The effectiveness of brief intervention among injured patients with alcohol dependence: Who benefits from brief interventions?
The effectiveness of brief intervention among injured patients with alcohol dependence: Who benefits from brief interventions?
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DOI：
10.1016/j.drugalcdep.2009.11.025
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发表时间：
2010-09-01
影响因子：
4.2
通讯作者：
Caetano, Raul
中科院分区：
文献类型：
--
作者：
Field, Craig A.;Caetano, Raul
背景：在医学背景下，对酒精依赖患者和非酒精依赖患者进行简短动机干预（bmi）效果差异的研究是有限的。临床指南建议BMI最适合酒精问题不太严重的患者。因此，大多数评估BMI有效性的研究都排除了有酒精依赖迹象的患者。方法：在创伤护理环境中进行一项随机对照试验，比较BMI与常规治疗加评估（TAU+）。使用DSM-IV诊断标准确定1336例患者的酒精依赖状态。在6个月和12个月的随访中，确定了酒精依赖和非酒精依赖患者之间BMI的差异有效性，包括每周量，最大消费量，戒酒天数百分比，酒精问题。此外，测定6个月和12个月时BMI对依赖状态的影响。结果:有一个一致的BMI和酒精依赖状态之间的相互作用,这表明显著高于每周减少量在6 - 12个月随访(β= 56,p = 03,β=点,p = .02点,分别),最大数量在6个月(β=。31 p = .04点),并显著降低百分比天禁欲的12个月(β=厚,p = .007)和酒精问题12个月(β= -2.7,p(12) = .04点)在酒精依赖患者接受BMI。此外，基线时接受BMI的酒精依赖患者。在6个月时达到酒精依赖标准的可能性降低了59倍（95% CI = 0.39 - 0.91）。结论：这些发现表明BMI对酒精相关损伤筛查阳性的酒精依赖患者更有利。2010爱思唯尔爱尔兰有限公司版权所有。
Background: Research investigating the differential effectiveness of Brief Motivational Interventions (BMIs) among alcohol-dependent and non-dependent patients in the medical setting is limited. Clinical guidelines suggest that BMI is most appropriate for patients with less severe alcohol problems. As a result, most studies evaluating the effectiveness of BMI have excluded patients with an indication of alcohol dependence.Methods: A randomized controlled trial of brief intervention in the trauma care setting comparing BMI to treatment as usual plus assessment (TAU+) was conducted. Alcohol dependence status was determined for 1336 patients using DSM-IV diagnostic criteria. The differential effectiveness of BMI among alcohol-dependent and non-dependent patients was determined with regard to volume per week, maximum amount consumed, percent days abstinent, alcohol problems at 6 and 12 months follow-up. In addition, the effect of BMI on dependence status at 6 and 12 months was determined.Results: There was a consistent interaction between BMI and alcohol dependence status, which indicated significantly higher reductions in volume per week at 6 and 12 months follow-up (beta = -.56, p = .03, beta = -.63, p = .02, respectively), maximum amount at 6 months (beta = -.31, p = .04), and significant decreases in percent days abstinent at 12 months (beta = .11, p = .007) and alcohol problems at 12 months (beta = -2.7, p(12) = .04) among patients with alcohol dependence receiving BMI. In addition, patients with alcohol dependence at baseline that received BMI were .59 (95% CI = .39-.91) times less likely to meet criteria for alcohol dependence at six months.Conclusions: These findings suggest that BMI is more beneficial among patients with alcohol dependence who screen positive for an alcohol-related injury. (C) 2010 Elsevier Ireland Ltd. All rights reserved.