A Cochrane review [Abstract] 1 [withdrawn from publication] included 15 studies involving a total of 6694 participants. Case management is a client-centred strategy involving assessment, planning and linking to relevant services and community resources, and advocacy by a single case manager. Its intent is to improve the co-ordination and continuity of delivery of services. Outcome on illicit drug use was reported from 7 studies with 2391 patients. The effect for illicit drug use was small and not significant (SMD 0.12, 95% CI -0.09 to 0.29, p=0.20), with substantial heterogeneity (I2 =69.9%). A single, large trial of case management with two arms, showed that case management was superior to psychoeducation and drug counselling in reducing drug use. Linkage to other treatment services was reported in 10 studies (n=3132). The effect size for linkage was moderate (SMD=0.42, 95% CI 0.21 to 0.62, p<0.001), but substantial heterogeneity was found (I2 =85.2%).
Comment: The quality of evidence is downgraded by study quality (several limitations), by inconsistency (heterogeneity), and by indirectness (differences in studied interventions).
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