Lécallier Dorothée, Hadj-Slimane Fatima, Landry Michel, Bristol-Gauzy Patricia, Cordoliani Christine, Grélois Marie, Delva Catherine, Michaud Philippe
IPPSA, 92110 Clichy, France.
Presse Med. 2012 Sep;41(9 Pt 1):e411-9. doi: 10.1016/j.lpm.2011.10.032. Epub 2012 Mar 23.
The DEP-ADO assessment questionnaire defines three alcohol- and drug-related risk levels: low (green light), intermediate (yellow light) and high risk (red light). Our study sought to evaluate whether a DEP-ADO systematic screening by school nurses and physicians improves referring to specialized addiction consultations.
Randomized controlled study with allocation of subjects by matched pairs of school classes: 1045 adolescents received a group information; 1075 adolescents were met individually and filled in the questionnaire; then either they received a risk reduction oriented intervention (yellow light) or were referred to an addiction outpatient clinic (red light).
In the DEP-ADO group, 27 yellow lights (2.8%) and 15 red lights (1.6%) were identified. One adolescent of the DEP-ADO group actually went to the addiction consultation during the 3 months following the intervention (NS). Twenty youths consulted at least a second time the school nurse or physician, among whom 18 belonging to the intervention group and two to the control group (p=0.0003).
A systematic screening with the DEP-ADO questionnaire did not increase the reference rate to the addiction consultation. The links between age, smoking and risk level suggest screening strategies restraining, for the younger, proposal of the DEP-ADO to the pupils smoking tobacco. ROC-ADO study demonstrates the need to empower the relations between school health providers and addiction consultations.
DEP-ADO评估问卷定义了三种与酒精和药物相关的风险水平:低风险(绿灯)、中度风险(黄灯)和高风险(红灯)。我们的研究旨在评估学校护士和医生进行的DEP-ADO系统筛查是否能改善转介至专业成瘾咨询服务的情况。
采用随机对照研究,通过对学校班级进行配对分配受试者:1045名青少年接受了团体信息;1075名青少年接受了单独面谈并填写了问卷;然后他们要么接受了以降低风险为导向的干预(黄灯),要么被转介至成瘾门诊(红灯)。
在DEP-ADO组中,确定了27个黄灯(2.8%)和15个红灯(1.6%)。DEP-ADO组中有一名青少年在干预后的3个月内实际去了成瘾咨询服务处(无显著差异)。20名青少年至少再次咨询了学校护士或医生,其中18名属于干预组,2名属于对照组(p = 0.0003)。
使用DEP-ADO问卷进行系统筛查并未提高成瘾咨询服务的转介率。年龄、吸烟与风险水平之间的联系表明,对于较年轻的吸烟学生,筛查策略应限制向其提出DEP-ADO问卷。ROC-ADO研究表明需要加强学校健康服务提供者与成瘾咨询服务之间的联系。