接受物质使用问题治疗的全科医疗患者：比利时的一项跨国观察性研究。

General practice patients treated for substance use problems: a cross-national observational study in Belgium.

作者信息

Boffin Nicole, Antoine Jerome, Moreels Sarah, Wanyama Simeon, De Ridder Karin, Peremans Lieve, Vanmeerbeek Marc, Van Casteren Viviane

机构信息

OD Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium.

Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.

出版信息

BMC Public Health. 2016 Dec 8;16(1):1235. doi: 10.1186/s12889-016-3885-0.

DOI:10.1186/s12889-016-3885-0

PMID:27927240

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5143443/

Abstract

BACKGROUND

General Practitioners (GPs) are well placed to care for patients with (chronic) substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous surveillance of substance use problems among general practice patients. The objectives were (i) to describe variables with missing values exceeding 1% and whether patients were reported without substance-related problems; (ii) the profile and the magnitude of the patient population that is treated for substance use problems.

METHODS

Observational study by the Belgian Network of Sentinel General Practices (SGP) in 2013. Baseline (at the first encounter) and 7-month follow-up data were reported of all patients treated for substance use problems. Two main measurements were type of substance use and patient status at follow-up. Multiple logistic regression analysis was used to examine patient status at follow-up.

RESULTS

Of 479 patients, 47.2% had problems with alcohol alone, 20.3% with prescription drugs, 16.7% with illicit drugs other than heroin or methadone and 15.9% with heroin or methadone. Problems with alcohol alone were more prevalent in Flanders (53.0%; 95% confidence interval (CI) 46.8-59.1%) than in Wallonia-Brussels (39.8%; 95% CI 33.1-46.8%), while problems with heroin or methadone were more prevalent in Wallonia-Brussels (27.0%; 95% CI 21.1-33.5%) than in Flanders (7.1%; 95% CI 4.3-10.9%). At follow-up, 32.8% of the patients had dropped out, 29.0% had discontinued GP treatment and 38.2% had continued GP treatment. Overall, 32.4% of 479 patients had continued GP treatment for substance use problems during the study period. In Wallonia-Brussels, this proportion was higher (42.7%; 95% CI 35.9-49.6%) than in Flanders (24.3%; 95% CI 19.2-29.8%).

CONCLUSIONS

A continuous surveillance of the general practice population treated for substance use problems seems to be feasible and useful. The latter is suggested by the specific profile and the relative magnitude of the population. Inter-regional health system differences should be taken into account to estimate the epidemiology of substance use problems among general practice patients.

摘要

背景

全科医生在照顾有（慢性）物质使用问题的患者方面具有优势。开展这项试点研究是为了探讨对全科医疗患者的物质使用问题进行持续监测的可行性和实用性。目标包括：（i）描述缺失值超过1%的变量以及是否有报告称患者不存在与物质相关的问题；（ii）接受物质使用问题治疗的患者群体的特征和规模。

方法

2013年比利时哨点全科医疗网络（SGP）开展的观察性研究。报告了所有接受物质使用问题治疗患者的基线（首次就诊时）和7个月随访数据。两项主要测量指标为物质使用类型和随访时的患者状态。采用多元逻辑回归分析来检查随访时的患者状态。

结果

在479名患者中，47.2%仅存在酒精问题，20.3%存在处方药问题，16.7%存在除海洛因或美沙酮以外的非法药物问题，15.9%存在海洛因或美沙酮问题。仅酒精问题在弗拉芒地区更为普遍（53.0%；95%置信区间（CI）46.8 - 59.1%），而在瓦隆 - 布鲁塞尔地区则为39.8%（95% CI 33.1 - 46.8%）；海洛因或美沙酮问题在瓦隆 - 布鲁塞尔地区更为普遍（27.0%；95% CI 21.1 - 33.5%），而在弗拉芒地区为7.1%（95% CI 4.3 - 10.9%）。随访时，32.8%的患者退出，29.0%停止了全科医生治疗，38.2%继续接受全科医生治疗。总体而言，在研究期间，479名患者中有32.4%继续接受全科医生针对物质使用问题的治疗。在瓦隆 - 布鲁塞尔地区，这一比例更高（42.7%；95% CI 35.9 - 49.6%），高于弗拉芒地区（24.3%；95% CI 19.2 - 29.8%）。