Associations between alcohol brief intervention in primary care and drinking and health outcomes in adults with hypertension and type 2 diabetes: a population-based observational study.
Associations between alcohol brief intervention in primary care and drinking and health outcomes in adults with hypertension and type 2 diabetes: a population-based observational study.
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DOI：
10.1136/bmjopen-2022-064088
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发表时间：
2023-01-19
期刊：
影响因子：
2.9
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中科院分区：
文献类型：
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评估初级保健中的酒精短暂干预 (BI) 与患有高血压和 2 型糖尿病 (T2D) 的成人 12 个月饮酒结果和 18 个月健康结果之间的关联。使用电子健康记录数据进行基于人群的观察性研究。一个综合医疗保健系统，在成人初级保健中实施全系统酒精筛查、BI 和转诊治疗。 2014 年至 2017 年间筛查出不健康饮酒呈阳性的成年初级保健高血压患者 (N=72 979) 或 T2D (N=19 642)。我们根据常规护理中进行的酒精筛查结果，检查了四种饮酒结果：从基线到 12 个月随访期间的重度饮酒天数/过去 3 个月、饮酒天数/周、饮酒/饮酒日和饮酒/周。健康结果指标是测量的收缩压和舒张压 (BP) 的变化以及 18 个月随访时血压降低 ≥3 mm Hg。对于 T2D 患者，我们还在 18 个月的随访中检查了糖化血红蛋白 (HbA1c) 水平和“控制的 HbA1c”(HbA1c<8%) 的变化。对于高血压患者，与未接受 BI 治疗的患者相比，接受 BI 治疗的患者在 12 个月时的饮酒量/饮酒天数额外减少了 -0.06 份（95% CI -0.11 至 -0.01），每周饮酒量额外减少了 -0.30 份（95% CI -0.59 至 -0.01）。接受 BI 的高血压患者在 18 个月时舒张压降低具有临床意义的可能性也更高（OR 1.05，95% CI 1.00 至 1.09）。在 T2D 患者中，未发现 BI 与饮酒或检查的健康结果之间存在显着关联。酒精 BI 有望减少饮酒并帮助改善不健康饮酒筛查呈阳性的高血压患者的健康状况。然而，在 T2D 患者中没有观察到类似的关联。需要更多的研究来了解不同亚群之间的异质性并研究商业智能对公共卫生的长期影响。
To evaluate associations between alcohol brief intervention (BI) in primary care and 12-month drinking outcomes and 18-month health outcomes among adults with hypertension and type 2 diabetes (T2D). A population-based observational study using electronic health records data. An integrated healthcare system that implemented system-wide alcohol screening, BI and referral to treatment in adult primary care. Adult primary care patients with hypertension (N=72 979) or T2D (N=19 642) who screened positive for unhealthy alcohol use between 2014 and 2017. We examined four drinking outcomes: changes in heavy drinking days/past 3 months, drinking days/week, drinks/drinking day and drinks/week from baseline to 12-month follow-up, based on results of alcohol screens conducted in routine care. Health outcome measures were changes in measured systolic and diastolic blood pressure (BP) and BP reduction ≥3 mm Hg at 18-month follow-up. For patients with T2D, we also examined change in glycohaemoglobin (HbA1c) level and ‘controlled HbA1c’ (HbA1c<8%) at 18-month follow-up. For patients with hypertension, those who received BI had a modest but significant additional −0.06 reduction in drinks/drinking day (95% CI −0.11 to −0.01) and additional −0.30 reduction in drinks/week (95% CI −0.59 to −0.01) at 12 months, compared with those who did not. Patients with hypertension who received BI also had higher odds for having clinically meaningful reduction of diastolic BP at 18 months (OR 1.05, 95% CI 1.00 to 1.09). Among patients with T2D, no significant associations were found between BI and drinking or health outcomes examined. Alcohol BI holds promise for reducing drinking and helping to improve health outcomes among patients with hypertension who screened positive for unhealthy drinking. However, similar associations were not observed among patients with T2D. More research is needed to understand the heterogeneity across diverse subpopulations and to study BI’s long-term public health impact.
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影响因子：
6
作者：
Babor, Thomas F.;Del Boca, Frances;Bray, Jeremy W.
通讯作者：
Bray, Jeremy W.
影响因子：
3.2
作者：
Gu, Qiuping;Burt, Vicki L.;Dillon, Charles F.
通讯作者：
Dillon, Charles F.
影响因子：
5.7
作者：
Abbo, Elmer D.;Zhang, Qi;Huang, Elbert S.
通讯作者：
Huang, Elbert S.
影响因子：
105.7
作者：
Kaner, Eileen;Bland, Martin;Drummond, Colin
通讯作者：
Drummond, Colin
DOI：
10.1136/bmj.h5651
发表时间：
2015-11-04
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Burke JF;Sussman JB;Kent DM;Hayward RA
通讯作者：
Hayward RA