物质筛查和转介物质滥用治疗在综合心理健康服务中的应用。
Substance screening and referral for substance abuse treatment in an integrated mental health care program.
机构信息
Department of Psychiatry and Behavioral Sciences, University of Washington, 1595 NE Pacific St., Box 356560, Seattle, WA 98195, USA.
出版信息
Psychiatr Serv. 2013 Jan;64(1):88-90. doi: 10.1176/appi.ps.201200082.
Abstract
OBJECTIVE
This study examined rates of substance screening and referral for substance abuse treatment as part of an integrated care program providing mental health services to low-income patients in primary care.
METHODS
Adults (N=11,150) who were enrolled in the program between 2008 and 2010 were included. Primary outcomes included substance screening rates, treatment referral rates, and correlates of accessing recommended treatment.
RESULTS
A total of 7,513 (67%) participants were screened for substance abuse. Among the 2,856 (38%) participants with a positive screen, 1,344 (47%) were referred for treatment. After adjustment for covariates, accessing recommended treatment was associated with past substance abuse treatment history, alcohol use, heavy drug use, posttraumatic stress disorder, and number of follow-up contacts with a care manager.
CONCLUSION
This study of a vulnerable population highlights missed opportunities for identifying and referring patients in primary care to substance abuse treatment.
摘要
目的
本研究旨在调查物质滥用治疗的物质筛查和转介率，作为为初级保健中低收入患者提供精神卫生服务的综合护理计划的一部分。
方法
该研究纳入了 2008 年至 2010 年期间参加该项目的成年人（N=11150）。主要结局包括物质筛查率、治疗转介率以及获得推荐治疗的相关因素。
结果
共有 7513 名（67%）参与者接受了物质滥用筛查。在 2856 名（38%）阳性筛查者中，有 1344 名（47%）被转介接受治疗。在调整了协变量后，接受推荐治疗与过去的物质滥用治疗史、酒精使用、重度药物使用、创伤后应激障碍以及与护理经理的随访接触次数有关。
结论
这项针对弱势人群的研究强调了在初级保健中识别和转介患者接受物质滥用治疗的机会错失。
相似文献
1
Substance screening and referral for substance abuse treatment in an integrated mental health care program.物质筛查和转介物质滥用治疗在综合心理健康服务中的应用。
Psychiatr Serv. 2013 Jan;64(1):88-90. doi: 10.1176/appi.ps.201200082.
2
Screening and Follow-Up Monitoring for Substance Use in Primary Care: An Exploration of Rural-Urban Variations.基层医疗中物质使用的筛查与随访监测：城乡差异探索
J Gen Intern Med. 2016 Feb;31(2):215-222. doi: 10.1007/s11606-015-3488-y. Epub 2015 Aug 13.
3
Substance use service availability in HIV treatment programs: Data from the global IeDEA consortium, 2014-2015 and 2017.艾滋病毒治疗项目中的物质使用服务提供情况：来自全球 IeDEA 联盟的 2014-2015 年和 2017 年的数据。
PLoS One. 2020 Aug 27;15(8):e0237772. doi: 10.1371/journal.pone.0237772. eCollection 2020.
4
Screening for substance abuse and psychiatric disorders among women patients in a VA Health Care System.在退伍军人事务部医疗保健系统中对女性患者进行药物滥用和精神疾病筛查。
Psychiatr Serv. 2003 Feb;54(2):214-8. doi: 10.1176/appi.ps.54.2.214.
5
A controlled trial of screening, brief intervention and referral for treatment (SBIRT) implementation in primary care in the United Arab Emirates.阿拉伯联合酋长国初级保健中实施筛查、简短干预和转诊治疗（SBIRT）的对照试验。
Prim Health Care Res Dev. 2018 Mar;19(2):165-175. doi: 10.1017/S1463423617000640. Epub 2017 Oct 9.
6
Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use.改善老年心理健康服务的可及性：一项随机试验，比较综合治疗与强化转诊护理在治疗抑郁症、焦虑症和高危饮酒方面的治疗参与度。
Am J Psychiatry. 2004 Aug;161(8):1455-62. doi: 10.1176/appi.ajp.161.8.1455.
7
Clinician screening and treatment of alcohol, drug, and mental problems in primary care: results from healthcare for communities.基层医疗中临床医生对酒精、药物和心理问题的筛查与治疗：社区医疗保健的结果
Med Care. 2004 Dec;42(12):1158-66. doi: 10.1097/00005650-200412000-00002.
8
Screening and brief intervention for alcohol and other abuse.酒精及其他滥用物质的筛查与简短干预
Adolesc Med State Art Rev. 2014 Apr;25(1):126-56.
9
Integrated Care for Pediatric Substance Abuse.
Child Adolesc Psychiatr Clin N Am. 2016 Oct;25(4):769-77. doi: 10.1016/j.chc.2016.05.007. Epub 2016 Aug 2.
