Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial
Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial
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DOI：
10.1016/s0140-6736(16)31590-2
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发表时间：
2017-01-14
期刊：
影响因子：
168.9
通讯作者：
Patel, Vikram
中科院分区：
文献类型：
--
作者：
Nadkarni, Abhijit;Weobong, Benedict;Patel, Vikram
背景尽管建议将结构性心理治疗作为有害饮酒的一线干预措施，但由于常规初级保健的机会很少，全球只有一小部分人接受这些治疗。我们评估了酒精问题咨询（CAP）的有效性和成本效益，CAP是一种由外行顾问向参加常规初级卫生保健机构的有害饮酒患者提供的简短心理治疗。我们招募了男性有害饮酒者，他们的年龄在18- 19岁之间，通过酒精使用障碍识别测试（AUDIT）得分为12-19分来定义。65岁，来自印度果阿的10个初级卫生中心。我们排除了需要紧急医疗或住院治疗的患者，无法清晰沟通的患者，以及筛选时醉酒的患者。参与者由初级卫生中心训练有素的卫生助理随机分配（1：1）到单独的增强常规护理（EUC）或EUC与CAP相结合，在随机大小的4到6个区组中，按初级卫生中心分层，并使用顺序编号的不透明信封隐藏分配。对提供EUC的医生和评估结局的医生设盲。主要结局为缓解（AUDIT评分为
Background Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psychological treatment delivered by lay counsellors to patients with harmful drinking attending routine primary health-care settings.Methods In this randomised controlled trial, we recruited male harmful drinkers defined by an Alcohol Use Disorders Identification Test (AUDIT) score of 12-19 who were aged 18-65 years from ten primary health centres in Goa, India. We excluded patients who needed emergency medical treatment or inpatient admission, who were unable to communicate clearly, and who were intoxicated at the time of screening. Participants were randomly allocated (1: 1) by trained health assistants based at the primary health centres to enhanced usual care (EUC) alone or EUC combined with CAP, in randomly sized blocks of four to six, stratified by primary health centre, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC and those assessing outcomes were masked. Primary outcomes were remission (AUDIT score of