Brief physician- and nurse practitioner-delivered counseling for high-risk drinkers -: Does it work?
Brief physician- and nurse practitioner-delivered counseling for high-risk drinkers -: Does it work?
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DOI：
10.1001/archinte.159.18.2198
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发表时间：
1999-10-11
影响因子：
--
通讯作者：
Hebert, JR
中科院分区：
文献类型：
--
作者：
Ockene, JK;Adams, A;Hebert, JR
背景资料：有必要为初级保健提供者有一个简短的有效的方法来干预高危饮酒者在定期outpatientvision.Objective：为了确定是否简短的医生和护士提供咨询干预是有效的一部分，常规初级保健在减少酒精消费的高危饮酒者。学术医疗中心附属的初级保健实践网站被随机分配到特殊干预或常规护理。从筛选的9772例患者寻求常规医疗保健与他们的初级保健提供者，530名高危饮酒者进入研究。特别干预包括培训提供者在一个简短的（5至10分钟）以病人为中心的咨询干预，和一个办公室支持系统，筛选病人，提示提供者进行干预，并提供病人的教育材料。主要结果的措施是从基线到6个月的酒精使用的变化，每周饮酒量和频率的狂饮epissions.Results：在特殊干预和常规护理组的参与者是相似的重要背景变量和潜在的混杂因素，除了特殊干预的参与者有显着较高的基线水平的酒精使用（P = .01）。在6个月的随访中，在91%提供随访信息的队列中，在调整年龄、性别和基线饮酒量后，饮酒量显著减少（特殊干预，每周-5.8杯;常规护理，每周-3.4杯; P = 0.001）。这项研究提供的证据表明，作为常规初级保健的一部分，医生或护士提供的筛查和非常简短（5至10分钟）的建议和咨询显着减少了高危饮酒者的饮酒量。
Background: There is a need for primary care providers to have brief effective methods to intervene with highrisk drinkers during a regular outpatient visit.Objective: To determine whether brief physician- and nurse practitioner-delivered counseling intervention is efficacious as part of routine primary care in reducing alcohol consumption by high-risk drinkers.Methods: Academic medical center-affiliated primary care practice sites were randomized to special intervention or to usual care. From a screened population of 9772 patients seeking routine medical care with their primary care providers, 530 high-risk drinkers were entered into the study. Special intervention included training providers in a brief (5- to 10-minute) patient-centered counseling intervention, and an office support system that screened patients, cued providers to intervene, and made patient education materials available. The primary outcome measures were change in alcohol use from baseline to 6 months as measured by weekly alcohol consumption and frequency of binge drinking episodes.Results: Participants in the special intervention and usual care groups were similar on important background variables and potential confounders except that special intervention participants had significantly higher baseline levels of alcohol usage (P = .01). At 6-month follow-up, in the 91% of the cohort who provided follow-up information, alcohol consumption was significantly reduced when adjusted for age, sex, and baseline alcohol usage (special intervention, -5.8 drinks per week; usual care, -3.4 drinks per week; P = .001).Conclusions: This study provides evidence that screening and very brief (5- to 10-minute) advice and counseling delivered by a physician or nurse practitioner as part of routine primary care significantly reduces alcohol consumption by high-risk drinkers.