Menzies School of Health Research, Northern Territory Baker IDI Heart & Diabetes Institute, Northern Territory Research Consultant, Northern Territory Central Australian Aboriginal Congress, Northern Territory.
Aust N Z J Public Health. 2013 Oct;37(5):450-6. doi: 10.1111/1753-6405.12122.
To evaluate a 12-month trial of an evidence-based non-residential treatment program for Indigenous clients with alcohol problems, offering three streams of care: pharmacotherapy, psychological and social support.
Process evaluation of program implementation; outcome evaluation of client outcomes.
despite constraints of time and remoteness, the trial demonstrated the feasibility of implementing such a program. The medical stream generated fewer pharmacotherapy prescriptions than expected. The most active stream was the psychological therapy stream.
between March 2008 and April 2009, 129 clients were referred to the program, of whom 49 consented to have de-identified data used for the evaluation. Of these, 19 clients received one or more streams of care, 15 of whom (78.9%) subsequently stopped or reduced drinking. However, among the remaining 30 consenting clients who had not received an intervention, 70.0% also reported stopping or reducing drinking. The evidence of program effectiveness is therefore equivocal and evaluation over a longer period is required.
The trial demonstrated the viability of, and demand for, evidence-based non-residential treatment for Indigenous clients with alcohol problems. Reasons behind an apparent reluctance among GPs to prescribe pharmacotherapy for Indigenous clients, and steps to overcome this, need further attention.
评估一项为期 12 个月的针对有酗酒问题的土著客户的基于证据的非住院治疗方案,提供三种护理途径:药物治疗、心理和社会支持。
对方案实施进行过程评估;对客户结果进行结果评估。
尽管受到时间和偏远的限制,试验证明了实施这样一个方案的可行性。医疗途径开出的药物治疗处方比预期的要少。最活跃的途径是心理治疗途径。
2008 年 3 月至 2009 年 4 月期间,有 129 名客户被转介到该方案,其中 49 名同意使用去识别数据进行评估。在这些客户中,有 19 名客户接受了一种或多种护理途径,其中 15 名(78.9%)随后停止或减少饮酒。然而,在其余 30 名同意但未接受干预的客户中,有 70.0%也报告停止或减少饮酒。因此,该方案的有效性证据是不确定的,需要进行更长时间的评估。
该试验证明了为有酗酒问题的土著客户提供基于证据的非住院治疗的可行性和需求。全科医生不愿意为土著客户开药物治疗处方的原因,以及克服这一问题的步骤,需要进一步关注。