Martin E, Canavan A, Butler R
University of Luton.
Br J Gen Pract. 1998 Oct;48(435):1679-82.
The government encourages general practitioners (GPs) to become involved in caring for drug users. However, in some areas of the country, including Bedford, secondary care support is inadequate. GPs in these areas have to decide how to cope with such patients entirely within general practice.
To assess the characteristics and quality of care given without secondary care support to drug users by one practice in Bedford over a decade.
A search was made of the practice computer for all patients with a problem title of 'addiction drug' between 1986 and 1995. The age, sex, social characteristics, and drug history were recorded.
One hundred and ninety-two patients were found, of which 155 took part in the practice programme; i.e. they consulted more than three times. Forty-three patients (37%) who took part and were prescribed Methadone were prescribed this drug as ampoules. Sixty-three patients (40.6%) who took part in the programme stopped using drugs. Thirty-two (33.6%) of the Methadone users became abstinent. A higher proportion of women (13-48%) than men (19-27.7%) stopped using Methadone (P = 0.019). Among patients who had a stable lifestyle, a higher proportion had been prescribed ampoules than mixture (22 out of 28: 78.6%; P = 0.001). Similarly, of those who had a job, eight out of 11 (72%; P = 0.037) had been prescribed methadone ampoules. Two-thirds of all patients prescribed amphetamines stopped using drugs.
Long-term care of drug users entirely within general practice is feasible. Among those prescribed methadone ampoules, a higher than average proportion had stable lifestyles and had a stable job.
政府鼓励全科医生(GPs)参与对吸毒者的护理。然而,在该国的一些地区,包括贝德福德,二级护理支持不足。这些地区的全科医生必须完全在全科医疗范围内决定如何应对此类患者。
评估贝德福德一家诊所十年来在没有二级护理支持的情况下为吸毒者提供护理的特征和质量。
在诊所电脑中搜索1986年至1995年间所有问题标题为“成瘾药物”的患者。记录年龄、性别、社会特征和用药史。
共找到192名患者,其中155名参与了诊所项目;即他们咨询次数超过三次。参与并被开具美沙酮的43名患者(37%)是以安瓿形式开具此药的。参与该项目的63名患者(40.6%)停止吸毒。32名(33.6%)美沙酮使用者戒毒。停止使用美沙酮的女性比例(13 - 48%)高于男性(19 - 27.7%)(P = 0.019)。在生活方式稳定的患者中,开具安瓿剂的比例高于合剂(28名中的22名:78.6%;P = 0.001)。同样,有工作的患者中,11名中有8名(72%;P = 0.037)被开具了美沙酮安瓿剂。所有开具苯丙胺类药物的患者中有三分之二停止吸毒。
完全在全科医疗范围内对吸毒者进行长期护理是可行的。在开具美沙酮安瓿剂的患者中,生活方式稳定且有稳定工作的比例高于平均水平。