Corrigan John D, Bogner Jennifer, Hungerford Daniel W, Schomer Katherine
Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, Ohio 43210, USA.
J Trauma. 2010 Sep;69(3):722-6. doi: 10.1097/TA.0b013e3181e904cc.
Research on screening and brief interventions (SBI) for substance misuse has demonstrated efficacy in a variety of medical settings including emergency departments and trauma centers. However, SBI has not yet been evaluated for persons who incur traumatic brain injury (TBI)-a substantial patient subpopulation for whom substance-related problems are frequent. To examine whether research on SBI efficacy and effectiveness can be generalized to persons with TBI, a systematic review of the literature was conducted to analyze how TBI populations were included in previous studies and whether there was evidence of differential outcomes.
Peer-reviewed studies that investigated SBI for misuse of alcohol or other drugs, that were implemented in emergency departments or trauma centers, and that were published in English since 1985 were examined. From 174 articles initially identified, 28 studies were determined to meet inclusion criteria.
The review revealed that research conducted on SBI for injury populations systematically neglected patients with more severe TBI and those who presented with sufficient confusion that they could not provide informed consent.
Future effectiveness studies should examine barriers to routine clinical use of SBI and evaluate the generalizability of expected benefits to the full spectrum of injured patients. Researchers should also develop and evaluate systematic accommodations for persons with neurobehavioral impairments who would benefit from brief interventions for substance misuse.
针对药物滥用的筛查与简短干预（SBI）研究已在包括急诊科和创伤中心在内的多种医疗环境中证明了其有效性。然而，尚未对创伤性脑损伤（TBI）患者进行SBI评估——这是一个大量存在与药物相关问题的患者亚群。为了检验SBI有效性和效果的研究是否能推广到TBI患者，我们对文献进行了系统综述，以分析以往研究中如何纳入TBI人群以及是否存在不同结果的证据。
我们审查了自1985年以来发表的、在急诊科或创伤中心实施的、针对酒精或其他药物滥用调查SBI的同行评审研究。从最初确定的174篇文章中，确定有28项研究符合纳入标准。
该综述显示，针对受伤人群进行的SBI研究系统性地忽视了TBI更严重的患者以及那些因意识混乱无法提供知情同意的患者。
未来的效果研究应检查SBI常规临床应用的障碍，并评估预期益处对所有受伤患者的可推广性。研究人员还应针对那些将从药物滥用简短干预中受益的神经行为障碍患者，开发并评估系统性的适应性措施。
