阿拉伯联合酋长国初级保健中实施筛查、简短干预和转诊治疗（SBIRT）的对照试验。
A controlled trial of screening, brief intervention and referral for treatment (SBIRT) implementation in primary care in the United Arab Emirates.
作者信息
Matheson Catriona, Pflanz-Sinclair Christiane, Almarzouqi Amna, Bond Christine M, Lee Amanda J, Batieha Anwar, Al Ghaferi H, El Kashef A
机构信息
1Centre for Addiction Services and Research,University of Stirling,Scotland.
3Academic Primary Care,University of Aberdeen,Aberdeen,Scotland.
出版信息
Prim Health Care Res Dev. 2018 Mar;19(2):165-175. doi: 10.1017/S1463423617000640. Epub 2017 Oct 9.
UNLABELLED
Aim This project evaluated the effectiveness of screening brief intervention and referral for treatment (SBIRT) in primary care in Abu Dhabi to manage patients with problematic substance use. This study aimed to determine whether: (i) training primary care physicians on the SBIRT model increased the identification of patients using substances at a harmful, hazardous or dependent level; (ii) training improved physicians' knowledge, attitudes and beliefs in self-efficacy in managing substance use.
BACKGROUND
Substance use is increasing in the United Arab Emirates yet there has been no formal primary care intervention. SBIRT was considered an appropriate model given its endorsement by the WHO.
METHODS
A controlled trial (two intervention and two matched control clinics) was undertaken. Intervention physicians (n=17) were trained in SBIRT. Physicians' attitudes were measured before and after training and eight months after implementation. Target recruitment was 900 patients. Inclusion criteria were: consenting UAE national, ⩾18 years, using the 'walk-in' primary care clinic. Patient data was collected by physician-administered questionnaire. Prevalence of drug use was measured through electronic patient records. Findings A total of 906 patients were screened, aged 18-82 years and 496 (55%) were female. Of these, 5.7% reported use of amphetamine, 3.9% alcohol, 3.3%, sedatives, 1.7% opioids and 1.1% cannabis. In all, 21 people had a moderate/high ASSIST score and received a brief intervention, but did not attend follow-up; three high-risk people were referred for specialist treatment. Physicians' attitudes towards patients with problematic substance use and providing treatment improved after training, but returned to pre-training levels after eight months. Including the 21 individuals identified from intervention screening, the prevalence of substance use increased to 0.208% (95% CI 0.154-0.274), significantly higher than in control clinics (P<0.001). In conclusion, physicians were generally positive towards SBIRT and SBIRT increased recorded drug related conditions at a practice level. However, poor patient attendance at follow-up requires investigation.
未标注
目的 本项目评估了在阿布扎比初级保健机构中进行筛查、简短干预及转介治疗（SBIRT）对管理有物质使用问题患者的有效性。本研究旨在确定：（i）对初级保健医生进行SBIRT模式培训是否能增加对处于有害、危险或依赖水平使用物质的患者的识别；（ii）培训是否能改善医生在管理物质使用方面的知识、态度和自我效能信念。
背景
阿拉伯联合酋长国的物质使用情况在增加，但尚未有正式的初级保健干预措施。鉴于世界卫生组织对SBIRT的认可，它被认为是一个合适的模式。
方法
进行了一项对照试验（两个干预诊所和两个匹配的对照诊所）。对干预医生（n = 17）进行了SBIRT培训。在培训前、培训后以及实施八个月后测量医生的态度。目标招募患者900名。纳入标准为：同意参与的阿联酋国民，年龄≥18岁，使用“无需预约”的初级保健诊所。患者数据通过医生发放的问卷收集。通过电子患者记录测量药物使用的患病率。结果 共筛查了906名患者，年龄在18 - 82岁之间，496名（55%）为女性。其中，5.7%报告使用过苯丙胺，3.9%使用过酒精，3.3%使用过镇静剂，1.7%使用过阿片类药物，1.1%使用过大麻。共有21人ASSIST评分中等/高并接受了简短干预，但未参加随访；3名高危人员被转介接受专科治疗。培训后医生对有物质使用问题患者及提供治疗的态度有所改善，但八个月后又回到了培训前的水平。包括从干预筛查中识别出的21人，物质使用的患病率增至0.208%（95%可信区间0.154 - 0.274），显著高于对照诊所（P < 0.001）。结论：医生总体上对SBIRT持积极态度，且SBIRT在实践层面增加了记录的与药物相关的情况。然而，患者随访出勤率低需要进行调查。
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