Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201 USA.
Drug Alcohol Depend. 2011 Nov 1;118(2-3):152-7. doi: 10.1016/j.drugalcdep.2011.03.012. Epub 2011 Apr 9.
Recent years have seen increased diffusion of Screening, Brief Intervention, Referral and Treatment (SBIRT) in healthcare environments. This study examined the relationship between substance use outcomes and service variables within the SBIRT model.
Over 55,000 adult patients were screened for substance misuse at rural health clinics throughout New Mexico during the SBIRT Initiative. This naturalistic pre-post services study used administrative baseline, 6 month follow-up, and services data for adult participants in the New Mexico SBIRT evaluation (n=1208). Changes in self-reported frequency of illicit drug use, alcohol use, and alcohol intoxication were examined as a function of service level (brief intervention - BI vs. brief treatment/referral - BT/RT) and number of service sessions.
Participants reported decreased frequency of illicit drug use, alcohol use, and alcohol intoxication 6 months after receipt of SBIRT services (p<.001 for each). Compared to those who received BI, participants who received BT/RT had sharper reductions in frequency of drinking (IRR=.78; p<.05) and alcohol intoxication (IRR=.75; p<.05). Number of service sessions was associated with reduced frequency of alcohol use (IRR=.84; p<.01) and intoxication (IRR=.82; p<.05), but only among those who received BI.
Substance-using patients with disparate levels of use may benefit from SBIRT. In a real-world, multi-site rural SBIRT program, services of higher intensity and (within the BI modality) frequency were associated with greater magnitude of change in drinking behaviors. Reductions in illicit drug use, while substantial, did not differ significantly based on service variables. Future studies should identify the preferred service mix in the SBIRT model as it continues to expand.
近年来，在医疗保健环境中，筛查、简短干预、转介和治疗（SBIRT）的应用日益普及。本研究考察了 SBIRT 模型中物质使用结果与服务变量之间的关系。
在 SBIRT 倡议期间，新墨西哥州农村地区的多家健康诊所对超过 55000 名成年患者进行了物质滥用筛查。本自然主义前后服务研究使用了新墨西哥州 SBIRT 评估的成年参与者的行政基线、6 个月随访和服务数据（n=1208）。根据服务水平（简短干预-BI 与简短治疗/转介-BT/RT）和服务次数，检查自我报告的非法药物使用、酒精使用和酒精中毒频率的变化。
参与者在接受 SBIRT 服务后 6 个月报告的非法药物使用、酒精使用和酒精中毒频率降低（每种情况均 p<.001）。与接受 BI 的参与者相比，接受 BT/RT 的参与者饮酒频率（IRR=.78；p<.05）和酒精中毒频率（IRR=.75；p<.05）的降低更为明显。服务次数与减少饮酒频率（IRR=.84；p<.01）和中毒频率（IRR=.82；p<.05）相关，但仅在接受 BI 的参与者中。
具有不同使用水平的物质使用患者可能会从 SBIRT 中受益。在现实世界中，多地点农村 SBIRT 计划中，服务强度更高（在 BI 模式内）和（在 BI 模式内）频率更高与饮酒行为变化幅度更大相关。虽然非法药物使用的减少显著，但与服务变量无显著差异。随着 SBIRT 的不断扩展，未来的研究应确定 SBIRT 模型中首选的服务组合。
