Grossberg Paul M, Brown David D, Fleming Michael F
Department of Pediatrics, University of Wisconsin, Madison, Wis, USA.
Ann Fam Med. 2004 Sep-Oct;2(5):474-80. doi: 10.1370/afm.122.
High-risk alcohol use in persons 18 to 30 years of age is a critical public health problem. It is the number 1 cause of death in this population. This article reports the results of a subanalysis of young adults (aged 18 to 30 years) who participated in Project TrEAT (Trial of Early Alcohol Treatment) conducted in the offices of 64 primary care physicians located in 10 counties in southern Wisconsin.
Project TrEAT was a randomized clinical trial designed to test the efficacy of a brief intervention protocol to reduce alcohol use, improve health status, and decrease health care utilization. A total of 226 young adults were randomly assigned to either a usual care or brief intervention group.
There were no significant differences between the 2 groups at baseline on a number of potential confounders. During the 4-year follow-up period, there were significant reductions in number of persons drinking more than 3 drinks per day, average 7-day alcohol use, number of persons drinking 6 or more drinks per occasion, and number of binge drinking episodes in the previous 30 days (P < .01 to P < .001). There were also significant differences (P < .05) in emergency department visits (103 vs 177), motor vehicle crashes (9 vs 20), total motor vehicle events (114 vs 149), and arrests for controlled substance or liquor violation (0 vs 8).
In this 4-year subanalysis of young adults who participated in Project TrEAT, we found long-term reductions in high-risk drinking behaviors and consequences. The findings of this study support more widespread implementation of brief interventions in primary care settings.
18至30岁人群的高风险饮酒是一个关键的公共卫生问题。它是该人群的首要死因。本文报告了参与“早期酒精治疗试验(TrEAT项目)”的18至30岁年轻成年人的亚分析结果,该项目在威斯康星州南部10个县的64名初级保健医生的办公室开展。
TrEAT项目是一项随机临床试验,旨在测试一种简短干预方案在减少饮酒、改善健康状况和降低医疗保健利用率方面的疗效。共有226名年轻成年人被随机分配到常规护理组或简短干预组。
两组在基线时的一些潜在混杂因素方面没有显著差异。在4年的随访期内,每天饮酒超过3杯的人数、平均7天饮酒量、每次饮酒6杯或更多的人数以及过去30天内的暴饮次数均有显著减少(P<.01至P<.001)。在急诊就诊(103次对177次)、机动车碰撞事故(9次对20次)、机动车事故总数(114次对149次)以及因受控物质或酒类违规被捕(0次对8次)方面也存在显著差异(P<.05)。
在对参与TrEAT项目的年轻成年人进行的这项4年亚分析中,我们发现高风险饮酒行为及其后果有长期减少。本研究结果支持在初级保健环境中更广泛地实施简短干预。