Screening & Brief Intervention of Problem Drinking Women

描述（由申请人提供）：早期识别和干预问题饮酒妇女可能会避免更严重的，酒精滥用和依赖的不良后果。自1995年以来，非怀孕育龄妇女饮酒，特别是频繁饮酒和酗酒等危险做法没有改变。此外，12%的60岁及以上的女性经常饮酒超过推荐量，作为一个群体，尽管是美国最大的医疗保健用户群体，但筛查和诊断不足。筛查和干预虽然普遍有效，但自1995年以来，尽管美国国立卫生研究院制定了关于将妇女纳入临床试验的指导方针，但在仅占短暂干预试验受试者27%的妇女中尚未进行充分的测试。这是令人担忧的，因为由于新陈代谢的差异，女性一般更容易受到酒精的负面影响。这项随机试验的目的是测试筛查和短暂干预的有效性，对非怀孕妇女的风险饮酒与特定的医疗问题加剧了过量饮酒。医疗问题是女性因素不孕症、高血压和糖尿病，这些疾病治疗费用高，难以控制。552名有风险饮酒（超过NIAAA每周7杯或每次1-2杯的合理饮酒限制）和不孕症、高血压或糖尿病的非妊娠女性将随机接受执业护士提供的简短干预，使用个人健康选择步骤：女性指南或常规药物治疗。这项随机临床试验的具体目的是检验一个假设，即45%接受医学导向的短暂干预的妇女和30%的对照组妇女将在研究入组后12个月内达到NIAAA合理饮酒限制。这项针对女性的拟议研究响应了PA-02-168，该研究旨在研究医疗环境中的筛查和干预措施，并建立在我们之前对孕妇进行的简短干预措施的研究基础上。

DESCRIPTION (provided by applicant): Early identification and intervention among problem-drinking women may avert the more severe, adverse consequences of alcohol abuse and dependence. Among nonpregnant women of childbearing age, the use of alcohol and, in particular, the riskier practices of frequent and binge drinking have not changed since 1995. Moreover, 12% of women 60 years and older regularly drink in excess of recommended amounts, and as a group are underscreened and underdiagnosed, despite being the largest group of health care users in the United States. Screening and intervention, while generally effective, have not been adequately tested among women who account for only 27% of brief intervention trial subjects since 1995, despite the NIH guidelines on inclusion of women in clinical trials. This is concerning, as women in general are more vulnerable to alcohol's negative effects due to differences in metabolism. The purpose of this randomized trial is to test the effectiveness of screening and brief intervention for risk drinking by nonpregnant women with specific medical problems exacerbated by excessive alcohol consumption. The medical problems are female factor infertility, hypertension, and diabetes, conditions that are costly to treat and difficult to manage. 552 nonpregnant women with risk drinking (exceeding NIAAA sensible drinking limits of 7 drinks a week or 1-2 drinks per episode) and infertility, hypertension, or diabetes will be randomized to receive either a nurse practitioner delivered brief intervention using Personal Steps to a Healthy Choice: A Woman's Guide or medical treatment as usual. The specific aim of this randomized clinical trial is to test the hypothesis that 45% of the women who receive the medically oriented brief intervention and 30% of the control group will achieve NIAAA sensible drinking limits in the 12 months after study enrollment. This proposed targeted study of women responds to PA-02-168, which seeks research on screening and interventions in medical settings, and builds upon our previous research on brief interventions for pregnant women.