Adolescent SBIRT Practices Among Pediatricians in Massachusetts
Adolescent SBIRT Practices Among Pediatricians in Massachusetts
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DOI：
10.1097/adm.0000000000000551
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发表时间：
2020-03-01
影响因子：
5.5
通讯作者：
Harris, Sion K.
中科院分区：
文献类型：
--
作者：
Levy, Sharon;Wiseblatt, Aria;Harris, Sion K.
目的：初级保健中的青少年筛查、简短干预和转诊治疗（SBIRT）是预防、识别和应对物质使用问题和障碍（包括阿片类药物和其他药物成瘾）的关键战略。尽管近年来大量投资，以增加其实施，很少有研究报告在儿科医生中的SBIRT实施的最新水平。我们的目的是评估自我报告的使用SBIRT框架与青少年患者之间的马萨诸塞州儿科医生，并描述自早期调查的趋势。方法：我们分析了2017年邮寄给马萨诸塞州儿科医生代表性样本的横断面调查的回复。我们计算了所有SBIRT练习题的响应频率。我们使用卡方检验将当前数据与2014年收集的数据进行比较，因为我们发现两个样本之间没有人口统计学差异。结果：在2017年的样本中，几乎所有的儿科医生（n = 160）都报告了他们的青少年患者的年度筛查（99%）。大多数人报告说，根据筛查结果，他们给予了积极的强化（87%）、简短的建议（92%）、咨询（90%）和转诊治疗（66%）。与2014年相比，2017年儿科医生转介的患者中，有更高比例的患者对有问题的酒精使用进行了积极的筛查，但筛查和随访的障碍仍然存在，例如没有足够的时间进行筛查和患者拒绝返回。结论：在一项马萨诸塞州儿科医生调查的受访者中，我们发现根据已公布的指南实施SBIRT的比例很高，尽管障碍仍然存在。咨询的内容是否符合指导方针尚不清楚。
Objectives: Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT) in primary care is a key strategy to prevent, identify, and respond to substance use problems and disorders, including opioid and other drug addictions. Despite substantial investment in recent years to increase its implementation, few studies have reported on recent levels of SBIRT implementation among pediatricians. We aimed to assess self-reported use of the SBIRT framework with adolescent patients among Massachusetts pediatricians, and describe trends since an earlier survey. Methods: We analyzed responses to a cross-sectional survey mailed in 2017 to a representative sample of pediatricians in Massachusetts. We computed response frequencies for all SBIRT practice questions. We used the chi-square test to compare current data to data collected in 2014, as we found no demographic differences between the 2 samples. Results: Nearly all pediatricians in the 2017 sample (n = 160) reported annual screening of their adolescent patients (99%). The majority reported giving positive reinforcement (87%), brief advice (92%), counseling (90%), and referral to treatment (66%) in response to screen results. Compared with 2014, a significantly higher proportion of pediatricians in 2017 referred patients who screened positively for problematic alcohol use, but perceived barriers to screening and follow-up remain, such as insufficient time to screen and patient refusal to return. Conclusions: Among respondents to a Massachusetts pediatrician survey, we found high rates of delivering SBIRT in accordance with published guidelines, though barriers remain. Whether the content of the counseling adheres to guidelines is unknown.