筛查、简短干预和转介治疗（SBIRT）：波兰急诊部一项随机对照临床试验的 12 个月结果。
Screening, brief intervention, and referral to treatment (SBIRT): 12-month outcomes of a randomized controlled clinical trial in a Polish emergency department.
机构信息
Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, California, USA.
出版信息
Alcohol Clin Exp Res. 2010 Nov;34(11):1922-8. doi: 10.1111/j.1530-0277.2010.01281.x.
BACKGROUND
A randomized controlled trial of screening, brief intervention, and referral to treatment (SBIRT) among at-risk (based on average number of drinks per week and drinks per drinking day) and dependent drinkers was conducted in an emergency department (ED) among 446 patients 18 and older in Sosnowiec, Poland.
METHODS
Patients were recruited over a 23-week period (4:00 pm to 12:00 midnight) and randomized to 1 of 3 conditions: screened-only (n = 147), assessed (n = 152), and intervention (n = 147). Patients in the assessed and intervention conditions were blindly reassessed via a telephone interview at 3 months, and all 3 groups were assessed at 12 months (screened-only = 92, assessed = 99, and intervention = 87).
RESULTS
No difference was found across the 3 conditions in at-risk drinking at 12 months, as the primary outcome variable, or in decrease in the number of drinks per drinking day, with all 3 groups showing a significant reduction in both. Significant declines between baseline and 12 months in secondary outcomes of the RAPS4, number of drinking days per week, and the maximum number of drinks on an occasion were seen only for the intervention condition, and in negative consequences for both the assessment and intervention conditions.
CONCLUSIONS
Data suggest that improvements in drinking outcomes found in the assessment condition were not because of assessment reactivity, with both the screened and intervention conditions demonstrating greater (although nonsignificant) improvement than the assessed condition. Only those in the intervention condition showed significant improvement in all outcome variables from baseline to 12-month follow-up. Although group by time interaction effects were not found to be significant, these findings suggest that declines in drinking measures for those receiving a brief intervention can be maintained at long-term follow-up.
背景
在波兰索斯诺维茨的一家急诊科，对处于危险之中（根据每周饮酒量和每日饮酒量来衡量）和依赖饮酒的患者进行了一项针对筛查、简短干预和转介治疗（SBIRT）的随机对照试验。
方法
患者在 23 周的时间内（下午 4 点至午夜 12 点）被招募，并随机分为 3 组：仅筛查组（n = 147）、评估组（n = 152）和干预组（n = 147）。评估组和干预组的患者通过电话访谈在 3 个月时进行盲法重新评估，所有 3 组在 12 个月时进行评估（仅筛查组 = 92，评估组 = 99，干预组 = 87）。
结果
在 12 个月时，主要结局变量即高危饮酒，以及每日饮酒量的减少，在这 3 个条件之间没有差异，所有 3 个组都显示出这两个方面的显著减少。仅干预组在 RAPS4、每周饮酒天数和单次最大饮酒量等次要结局方面出现了从基线到 12 个月的显著下降，而且评估和干预组的负面后果都有所下降。
结论
数据表明，在评估条件下发现的饮酒结果的改善不是因为评估反应性，筛查和干预条件都显示出比评估条件更大（尽管无统计学意义）的改善。只有干预组在所有结局变量上都显示出从基线到 12 个月随访的显著改善。尽管未发现组间时间交互效应有统计学意义，但这些发现表明，接受简短干预的患者的饮酒量下降可以在长期随访中得到维持。
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