Santa Ana Elizabeth J, LaRowe Steven D, Armeson Kent, Lamb Kayla E, Hartwell Karen
Ralph H. Johnson VAMC, Charleston, South Carolina.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.
Am J Addict. 2016 Oct;25(7):533-41. doi: 10.1111/ajad.12426. Epub 2016 Sep 2.
Prior studies have shown that Group Motivational Interviewing (GMI) for dually diagnosed patients holds promise for increasing treatment engagement.
The current study evaluated the impact of a novel GMI protocol that included tobacco-specific components (referred to as "Tobacco GMI or T-GMI") targeting enhanced engagement in smoking cessation treatment.
Thirty-seven primary alcohol and nicotine-dependent cigarette smoking homeless Veterans with co-morbid psychiatric conditions were recruited to receive four GMI sessions over 4 consecutive days. The first 16 participants received standard GMI, aimed at enhancing engagement in substance abuse treatment and for reducing substance use, while the remaining 21 participants received a modified "tobacco-specific" GMI protocol (T-GMI) that included additional content specific to cessation of tobacco use and enhancing smoking cessation treatment, in addition to the standard substance abuse content of GMI.
Participants in T-GMI were more likely to attend tobacco cessation programming (p = .05), as well as to attend combined tobacco cessation programming with prescribed nicotine replacement therapy (p = .03), compared to those in standard GMI. Differences between treatment conditions with respect to alcohol and illicit drug use outcomes were not significant, although overall substance use declined over time in both groups.
Results suggest that inclusion of tobacco-specific components in the context of GMI for substance abuse may enhance treatment engagement for tobacco cessation behaviors among dually diagnosed nicotine dependent homeless patients, a highly vulnerable population for which interventional resources targeting engagement in smoking cessation treatment has historically been lacking. (Am J Addict 2016;25:533-541).
先前的研究表明，针对双重诊断患者的团体动机性访谈（GMI）有望提高治疗参与度。
本研究评估了一种新型GMI方案的影响，该方案包含针对增强戒烟治疗参与度的烟草特定成分（称为“烟草GMI或T-GMI”）。
招募了37名患有共病精神疾病、主要依赖酒精和尼古丁的无家可归退伍军人吸烟者，连续4天接受4次GMI治疗。前16名参与者接受标准GMI，旨在提高药物滥用治疗的参与度并减少药物使用，而其余21名参与者接受改良的“烟草特定”GMI方案（T-GMI），除了GMI的标准药物滥用内容外，还包括特定于戒烟和增强戒烟治疗的额外内容。
与标准GMI组相比，T-GMI组的参与者更有可能参加戒烟项目（p = 0.05），以及参加结合规定尼古丁替代疗法的联合戒烟项目（p = 0.03）。尽管两组的总体药物使用随时间均有所下降，但治疗条件在酒精和非法药物使用结果方面的差异并不显著。
结果表明，在针对药物滥用的GMI中纳入烟草特定成分，可能会提高双重诊断的尼古丁依赖无家可归患者中戒烟行为的治疗参与度，这是一个历史上缺乏针对戒烟治疗参与度的干预资源的高度脆弱人群。（《美国成瘾杂志》2016年；25:533 - 541）
