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酒精滥用筛查:2016 年美国初级保健提供者的实践。

Screening for Alcohol Misuse: Practices Among U.S. Primary Care Providers, DocStyles 2016.

机构信息

Centers for Disease Control and Prevention, Atlanta, Georgia.

Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Am J Prev Med. 2018 Feb;54(2):173-180. doi: 10.1016/j.amepre.2017.11.008. Epub 2017 Dec 11.

Abstract

INTRODUCTION

Excessive alcohol use is associated with car crashes, violence, and multiple disease conditions, including fetal alcohol spectrum disorders. The U.S. Preventive Services Task Force (USPSTF) recommends that primary care providers screen all adults and conduct brief counseling interventions with those who misuse alcohol. The USPSTF prefers use of three screening tools that measure alcohol consumption (Alcohol Use Disorders Identification Test, Alcohol Use Disorders Identification Test-Consumption, and National Institute on Alcohol Abuse and Alcoholism Single Question) because these tools detect the full spectrum of alcohol misuse in adults. This study estimated the prevalence of primary care provider screening practices for alcohol misuse and examined factors associated with using a USPSTF-preferred screening tool.

METHODS

In 2016, a cross-sectional analysis was conducted on self-reported 2016 DocStyles data to estimate the prevalence of different screening tools used by 1,506 primary care providers-family practitioners, internists, obstetrician/gynecologists, and nurse practitioners. Adjusted prevalence ratios were calculated using logistic regression to examine the association between provider attributes and use of USPSTF-preferred screening tools.

RESULTS

In this study, 96% of providers reported screening patients for alcohol misuse. Among those that screened, 38% used a USPSTF-preferred screening tool. Provider specialty, awareness of USPSTF guidelines, and mode of administering screening tool were associated with using a preferred screening tool.

CONCLUSIONS

Although most primary care providers reported screening for alcohol misuse, about two thirds did not use a tool capable of detecting the full spectrum of alcohol misuse. Using suitable screening tools will better identify patients who misuse alcohol and increase the opportunity for appropriate intervention, ultimately helping to reduce the burden from the many conditions associated with excessive alcohol consumption.

摘要

简介

过量饮酒与车祸、暴力和多种疾病状况有关,包括胎儿酒精谱系障碍。美国预防服务工作组(USPSTF)建议初级保健提供者对所有成年人进行筛查,并对滥用酒精的人进行简短的咨询干预。USPSTF 推荐使用三种衡量饮酒量的筛查工具(酒精使用障碍识别测试、酒精使用障碍识别测试-消费和国家酒精滥用和酒精中毒单一问题),因为这些工具可以检测成年人中所有类型的酒精滥用。本研究估计了初级保健提供者筛查酒精滥用的做法的流行率,并研究了与使用 USPSTF 推荐的筛查工具相关的因素。

方法

2016 年,对自我报告的 2016 年 DocStyles 数据进行了横断面分析,以估计 1506 名初级保健提供者(家庭医生、内科医生、妇产科医生和执业护士)使用不同筛查工具的流行率。使用逻辑回归计算调整后的患病率比,以检查提供者特征与使用 USPSTF 推荐的筛查工具之间的关联。

结果

在这项研究中,96%的提供者报告对患者进行了酒精滥用筛查。在进行筛查的人中,有 38%使用了 USPSTF 推荐的筛查工具。提供者的专业、对 USPSTF 指南的认识以及筛查工具的管理模式与使用推荐的筛查工具有关。

结论

尽管大多数初级保健提供者报告对酒精滥用进行了筛查,但大约三分之二的人没有使用能够检测到酒精滥用全貌的工具。使用合适的筛查工具将更好地识别滥用酒精的患者,并增加适当干预的机会,最终有助于减轻与过量饮酒相关的许多疾病的负担。

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