The impact of screening, brief intervention, and referral for treatment on emergency department patients' alcohol use
The impact of screening, brief intervention, and referral for treatment on emergency department patients' alcohol use
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DOI：
10.1016/j.annemergmed.2007.06.486
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发表时间：
2007-12-01
影响因子：
6.2
通讯作者：
D'Onofrio, Gail
中科院分区：
文献类型：
--
作者：
Aseltine, Robert H., Jr.;Bernstein, Edward;D'Onofrio, Gail
研究目的：我们确定筛查、短暂干预和转诊治疗（SBIRT）计划对减少急诊科（ED）患者饮酒的影响。方法：2004年4月至8月，从全国14个地点招募了饮酒高于国家酒精滥用和酒精中毒研究所低风险指南的患者。采用准实验比较组设计，在每个地点依次招募对照组和干预组患者。对照组患者收到一份书面讲义。干预组收到了讲义和一个简短的干预，即简短的协商访谈，以减少不健康的酒精使用。随访调查于3个月时通过电话使用交互式语音应答系统进行。结果：在7751名接受筛查的患者中，2051名（26%）超过了国家酒精滥用和酒精中毒研究所设定的低风险限值；1132名（55%）符合条件的患者同意并入组（581名对照组，551名干预组）。699人（62%）使用交互式语音应答系统完成了为期3个月的随访调查。在随访中，接受简短协商访谈的患者报告每周饮酒量比对照组少3.25（系数[B] -3.25； 95%可信区间[CI] -5.76至-0.75），接受简短协商访谈的患者每次最大饮酒量几乎比对照组少四分之三（B -0.72; 95% CI -1.42至-0.02）。高危饮酒者（CAGE 2）。在3个月的随访中，干预组37.2%的CAGE小于2的患者不再超过国家酒精滥用和酒精中毒研究所的低风险限值，而对照组为18.6% （A 18.6%; 95% CI 11.5%至25.6%）。结论：SBIRT对ED患者在3个月时减少不健康饮酒是有效的。
Study objective: We determine the impact of a screening, brief intervention, and referral for treatment (SBIRT) program in reducing alcohol consumption among emergency department (ED) patients.Methods: Patients drinking above National Institute of Alcohol Abuse and Alcoholism low-risk guidelines were recruited from 14 sites nationwide from April to August 2004. A quasiexperimental comparison group design was used in which control and intervention patients were recruited sequentially at each site. Control patients received a written handout. The intervention group received the handout and a brief intervention, the Brief Negotiated Interview, to reduce unhealthy alcohol use. Follow-up surveys were conducted at 3 months by telephone using an interactive voice response system.Results: Of 7,751 patients screened, 2,051 (26%) exceeded the low-risk limits set by National Institute of Alcohol Abuse and Alcoholism; 1,132 (55%) of eligible patients consented and were enrolled (581 control, 551 intervention). Six hundred ninety-nine (62%) completed a 3-month follow-up survey, using the interactive voice response system. At follow-up, patients receiving a Brief Negotiated Interview reported consuming 3.25 fewer drinks per week than controls (coefficient [B] -3.25; 95% confidence interval [CI] -5.76 to -0.75), and the maximum number of drinks per occasion among those receiving Brief Negotiated Interview was almost three quarters of a drink less than controls (B -0.72; 95% CI -1.42 to -0.02). At-risk drinkers (CAGE 2). At 3-month follow-up, 37.2% of patients with CAGE less than 2 in the intervention group no longer exceeded National Institute of Alcohol Abuse and Alcoholism low-risk limits compared with 18.6% in the control group (A 18.6%; 95% CI 11.5% to 25.6%).Conclusion: SBIRT appears effective in the ED setting for reducing unhealthy drinking at 3 months.