Elder Joshua W, Wu Evan F, Chenoweth James A, Holmes James F, Parikh Aman K, Moulin Aimee K, Trevino Tommie G, Richards John R
Department of Emergency Medicine, University of California Davis Medical Center, Sacramento, CA, USA.
Emerg Med Int. 2020 Jul 17;2020:8275386. doi: 10.1155/2020/8275386. eCollection 2020.
Screening for unhealthy alcohol and drug use in the emergency department (ED) can be challenging due to crowding, lack of privacy, and overburdened staff. The objectives of this study were to determine the feasibility and utility of a brief tablet-based screening method in the ED and if patients would consider a face-to-face meeting with a certified alcohol and drug counselor (CADC) for more in-depth screening, brief intervention, and referral to treatment (SBIRT) helpful via this interface.
A tablet-based questionnaire was offered to 500 patients. Inclusion criteria were age ≥18, Emergency Severity Index 2-5, and English comprehension. Subjects were excluded if they had evidence of acute intoxication and/or received sedating medication.
A total of 283 (57%) subjects were enrolled over a 4-week period, which represented an increase of 183% over the monthly average of patients referred for SBIRT by the CADC prior to the study. There were 131 (46%) who screened positive for unhealthy alcohol and drug use, with 51 (39%) and 37 (28%) who screened positive for solely unhealthy alcohol use and drug use/drug use disorders, respectively. There were 43 (33%) who screened positive for combined unhealthy alcohol and drug use. Despite willingness to participate in the tablet-based questionnaire, only 20 (15%) with a positive screen indicated via the tablet that a face-to-face meeting with the CADC for further SBIRT would be helpful.
Brief tablet-based screening for unhealthy alcohol and drug use in the ED was an effective method to increase the number of adult patients identified than solely by their treating clinicians. However, only a minority of subjects screening positive using this interface believed a face-to-face meeting with the CADC for further SBIRT would be helpful.
由于急诊室人满为患、缺乏隐私且工作人员负担过重，在急诊室筛查不健康的酒精和药物使用情况具有挑战性。本研究的目的是确定一种基于平板电脑的简短筛查方法在急诊室的可行性和实用性，以及患者是否会认为通过该界面与认证酒精和药物顾问（CADC）进行面对面会议以进行更深入的筛查、简短干预和转介治疗（SBIRT）会有所帮助。
向500名患者提供了基于平板电脑的问卷。纳入标准为年龄≥18岁、急诊严重程度指数为2 - 5且具备英语理解能力。如果受试者有急性中毒证据和/或接受了镇静药物治疗，则将其排除。
在4周内共招募了283名（57%）受试者，这比研究前CADC每月转介进行SBIRT的患者平均人数增加了183%。有131名（46%）受试者筛查出不健康的酒精和药物使用呈阳性，其中分别有51名（39%）和37名（28%）仅筛查出不健康的酒精使用和药物使用/药物使用障碍呈阳性。有43名（33%）受试者筛查出不健康的酒精和药物联合使用呈阳性。尽管愿意参与基于平板电脑的问卷，但只有20名（15%）筛查呈阳性的受试者通过平板电脑表示与CADC进行面对面会议以进行进一步的SBIRT会有所帮助。
在急诊室基于平板电脑对不健康的酒精和药物使用进行简短筛查是一种有效的方法，可增加被识别出的成年患者数量，而不仅仅依靠其主治医生识别。然而，使用该界面筛查呈阳性的受试者中，只有少数人认为与CADC进行面对面会议以进行进一步的SBIRT会有所帮助。
