A cascade of care for alcohol use disorder: Using 2015-2019 National Survey on Drug Use and Health data to identify gaps in past 12-month care.
A cascade of care for alcohol use disorder: Using 2015-2019 National Survey on Drug Use and Health data to identify gaps in past 12-month care.
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DOI：
10.1111/acer.14609
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Bierut LJ
中科院分区：
文献类型：
--
作者：
Mintz CM;Hartz SM;Fisher SL;Ramsey AT;Geng EH;Grucza RA;Bierut LJ
尽管存在有效的治疗方法，但酒精使用障碍(AUD)仍未得到充分治疗。我们使用级联护理框架来了解澳门氏症患者在护理方面的差距。使用2015-2019年全国药物使用和健康调查数据，我们评估了级联护理中的以下步骤：1)成人AUD患病率；2)AUD成年人在过去12个月内使用医疗保健的比例；3)AUD患者就其酒精使用情况进行筛查的比例；4)AUD患者接受过酒精滥用短暂干预的比例；5)AUD患者接受酒精滥用治疗信息的比例；以及6)AUD患者接受治疗的比例。分析按AUD严重程度分层。在纳入样本的214,505人中，AUD加权患病率为7.8%(95%可信区间为7.6-8.0%)。一连串的护理显示，大多数患有酒精性尿崩症的患者接受了医疗保健，并接受了酒精使用筛查，但只有一小部分人接受了随后的护理步骤：81.4%(95%可信区间80.7%，−82.1%)的澳门氏症患者在过去12个月中利用了医疗保健，69.9%(95%可信区间68.9-70.8%)报告接受了酒精使用筛查，但11.6%(95%可信区间11.0-12.2%)报告接受了短暂的干预，5.1%(95%可信区间4.6~5.6%)涉及治疗，5.8%(95%可信区间5.4~6.3%)接受治疗。当护理的级联按AUD严重程度分层时，也观察到类似的模式。AUD患者利用医疗保健，并接受酒精使用筛查，发病率高，但很少接受治疗。卫生保健环境--特别是初级保健环境--是实施AUD治疗以改善这一高危人群预后的绝佳机会。
Although effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care for persons with AUD. Using 2015–2019 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) adult prevalence of AUD; 2) proportion of adults with AUD who utilized health care in the past 12 months; 3) proportion with AUD screened about their alcohol use; 4) proportion with AUD who received a brief intervention about their alcohol misuse; 5) proportion with AUD who received information about treatment for alcohol misuse; and 6) proportion with AUD who received treatment. Analyses were stratified by AUD severity. Of the 214,505 persons included in the sample, weighted prevalence of AUD was 7.8% (95% CI 7.6–8.0%). Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but only a minority received subsequent steps of care: 81.4% (95% CI 80.7%−82.1%) of persons with AUD utilized health care in the past 12 months and 69.9% (95% CI 68.9–70.8%) reported being screened about alcohol use, but 11.6% (95% CI 11.0–12.2%) reported receiving a brief intervention, 5.1% (95% CI 4.6–5.6%) were referred to treatment, and 5.8% (95% CI 5.4–6.3%) received treatment. Similar patterns were observed when cascades of care were stratified by AUD severity. Persons with AUD utilize health care and are screened about alcohol use with high prevalence, but few receive treatment. Health care settings- particularly primary care settings- represent a prime opportunity to implement AUD treatment to improve outcomes in this high-risk population.
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影响因子：
11.1
作者：
Laramee, Philippe;Leonard, Saoirse;Rehm, Juergen
通讯作者：
Rehm, Juergen
DOI：
10.1001/jama.2018.11406
发表时间：
2018-08-28
期刊：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
5.7
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Bradley, KA