酒精影响下首次被捕后不久进行简短动机性访谈对问题饮酒行为的影响：一项随机试验。

The effect on problematic drinking behavior of a brief motivational interview shortly after a first arrest for driving under the influence of alcohol: a randomized trial.

机构信息

From the Department of Surgery (G.H.U., J.B.Y., C.R.S.), University of California, Davis, Medical Center; and Sacramento Police Department (L.A.T., D.M.C., C.J.M.), Sacramento; and Department of Surgery (L.J.O.), Mercy San Juan Hospital, Carmichael, California; and Department of Health Management & Policy (D.E.), University of Michigan, Ann Arbor, Michigan.

出版信息

J Trauma Acute Care Surg. 2014 Mar;76(3):661-70; discussion 670-1. doi: 10.1097/TA.0000000000000144.

DOI:10.1097/TA.0000000000000144

PMID:24553532

Abstract

BACKGROUND

In medical settings, motivational interviewing-based "brief intervention" (BI) counseling reduces alcohol-related risk-taking behavior and harm in high-risk populations. Individuals arrested for driving under the influence of alcohol (DUI) are another at-risk population. We sought to determine whether a BI administered shortly after a first DUI arrest might decrease problematic drinking behavior.

METHODS

We conducted a single-center, parallel-group, double-blinded superiority randomized trial (NCT01270217), enrolling first-time DUI arrestees at a county jail from December 2010 through April 2011. Before their release, we randomized participants by computer-generated sequence to either a single BI or no discussion. We assessed 90-day change in Alcohol Use Disorders Identification Test (AUDIT) scores (range 0-40, higher values indicating more problematic drinking) as the primary outcome.

RESULTS

We enrolled 200 subjects (100 to each arm), and 181 (90.5%, 86 control and 95 BI) completed the 90-day follow-up. Mean (SD) age was 30 (10) years, and 50% were men. Mean (SD) blood alcohol concentration upon arrest was 0.14% (0.04%). Mean (SD) baseline AUDIT scores were 8.8 (5.8) among control subjects and 7.7 (6.3) among BI subjects. At 90 days, AUDIT scores decreased by a mean (SD) 4.7 (5.1) units among control subjects and 3.4 (5.0) among BI subjects (difference, -1.3; 95% confidence interval [CI], -2.8 to +0.1). The likelihood of subsequent binge drinking [relative risk (RR) 1.6; 95% CI, 0.8-3.0; BI vs. control], abstinence (RR, 0.9; 95% CI, 0.4-2.1), alcohol-related injury to self or others (RR, 0.4; 95% CI, 0.1-2.4), and seeking treatment (RR, 1.2; 95% CI, 0.8-1.7) did not differ.

CONCLUSION

A single BI counseling session shortly after first-time DUI arrest does not reduce 90-day self-reported drinking behavior or increase seeking treatment for drinking beyond that which occurs without such a discussion.

LEVEL OF EVIDENCE

Therapeutic study, level III.

摘要

背景

在医疗环境中，基于动机访谈的“简短干预”（BI）咨询可减少高危人群的与酒精相关的冒险行为和伤害。因酒后驾车（DUI）被捕的个体也是另一个高危人群。我们试图确定在首次 DUI 被捕后进行 BI 是否可能减少不良饮酒行为。

方法

我们进行了一项单中心、平行组、双盲优效随机试验（NCT01270217），于 2010 年 12 月至 2011 年 4 月在县监狱招募首次 DUI 被捕者。在他们获释之前，我们通过计算机生成的序列将参与者随机分配至 BI 组或无讨论组。我们评估了 90 天内酒精使用障碍识别测试（AUDIT）评分的变化（范围 0-40，分数越高表示饮酒问题越严重）作为主要结局。

结果

我们共招募了 200 名受试者（每组 100 名），其中 181 名（86 名对照组和 95 名 BI 组）完成了 90 天的随访。平均（SD）年龄为 30（10）岁，50%为男性。被捕时平均（SD）血液酒精浓度为 0.14%（0.04%）。对照组的平均（SD）基线 AUDIT 评分为 8.8（5.8）分，BI 组为 7.7（6.3）分。在 90 天时，对照组的 AUDIT 评分平均（SD）下降了 4.7（5.1）分，BI 组下降了 3.4（5.0）分（差异，-1.3；95%置信区间[CI]，-2.8 至 0.1）。随后 binge 饮酒的可能性[相对风险（RR）1.6；95% CI，0.8-3.0；BI 与对照组]、戒酒（RR，0.9；95% CI，0.4-2.1）、与酒精相关的自我或他人受伤（RR，0.4；95% CI，0.1-2.4）和寻求治疗（RR，1.2；95% CI，0.8-1.7）无差异。