Thirty-six studies were included for the review (n=33,394): seventeen randomised controlled trials (RCTs, n=6,834 participants), two partial RCTs (n=1,073 participants), one non-randomised controlled trial (n=70 participants), two quasi-experimental studies (n=1,195 participants), six uncontrolled pre/post-tests (n=2,071 participants), one pre/post study (n=53 participants), six retrospective studies (n=22,088 participants) and one case study (n=10 participants). Statistical data were not provided for any of the studies.
Intensive case management (18 studies, n=6,546 participants): Intensive case management was associated with significantly improved outcomes in adolescents receiving residential treatment (one RCT, n=114 participants), pregnant and post-partum women (one study, n=152 participants), in people involved in the criminal justice system (two studies, n=1,454 participants) and in people with complex problems (one study, n=24 participants). Intensive case management of children with cocaine-abusing mothers only resulted in significant improvement in cognitive and verbal outcomes (one study, n=70 participants). Intensive case management did not significantly improve outcomes compared to controls in four of the five studies of homeless substance abusing populations (n=2,186 participants) and in the RCT (n=190 participants) of HIV (human immunodeficiency virus) populations. Participants with a dual diagnosis did not show significantly improved outcomes with intensive case management, except where intensive case management was robustly applied (three studies, n=245 participants).
Assertive community treatment (two studies, n=461 participants): Assertive community treatment did not show a significant benefit for substance misusing parolees (one RCT, n=258 participants) or for people with co-morbid mental illness(one RCT, n=203 participants), except for some measures of substance use and quality of life in the people with mental illness.
Strengths-based case management (three studies, n=1,304): Strengths-based case management was associated with significant improvements in use of medical and substance abuse services, legal outcomes, family relationships and parental attitudes (one RCT, n=662 participants), improved treatment retention, aftercare participation and employment functioning (one RCT, n=632 participants) compared to standard treatment. One case study found improved employment amongst those participants that continued with the programme.
Generalist case management (10 studies, n=23,801): Generalist case management was associated with some significantly improved outcomes in homeless substance-abusing populations (two of the three studies in this population, n=852 participants), in pregnant or post-partum women (two studies, n=883 women), in offenders (one study, n=259 participants) and in people discharged from treatment (one study, n=21,207 participants). Generalist case management had poorer outcomes for cocaine-abusing mothers compared to a comprehensive programme including psychotherapy (one RCT, n=84 participants) and the results were mixed for the two studies of intravenous drug users (n=516 participants).
Brokerage case management (one study, n=692 participants): Brokerage case management was associated with significant improvements in some aspects of service utilisation compared to no case management in one RCT (n=692 participants). Brokerage case management did not show significantly different outcomes to intensive case management, when used a a control condition for this intervention (two studies, n=912 participants).
Clinical case management (two studies, n=590): Clinical case management was associated with significantly improved alcohol and drug use, medical and psychiatric status and employment functioning at six months (one study, n=537 participants) and with significantly fewer emergency and inpatients visits and alcohol and drug use at 12 months (one study, n=53 participants).