ALCOHOL INTERVENTION IN A LEVEL-1 TRAUMA CENTER

一级创伤中心的酒精干预

• 批准号: 2045258
• 负责人: LARRY GENTILELLO
• 金额: $ 51.43万
• 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/2045258
• 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%住进创伤中心的患者与酒精有关 受伤，然而创伤中心目前治疗受伤而忽视 潜在的酒精问题。这项研究的目的是确定 将筛查、干预和转诊计划纳入 创伤中心减少未来与酒精有关的伤害和其他 病态。所有住进一级区域创伤中心的病人 将根据血液酒精水平进行酒精问题筛查， 生化标记物和简明筛选问卷。患者 将筛查阳性者随机分为干预组和对照组。 干预组将收到关于他们饮酒状况的反馈 和短暂的激励增强，以及中到高度的患者 酒精依赖程度将被转介到 以社区为基础的酒精治疗计划在他们的 酒精依赖的强度达到评估的水平。对照组 将接受传统的创伤护理；不讨论酒精问题 依赖将由研究人员发起。招生评估 将对干预组患者进行调查，以确定 患者的特征，预示着对 干预和成功的行为改变。控制组的一个子集 患者将接受摄入量评估，然而，大多数患者将 只接受后续跟进。这将使我们能够确定反应性 在保持一个纯粹的控制条件的同时，评估过程。 这项研究评估了创伤中心、筛查、 对有酒精问题的患者进行鉴定和分类。 我们将在诱导治疗时评估干预的效果 进入和完成，并通过使用 全州范围内识别研究患者的计算机化跟踪系统 后来在华盛顿州的任何一家医院接受治疗 创伤/非创伤问题。全州范围的计算机化数据库也将 用于评估后续的医疗费用、死亡率、机动车辆 撞车和DWI违规。患者也将在6点接受采访。 几个月和一年来评估其他结果，如利用 正式和自助服务、饮酒量和频率、社交 饮酒的后果，以及其他行为后果。这项研究将 在18个月内招募1200名患者，并将有能力检测到 创伤复发率下降50%，变化小至20% 在其他后续电池中。这个项目是建立在我们最近的基础上的 酒精对创伤处理和治疗的影响研究已完成 结果，以及我们的试点研究。如果有效，建议的 干预可能会为创伤中心解决酒精问题提供动力 将问题作为护理受伤病人的常规组成部分。