Linking alcohol- and drug-dependent adults to primary medical care: a randomized controlled trial of a multi-disciplinary health intervention in a detoxification unit.
Linking alcohol- and drug-dependent adults to primary medical care: a randomized controlled trial of a multi-disciplinary health intervention in a detoxification unit.
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将酒精和药物依赖的成年人与初级医疗保健联系起来：在戒毒单位进行多学科健康干预的随机对照试验。
DOI：
10.1046/j.1360-0443.2003.00328.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Saitz,Richard
中科院分区：
文献类型：
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作者：
Samet,JeffreyH;Larson,MaryJo;Horton,NicholasJ;Doyle,Kathleen;Winter,Michael;Saitz,Richard
目的：需要将医疗保健与药物滥用治疗相结合的务实方法。我们评估了一种新型多学科诊所将住院戒毒计划中的患者与初级医疗保健联系起来的有效性。我们招募了正在接受酒精、海洛因或可卡因住院戒毒的患者，这些患者没有初级保健医生。干预措施包括由护士、社会工作者和医生在戒毒单位的健康评估和与初级保健诊所的联系中进行临床评估，并促进转诊到场外初级保健诊所。主要关注的结果是在12个月内参加初级保健预约。 在24个月内评估的次要结果是成瘾严重程度，健康相关的生活质量，医疗和成瘾服务的利用和HIV风险behaviors.FindingsOf入组的470名受试者中，235名被随机分配到HELP诊所干预。 与初级医疗保健相关的干预组为69%，对照组为53%（P= 0.0003）。 该诊所对酒精和非法药物问题的受试者同样有效。随机化到HELP诊所导致次要outcome.ConclusionsThe HELP诊所，一个多学科的诊所位于戒毒单位，有效地连接酒精和药物依赖的个人，初级医疗保健没有显着差异。这种干预利用了一个“可达到的时刻”，即成瘾护理期间，作为将药物滥用者与医疗护理联系起来的机会之窗。
AimPragmatic approaches to integration of medical care and substance abuse treatment are desired. We assessed the effectiveness of a novel multi‐disciplinary clinic for linking patients in a residential detoxification program to primary medical care.ParticipantsWe enrolled patients undergoing in‐patient detoxification from alcohol, heroin or cocaine who had no primary care physician into a randomized controlled trial. The intervention consisted of a clinical evaluation at the detoxification unit in the health evaluation and linkage to primary care (HELP) clinic by a nurse, social worker and physician and facilitated referral to an off‐site primary care clinic. The primary outcome of interest was attendance at a primary care appointment within 12 months. Secondary outcomes assessed over 24 months were addiction severity, health‐related quality of life, utilization of medical and addiction services and HIV risk behaviors.FindingsOf the 470 subjects enrolled, 235 were randomized to the HELP clinic intervention. Linkage to primary medical care occurred in 69% of the intervention group compared to 53% in the control group (P= 0.0003). The clinic was similarly effective for subjects with alcohol and illicit drug problems. Randomization to the HELP clinic resulted in no significant differences in secondary outcomes.ConclusionsThe HELP clinic, a multi‐disciplinary clinic located in a detoxification unit, effectively linked alcohol‐ and drug‐dependent individuals to primary medical care. This intervention utilized a ‘reachable moment’, the period of addiction care, as a window of opportunity for linking substance abusers to medical care.