Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings.
Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings.
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DOI：
10.1111/add.16064
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发表时间：
2023-03
期刊：
影响因子：
6
通讯作者：
Hart, M. Kate
中科院分区：
文献类型：
--
作者：
Scott, Christy K.;Dennis, Michael L.;Grella, Christine E.;Watson, Dennis P.;Davis, Jordan P.;Hart, M. Kate
关键词：
康复管理检查 (RMC) 已确定将患者与药物滥用障碍 (SUD) 治疗联系起来的有效性。这项研究测试了与单独使用 SBIRT 相比，使用 RMC 与筛查、简短干预和转诊治疗 (SBIRT) 相结合是否可以改善初级保健患者转诊至 SUD 治疗的联系。照常进行 SBIRT (n = 132) 与 SBIRT 加初级保健恢复管理检查 (RMC-PC) (n = 134) 的随机对照试验，并在基线后 3 个月进行随访评估。美国有四个符合联邦资格的医疗中心，为低收入人群提供服务。 SBIRT 后转诊至 SUD 治疗的初级保健患者（n = 266，64% 男性，80% 黑人，平均年龄 48.3 岁 [范围，19-53]）。单独 SBIRT（对照条件）与 SBIRT + RMC-PC（实验条件）进行比较。主要结局是过去 3 个月内接受 SUD 治疗的任何天数。关键的次要结局是总体和护理水平的 SUD 治疗天数、戒酒和其他药物 (AOD) 的天数以及使用特定物质的天数，所有这些均基于自我报告。在 3 个月的随访中，与仅 SBIRT 相比，分配至 SBIRT + RMC-PC 的患者 (n = 134) 接受任何 SUD 治疗的几率更高（46% vs 20%；调整后优势比 = 4.50 [2.49, 8.48]），包括进入住院治疗和强化门诊治疗的比例更高。他们还报告了更多的治疗天数（14.45 vs 7.13；d = +0.26），更多的戒酒天数（41.3 vs 31.9；d = +0.22），以及更少的饮酒天数（27.14 vs 36.31；d = −0.25）和大麻（19.49 vs 28.6；d = −0.20)。康复管理检查与筛查、简短干预和转诊治疗相结合是改善需要药物滥用障碍治疗的初级保健患者 3 个月以上联系的有效策略。
Recovery management checkups (RMC) have established efficacy for linking patients to substance use disorder (SUD) treatment. This study tested whether using RMC in combination with screening, brief intervention, and referral to treatment (SBIRT), versus SBIRT alone, can improve linkage of primary care patients referred to SUD treatment. A randomized controlled trial of SBIRT as usual (n = 132) versus SBIRT plus recovery management checkups for primary care (RMC‐PC) (n = 134) with follow‐up assessments at 3 months post‐baseline. Four federally qualified health centers in the United States serving low‐income populations. Primary care patients (n = 266, 64% male, 80% Black, mean age, 48.3 [range, 19–53]) who were referred to SUD treatment after SBIRT. SBIRT alone (control condition) compared with SBIRT + RMC‐PC (experimental condition). The primary outcome was any days of SUD treatment in the past 3 months. Key secondary outcomes were days of SUD treatment overall and by level of care, days of alcohol and other drug (AOD) abstinence, and days of using specific substances, all based on self‐report. At 3‐month follow‐up, those assigned to SBIRT + RMC‐PC (n = 134) had higher odds of receiving any SUD treatment (46% vs 20%; adjusted odds ratio = 4.50 [2.49, 8.48]) compared with SBIRT only, including higher rates of entering residential and intensive outpatient treatment. They also reported more days of treatment (14.45, vs 7.13; d = +0.26), more days abstinent (41.3 vs 31.9; d = +0.22), and fewer days of using alcohol (27.14, vs 36.31; d = −0.25) and cannabis (19.49, vs 28.6; d = −0.20). Recovery management checkups in combination with screening, brief intervention, and referral to treatment are an effective strategy for improving linkage of primary care patients in need to substance use disorder treatment over 3 months.
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