Doctor-Older Patient Communication About Alcohol Misuse

描述（由申请人提供）：危险的酒精使用和处方药滥用对美国中老年的生产力和健康有重大影响。联邦共识小组、NIAAA和AMA建议初级保健临床医生对老年患者中出现的最迫切需要的物质使用问题和障碍进行筛查（Blow, 1998）。简短的、以办公室为基础的咨询和其他经过测试的策略是有效和具有成本效益的。然而，只有不到20%的医生认为自己准备好评估或治疗酒精和药物滥用。新英格兰研究机构建议开发和评估一个互动式的基于网络的、cme认证的继续教育项目，以促进医生与老年患者之间关于酒精和处方药滥用的沟通。本课程将结合医老关系以及治疗和预防障碍的科学知识，介绍由NIAAA（2003）制定的医生指南和美国医学协会（1997）针对老年人的指南。该项目将是第一个1)综合现有的针对老年人的建议和评估技术，2)最大限度地利用网络技术，在初级保健领域（老年人卫生保健的第一线）描绘有效的药物和酒精筛查的“科学”和“艺术”。在新英格兰研究机构的一组有成就的研究人员和网络生产者将在内容开发由Jeffrey H. Samet， MD，药物滥用医学教育和研究协会的过去主席和2个其他临床顾问协助。第一阶段的具体目标是：1)为完整的基于网络的课程制定内容大纲；2)定义和测试技术设计和用户适合的格式；3)根据目标群体访谈的输入，充分开发一个原型章节；（四）对拟建项目进行可行性评估；5)概述第二阶段计划，包括对设计和格式的改进建议，制作完整课程的时间表（具有CME认证），以及完整的评估计划。完成的程序将通过NERI的电子商务网站提供，并向美国25万初级保健医生销售。该程序也可用于医学院和高级实习护士。

DESCRIPTION (provided by applicant): Risky alcohol use and prescription drug misuse have a substantial impact on the productivity and health of middle aged and older Americans. Federal Consensus Panels, the NIAAA, and the AMA have recommended that primary care clinicians screen adult patients for substance use problems and disorders with the most pressing needs emerging among older patients (Blow, 1998). Brief, office-based counseling and other tested strategies are efficacious and cost-effective. Yet less than 20% of physicians consider themselves prepared to assess or treat alcohol and drug misuse. The New England Research Institutes proposes to develop and evaluate an interactive Web-based, CME-accredited continuing education program in doctor-older patient communication about alcohol and prescription drug misuse. This program will present the physician guidelines established by NIAAA (2003) and the elder-specific guidelines of the American Medical Association (1997) in combination with scientific knowledge about physician-older patient relationships and barriers to treatment and prevention. The program will be the first to 1) synthesize established recommendations and assessment techniques for older persons and 2) maximize use of Web technologies to portray both the "science" and the "art" of effective drug and alcohol screening in the primary care arena, the front line of older adults' health care. A team of accomplished researchers and web producers at the New England Research Institutes will be assisted in content development by Jeffrey H. Samet, MD, past president of the Association for Medical Education and Research in Substance Abuse and 2 other clinical consultants. The Specific Aims of Phase I are to: 1) develop the content outline for the full Web-based program; 2) define and test the technical design and user-appropriate format; 3) fully develop a prototype chapter with input from target-group interviews; 4) conduct a feasibility assessment of the proposed program; and, 5) outline a Phase II plan with proposed refinements to the design and format, a schedule for producing the full-length program (with CME- accreditation), and a full evaluation plan. The completed program will be available through NERI's e- commerce site and marketed to the quarter million primary care physicians in the US. The program can also be used in medical schools and by advance practice nurses.