Effectiveness of alcohol treatment interventions integrated into routine tuberculosis care in Tomsk, Russia: Integrated alcohol and TB treatment in Tomsk, Russia
Open accessAbstract
AIMS: To test the feasibility and effectiveness of brief counseling intervention (BCI) and naltrexone integrated into tuberculosis (TB) care in Tomsk, Russia. DESIGN: Using a factorial randomized controlled trial design, patients were randomized into: naltrexone (NTX), brief behavioral compliance enhancement therapy (BBCET), treatment as usual (TAU) and BCI. SETTING AND PARTICIPANTS: In the Tomsk Oblast, hospitalized TB patients diagnosed with alcohol use disorders (AUDs) by the DSM-IV were referred at the start of TB treatment. Of the 196 participants, the mean age was 41 years and 82% were male. Severe TB (84.7% had cavitary disease) and smoking (92.9%) were common. The majority had a diagnosis of an AUD (63.0%); 27.6% reported nearly daily drinking and consumed a median of 16 standard drinks per day. MEASUREMENTS: Primary outcomes were 'favorable' TB outcome (cured, completed treatment) and change in mean number of abstinent days in the last month of study compared with baseline. Change in mean number of heavy drinking days, defined as four drinks per day and five drinks per day for women and men, respectively, and TB adherence, measured as percentage of doses taken as prescribed under direct observation, were secondary outcomes. Analysis based on 'intention-to-treat' was performed for multivariable analysis. FINDINGS: Primary TB and alcohol end-points between naltrexone and no-naltrexone or BCI and no-BCI groups did not differ significantly. TB treatment adherence and change in number of heavy drinking days also did not differ significantly among treatment arms. Among individuals with a prior quitting attempt (n = 111), naltrexone use was associated with an increased likelihood of favorable TB outcomes (92.3% versus 75.9%, P = 0.02). CONCLUSIONS: In Tomsk Oblast, Russia, tuberculosis patients with severe alcohol use disorders who were not seeking alcohol treatment did not respond to naltrexone or behavioral counselling integrated into tuberculosis care; however, those patients with past attempts to quit drinking had improved tuberculosis outcomes.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In Shin 2013, blinding of participants and personnel was judged to be at high risk of performance bias.
“Non‐blinded randomization assignment was generated by computer by the study team.”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Shin 2013
The Methods (Study protocol) state that participants were assigned to non-blinded interventions, supporting the non-blinding basis of the claim. The passage does not judge blinding of participants and personnel to be at high risk of performance bias; that is a separate assessment not stated in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn Shin 2013, incomplete outcome data was judged to be at low risk of attrition bias.
“We performed analysis based on”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Shin 2013
The Results (Enrollment and follow-up; page unavailable) report outcome data for 99.0% of TB endpoints but only 78.1% of alcohol endpoints. The Methods (Analytic approach; page unavailable) describe intention-to-treat analysis and imputation for missing alcohol data, but the paper does not itself judge incomplete outcome data to be at low risk of attrition bias. (LLM, conf=0.78)
Experimental — accuracy not yet measuredIn Shin 2013, blinding of outcome assessment was judged to be at high risk of detection bias.
“Outcomes reported by participant not blind to intervention”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Shin 2013
In Shin 2013, allocation concealment was judged to be at high risk of selection bias.
“Non‐blinded randomization assignment was generated by computer by the study team.”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Shin 2013
In Shin 2013, random sequence generation was judged to be at low risk of selection bias.
“Non‐blinded randomization assignment was generated by computer by the study team.”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Shin 2013
In Shin 2013, selective reporting was judged to be at unclear risk of reporting bias.
“Protocol not available”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Shin 2013
The Methods sections headed “Study protocol” and “Data collection and analysis” describe the design and give a trial registration number. They do not say whether a full protocol was available or assess selective-reporting bias, so the citing document’s unclear-risk judgment cannot be verified from our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 31 · Cited by 44
Research works printed but not linked: 1
- [35]Shin SS Livchits V Nelson AK Lastimoso CS Yanova GV Yanov SA Implementing Evidence-Based Alcohol Interventions in a Resource-Limited Setting: Novel Delivery Strategies in Tomsk, Russia Harv Rev Psychiatry 2012 Jan-Feb 20 1 22335183 PMC3318976
- Authors
- Shin, S., Livchits, V., Connery, H. S., Shields, A., Yanov, S., Yanova, G., Fitzmaurice, G. M., Nelson, A. K., Greenfield, S. F., & Tomsk Tuberculosis Alcohol Working Group
- Affiliations
- Brigham and Women's Hospital (US)
- Partners In Health (US)
- Harvard University (US)
- Tomsk Oblast Clinical Tuberculosis Hospital; Tomsk; Russian Federation
- Corresponding author
- Shin, Sonya
- ORCID
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2013-05-13
- Volume
- 108
- Issue
- 8
- Pages
- 1387-1396
- ISSN
- 0965-2140 (ISSN-L)
- PMC
- PMC3710528
- OpenAlex
- W1484429038
- Semantic Scholar
- ab616b4197ea8a09330a09cafbfa5810a7e756ab
- Cited by
- 44
- References
- 31
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5k24da019855-10)
- National Institute on Alcohol Abuse and Alcoholism (R01AA016318)
- National Institute on Drug Abuse (K24-DA019855)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- tuberculosis, alcoholism, naltrexone, brief counseling intervention, integrated care, medication adherence, alcohol abstinence, heavy drinking, smoking, Tomsk Oblast
- MeSH terms
- Adult, Alcohol Deterrents, Alcoholism, Behavior Therapy, Combined Modality Therapy, Counseling, Feasibility Studies, Female, Humans, Male, Naltrexone, Patient Compliance, Russia, Tuberculosis, Treatment Outcome, Alcohol Abstinence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
