Identification of and guidance for problem drinking by general medical providers - Results from a national survey
Identification of and guidance for problem drinking by general medical providers - Results from a national survey
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DOI：
10.1097/00005650-200503000-00005
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发表时间：
2005-03-01
期刊：
影响因子：
3
通讯作者：
Kung, FY
中科院分区：
文献类型：
--
作者：
D'Amico, EJ;Paddock, SM;Kung, FY
背景：大量饮酒与健康成本和医疗问题有关。越来越多的人认为，初级保健患者应进行酒精问题筛查。目的：我们检查了患者被问及酒精或药物使用和问题的比率，通过使用标准化的问题饮酒工具在全国范围内进行大样本扩展了这一领域的研究，检查了社区水平的变量，并评估了被确定的患者接受随访的程度。1998年社区卫生保健调查的7371人的子样本，他们报告在过去的一年里访问了一个普通的医疗提供者（GMP）。措施：参与者完成了关于人口统计学、精神和身体健康、酒精、药物使用和问题、管理式医疗保健计划的登记、他们的医疗提供者是否询问酒精或药物使用情况以及他们是否接受建议、咨询或转诊的问卷。被问及酒精和毒品使用与男性，年轻，受过高等教育，更多的健康问题，心理健康诊断，并被列为酗酒者只有48%的问题饮酒者接受任何后续行动，大多数人被告知“停止饮酒”的GMP。结论：很少有人询问酒精或药物使用时，他们访问GMP。当发现问题使用时，大多数患者没有得到适当的随访和善后护理。初级保健的质量可以提高，如果GMP的教育提供简短的建议/咨询，并给予有关资源的信息，在他们的社区，使病人适当的转介。
Background: Heavy alcohol use is associated with health costs and medical problems. There has been a growing consensus that primary care patients should be screened for alcohol problems.Objectives: We examined rates at which patients were asked about alcohol or drug use and problems, extending research in this area by using a standardized problem drinking instrument with a large national sample, examining community level variables, and assessing the extent to which patients who were identified received follow-up.Subjects: A subsample of 7371 persons from the 1998 Healthcare for Communities survey who reported visiting a general medical provider (GMP) in,the past year. Measures: Participants completed questionnaires on demographics, mental and physical health, alcohol, drug use and problems, enrollment in a managed health care plan, whether their medical provider asked about alcohol or drug use, and whether they received advice, counseling, or referral.Results: Being asked about alcohol and drug use was associated with being male, young, highly educated, more health problems, mental health diagnosis, and being classified as a problem drinker. Only 48% of problem drinkers received any follow-up, with most being told to "stop drinking" by their GMP.Conclusions: Few people are queried about alcohol or drug use when they visit a GMP. When problem use is identified, most patients do not receive appropriate follow-up and aftercare. The quality of primary care could improve if GMPs were educated about providing brief advice/counseling and were given information conceming resources in their community to make appropriate referrals for patients.