A Single-Question Screening Test for Drug Use in Primary Care
A Single-Question Screening Test for Drug Use in Primary Care
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DOI：
10.1001/archinternmed.2010.140
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发表时间：
2010-07-12
影响因子：
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通讯作者：
Saitz, Richard
中科院分区：
文献类型：
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作者：
Smith, Peter C.;Schmidt, Susan M.;Saitz, Richard
背景：药物使用（非法药物使用和处方药的非医疗使用）是常见的，但在初级保健环境中认识不足。我们验证了一个单一的问题筛选测试药物使用和药物使用障碍在primary care.Methods：从初级保健候诊室招募的成年患者被问到单一的筛选问题，“有多少次在过去的一年中，你使用了非法药物或使用处方药的非医疗原因？“至少1次的反应被认为是药物使用阳性。他们还被要求进行10项药物滥用筛选测试（DAST-10）。参考标准是通过标准化诊断访谈确定的当前（过去一年）药物使用或药物使用障碍（滥用或依赖）的存在与否。药物的使用也确定了口腔液测试常见drugsabuse.Results：394个合格的初级保健患者，286（73%）完成了采访。单一筛选问题对于检测药物使用障碍的敏感性为100%（95%置信区间[CI]，90.6%-100%），特异性为73.5%（95% CI，67.7%-78.6%）。对自我报告的当前药物使用检测（92.9%; 95% CI，86.1%-96.5%）和通过口腔液体检测或自我报告检测的药物使用检测（81.8%; 95% CI，72.5%-88.5%）的敏感性较低。测试特性是类似的DAST-10和受影响很小的参与者的人口统计学特征。结论：单一筛选问题准确地确定药物使用在这个样本的初级保健患者，支持这种简短的屏幕在初级保健的有用性。
Background: Drug use (illicit drug use and nonmedical use of prescription drugs) is common but underrecognized in primary care settings. We validated a single-question screening test for drug use and drug use disorders in primary care.Methods: Adult patients recruited from primary care waiting rooms were asked the single screening question, "How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?" A response of at least 1 time was considered positive for drug use. They were also asked the 10-item Drug Abuse Screening Test (DAST-10). The reference standard was the presence or absence of current (past year) drug use or a drug use disorder (abuse or dependence) as determined by a standardized diagnostic interview. Drug use was also determined by oral fluid testing for common drugs of abuse.Results: Of 394 eligible primary care patients, 286 (73%) completed the interview. The single screening question was 100% sensitive (95% confidence interval [CI], 90.6%-100%) and 73.5% specific (95% CI, 67.7%-78.6%) for the detection of a drug use disorder. It was less sensitive for the detection of self-reported current drug use (92.9%; 95% CI, 86.1%-96.5%) and drug use detected by oral fluid testing or self-report (81.8%; 95% CI, 72.5%-88.5%). Test characteristics were similar to those of the DAST-10 and were affected very little by participant demographic characteristics.Conclusion: The single screening question accurately identified drug use in this sample of primary care patients, supporting the usefulness of this brief screen in primary care.