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医生在青少年物质使用障碍筛查中面临的障碍。

Barriers Faced by Physicians in Screening for Substance Use Disorders Among Adolescents.

机构信息

IBM Watson Health, Bethesda, Maryland (Palmer, Karakus); RTI International, Rockville, Maryland (Mark).

出版信息

Psychiatr Serv. 2019 May 1;70(5):409-412. doi: 10.1176/appi.ps.201800427. Epub 2019 Feb 20.

Abstract

OBJECTIVE

This study identifies key barriers faced by primary care providers (PCP) in implementation of screening, brief intervention, and referral to treatment (SBIRT) services for substance use disorders among adolescents.

METHODS

The authors used mixed methods, including 12 key informant interviews and a survey with 75 PCPs, to identify key barriers to PCP implementation of SBIRT services.

RESULTS

Time constraints, challenges related to parental involvement, a perceived lack of effectiveness of brief intervention services, and lack of training in providing brief intervention were barriers to screening and brief intervention. Referral to treatment was frequently perceived as a challenge. Increased reimbursement and dedicated resources were important interventions for improving screening rates.

CONCLUSIONS

Increased reimbursement could support workflow enhancements to improve the consistency of SBIRT procedures and alleviate time constraints. Consistent SBIRT applications for all adolescents could also be supported by increasing PCP training in brief intervention.

摘要

目的

本研究确定了初级保健提供者(PCP)在实施青少年物质使用障碍筛查、简短干预和转介治疗(SBIRT)服务方面面临的主要障碍。

方法

作者采用混合方法,包括 12 名关键信息提供者访谈和 75 名 PCP 的调查,以确定 PCP 实施 SBIRT 服务的主要障碍。

结果

时间限制、与父母参与相关的挑战、对简短干预服务效果的感知不足以及提供简短干预方面的培训不足是筛查和简短干预的障碍。转介治疗经常被认为是一个挑战。增加报销和专用资源是提高筛查率的重要干预措施。

结论

增加报销可以支持工作流程的改进,以提高 SBIRT 程序的一致性并减轻时间限制。通过增加 PCP 在简短干预方面的培训,也可以支持对所有青少年进行一致的 SBIRT 应用。

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