Chossis Isabelle, Lane Claire, Gache Pascal, Michaud Pierre-André, Pécoud Alain, Rollnick Stephen, Daeppen Jean-Bernard
Alcohol Treatment Center, Lausanne University Hospital, Lausanne, Switzerland.
J Gen Intern Med. 2007 Aug;22(8):1144-9. doi: 10.1007/s11606-007-0240-2. Epub 2007 May 31.
Brief alcohol interventions (BAI) reduce alcohol use and related problems in primary care patients with hazardous drinking behavior. The effectiveness of teaching BAI on the performance of primary care residents has not been fully evaluated.
A cluster randomized controlled trial was conducted with 26 primary care residents who were randomized to either an 8-hour, interactive BAI training workshop (intervention) or a lipid management workshop (control). During the 6-month period after training (i.e., from October 1, 2003 to March 30, 2004), 506 hazardous drinkers were identified in primary care, 260 of whom were included in the study. Patients were interviewed immediately and then 3 months after meeting with each resident to evaluate their perceptions of the BAI experience and to document drinking patterns.
Patients reported that BAI trained residents: conducted more components of BAI than did controls (2.4 vs 1.5, p = .001); were more likely to explain safe drinking limits (27% vs 10%, p = .001) and provide feedback on patients' alcohol use (33% vs 21%, p = .03); and more often sought patient opinions on drinking limits (19% vs 6%, p = .02). No between-group differences were observed in patient drinking patterns or in use of 9 of the 12 BAI components.
The BAI-trained residents did not put a majority of BAI components into practice, thus it is difficult to evaluate the influence of BAI on the reduction of alcohol use among hazardous drinkers.
简短酒精干预(BAI)可减少有危险饮酒行为的初级保健患者的酒精使用及相关问题。关于教授BAI对初级保健住院医师表现的有效性尚未得到充分评估。
对26名初级保健住院医师进行了一项整群随机对照试验,他们被随机分配到一个8小时的互动式BAI培训工作坊(干预组)或一个血脂管理工作坊(对照组)。在培训后的6个月期间(即2003年10月1日至2004年3月30日),在初级保健中识别出506名危险饮酒者,其中260名被纳入研究。在与每位住院医师会面后立即对患者进行访谈,然后在3个月后再次访谈,以评估他们对BAI体验的看法并记录饮酒模式。
患者报告称,接受BAI培训的住院医师:进行的BAI组成部分比对照组更多(2.4对1.5,p = .001);更有可能解释安全饮酒限量(27%对10%,p = .001)并就患者的酒精使用提供反馈(33%对21%,p = .03);并且更经常征求患者对饮酒限量的意见(19%对6%,p = .02)。在患者饮酒模式或12个BAI组成部分中的9个的使用方面未观察到组间差异。
接受BAI培训的住院医师并未将大多数BAI组成部分付诸实践,因此难以评估BAI对减少危险饮酒者酒精使用的影响。