南非医院门诊患者中有害及有害饮酒的筛查与简短干预：一项随机对照试验的结果
Screening and brief interventions for hazardous and harmful alcohol use among hospital outpatients in South Africa: results from a randomized controlled trial.
作者信息
Pengpid Supa, Peltzer Karl, Skaal Linda, Van der Heever Hendry
机构信息
Department of Health System Management and Policy, University of Limpopo (MEDUNSA Campus), Pretoria, South Africa.
出版信息
BMC Public Health. 2013 Jul 11;13:644. doi: 10.1186/1471-2458-13-644.
BACKGROUND
High prevalence rates of hazardous and harmful alcohol use have been found in a hospital outpatient setting in South Africa. Hospital settings are a particularly valuable point of contact for the delivery of brief interventions because of the large access to patient populations each year. With this in mind, the primary purpose of this randomized controlled trial is to provide screening for alcohol misuse and to test the effectiveness of brief interventions in reducing alcohol intake among hospital outpatients in South Africa.
METHODS
The study design for this effectiveness study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous or harmful drinkers in a hospital setting. Outpatients were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counselling session on alcohol risk reduction, while the control group received a health education leaflet.
RESULTS
Of the 1419 screened for alcohol misuse who agreed to participate in the trial 392 (27.6%) screened positive for hazardous or harmful use on the Alcohol Use Disorder Identification Test (AUDIT) (score 7/8-19) and 51 (3.6%) had an AUDIT score of 20 or more. Among the 282 (72%) hospital outpatients who also attended the 12-month follow-up session, the time effects on the AUDIT scores were significant [F (1,195 = 7.72), P < 0.01] but the intervention effect on the AUDIT score was statistically not significant [F (1,194 = 0.06), P < 0.804].
CONCLUSION
Given the lack of difference in outcome between control and intervention group, alcohol screening and the provision of an alcohol health education leaflet may in itself cause reduction in drinking.
TRIAL REGISTRATION
PACTR201110000319392.
背景
在南非的一家医院门诊环境中，发现有害和危险饮酒的患病率很高。由于每年有大量患者就诊，医院环境是提供简短干预措施的一个特别有价值的接触点。考虑到这一点，这项随机对照试验的主要目的是对酒精滥用进行筛查，并测试简短干预措施在减少南非医院门诊患者酒精摄入量方面的有效性。
方法
这项有效性研究的设计是一项随机对照试验，进行6个月和12个月的随访，以检查简短酒精干预措施对减少医院环境中危险或有害饮酒者酒精使用的效果。对门诊患者进行酒精问题筛查，那些被确定为危险或有害饮酒者被随机分为实验组或对照组。实验组接受一次关于降低酒精风险的简短咨询，而对照组收到一份健康教育传单。
结果
在1419名接受酒精滥用筛查并同意参与试验的患者中，392人（27.6%）在酒精使用障碍识别测试（AUDIT）中筛查出危险或有害使用呈阳性（得分7/8 - 19），51人（3.6%）的AUDIT得分为20或更高。在282名（72%）也参加了12个月随访的医院门诊患者中，对AUDIT得分的时间效应显著[F(1,195 = 7.72)，P < 0.01]，但干预对AUDIT得分的效应在统计学上不显著[F(1,194 = 0.06)，P < 0.804]。
结论
鉴于对照组和干预组之间的结果没有差异，酒精筛查和提供酒精健康教育传单本身可能会导致饮酒量减少。
试验注册
PACTR201110000319392。
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