酒精、烟草和阿片类物质使用障碍的筛查与治疗：安大略省家庭医生调查
Screening and Treatment for Alcohol, Tobacco and Opioid Use Disorders: A Survey of Family Physicians across Ontario.
作者信息
Loheswaran Genane, Soklaridis Sophie, Selby Peter, Le Foll Bernard
机构信息
Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada.
CAMH Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
出版信息
PLoS One. 2015 Apr 29;10(4):e0124402. doi: 10.1371/journal.pone.0124402. eCollection 2015.
INTRODUCTION
As a primary point of contact within the health care system, family physicians are able to play a vital role in identifying individuals with substance use disorders and connecting them to the appropriate treatment. However, there is very little data available on whether family physicians are actively screening for and treating substance use disorders. The objective of the current survey was to assess whether family physicians in Ontario are screening for alcohol, opioid and tobacco use disorders, using validated tools and providing treatment.
METHODS
An online survey consisting of a series of 38 primarily close-ended questions was circulated to family physicians in Ontario. Rates of screening for alcohol, opioid and tobacco dependence, use of validated tools for screening, providing treatment for dependent individuals and the current barriers to the prescription of pharmacotherapies for these drug dependences were assessed.
RESULTS
The use of validated screening tools was limited for all three substances. Screening by family physicians for the substance use disorders among adolescents was much lower than screening among adults. Pharmacotherapy was more commonly used as an intervention for tobacco dependence than for alcohol and opioid dependence. This was explained by the lack of knowledge among family physicians on the pharmacotherapies for alcohol and opioid dependence.
CONCLUSIONS
Findings from the current study suggest there is a need for family physicians to integrate screening for substance use disorders using validated tools into their standard medical practice. Furthermore, there is a need for increased knowledge on pharmacotherapies for alcohol and opioid use disorders. It is important to note that the low response rate is a major limitation to this study. One possible reason for this low response rate may be a lack of interest and awareness among family physicians on the importance of screening and treatment of substance use disorders in Ontario.
引言
作为医疗保健系统中的主要接触点，家庭医生在识别患有物质使用障碍的个体并将他们与适当的治疗联系起来方面能够发挥至关重要的作用。然而，关于家庭医生是否积极筛查和治疗物质使用障碍的数据非常少。本次调查的目的是评估安大略省的家庭医生是否使用经过验证的工具对酒精、阿片类药物和烟草使用障碍进行筛查并提供治疗。
方法
向安大略省的家庭医生发放了一份包含一系列38个主要为封闭式问题的在线调查问卷。评估了酒精、阿片类药物和烟草依赖的筛查率、用于筛查的经过验证的工具的使用情况、为依赖个体提供治疗的情况以及目前这些药物依赖的药物治疗处方障碍。
结果
对于所有三种物质，经过验证的筛查工具的使用都很有限。家庭医生对青少年物质使用障碍的筛查远低于对成年人的筛查。药物治疗作为烟草依赖的干预措施比作为酒精和阿片类药物依赖的干预措施更常用。这是由于家庭医生对酒精和阿片类药物依赖的药物治疗缺乏了解。
结论
本研究的结果表明，家庭医生需要将使用经过验证的工具对物质使用障碍进行筛查纳入其标准医疗实践中。此外，需要增加对酒精和阿片类药物使用障碍药物治疗的了解。需要注意的是，低回复率是本研究的一个主要局限。回复率低的一个可能原因可能是安大略省的家庭医生对物质使用障碍筛查和治疗的重要性缺乏兴趣和认识。
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