Effectiveness of physician-based interventions with problem drinkers: a review.
Effectiveness of physician-based interventions with problem drinkers: a review.
复制标题
基于医生的干预措施对问题饮酒者的有效性：综述。
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
Lorne Becker
中科院分区：
文献类型：
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作者：
M. Kahan;L. Wilson;Lorne Becker
目的
回顾随机对照试验的结果，简单的医生干预问题饮酒者的有效性。
数据源
在MEDLINE和EMBASE数据库中分别检索1966年和1972年发表的文章，检索词为“问题/控制/责任/中等/风险/饮酒”;“建议/饮酒”;“医生、护士、全科医生”;和“随机”。在EMBASE检索中识别出43篇文章，在MEDLINE检索中识别出112篇文章。
资料选择
所有的试验检查干预措施的有效性，由医生在减少饮酒的问题参加医疗机构的饮酒者进行了审查。涉及参加酒精治疗诊所的受试者和仅由非医生提供干预措施的受试者的试验被排除在外。11项试验符合最终选择标准。
数据提取
对于每一篇文章，两位作者独立地根据有效性和普遍性的一些标准从0到2打分。
资料综合
有效性得分最高的四项试验表明，干预组的男性每周饮酒量比对照组的男性多减少了5到7个标准饮酒量。女性的结果不一致。没有令人信服的证据表明男性或女性与酒精有关的发病率下降。
结论
这些试验支持医生对有饮酒问题的患者进行简短干预。虽然需要进一步研究以确定其对发病率和死亡率的影响，但这些干预措施对公共卫生的影响可能是巨大的。需要进一步研究以确定哪些患者最适合短期干预，治疗的最佳强度以及短期干预的哪些组成部分最有效。还需要进行研究，以确定哪些策略可以有效地诱导医生使用简短的干预措施。
OBJECTIVE
To review the results of randomized controlled trials on the effectiveness of brief physician interventions with problem drinkers.
DATA SOURCES
The MEDLINE and EMBASE databases were searched for articles published from 1966 and 1972 respectively, with the terms "problem/controlled/responsible/moderate/risk/drink"; "advice/drink"; "physician, nurse, general practitioner"; and "random." Forty-three articles were identified in the EMBASE search and 112 articles in the MEDLINE search.
STUDY SELECTION
All trials examining the effectiveness of interventions by physicians in reducing alcohol consumption among problem drinkers attending a health-care facility were reviewed. Trials involving subjects attending an alcohol treatment clinic and those involving interventions delivered solely by nonphysicians were excluded. Eleven trials met the final selection criteria.
DATA EXTRACTION
For each article, two of the authors independently assigned a score from 0 to 2 on a number of criteria for validity and generalizability.
DATA SYNTHESIS
The four trials with the highest validity scores showed that men in the intervention groups reduced their weekly alcohol consumption by five to seven standard drinks more than the men in the control groups. Results for women were inconsistent. No convincing evidence of declines in alcohol-related morbidity among men or women was found.
CONCLUSIONS
The trials support the use of brief interventions by physicians for patients with drinking problems. Although further studies are needed to determine their effect on morbidity and mortality, the public health impact of such interventions is potentially enormous. Further research is needed to determine which patients are best suited for brief interventions, the optimal intensity of treatment and which components of brief interventions are most effective. Research is also needed to establish which strategies are effective in inducing physicians to use brief interventions.