Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Central Virginia VA Health Care System, Richmond, VA, USA.
Department of Psychiatry, Virginia Commonwealth University and Central Virginia VA Health Care System, Richmond, VA, USA.
Liver Int. 2020 Sep;40(9):2090-2094. doi: 10.1111/liv.14589. Epub 2020 Jul 15.
Alcohol use disorder (AUD) screening is important but focused training with using AUDIT-10 with counselling/mental health (MH) referral may be needed. We aimed to compare the effect of training on AUD screening/intervention in hepatology clinics in pre vs post-training phases of a quality-improvement initiative. Pre-training encounters were evaluated for inquiry into AUD, AUDIT-10 and MH referrals. Dedicated AUD-related training was provided to hepatology providers and analyses repeated post-training. Pre-training (n = 378) and post-training patients(n = 318) had similar demographics and disease characteristics. Post-training there was higher inquiry about alcohol(92% vs 80%, P < .0001), counselling (82% vs 68%, P < .0001). This led to higher diagnosis of drinkers (49% vs 31%, P < .0001) of whom higher proportion had AUDIT-10 administered(91% vs 34%, P < .0001) and referred to MH(29% vs 8%, P < .0001). On regression presumed alcohol-related aetiology, younger age and post-training period were associated with AUDIT-10 administration. AUD-focused training significantly improves rates of screening and MH referral for problem drinking in a hepatology clinic population.
酒精使用障碍(AUD)筛查很重要,但可能需要使用 AUDIT-10 进行有针对性的培训,并提供咨询/心理健康(MH)转介。我们旨在比较在质量改进计划的培训前和培训后阶段,AUD 筛查/干预在肝病诊所中的效果。在培训前评估了对 AUD、AUDIT-10 和 MH 转介的询问。为肝病提供者提供了专门的 AUD 相关培训,并在培训后重复进行了分析。培训前(n = 378)和培训后(n = 318)患者的人口统计学和疾病特征相似。培训后,对酒精的询问更多(92%比 80%,P <.0001),咨询更多(82%比 68%,P <.0001)。这导致更多的饮酒者被诊断出来(49%比 31%,P <.0001),其中更多的人接受了 AUDIT-10 评估(91%比 34%,P <.0001),并被转介到 MH(29%比 8%,P <.0001)。在回归中,假定与酒精相关的病因、年龄较小和培训后时期与 AUDIT-10 的使用有关。针对 AUD 的培训可显著提高肝病诊所人群的筛查率和 MH 转介率,以治疗酗酒问题。