Vallersnes Odd Martin, Jacobsen Dag, Ekeberg Øivind, Brekke Mette
Department of General Practice, University of Oslo, Oslo, Norway.
Oslo Accident and Emergency Outpatient Clinic, Department of Emergency General Practice, City of Oslo Health Agency, Oslo, Norway.
Scand J Prim Health Care. 2016 Sep;34(3):309-316. doi: 10.1080/02813432.2016.1207152. Epub 2016 Jul 12.
To chart follow-up of patients after acute poisoning by substances of abuse, register whether patients referred to specialist health services attended, and whether patients contacted a general practitioner (GP) after the poisoning episode. Observational cohort study. A primary care emergency outpatient clinic in Oslo, Norway. Patients ≥12 years treated for acute poisoning by substances of abuse were included consecutively from October 2011 to September 2012. Follow-up initiated at discharge, proportion of cases in which referred patients attended within three months, and proportion of cases in which the patient consulted a GP the first month following discharge. There were 2343 episodes of acute poisoning by substances of abuse. In 391 (17%) cases the patient was hospitalised, including 49 (2%) in psychiatric wards. In 235 (10%) cases the patient was referred to specialist health services, in 91 (4%) advised to see their GP, in 82 (3%) to contact social services, in 74 (3%) allotted place in a homeless shelter, and in 93 (4%) other follow-up was initiated. In 1096 (47%) cases, the patient was discharged without follow-up, and in a further 324 (14%), the patient self-discharged. When referred to specialist health services, in 200/235 (85%) cases the patient attended within three months. Among all discharges, in 527/1952 (27%) cases the patient consulted a GP within one month. When advised to see their GP, in 45/91 (49%) cases the patient did. Attendance was high for follow-up initiated after acute poisoning by substances of abuse.KEY POINTSDespite poor long-term prognosis, patients treated for acute poisoning by substances of abuse are frequently not referred to follow-up.Nearly all patients referred to specialist health services attended, indicating the acute poisoning as an opportune moment for intervention.Advising patients to contact their GP was significantly associated with patients consulting the GP, but few patients were so advised.One out of three patients was discharged without follow-up, and there seems to be an unused potential for GP involvement.
为了记录药物滥用急性中毒患者的后续情况，登记转至专科医疗服务机构的患者是否就诊，以及中毒事件发生后患者是否联系过全科医生（GP）。观察性队列研究。挪威奥斯陆的一家初级保健急诊门诊。2011年10月至2012年9月连续纳入≥12岁的药物滥用急性中毒治疗患者。出院时开始随访，转介患者在三个月内就诊的病例比例，以及出院后第一个月患者咨询全科医生的病例比例。共有2343例药物滥用急性中毒事件。391例（17%）患者住院治疗，其中49例（2%）入住精神科病房。235例（10%）患者被转介至专科医疗服务机构，91例（4%）被建议去看全科医生，82例（3%）被建议联系社会服务机构，74例（3%）被安排入住无家可归者收容所，93例（4%）开始了其他随访。1096例（47%）患者出院时未进行随访，另有324例（14%）患者自行出院。转介至专科医疗服务机构后，200/235例（85%）患者在三个月内就诊。在所有出院患者中，527/1952例（27%）患者在一个月内咨询了全科医生。被建议去看全科医生的患者中，45/91例（49%）确实去看了。药物滥用急性中毒后开始的随访就诊率较高。要点尽管长期预后不佳，但药物滥用急性中毒治疗患者往往未被转介进行随访。几乎所有转介至专科医疗服务机构的患者都就诊了，这表明急性中毒是进行干预的有利时机。建议患者联系全科医生与患者咨询全科医生显著相关，但很少有患者得到这样的建议。三分之一的患者出院时未进行随访，全科医生参与似乎存在未被利用的潜力。
