A novel community‐based therapeutic education program for reducing alcohol‐related harms and stigma in people with alcohol use disorders: A quasi‐experimental study ( ETHER study)

Tangui Barré (1, 2, 3) , Clémence Ramier (1, 2, 3) , Saskia Antwerpes (1, 2, 3) , Marie Costa (1, 2, 3) , Morgane Bureau (1, 2, 3) , Gwenaelle Maradan (1, 2, 3) , Vincent Di Beo (1, 2, 3) , Christophe Cutarella (4, 5) , Jacques Leloutre (5) , Olivier Riccobono-Soulier (5) , Sophie Hedoire (4) , Elodie Frot (5) , Fabienne Vernier (5) , Stéphanie Vassas-Goyard (5) , Sabine Dufort (5) , Camelia Protopopescu (1, 2, 3) , Fabienne Marcellin (1, 3) , Danielle Casanova (5) , Marion Coste (6, 1, 3, 2) , Patrizia Carrieri (1, 3, 2)

1 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
2 ISSPAM - Institut des sciences de la santé publique [Marseille]
3 IRD - Institut de Recherche pour le Développement
4 CSB-RS - Clinique Saint Barnabé - Ramsay Santé [Marseille]
5 Association Addictions France
6 AMSE - Aix-Marseille Sciences Economiques

Introduction Alcohol use disorder (AUD) is associated with a significant disease burden in France, where alcohol use is deeply rooted in culture. However, the treatment gap is large because of several barriers, including stigmatisation and drinkers' apprehension about total abstinence. However, standardised and evidence-based interventions based on controlled-drinking for people with AUD are lacking. We aimed to assess the effectiveness of a novel community-based French therapeutic patient education (TPE) program for people with AUD named Choizitaconso. Methods A before-after non-randomised quasi-experimental study, named ETHER, was designed and implemented with people living with AUD, over a period of 6 months. The primary outcome was percentage change in the number of alcohol-related harms experienced. Secondary outcomes were percentage changes in psycho-social patient-reported and community-validated outcomes. Participants in the intervention group (n = 34) benefited from the 10-week TPE program Choizitaconso, while the comparison group (n = 58) received standard care. The Kruskall–Wallis and chi-squared or Fisher's exact tests were used to compare before-after changes in variables in both groups. Linear regression models were used to test for the effect of study group on each outcome and to test for the effect of alcohol consumption as a confounder. Results At 6 months, all outcomes but one either remained stable or numerically improved in both groups. Internalised stigma significantly improved in the intervention group (p = 0.026) but not in the comparison group (p = 0.207), with a significant group effect (p = 0.014). Discussion and Conclusions This study demonstrates the effectiveness of the Choizitaconso TPE program on community-validated outcomes, especially internalised stigma.

Mots clés: harm reduction; psychosocial skills; therapeutic patient education; France; alcohol use disorder

Domaines: Sciences du Vivant [q-bio]; Sciences de l'Homme et Société

Tangui Barré, Clémence Ramier, Saskia Antwerpes, Marie Costa, Morgane Bureau, et al.. A novel community‐based therapeutic education program for reducing alcohol‐related harms and stigma in people with alcohol use disorders: A quasi‐experimental study ( ETHER study). Drug and Alcohol Review, 2023, 42 (3), pp.664-679. ⟨10.1111/dar.13605⟩. ⟨hal-04021886⟩