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critically analyze Managed alcohol programs We identified one Cochrane systematic review [68] and two grey literature systematic reviews [69,70] examining the effects of managed alcohol programs (MAPs) for homeless populations. There was a lack of high-quality evidence in the peer reviewed literature for this intervention [68]. Existing evidence consisted largely of uncontrolled evaluations of small scale pilot programs. Few studies reported on deaths among MAP clients [70]. In a case study of a Canadian MAP, “out of few dozen men who cycled through the program, eight clients of the MAP had passed away since its opening in 2006” [70]. Additionally, a MAP within a shelter-based palliative care program had 28 consecutive patients die between 2001 and 2003 [70]. Impacts of MAPs on hepatic function are mixed, with some studies reporting improvement in hepatic laboratory markers over time, and others showing increases in alcohol-related hepatic damage [70], however this may have occurred regardless of entry into a MAP. This evidence suggested that MAPs result in stabilized alcohol consumption and can facilitate engagement with medical and social services [69]. MAP clients also reduced their consumption of non-beverage alcohol products, liquids containing a form of comparatively harmful forms of alcohol that were not
SCIENCE
HEALTH SCIENCE
NURSING

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