Patient and provider factors associated with receipt and delivery of brief interventions for unhealthy alcohol use in primary care.
Patient and provider factors associated with receipt and delivery of brief interventions for unhealthy alcohol use in primary care.
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DOI：
10.1111/acer.14702
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Sterling SA
中科院分区：
文献类型：
--
作者：
Lu Y;Chi FW;Parthasarathy S;Palzes VA;Kline-Simon AH;Metz VE;Weisner C;Satre DD;Campbell CI;Elson J;Ross TB;Awsare SV;Sterling SA
不健康的饮酒是一个严重且代价高昂的公共健康问题。酒精筛查和简单的干预措施有效地减少了不健康的酒精消费。然而，简短干预措施的收发率在不同的医疗保健环境中差异很大，对相关的患者和提供者因素知之甚少。这项研究基于电子健康记录中记录的简短干预措施，检查了与在综合医疗系统中接受不健康酒精使用的简短干预措施相关的患者和提供者因素。我们使用多水平Logistic回归模型对2014至2017年间筛查出不健康饮酒阳性的287551名成人初级保健患者(及其2952名提供者)进行了回顾分析。我们发现，在那些只超过每天或每周饮酒限制(而不是同时超过这两个限制)、女性、年龄较大、医疗复杂性较高以及已被诊断为酒精使用障碍的人中，接受短暂干预的几率较低。有其他不健康生活方式活动的患者(如吸烟、不运动/运动不足)更有可能接受短暂的干预。我们还发现，女性提供者和那些在卫生系统任职时间较长的人更有可能提供简短的干预。这些发现指出了可以有针对性地改善对短暂干预的普遍接受程度的特征。
Unhealthy alcohol use is a serious and costly public health problem. Alcohol screening and brief interventions are effective in reducing unhealthy alcohol consumption. However, rates of receipt and delivery of brief interventions vary significantly across healthcare settings, and relatively little is known about the associated patient and provider factors. This study examines patient and provider factors associated with the receipt of brief interventions for unhealthy alcohol use in an integrated healthcare system, based on documented brief interventions in the electronic health record. We retrospectively analyzed 287,551 adult primary care patients (and their 2,952 providers) who screened positive for unhealthy drinking between 2014 and 2017 using multi-level logistic regression model. We found lower odds of receiving a brief intervention among those exceeding only daily or weekly drinking limits (vs. exceeding both limits), female gender, older age groups, higher medical complexity and those already diagnosed with alcohol use disorders. Patients with other unhealthy lifestyle activities (e.g., smoking, no/insufficient exercise) were more likely to receive a brief intervention. We also found that female providers and those with longer tenure in the health system were more likely to deliver brief interventions. These findings point to characteristics that can be targeted to improve universal receipt of brief intervention.
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影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
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作者：
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影响因子：
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影响因子：
4.2
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通讯作者：
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