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use and, where appropriate, a referral to specialized treatment. Outcomes measure and analysis: Long-term assessment primary outcome was the proportion of at-risk alcohol use measured by AUDIT-C scale. The main effectiveness analysis at 18 weeks and 12 months' follow-up was conducted with multilevel logistic regression analyses. Missing values were imputed with the last observation carried forward. Main results: Of 200 patients included in the study, 133 (66.5%) and 131 (65.5%) completed 18 weeks and 1-year follow-up respectively. Although the proportion of risky drinkers was substantially lower in the intervention group (38.5 vs. 57.4% at 4.5 months and 58.5 vs 68.2% at 1 year), these results did not reach statistical significance (OR = 2.15; CI, 0.87-5.33). Conclusions: In this secondary analysis for mid- and long-term effects of a specialized SBIRT program, there was no significant difference in the reduction of risky drinkers at 18 weeks and 1 year. The small size of the studied sample and the low retention rate precluded any significant conclusion, although point estimates suggest a positive effect. Overall, SBIRT programs are an effective tool to reduce alcohol use at short time and to refer patients to specialized treatment; however, its effects seem to decay over time.
MeSH term(s)	Alcohol Drinking ; Alcoholism/diagnosis ; Alcoholism/therapy ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Referral and Consultation
Language	English
Publishing date	2021-03-04
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000000810
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Article: Mid and long-term effects of a SBIRT program for at-risk drinkers attending to an emergency department. Follow-up results from a randomized controlled trial.

European Journal of Emergency Medicine

2021 Volume 28, Issue 5, Page(s) 373–379

Title translation	Mittel- und langfristige Auswirkungen eines Programms für Risikotrinker, die eine Notaufnahme aufsuchen. Follow-up-Ergebnisse einer randomisierten kontrollierten Studie (DeepL)
Abstract	Background and importance: SBIRT programs (Screening Brief Intervention and Referral to Treatment) for at-risk drinkers in emergency departments (ED) have shown to be effective, particularly at short term. In this article, we report mid and long-term follow-up results of a specialized SBIRT program. A short-term follow-up after 1.5 months showed encouraging results, with more than a 20% greater reduction of at-risk drinking in the intervention group and more than double of successful referrals to specialized treatment. Objective: We aimed to evaluate the mid and long-term efficacy of an SBIRT program conducted by psychiatrist specialists in addictive disorders and motivational interviewing in the ED of a tertiary hospital. Design, settings and participants: We conducted a secondary analysis of a previously published randomized controlled trial of an SBIRT program conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the AUDIT-C scale. Intervention or exposure: Patients were randomized into two groups, with the control group receiving two leaflets: one regarding alcohol use and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use and, where appropriate, a referral to specialized treatment. Outcomes measure and analysis: Long-term assessment primary outcome was the proportion of at-risk alcohol use measured by AUDIT-C scale. The main effectiveness analysis at 18 weeks and 12 months' follow-up was conducted with multilevel logistic regression analyses. Missing values were imputed with the last observation carried forward. Main results: Of 200 patients included in the study, 133 (66.5%) and 131 (65.5%) completed 18 weeks and 1-year follow-up respectively. Although the proportion of risky drinkers was substantially lower in the intervention group, these results did not reach statistical significance. Conclusions: In this secondary analysis for mid- and long-term effects of a specialized SBIRT program, there was no significant difference in the reduction of risky drinkers at 18 weeks and 1 year. The small size of the studied sample and the low retention rate precluded any significant conclusion, although point estimates suggest a positive effect. Overall, SBIRT programs are an effective tool to reduce alcohol use at short time and to refer patients to specialized treatment; however, its effects seem to decay over time.
Keywords	Alcohol Abuse ; Alkoholmissbrauch ; At Risk Populations ; Drinking Behavior ; Gesundheitliches Risikoverhalten ; Health Risk Behavior ; Intervention ; Motivation ; Professional Referral ; Risikogruppen ; Therapieerfolgskontrolle ; Treatment Effectiveness Evaluation ; Trinkverhalten ; Überweisung zur Fachbehandlung
Language	English
Document type	Article
ZDB-ID	1233544-7
ISSN	0969-9546
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000000810
Database	PSYNDEX

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Article: Methadone for the treatment of Prescription Opioids Dependence. A retrospective chart review.

Barrio, Pablo / Ezzeldin, Mohamed / Bruguera, Pol / Pérez, Ana / Mansilla, Sara / Fàbrega, Marina / Lligoña, Anna / Mondón, Sílvia / Balcells, Mercè

Adicciones

2016 Volume 29, Issue 1, Page(s) 55–60

Abstract: Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a ... ...

Title translation	Metadona para el tratamiento de la dependencia de opioides de prescripción médica. Una revisión retrospectiva de historias clínicas.
Abstract	Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample. Eleven patients were included, mostly women (81.8%), with a median age of 50 years. The median duration of dependence was 8 years. Dependence on other substances and psychiatric comorbidities were high. Eight patients were monitored during three months. Of these, 7 (87.5%) were abstinent after that period. The results suggest that methadone deserves further exploration as a potentially efficacious treatment option for PO dependence.
Language	Spanish
Publishing date	2016-06-14
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2018873-0
ISSN	0214-4840
ISSN	0214-4840
DOI	10.20882/adicciones.832
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