一项针对急性医院环境中酒精依赖患者的扩展简短干预的随机对照试验（ADPAC）。

A randomised controlled trial of extended brief intervention for alcohol dependent patients in an acute hospital setting (ADPAC).

机构信息

The Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.

出版信息

BMC Public Health. 2011 Jul 4;11:528. doi: 10.1186/1471-2458-11-528.

DOI:10.1186/1471-2458-11-528

PMID:21726445

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3141470/

Abstract

BACKGROUND

Alcohol dependence affects approximately 3% of the English population, and accounts for significant medical and psychiatric morbidity. Only 5.6% of alcohol-dependent individuals ever access specialist treatment and only a small percentage ever seek treatment. As people who are alcohol dependent are more likely to have experienced health problems leading to frequent attendance at acute hospitals it would seem both sensible and practical to ensure that this setting is utilised as a major access point for treatment, and to test the effectiveness of these treatments.

METHODS/DESIGN: This is a randomised controlled trial with a primary hypothesis that extended brief interventions (EBI) delivered to alcohol-dependent patients in a hospital setting by an Alcohol Specialist Nurse (ASN) will be effective when compared to usual care in reducing overall alcohol consumption and improving on the standard measures of alcohol dependence. Consecutive patients will be screened for alcohol misuse in the Emergency Department (ED) of a district general hospital. On identification of an alcohol-related problem, following informed written consent, we aim to randomize 130 patients per group. The ASN will discharge to usual clinical care all control group patients, and plan a programme of EBI for treatment group patients. Follow-up interview will be undertaken by a researcher blinded to the intervention at 12 and 24 weeks. The primary outcome measure is level of alcohol dependence as determined by the Severity of Alcohol Dependence Questionnaire (SADQ) score. Secondary outcome measures include; Alcohol Use Disorders Identification Test (AUDIT) score, quantity and frequency of alcohol consumption, health-related quality of life measures, service utilisation, and patient experience. The trial will also allow an assessment of the cost-effectiveness of EBI in an acute hospital setting. In addition, patient experience will be assessed using qualitative methods.

DISCUSSION

This paper presents a protocol for a RCT of EBI delivered to alcohol dependent patients by an ASN within an ED. Importantly; the trial will also seek to understand patients' perceptions and experiences of being part of a RCT and of receiving this form of intervention.

TRIAL REGISTRATION NUMBER

ISRCTN: ISRCTN78062794.

摘要

背景

酒精依赖影响了约 3%的英国人口，导致了大量的医疗和精神疾病发病率。只有 5.6%的酒精依赖者曾经接受过专科治疗，只有一小部分人寻求过治疗。由于酒精依赖者更有可能因健康问题而频繁前往急症医院就诊，因此似乎明智且切实可行的做法是确保将该环境用作治疗的主要切入点，并测试这些治疗方法的有效性。

方法/设计：这是一项随机对照试验，主要假设是，由酒精专科护士（ASN）在医院环境中向酒精依赖患者提供的扩展简短干预（EBI）与常规护理相比，在减少总体酒精摄入量和改善酒精依赖的标准衡量标准方面将是有效的。连续的患者将在区综合医院的急症室（ED）接受酒精滥用筛查。在确定与酒精相关的问题后，在获得书面知情同意后，我们的目标是为每组随机分配 130 名患者。ASN 将向所有对照组患者提供常规临床护理，并为治疗组患者制定 EBI 计划。在 12 周和 24 周时，将由一名对干预措施不知情的研究人员进行随访访谈。主要结局测量指标是酒精依赖严重程度问卷（SADQ）评分确定的酒精依赖程度。次要结局指标包括：酒精使用障碍识别测试（AUDIT）评分、酒精摄入量和频率、健康相关生活质量指标、服务利用情况和患者体验。该试验还将评估急性医院环境中 EBI 的成本效益。此外，还将使用定性方法评估患者体验。