非法药物使用筛查及简短干预效果的随机临床试验：Life Shift/Shift Gears研究
Randomized clinical trial of the effects of screening and brief intervention for illicit drug use: the Life Shift/Shift Gears study.
作者信息
Woodruff Susan I, Clapp John D, Eisenberg Kimberly, McCabe Cameron, Hohman Melinda, Shillington Audrey M, Sise C Beth, Castillo Edward M, Chan Theodore C, Sise Michael J, Gareri Joey
机构信息
San Diego State University, School of Social Work, Center for Alcohol and Drug Studies, 5500 Campanile Drive, San Diego, CA HH-203E, USA.
出版信息
Addict Sci Clin Pract. 2014 May 22;9(1):8. doi: 10.1186/1940-0640-9-8.
BACKGROUND
Although screening, brief intervention, and referral to treatment (SBIRT) has shown promise for alcohol use, relatively little is known about its effectiveness for adult illicit drug use. This randomized controlled trial assessed the effectiveness of the SBIRT approach for outcomes related to drug use among patients visiting trauma and emergency departments (EDs) at two large, urban hospitals.
METHODS
A total of 700 ED patients who admitted using illegal drugs in the past 30 days were recruited, consented, provided baseline measures of substance use and related problems measured with the Addiction Severity Index-Lite (ASI-Lite), and then randomized to the Life Shift SBIRT intervention or to an attention-placebo control group focusing on driving and traffic safety (Shift Gears). Both groups received a level of motivational intervention matched to their condition and risk level by trained paraprofessional health educators. Separate measurement technicians conducted face-to-face follow-ups at 6 months post-intervention and collected hair samples to confirm reports of abstinence from drug use. The primary outcome measure of the study was past 30-day drug abstinence at 6 months post-intervention, as self-reported on the ASI-Lite.
RESULTS
Of 700 participants, 292 (42%) completed follow-up. There were no significant differences in self-reported abstinence (12.5% vs. 12.0% , p = 0.88) for Life Shift and Shift Gears groups, respectively. When results of hair analyses were applied, the abstinence rate was 7 percent for Life Shift and 2 percent for Shift Gears (p = .074). In an analysis in which results were imputed (n = 694), there was no significant difference in the ASI-Lite drug use composite scores (Life Shift +0.005 vs. Shift Gears +0.017, p = 0.12).
CONCLUSIONS
In this randomized controlled trial, there was no evidence of effectiveness of SBIRT on the primary drug use outcome.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01683227.
背景
尽管筛查、简短干预及转介治疗（SBIRT）已显示出在酒精使用方面的前景，但对于其在成人非法药物使用方面的有效性知之甚少。这项随机对照试验评估了SBIRT方法对两家大型城市医院创伤和急诊科就诊患者与药物使用相关结局的有效性。
方法
共招募了700名在过去30天内承认使用非法药物的急诊科患者，他们同意参与研究，提供了使用成瘾严重程度指数简表（ASI-Lite）测量的物质使用及相关问题的基线指标，然后被随机分配至“生活转变SBIRT干预组”或专注于驾驶和交通安全的注意力安慰剂对照组（“换挡”组）。两组均由经过培训的非专业健康教育工作者根据其状况和风险水平提供相应水平的动机干预。独立的测量技术人员在干预后6个月进行面对面随访，并采集头发样本以确认药物使用戒断报告。该研究的主要结局指标是干预后6个月时过去30天的药物戒断情况，通过在ASI-Lite上的自我报告得出。
结果
700名参与者中，292人（42%）完成了随访。“生活转变”组和“换挡”组自我报告的戒断率分别为12.5%和12.0%，无显著差异（p = 0.88）。应用头发分析结果时，“生活转变”组的戒断率为7%，“换挡”组为2%（p = 0.074）。在进行结果推算的分析中（n = 694），ASI-Lite药物使用综合评分无显著差异（“生活转变”组为+0.005，“换挡”组为+0.017，p = 0.12）。
结论
在这项随机对照试验中，没有证据表明SBIRT对主要药物使用结局有效。
试验注册
ClinicalTrials.gov NCT01683227。
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