Brief Alcohol Intervention to Reduce At-Risk Drinking Among Type 2 Diabetes

描述（由申请人提供）：高危饮酒在糖尿病患者中很常见，与较差的糖尿病治疗依从性和结局相关。虽然到目前为止，在这一人群中减少酒精使用的方法在很大程度上尚未探索，但减少危险饮酒的简短干预措施已在其他患者人群中得到充分验证，并有望减少糖尿病患者的危险饮酒，从而改善糖尿病治疗依从性和结果。我们假设，相对于一般的健康教育，在标准的糖尿病治疗中加入简短的酒精干预，将减少糖尿病患者的总饮酒量和大量饮酒的天数。此外，我们预计接受短暂酒精干预的参与者比接受一般健康教育的参与者有更好的糖尿病治疗依从性和结果。我们还预计，减少饮酒将介导短暂酒精干预对糖尿病治疗依从性和结果的影响。此外，我们还将探索潜在的治疗机制。这项研究是一项随机、两组设计，随着时间的推移进行重复测量，将护士提供的简短酒精干预加标准糖尿病治疗与一般健康教育进行比较。在这项研究中，我们将从一家大型城市初级保健诊所招募240名2型糖尿病患者。为了有资格参加这项研究，患者必须报告有饮酒风险和糖尿病治疗依从性差的情况。这项研究有望为2型糖尿病患者建立一种有效的干预方法，这些患者是高危饮酒者，在没有改变其饮酒行为的情况下，可能会维持较差的糖尿病治疗依从性和结果，导致糖尿病相关的发病率和死亡率增加。本研究中提出的干预措施代表了一种减少糖尿病患者危险饮酒的新方法，如果有效，可以很容易地整合到各种治疗环境中的糖尿病治疗中。此外，这项研究将提供有关酒精使用和糖尿病治疗依从性和结果之间的关系以及2型糖尿病患者中酒精使用变化机制的有价值的信息。

DESCRIPTION (provided by applicant): At-risk drinking is common among diabetic patients and is associated with inferior diabetes treatment adherence and outcomes. While methods for reducing alcohol use in this population have been largely unexplored to date, brief interventions to reduce at-risk drinking have been well-validated in other patient populations and offer the promise to reduce at-risk drinking among diabetic patients, resulting in improved diabetes treatment adherence and outcomes. We hypothesize that adding a brief alcohol intervention to standard diabetes treatment, relative to general health education, will reduce overall drinking volume and heavy drinking days among diabetic patients who are at-risk drinkers. Furthermore, we expect participants who receive the brief alcohol intervention to have better diabetes treatment adherence and outcomes than the participants receiving general health education. We also expect that reduced alcohol consumption will mediate the effect of the brief alcohol intervention on diabetes treatment adherence and outcomes. In addition, we will explore potential treatment mechanisms. The proposed study is a randomized, two-group design with repeated measures over time, comparing a brief nurse-delivered alcohol intervention plus standard diabetes treatment to general health education. For this study, we will recruit a sample of 240 Type 2 diabetic patients from a large, urban primary care clinic. To be eligible for the study, patients must report at-risk drinking and poor diabetes treatment adherence. This study holds the promise of establishing an efficacious intervention approach for Type 2 diabetic patients who are at-risk drinkers and are likely to maintain poor diabetes treatment adherence and outcomes in the absence of a change in their drinking behavior, resulting in increased diabetes-related morbidity and mortality. The intervention proposed in this study represents a novel approach to reducing at-risk drinking among diabetic patients that, if efficacious, can be readily integrated into the treatment of diabetes in a variety of treatment settings. In addition, this study will provide valuable information regarding the relationship between alcohol use and diabetes treatment adherence and outcomes and about the mechanisms of change in alcohol use among Type 2 diabetic patients who are at-risk drinkers.