Guth Sarah, Lindberg Sarah A, Badger Gary J, Thomas Colleen S, Rose Gail L, Helzer John E
University of Vermont, College of Medicine, Health Behavior Research Center, UHC #4570H3, 1 South Prospect Street, Burlington, Vermont 05401, USA.
J Stud Alcohol Drugs. 2008 Mar;69(2):243-50. doi: 10.15288/jsad.2008.69.243.
Randomized trials examining the effects of brief alcohol interventions by primary care providers have consistently excluded individuals with alcohol dependence. The purpose of this study was to examine whether a diagnosis of alcohol dependence, according to the criteria in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, predicted differential effectiveness of a brief intervention (BI).
Retrospective analyses were performed on participants (N = 326) enrolled in a randomized trial designed to examine the impact of interactive voice response following BI. All participants had received a BI from their primary care provider before enrolling in the study. Daily consumption data were collected using the Timeline Followback for the period before the BI (mean = 71 days) and for 6 months following the BI. We compared nondependent and dependent participants on a number of consumption-based outcomes.
Dependent participants had significantly higher pre-BI consumption. At the index assessment (median =15 days after BI), both dependent and nondependent participants reported significant reductions in total drinks per week and drinking days per week after BI. Dependent participants significantly reduced their drinks per drinking day. After BI, dependent participants no longer differed significantly from nondependent participants on these measures. Similar decreases from before BI were observed in both groups through 6 months, although dependent participants drank on fewer days and significantly more on days on which they drank than did nondependent participants. Regression analyses showed that baseline consumption was the only significant predictor of post-BI consumption.
We found no evidence that dependent participants realized less benefit on measures of alcohol consumption following a BI than nondependent participants.
考察初级保健提供者进行简短酒精干预效果的随机试验一直将酒精依赖者排除在外。本研究的目的是根据《精神疾病诊断与统计手册》第四版标准诊断的酒精依赖是否能预测简短干预(BI)的不同效果。
对参与一项旨在考察BI后交互式语音应答影响的随机试验的参与者(N = 326)进行回顾性分析。所有参与者在参加研究前均已从其初级保健提供者处接受过BI。使用时间线追溯法收集BI前阶段(平均 = 71天)和BI后6个月的每日饮酒数据。我们在一些基于饮酒量的结果方面比较了非依赖者和依赖者。
依赖者在BI前的饮酒量显著更高。在指标评估时(BI后中位数 = 15天),依赖者和非依赖者均报告BI后每周总饮酒量和每周饮酒天数显著减少。依赖者显著减少了每次饮酒日的饮酒量。BI后,依赖者在这些指标上与非依赖者不再有显著差异。两组在6个月内均观察到与BI前相比有类似程度的下降,尽管依赖者饮酒天数较少,但在饮酒日的饮酒量显著多于非依赖者。回归分析表明,基线饮酒量是BI后饮酒量的唯一显著预测因素。
我们没有发现证据表明依赖者在BI后饮酒量指标上比非依赖者获益更少。