Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany; German Center for Cardiovascular Research, Site Greifswald, Greifswald, Germany.
German Center for Cardiovascular Research, Site Greifswald, Greifswald, Germany; Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Germany.
Prev Med. 2020 Oct;139:106106. doi: 10.1016/j.ypmed.2020.106106. Epub 2020 Apr 28.
Little is known about the long-term impact of brief alcohol interventions (BAIs) on health and on sick days in particular. The aim was to investigate whether BAIs reduce sick days in general hospital patients over two years, and whether effects depend on how BAIs are delivered; either through in-person counseling (PE) or computer-generated written feedback (CO). To investigate this, secondary outcome data from a three-arm randomized controlled trial with 6-, 12-, 18- and 24-month follow-ups were used. The sample included 960 patients (18-64 years) with at-risk alcohol use identified through systematic screening on 13 hospital wards. Patients with particularly severe alcohol problems were excluded. Participants were allocated to PE, CO and assessment only (AO). Both interventions were tailored according to behavior change theory and included three contacts. Self-reported number of sick days in the past 6 months was assessed at all time-points. A zero-inflated negative binomial latent growth model adjusted for socio-demographics, substance use related variables and medical department was calculated. In comparison to AO, PE (OR = 2.18, p = 0.047) and CO (OR = 2.08, p = 0.047) resulted in statistically significant increased odds of reporting no sick days 24 months later. Differences between PE and CO, and concerning sick days when any reported, were non-significant. This study provides evidence for the long-term efficacy of BAIs concerning health, and concerning sick days in particular. BAIs have the potential to reduce the occurrence of sick days over 2 years, independent of whether they are delivered through in-person counseling or computer-generated written feedback.
关于简短酒精干预(BAIs)对健康的长期影响,尤其是对病假的长期影响,人们知之甚少。本研究旨在调查 BAIs 是否会在两年内减少综合医院患者的病假天数,以及这些效果是否取决于 BAIs 的实施方式;即通过面对面咨询(PE)还是计算机生成的书面反馈(CO)。为此,使用了一项三臂随机对照试验的次要结果数据,该试验有 6、12、18 和 24 个月的随访。该样本包括 960 名(18-64 岁)在 13 个病房通过系统筛查发现有高危饮酒行为的患者。排除了有特别严重酒精问题的患者。参与者被分配到 PE、CO 和仅评估(AO)组。两种干预措施均根据行为改变理论进行了定制,包括 3 次联系。在所有时间点都评估了过去 6 个月的病假天数。针对社会人口统计学、与物质使用相关的变量和医疗部门,使用零膨胀负二项式潜在增长模型进行了调整。与 AO 相比,PE(OR=2.18,p=0.047)和 CO(OR=2.08,p=0.047)在 24 个月后报告无病假的可能性具有统计学意义上的增加。PE 和 CO 之间以及关于任何报告的病假天数的差异没有统计学意义。本研究为 BAIs 对健康的长期疗效提供了证据,特别是对病假的影响。BAIs 有可能在 2 年内减少病假的发生,而与它们是通过面对面咨询还是计算机生成的书面反馈来实施无关。