PATIENTS, CLINICS, AND SYSTEMS: SCREENING FOR ALCOHOL

患者、诊所和系统：酒精筛查

• 批准号: 6371243
• 负责人: GRACE CHANG
• 金额: $ 11.61万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-24 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6371243
• 关键词: Medicare /Medicaid; alcoholism /alcohol abuse; bone marrow transplantation; chronic myelogenous leukemia; clinical research; comorbidity; drug abuse therapy; functional ability; health care policy; health care service utilization; health services research tag; homologous transplantation; human subject; human therapy evaluation; long term survivor; longitudinal human study; managed care; mass screening; neoplasm /cancer surgery; neoplasm /cancer transplantation; training

The majority of patients with alcohol problems present to general medical and other clinical settings, rather than directly to alcohol treatment. The consequences of untreated alcohol problems are well known, and include a whole range of medical and social complications. The identification and treatment of alcohol problems, when patients present for prenatal care, emergency services, or a medical appointment, has been a longstanding clinical research interest. A Midcareer Investigator Award in Clinical Research would allow the applicant to focus on patient-oriented research interests during a critical professional period. The purpose of the current project, "Alcohol Abuse in Bone Marrow Transplant," is to test the hypothesis that alcohol abuse or dependence has an adverse impact on survival after bone marrow transplant, the second most frequent major organ transplant in the United States and the transplant with the least limited donor organ supply. A prospective cohort study of 124 patients with Chronic Myeloid Leukemia undergoing allogeneic bone marrow transplant is underway. The purpose of the proposed project, "Alcohol Screening in Medicaid Managed Care," is to test the hypothesis that routine alcohol and substance abuse screening of Medicaid members at health plan (HMO) enrollment is less effective than alcohol and substance abuse screening at the HMO primary care site. A sample of 2,000 Medicaid enrollees screened at enrollment will compared with a sample of 715 patients who will be screened for alcohol and substance abuse as they initiate care at primary care HMO sites. Their utilization of alcohol and substance abuse treatment, psychiatric and medical treatment for 12 months subsequent to screening will be compared. A sample of 150 patients with positive primary care screens will be studied more intensively. Both of these studies will focus on patients, but will have important practice and policy implications, as transplant medicine and managed care are increasingly prevalent and underscore the need for alcohol and drug screening of patients.

大多数有酒精问题的患者会到一般医疗机构和其他临床机构就诊，而不是直接接受酒精治疗。 未经治疗的酗酒问题的后果是众所周知的，包括一系列的医疗和社会并发症。 当患者接受产前护理、紧急服务或医疗预约时，酒精问题的识别和治疗一直是临床研究的长期兴趣。 临床研究领域的职业中期研究员奖将使申请人能够在关键的职业时期专注于以患者为导向的研究兴趣。 当前项目“骨髓移植中的酒精滥用”的目的是检验这样的假设：酒精滥用或依赖对骨髓移植后的生存产生不利影响，骨髓移植是美国第二常见的主要器官移植，也是供体器官供应最有限的移植。 一项针对 124 名接受同种异体骨髓移植的慢性粒细胞白血病患者的前瞻性队列研究正在进行中。 拟议项目“医疗补助管理护理中的酒精筛查”的目的是检验以下假设：在健康计划 (HMO) 登记时对医疗补助成员进行的常规酒精和药物滥用筛查不如 HMO 初级保健机构的酒精和药物滥用筛查有效。 登记时筛查的 2,000 名医疗补助参与者样本将与在初级保健 HMO 站点开始护理时接受酒精和药物滥用筛查的 715 名患者样本进行比较。 我们将比较他们在筛查后 12 个月内对酒精和药物滥用治疗、精神科治疗和药物治疗的使用情况。 将对 150 名初级保健筛查呈阳性的患者样本进行更深入的研究。 这两项研究都将重点关注患者，但将具有重要的实践和政策影响，因为移植医学和管理式护理越来越普遍，并强调对患者进行酒精和药物筛查的必要性。