A randomized controlled trial of recovery management checkups for primary care patients: Twelve-month results.
A randomized controlled trial of recovery management checkups for primary care patients: Twelve-month results.
复制标题
初级保健患者康复管理检查的随机对照试验：十二个月的结果。
DOI：
10.1111/acer.15172
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Hart,MKate
中科院分区：
文献类型：
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作者：
Scott,ChristyK;Dennis,MichaelL;Grella,ChristineE;Watson,DennisP;Davis,JordanP;Hart,MKate
背景初级保健机构，如联邦合格的卫生中心（UHC）是最佳的位置，以确定个人与物质使用障碍（SUD），并将他们与SUD治疗，但成功的联系已被证明是困难的。恢复管理检查的初级保健（RMC-PC）是一个很有前途的方法，增加联系到护理，参与治疗，减少substance use.MethodsParticipants（n= 266）谁接受了筛选，简短的干预，并转介治疗（SBIRT）在四个CIMHC网站和需要SUD治疗随机接受SBIRT或SBIRT+RMC-PC。所有参与者在随机化之前接受SBIRT作为常规护理的一部分，而实验组的参与者也接受季度检查。所有参与者在入组时以及入组后3、6、9和12个月完成了研究访谈。主要结果是参与者是否接受了任何天数的SUD治疗。关键次要结局为SUD治疗天数（总的和SUD护理水平），酒精或药物戒断的天数，以及特定物质使用天数的减少，所有这些都基于自我报告。分配到SBIRT+RMC‐PC组的受试者在12个月内接受任何SUD治疗的可能性显著更高（调整的比值比[AOR] = 3.85）和12个月内SUD治疗天数更多（Cohen效应量= +0.41）。SBIRT+ RMC-PC组还报告了12个月内禁欲天数显著增加（d= +0.30），饮酒天数减少（d=-0.20）和大麻使用天数减少（d=-0.20），以及组合药物使用频率降低（d=-0.25）。天的治疗被认为是积极介导的直接影响SBIRT+ RMC-PC上的天abstinence.ConclusionThis研究提供了进一步的证据的有效性的“转诊治疗”的组成部分SBIRT时，结合RMC的患者在初级保健环境，包括那些药物使用的问题。此外，结果证明了重复检查对长期治疗和物质使用结果的价值。
BackgroundPrimary care settings like federally qualified health centers (FQHC) are optimal locations to identify individuals with substance use disorders (SUD) and link them to SUD treatment, yet successful linkage has proven difficult. Recovery management checkups for primary care (RMC‐PC) is a promising method for increasing linkage to care, engagement in treatment, and reducing substance use.MethodsParticipants (n= 266) who received screening, brief intervention, and referral to treatment (SBIRT) at four FQHC sites and needed SUD treatment were randomized to receive SBIRT only or SBIRT+RMC‐PC. All participants received SBIRT prior to randomization as part of usual care while those in the experimental group also received quarterly checkups. All participants completed research interviews at enrollment and 3, 6, 9, and 12 months post‐enrollment. The primary outcome was whether participants received any days of SUD treatment. Key secondary outcomes were days of SUD treatment (total and by SUD level of care), days of alcohol or drug abstinence, and a reduction in days of specific substance use, all based on self‐report.ResultsRelative to participants receiving SBIRT only, participants assigned to SBIRT+RMC‐PC were significantly more likely to have received any SUD treatment over 12 months (adjusted odds ratio [AOR] = 3.85) and more days of SUD treatment over 12 months (Cohen's effect sized= +0.41). The SBIRT+RMC‐PC group also reported significantly more days of abstinence over 12 months (d= +0.30), fewer days of alcohol use (d= −0.20) and cannabis use (d= −0.20), and lower combined substance use frequency (d= −0.25). Days of treatment were found to positively mediate the direct effect of SBIRT+RMC‐PC on days of abstinence.ConclusionThis study provides further evidence of the effectiveness of the “referral to treatment” component of SBIRT when combined with RMC for patients in primary care settings, including those with drug use problems. Moreover, results demonstrate the value of repeated checkups on longer‐term treatment and substance use outcomes.