Grant Sean, Watkins Katherine E, Bogart Andy, Paddock Susan M, Hepner Kimberly A
From the RAND Corporation, Santa Monica, CA.
J Am Board Fam Med. 2016 Nov 12;29(6):682-687. doi: 10.3122/jabfm.2016.06.160023.
This study assessed patient-reported alcohol treatment offers by health care providers following routine annual screening for alcohol use in primary care.
A telephone interview within 30 days of the annual screen assessed demographics, alcohol and other drug use, mental health symptoms, and offers of formal treatment for alcohol by a Veterans Affairs health care provider. We included male patients (n = 349) at high risk for an alcohol use disorder (AUD) who had not received alcohol treatment in the past 3 months. We assessed self-reported receipt of any offers of formal treatment for alcohol use and associations of offers of formal treatment for alcohol with demographic and clinical variables.
A total of 145 patients (41.5%) reported an offer of at least 1 type of formal treatment for alcohol use. More severe alcohol misuse (odds ratio, 1.07; 95% confidence interval, 1.03-1.11) and younger age (odds ratio, 0.97, 95% confidence interval, 0.95-0.99) were associated with reporting an offer of formal treatment.
Most primary care patients at high risk for an AUD were not offered treatment following annual screening. Our results highlight the importance of training primary care providers in what constitutes appropriate medical treatment for this population and the most effective ways of offering treatment.
本研究评估了在初级保健机构对酒精使用进行常规年度筛查后,医疗保健提供者报告的向患者提供酒精治疗的情况。
在年度筛查后30天内进行电话访谈,评估人口统计学特征、酒精及其他药物使用情况、心理健康症状,以及退伍军人事务部医疗保健提供者提供的酒精正式治疗情况。我们纳入了过去3个月内未接受过酒精治疗的酒精使用障碍(AUD)高危男性患者(n = 349)。我们评估了自我报告的是否收到任何酒精使用正式治疗的提议,以及酒精使用正式治疗提议与人口统计学和临床变量之间的关联。
共有145名患者(41.5%)报告收到了至少一种酒精使用正式治疗的提议。更严重的酒精滥用(比值比,1.07;95%置信区间,1.03 - 1.11)和较年轻的年龄(比值比,0.97,95%置信区间,0.95 - 0.99)与报告收到正式治疗提议相关。
大多数AUD高危的初级保健患者在年度筛查后未得到治疗。我们的结果凸显了培训初级保健提供者了解针对该人群的适当医学治疗内容以及提供治疗的最有效方法的重要性。