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急诊护理中酒精相关事件后针对青少年和青年的简短现场干预:系统评价与欧洲证据综合分析

Brief in Person Interventions for Adolescents and Young Adults Following Alcohol-Related Events in Emergency Care: A Systematic Review and European Evidence Synthesis.

作者信息

Diestelkamp Silke, Drechsel Magdalena, Baldus Christiane, Wartberg Lutz, Arnaud Nicolas, Thomasius Rainer

机构信息

German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Eur Addict Res. 2016;22(1):17-35. doi: 10.1159/000435877. Epub 2015 Aug 29.

Abstract

BACKGROUND

Increasing numbers of youth in need of emergency medical treatment following alcohol intoxication have been a major public health concern in Europe in recent years. Brief interventions (BIs) in the emergency department (ED) could prevent future risky drinking. However, effectiveness and feasibility of this approach are currently unclear.

METHOD

A systematic literature search on controlled trials including participants aged 12-25 years treated in an ED following an alcohol-related event was conducted. Additionally, a grey literature search was conducted to support findings from the systematic review with evidence from practice projects and uncontrolled trials. Data on effectiveness, acceptance, implementation and reach were extracted.

RESULTS

Seven randomised controlled trials (RCT), 6 practice projects, 1 non-randomised pilot study and 1 observational study were identified. Six RCTs found reductions of alcohol use for all participants. Four RCTs found effects on alcohol consumption, alcohol-related risk-behaviour or referral to treatment. Participation and referral rates varied strongly, whereas data on acceptance and implementation were rarely assessed.

CONCLUSION

Heterogeneity of study designs and effects limit conclusions on effectiveness of BIs for young ED patients following an alcohol-related event. However, the number of practice projects in Europe indicates a need perceived by practitioners to address this population.

摘要

背景

近年来,因酒精中毒而需要紧急医疗救治的年轻人数量不断增加,这已成为欧洲的一个主要公共卫生问题。在急诊科(ED)进行简短干预(BIs)可以预防未来的危险饮酒行为。然而,这种方法的有效性和可行性目前尚不清楚。

方法

对包括在与酒精相关事件后在急诊科接受治疗的12至25岁参与者的对照试验进行了系统的文献检索。此外,还进行了灰色文献检索,以用实践项目和非对照试验的证据支持系统评价的结果。提取了关于有效性、接受度、实施情况和覆盖范围的数据。

结果

共识别出7项随机对照试验(RCT)、6个实践项目、1项非随机试点研究和1项观察性研究。6项RCT发现所有参与者的酒精使用量都有所减少。4项RCT发现对酒精消费、与酒精相关的危险行为或转诊治疗有影响。参与率和转诊率差异很大,而关于接受度和实施情况的数据很少被评估。

结论

研究设计和效果的异质性限制了对与酒精相关事件后急诊科年轻患者进行简短干预有效性的结论。然而,欧洲实践项目的数量表明从业者意识到有必要针对这一人群开展工作。

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