Preventive care in the emergency department:: Screening and brief intervention for alcohol problems in the emergency department:: A systematic review
Preventive care in the emergency department:: Screening and brief intervention for alcohol problems in the emergency department:: A systematic review
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DOI：
10.1197/aemj.9.6.627
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发表时间：
2002-06-01
影响因子：
4.4
通讯作者：
Degutis, LC
中科院分区：
文献类型：
--
作者：
D'Onofrio, G;Degutis, LC
目的：系统地回顾医学文献，以确定在急诊科（ED）环境中对酒精相关问题进行筛查和短暂干预（SBI）的推荐强度。方法：评估遵循系统评估的方法，并通过使用结构化模板、配套解释性文章以及基于已公布的关键评估标准的分级和方法评分系统来促进。主要结局指标是预防酒精相关疾病/伤害的死亡率和发病率，次要结局指标包括：减少消费；急诊科/门诊就诊和住院次数减少；减少：社会后果的减少；并且增加了后续和/或治疗的转诊。进行了三次Medline检索和一次Cochrane Library检索。两名小组成员审阅摘要并选择相关文章。对参考文献进行了筛选，以寻找其他相关文章。结果：除了1996年美国预防服务工作组报告中包含的14篇主要文章外，还确定并审查了27篇文章。研究人群多种多样，包括住院患者、门诊患者和大学患者，年龄从12岁到70岁不等。四项研究以ed为基础，两项研究将ed作为多个位点之一。39项关于SBI的研究，30项随机对照研究和9项队列研究，被用于制定目前的建议。这些研究中有32项证明了干预的积极作用。结论：作者建议将SBI纳入ED酒精相关问题的临床实践。
Objective: To systematically review the medical literature in order to determine the strength of the recommendation for screening and brief intervention (SBI) for alcohol-related problems in the emergency department (ED) setting. Methods: The review followed the methodology of systematic reviews and was facilitated through the use of a structured template, a companion explanatory piece, and a grading and methodological scoring system based on published criteria for critical appraisal. The primary outcome measure was the prevention of mortality and morbidity secondary to alcohol-related illnesses/injuries, The secondary outcome measures included: decreased consumption; fewer ED/outpatient visits and hospitalizations; a decrease in social consequences; and increased referrals for follow-up and/or treatment. Three Medline searches as well as a search of the Cochrane Library were performed. Two team members reviewed the abstracts and selected pertinent articles. References were screened for additional pertinent articles. Results: Twenty-seven articles were identified and reviewed, in addition to the 14 primary articles included in the 1996 U.S. Preventive Services Task Force Report. The study populations were diverse, including inpatient, outpatient, and college settings, with ages ranging from 12 to 70 years. Four studies were ED-based and two included EDs as one of multiple sites. Thirty-nine studies on SBI, 30 randomized controlled and nine cohort, were used to formulate the current recommendation. A positive effect of the intervention was demonstrated in 32 of these studies. Conclusions: The authors recommend that SBI for alcohol-related problems in the ED be incorporated into clinical practice.