10
A randomized clinical trial of the health evaluation and referral assistant (HERA): research methods.健康评估与转诊助手（HERA）的随机临床试验：研究方法。
Contemp Clin Trials. 2013 Jul;35(2):87-96. doi: 10.1016/j.cct.2013.04.010. Epub 2013 May 7.
引用本文的文献
1
Principles of Care for Young Adults With Co-Occurring Psychiatric and Substance Use Disorders.青少年共病精神障碍和物质使用障碍的护理原则。
Pediatrics. 2021 Jan;147(Suppl 2):229-239. doi: 10.1542/peds.2020-023523F.
2
Variation In The Effectiveness Of Collaborative Care For Depression: Does It Matter Where You Get Your Care?抑郁症协作护理效果的差异：在哪里接受护理重要吗？
Health Aff (Millwood). 2020 Nov;39(11):1943-1950. doi: 10.1377/hlthaff.2019.01714.
3
Referral to Treatment After Positive Screens for Unhealthy Drug Use in an Outpatient Veterans Administration Setting.在退伍军人管理局门诊环境中，对药物滥用阳性筛查后的治疗转介。
J Addict Med. 2020 May/Jun;14(3):236-243. doi: 10.1097/ADM.0000000000000567.
4
Developing a Collaborative Care Training Program in a Psychiatry Residency.在精神病学住院医师培训中开展协作护理培训项目。
Psychosomatics. 2017 May-Jun;58(3):245-249. doi: 10.1016/j.psym.2016.12.006. Epub 2016 Dec 20.
5
Screening and Follow-Up Monitoring for Substance Use in Primary Care: An Exploration of Rural-Urban Variations.基层医疗中物质使用的筛查与随访监测：城乡差异探索
J Gen Intern Med. 2016 Feb;31(2):215-222. doi: 10.1007/s11606-015-3488-y. Epub 2015 Aug 13.
6
Brief intervention for problem drug use in safety-net primary care settings: a randomized clinical trial.安全网基层医疗环境中针对问题药物使用的简短干预：一项随机临床试验。
JAMA. 2014 Aug 6;312(5):492-501. doi: 10.1001/jama.2014.7860.
本文引用的文献
1
Quality improvement with pay-for-performance incentives in integrated behavioral health care.基于绩效激励的综合性心理健康护理中的质量改进。
Am J Public Health. 2012 Jun;102(6):e41-5. doi: 10.2105/AJPH.2011.300555. Epub 2012 Apr 19.
2
Variations in depression care and outcomes among high-risk mothers from different racial/ethnic groups.不同种族/族裔的高危产妇在抑郁护理和结局方面的差异。
Fam Pract. 2012 Aug;29(4):394-400. doi: 10.1093/fampra/cmr108. Epub 2011 Nov 16.
3
Missed opportunities: fewer service referrals after positive alcohol misuse screens in VA primary care.错失的机会：退伍军人事务部初级保健中阳性酒精滥用筛查后服务转介减少。
Psychiatr Serv. 2011 Mar;62(3):310-2. doi: 10.1176/ps.62.3.pss6203_0310.
4
Disparities in use of mental health and substance abuse services by persons with co-occurring disorders.患有共病障碍的人群在使用心理健康和药物滥用服务方面的差异。
Psychiatr Serv. 2009 Feb;60(2):217-23. doi: 10.1176/ps.2009.60.2.217.
5
Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment.接受药物滥用治疗的青少年和成年人中主要内化和外化问题的患病率及共病情况。
J Subst Abuse Treat. 2008 Jan;34(1):14-24. doi: 10.1016/j.jsat.2006.12.031. Epub 2007 Jun 15.
6
Development and validation of the GAIN Short Screener (GSS) for internalizing, externalizing and substance use disorders and crime/violence problems among adolescents and adults.青少年和成年人内化、外化及物质使用障碍以及犯罪/暴力问题的GAIN简短筛查工具（GSS）的开发与验证。
Am J Addict. 2006;15 Suppl 1(Suppl 1):80-91. doi: 10.1080/10550490601006055.
7
Impact of program services on treatment outcomes of patients with comorbid mental and substance use disorders.项目服务对合并精神障碍和物质使用障碍患者治疗结果的影响。
Psychiatr Serv. 2006 Jul;57(7):1007-15. doi: 10.1176/ps.2006.57.7.1007.
8
Alcohol screening and brief intervention in primary care settings: implementation models and predictors.初级保健机构中的酒精筛查与简短干预：实施模式及预测因素
J Stud Alcohol. 2005 May;66(3):361-8. doi: 10.15288/jsa.2005.66.361.
9
Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial.初级保健环境中晚期抑郁症的协作式护理管理：一项随机对照试验。
JAMA. 2002 Dec 11;288(22):2836-45. doi: 10.1001/jama.288.22.2836.
10
Alcohol-related discussions during general medicine appointments of male VA patients who screen positive for at-risk drinking.在对有饮酒风险筛查呈阳性的男性退伍军人事务部患者进行普通内科门诊时，与酒精相关的讨论。
J Gen Intern Med. 2002 May;17(5):315-26. doi: 10.1046/j.1525-1497.2002.10618.x.
Zotero 插件