Patient perspectives on medications for alcohol use disorder: A systematic scoping review

Abstract

Front-line treatments for alcohol use disorder (AUD) include psychotherapy and medication, and both treatments are underused. However, utilization rates of medications for alcohol use disorder (MAUD) are particularly low. The goal of the present scoping review is to characterize patient perspectives about MAUD to identify barriers to MAUD and potential areas of future work to increase access, initiation, and retention on MAUD. Searches of titles and abstracts were conducted on PubMed, EMBASE, PsycINFO, and CINAHL until March 2024 with patient perspective-, MAUD-, and alcohol-related keywords. Articles were assessed for eligibility and included in the present review if they examined adult patients' perspectives of MAUD. Fourteen studies were included in the review. The majority of patient populations assessed were individuals with AUD, and most studies evaluated MAUD in general (n = 7) or specific medications (i.e., naltrexone, n = 5; disulfiram, n = 2; acamprosate, n = 1). Important themes related to patient-perceived barriers to MAUD were identified, including a lack of awareness and misunderstanding about the effectiveness and effects of MAUD, apprehensiveness or experience with side effects, and perceived stigma of MAUD. Future work incorporating patient perspectives of MAUD into interventions and strategies may help improve MAUD uptake, including person-centered discussions factoring in unique patient perspectives about MAUD to increase patient MAUD knowledge and reduce MAUD stigma.