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全科医生对酒精滥用患者实施的简短干预项目的一年评估

[One-year assessment of the brief intervention program carried out by general practitioners in patients with alcohol misuse].

作者信息

Casset Jean-Claude, Bérenger Pascal, Bosson Jean-Luc, Lacroix Alice

机构信息

Réseau départemental d'ALcoologie de la Savoie (RéALS), 73000 Chambéry, France.

出版信息

Rev Prat. 2008 Jun 30;58(12 Suppl):25-31.

Abstract

GOALS

As part of the integration process of the long-term, large-scale RPIB program ("repérage précoce et intervention brève" or early screening and brief intervention program) conducted in general practice in the French department of Savoie, we believed it was essential to provide general practitioners planning to initiate the RPIB program with an assessment of the work carried out by their local colleagues. For 6months, 29 attending general practitioners from Savoie, France, screened 5,552 patients on a random basis regarding their alcohol consumption. They performed one or more brief interventions in most of the patients misusing alcohol. The impact at one year was analysed in these patients.

METHODOLOGY

The tools used were declared consumption of alcohol (DCA) and the FACE questionnaire, which allowed classifying the patients on the basis of their use of alcohol (French Society of Alcohology): use (consumption below the WHO threshold), misuse (risky use), harmful use, alcohol dependence. The patients displaying misuse were subject to a brief intervention (set up in France by the ANPAA-BMCM team*), as recommended by WHO. One year later, the physicians re-evaluated the DCA and FACE score in these patients. The analysis consisted in comparing the progress of the DCA and checking whether the patients initially displaying misuse could now be classified among the use group.

RESULTS

The following significant changes were observed (Student's test, Chi2, logistic regression): the DCA decreased on average from 20 to 14.9 glasses per week; 32,5% of the 400patients misusing alcohol were classified in the use group; 38,2% of patients lowered their consumption by at least 30%; women with a FACE score of 4 had a mean consumption of 7 glasses per week (a figure well under the WHO threshold) and the percentage of women over this threshold was low (6%).

CONCLUSION

These results agree with those of the international publications. The french FACE tool seems to require slight modification (brief intervention should not be considered in women with a score of 4: in most cases, they do not seem to have an alcohol misuse issue).

摘要

目标

作为在法国萨瓦省全科医疗中开展的长期、大规模RPIB项目(“早期筛查与简短干预项目”)整合过程的一部分,我们认为有必要为计划启动RPIB项目的全科医生提供对当地同事所开展工作的评估。在6个月的时间里,来自法国萨瓦省的29名全科医生随机筛查了5552名患者的饮酒情况。他们对大多数酗酒患者进行了一次或多次简短干预。对这些患者一年后的情况进行了分析。

方法

使用的工具是酒精申报消费(DCA)和FACE问卷,这使得能够根据患者的酒精使用情况(法国酒精学协会)对患者进行分类:使用(消费量低于世界卫生组织阈值)、滥用(危险使用)、有害使用、酒精依赖。对显示有滥用情况的患者,按照世界卫生组织的建议,进行了简短干预(由ANPAA - BMCM团队*在法国设立)。一年后,医生重新评估了这些患者的DCA和FACE评分。分析包括比较DCA的进展情况,并检查最初显示有滥用情况的患者现在是否可以归类到使用组。

结果

观察到以下显著变化(学生检验、卡方检验、逻辑回归):DCA平均每周从20杯降至14.9杯;400名酗酒患者中有32.5%被归类到使用组;38.2%的患者饮酒量至少降低了30%;FACE评分为4的女性平均每周饮酒7杯(远低于世界卫生组织阈值),超过该阈值的女性比例较低(6%)。

结论

这些结果与国际出版物的结果一致。法国的FACE工具似乎需要稍作修改(评分为4的女性不应进行简短干预:在大多数情况下,她们似乎没有酗酒问题)。

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