Laporte Catherine, Vaillant-Roussel Hélène, Pereira Bruno, Blanc Olivier, Eschalier Bénédicte, Kinouani Shérazade, Brousse Georges, Llorca Pierre-Michel, Vorilhon Philippe
Univ Clermont 1, UFR Medicine, Department of General Practice, Clermont-Ferrand, F-63001, France
Univ Clermont 1, UFR Medicine, EA7280, Clermont-Ferrand, F-63001, France.
Ann Fam Med. 2017 Mar;15(2):131-139. doi: 10.1370/afm.2003.
Brief intervention to reduce cannabis is a promising technique that could be adapted for use in primary care, but it has not been well studied in this setting. We tested the efficacy of a brief intervention conducted by general practitioners among cannabis users aged 15 to 25 years.
We performed a cluster randomized controlled trial with 77 general practitioners in France. The intervention consisted of an interview designed according to the FRAMES (feedback, responsibility, advice, menu, empathy, self-efficacy) model, while the control condition consisted of routine care.
The general practitioners screened and followed up 261 young cannabis users. After 1 year, there was no significant difference between the intervention and control groups in the median number of joints smoked per month among all users (17.5 vs 17.5; = .13), but there was a difference in favor of the intervention among nondaily users (3 vs 10; = .01). After 6 months, the intervention was associated with a more favorable change from baseline in the number of joints smoked (-33.3% vs 0%, = .01) and, among users younger than age of 18, smoking of fewer joints per month (12.5 vs 20, = .04).
Our findings suggest that a brief intervention conducted by general practitioners with French young cannabis users does not affect use overall. They do, however, strongly support use of brief intervention for younger users and for moderate users.
简短干预以减少大麻使用是一项有前景的技术，可适用于初级保健，但在这种环境下尚未得到充分研究。我们测试了全科医生对15至25岁大麻使用者进行简短干预的效果。
我们在法国对77名全科医生进行了一项整群随机对照试验。干预包括根据FRAMES（反馈、责任、建议、菜单、同理心、自我效能）模型设计的访谈，而对照条件为常规护理。
全科医生筛查并随访了261名年轻大麻使用者。1年后，干预组和对照组在所有使用者中每月吸食大麻烟卷的中位数方面无显著差异（17.5对17.5；P = 0.13），但在非每日使用者中，干预组更具优势（3对10；P = 0.01）。6个月后，干预与吸食大麻烟卷数量相对于基线的更有利变化相关（-33.3%对0%，P = 0.01），并且在18岁以下使用者中，每月吸食的大麻烟卷更少（12.5对20，P = 0.04）。
我们的研究结果表明，全科医生对法国年轻大麻使用者进行的简短干预总体上不影响大麻使用。然而，它们确实有力地支持对年轻使用者和中度使用者使用简短干预。
