ALCOHOL INTERVENTION IN A LEVEL-1 TRAUMA CENTER

一级创伤中心的酒精干预

• 批准号: 3113179
• 负责人: LARRY GENTILELLO
• 金额: $ 31.99万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-07-01 至 1997-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3113179
• 关键词: alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse education; alcoholism /alcohol abuse prevention; alcoholism /alcohol abuse therapy; emergency health services; health care referral /consultation; health care service utilization; human subject; human therapy evaluation; injury prevention; questionnaires; trauma

Nearly 50% of patients admitted to trauma centers have an alcohol related injury, yet trauma centers currently treat the injury and ignore the underlying alcohol problem. The purpose of this study is to determine if incorporating a program of screening, intervention and referral in a trauma center reduces future alcohol related injuries and other morbidities. All patients admitted to a Level 1 Regional Trauma Center will be screened for alcohol problems using blood alcohol levels, biochemical markers, and brief screening questionnaire. Patients who screen positive will be randomized into an intervention or control group. The intervention group will receive feedback about their drinking status and brief motivational enhancement, and patients with moderate to high levels of alcohol dependence will receive in addition a referral to community-based alcohol treatment programs that are matched in their intensity to the assessed level of alcohol dependence. The control group will receive traditional trauma care; no discussion regarding alcohol dependence will be initiated by the study staff. An intake assessment will be obtained on intervention group patients in order to determine patient characteristics that predict a positive response to the intervention and successful behavioral change. A subset of control group patients will undergo the intake assessment, however, the majority will receive follow-up only. This will enable us to determine the reactivity of the assessment process while maintaining a pure control condition. The study assesses the appropriate role of the trauma center, screening, identification and triaging of patients with alcohol problems. We will evaluate the effect of the intervention at inducing treatment entry and completion, and perform long-term follow-up by using a statewide computerized tracking system to identify study patients subsequently admitted to any hospital in Washington State for trauma/non-trauma problems. Statewide computerized databases will also be used to assess subsequent health care costs, mortality, motor vehicle crashes and DWI violations. Patients will also be interviewed at six months and one year to assess other outcomes such as utilization of formal and self help services, drinking quantity and frequency, social consequences of drinking, and other behavioral outcomes. The study will enroll 1200 patients over 18 months, and will have the power to detect a 50% reduction in the trauma recidivism rate, and change as small as 20% in other follow up batteries. The project builds upon our recently completed study on the effect of alcohol on trauma management and outcome, as well as our pilot studies. If effective, the proposed intervention may provide an impetus for trauma centers to address alcohol problems as a routine component of care for the injured patient.

近50%的创伤中心收治的患者有酒精相关的 受伤，但创伤中心目前治疗受伤，忽视了 潜在的酒精问题。 本研究的目的是确定， 将筛查、干预和转诊方案纳入一个 创伤中心减少未来酒精相关的伤害和其他 病态 所有患者均入住1级区域创伤中心 将通过血液酒精含量来筛查酒精问题， 生化标志物和简短的筛查问卷。 的患者 筛选阳性者将被随机分配到干预组或对照组。 干预组将收到关于他们饮酒状况的反馈 和短暂的动机增强，以及中度至高度 酒精依赖程度将得到另外一个转介， 以社区为基础的酒精治疗计划， 酒精依赖程度的评估。 对照组 将接受传统的创伤护理;没有关于酒精的讨论 依赖性将由研究工作人员启动。 摄入量评估 将在干预组患者中获得，以确定 预测对药物有积极反应的患者特征 干预和成功的行为改变。 对照组的一个子集 患者将接受摄入量评估，然而，大多数患者将 只接受后续。 这将使我们能够确定反应性 同时保持一个纯粹的控制条件。 这项研究评估了创伤中心的适当作用，筛查， 酒精问题患者的识别和分类。 我们将在诱导治疗中评估干预的效果 输入和完成，并通过使用 全州范围的计算机化跟踪系统，以识别研究患者 随后在华盛顿州的任何一家医院住院， 创伤/非创伤问题。 全州范围的计算机化数据库也将 用于评估随后的医疗保健费用，死亡率，机动车 车祸和酒后驾车 病人也将在六点接受采访 评估其他成果，例如 正式和自助服务，饮酒量和频率，社会 饮酒的后果和其他行为后果。 这项研究将 在18个月内招募了1200名患者，并将有能力检测出 创伤复发率降低50%，变化小至20% 在其他后续电池中。 该项目建立在我们最近 完成了关于酒精对创伤处理的影响的研究， 以及我们的试点研究。 如果有效，建议 干预可能会为创伤中心提供动力， 作为受伤患者护理的常规组成部分。