Economic evaluations of interventions aimed at the prevention, treatment and/or rehabilitation of alcohol-related disorders: A systematic review

The aim of this systematic literature review is to identify economic evalu- ations of programmes or interventions aimed at the prevention, treatment and rehabilitation of alcohol use disorders, as well as to determine those types of programmes, treatments or interventions that are efficient. The systematic literature review was conducted by searching the following data- bases: National Health Service Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA), MEDLINE Ovid and PubMed. The search terms used were in English. No time restriction was applied. A data extraction form was used to draw information. The systematic review fol- lows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) on reporting systematic reviews. The interventions were classified into three categories: "A" treat- ments for people with alcohol use disorders (tertiary prevention); "B" treat- ments for people at risk for alcohol-related problems (secondary prevention); "C" policy legislation and enforcement interventions (primary prevention). Furthermore, the "A" interventions were subclassified into psychological, pharmacological and combined interventions. The review included 63 pa- pers. In terms of treatments for people with alcohol use disorders, any psy- chosocial intervention compared to no intervention appeared to be a dom- inant strategy. In terms of treatments for people at risk of alcohol-related problems, brief intervention appears to be dominant or cost-effective when compared to no intervention. Advertising controls, tax increases, licensing, legal drinking age, and mass media campaigns seem to be dominant or cost-effective strategies compared to no intervention or random breath test- ing. Previous reviews have been extended by depicting alcohol programmes according to their efficiency. Despite this, the available studies in this regard have heterogeneous approaches and most do not adequately define the costs included in their analyses. Therefore, it is necessary to encourage the evalu- ation of the efficiency of these types of interventions to aid decision-making in public health.