Agley Jon, Crabb David W, Harris Lisa E, Gassman Ruth A, Gerke Steven P
Institute for Research on Addictive Behavior, School of Public Health, Indiana University, Bloomington, IN, USA.
Indiana University School of Medicine, Indianapolis, IN, USA.
Health Serv Res Manag Epidemiol. 2015 Oct 26;2:2333392815612476. doi: 10.1177/2333392815612476. eCollection 2015 Jan-Dec.
Screening, brief intervention, and referral to treatment (SBIRT) is an efficacious prevention practice. However, little research has assessed differences in prescreening outcomes between inpatient and outpatient primary care or among different prescreening administration methods. This study tested whether administration method (self-administered vs interview) and setting (inpatient versus outpatient) predicted prescreening outcomes in a large sample of primary care patients. Then, among patients who prescreened positive, it tested whether full screening scores differed by administration method and setting.
Researchers used binomial logistic regression to assess predicted prescreening outcomes and analysis of variance to assess differences in SBIRT screening scores across a total of 14 447 unique patient visits in 10 outpatient sites and 1 centrally located hospital.
Controlling for gender, depression, and other substance use, both medical setting and method of prescreening, predicted prescreening results. Among patients who prescreened positive for alcohol, setting also was associated with mean screening scores. However, outcomes were not uniform by substance (eg, alcohol vs other drugs).
The results support previous studies on this topic that had utilized cross-study comparison or that were not specific to SBIRT prescreening/screening mechanisms. At the same time, nuanced findings were observed that had not previously been reported and suggest the need for further research in this area.
筛查、简短干预及转介治疗（SBIRT）是一种有效的预防措施。然而，很少有研究评估住院和门诊初级保健患者在预筛查结果上的差异，或不同预筛查管理方法之间的差异。本研究测试了管理方法（自我管理与面谈）和环境（住院与门诊）是否能预测大量初级保健患者样本的预筛查结果。然后，在预筛查呈阳性的患者中，测试全面筛查分数是否因管理方法和环境而异。
研究人员使用二项逻辑回归来评估预测的预筛查结果，并使用方差分析来评估在10个门诊地点和1家位于中心位置的医院共14447次独特患者就诊中SBIRT筛查分数的差异。
在控制了性别、抑郁和其他物质使用情况后，医疗环境和预筛查方法均能预测预筛查结果。在酒精预筛查呈阳性患者中，环境也与平均筛查分数相关。然而，不同物质（如酒精与其他药物）的结果并不一致。
结果支持了此前关于该主题的研究，这些研究采用了跨研究比较，或并非特定针对SBIRT预筛查/筛查机制。同时，观察到了此前未报告的细微差别，表明该领域需要进一步研究。
