Brief intervention for patients with problematic drug use presenting in emergency departments: a randomized clinical trial.
Brief intervention for patients with problematic drug use presenting in emergency departments: a randomized clinical trial.
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DOI：
10.1001/jamainternmed.2014.4052
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发表时间：
2014-11
影响因子：
39
通讯作者：
Douaihy, Antoine
中科院分区：
文献类型：
--
作者：
Bogenschutz, Michael P.;Donovan, Dennis M.;Mandler, Raul N.;Perl, Harold I.;Forcehimes, Alyssa A.;Crandall, Cameron;Lindblad, Robert;Oden, Neal L.;Sharma, Gaurav;Metsch, Lisa;Lyons, Michael S.;McCormack, Ryan;Konstantopoulos, Wendy Macias;Douaihy, Antoine
急诊科等医疗机构为解决有问题的药物使用问题提供了重要机会。目前，ED通常不会在急性医疗稳定之外进行干预。在使用药物的艾德患者中，对比使用电话助推器（BI-B）的简短干预与筛查、评估和转诊治疗（SAR）以及仅进行最小筛查（MSO）的效果。2010年10月至2012年2月期间，1285例患者被随机分配至MSO（n = 431）、SAR（n = 427）或BI-B（n = 427）组。在3、6和12个月时由盲法访谈者进行随访评估。美国六家学术医院的ED参与者是在10项药物滥用筛查测试中得分≥ 3（表明与药物使用相关的中度至严重问题）且目前正在使用药物的成年艾德患者。筛选后，MSO参与者仅收到一份信息小册子。SAR参与者接受评估，并在有需要时接受成瘾治疗。BI-B参与者接受了SAR中的评估和转介，以及基于激励性面试原则的手动指导咨询课程，以及在艾德就诊后的一个月内通过电话进行的最多2次“加强”课程。随访时评估的结果包括自我报告的使用患者定义的主要问题药物的天数、使用任何药物的天数、大量饮酒的天数以及基于头发样本分析的药物使用情况。3个月、6个月和12个月的随访率分别为88%、86%和81%。在3、6或12个月时，两组之间自我报告的使用主要药物的天数、使用任何药物的天数或重度饮酒天数均无显著差异。在3个月的随访中，SAR组的参与者的头发样本对主要滥用药物呈阳性的比例（265/280，95%）高于MSO组（253/287，88%）或BI-B组（244/275，89%）。在其他时间点，组间毛发分析差异不显著。在这一寻求紧急医疗的吸毒者样本中，相对强有力的短暂干预并没有改善物质使用的结果。需要更多的工作来确定如何在ED中有效地解决药物使用障碍。
Medical treatment settings such as Emergency Departments (EDs) present important opportunities to address problematic substance use. Currently, EDs do not typically intervene beyond acute medical stabilization. To contrast the effects of a brief intervention with telephone boosters (BI-B) to those of screening, assessment, and referral to treatment (SAR) and minimal screening only (MSO) among drug-using ED patients. Between October 2010 and February 2012, 1285 patients were randomized to MSO (n = 431), SAR (n = 427), or BI-B (n = 427). Follow-up assessments were conducted at 3, 6, and 12 months by blinded interviewers. EDs of six academic hospitals in the U.S. Participants were adult ED patients scoring ≥ 3 on the 10-item Drug Abuse Screening Test (indicating moderate to severe problems related to drug use) and currently using drugs. Following screening, MSO participants received only an informational pamphlet. SAR participants received assessment plus referral to addiction treatment if indicated. BI-B participants received assessment and referral as in SAR, plus a manual-guided counseling session based on motivational interviewing principles and up to 2 “booster” sessions by telephone during the month following the ED visit. Outcomes evaluated at follow-up visits included self-reported days using the patient-defined primary problem drug, days using any drug, days of heavy drinking, and drug use based on analysis of hair samples. Follow-up rates were 88%, 86%, and 81% at 3, 6, and 12 months, respectively. There were no significant differences between groups in self-reported days using the primary drug, days using any drug, or heavy drinking days at 3, 6, or 12 months. At the 3-month follow-up, participants in the SAR group had a higher rate of hair samples positive for their primary drug of abuse (265/280, 95%) than did participants in the MSO group (253/287, 88%) or the BI-B group (244/275, 89%). Hair analysis differences between groups at other time points were not significant. In this sample of drug users seeking emergency medical treatment, a relatively robust brief intervention did not improve substance use outcomes. More work is needed to determine how drug use disorders may be addressed effectively in the ED.
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影响因子：
3.9
作者：
Moyers, TB;Martin, T;Miller, WR
通讯作者：
Miller, WR
DOI：
10.3109/00952990.2011.596971
发表时间：
2011-09
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
Bogenschutz MP;Donovan DM;Adinoff B;Crandall C;Forcehimes AA;Lindblad R;Mandler RN;Oden NL;Perl HI;Walker R
通讯作者：
Walker R
影响因子：
9
作者：
Gentilello, LM;Rivara, FP;Ries, RR
通讯作者：
Ries, RR
影响因子：
6.2
作者：
D'Onofrio, Gail;Fiellin, David A.;O'Connor, Patrick G.
通讯作者：
O'Connor, Patrick G.
DOI：
10.1007/s10488-012-0405-0
发表时间：
2013-07-01
影响因子：
2.6
作者：
Croft, Bevin;Parish, Susan L.
通讯作者：
Parish, Susan L.