British Columbia Centre on Substance Use, Vancouver, BC, Canada.
Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, BC, Canada.
Addiction. 2021 Jul;116(7):1892-1900. doi: 10.1111/add.15383. Epub 2021 Jan 27.
To improve evidence-based addiction care in acute care settings, many hospitals across North America are developing an inpatient addiction medicine consultation service (AMCS). St Paul's Hospital in Vancouver, Canada houses a large interdisciplinary AMCS. This study aimed to: (1) describe the current model of clinical care and its evolution over time; (2) evaluate requests for an AMCS consultation over time; (3) highlight the established clinical training opportunities and educational curriculum and (4) provide some lessons learned.
DESIGN, SETTING AND PARTICIPANTS: A retrospective observational analysis in an urban, academic hospital in Vancouver, Canada with a large interdisciplinary AMCS, studied from 2013 to 2018, among individuals who presented to hospital and had a substance use disorder.
Data were collected using the hospital's electronic medical records. The primary outcome was number of AMCS consultations over time.
In 2014 the hospital's AMCS was restructured into an academic, interdisciplinary consultation service. A 228% increase in the number of consultations was observed between 2013 (1 year prior to restructuring) and 2018 (1373 versus 4507, respectively; P = 0.027). More than half of AMCS consultations originated from the emergency department, with this number increasing over time (55% in 2013 versus 74% in 2018). Referred patients were predominantly male (> 60% in all 5 years) between the ages of 45 and 65 years. Reasons for consultation remained consistent and included: opioids (33%), stimulants (30%), alcohol (23%) and cannabis use (8%).
After St Paul's Hospital in Vancouver, Canada was restructured in 2014 to a large, interdisciplinary addiction medicine consultation service (AMCS), the AMCS saw a 228% increase in the number of consultation requests with more than half of requests originating from the emergency department. Approximately two-thirds of consultation requests were for opioid or stimulant use.
为了在急症护理环境中提供基于证据的成瘾治疗，北美许多医院正在开发住院成瘾医学咨询服务（AMCS）。加拿大温哥华的圣保罗医院拥有一个大型的跨学科 AMCS。本研究旨在：（1）描述当前的临床护理模式及其随时间的演变；（2）评估随时间推移对 AMCS 咨询的需求；（3）突出既定的临床培训机会和教育课程；（4）提供一些经验教训。
设计、设置和参与者：在加拿大温哥华的一家城市学术医院中进行的回顾性观察分析，该医院设有大型跨学科 AMCS，研究时间为 2013 年至 2018 年，对象为就诊于医院且存在物质使用障碍的个体。
使用医院的电子病历收集数据。主要结果是随时间推移的 AMCS 咨询次数。
2014 年，医院的 AMCS 改组为学术性、跨学科咨询服务。2013 年（改组前 1 年）和 2018 年（分别为 1373 次和 4507 次；P=0.027）之间，咨询次数增加了 228%。超过一半的 AMCS 咨询来自急诊科，而且这个数字随着时间的推移而增加（2013 年为 55%，2018 年为 74%）。转介患者主要是 45 至 65 岁之间的男性（所有 5 年中均超过 60%）。咨询的原因仍然一致，包括：阿片类药物（33%）、兴奋剂（30%）、酒精（23%）和大麻使用（8%）。
在加拿大温哥华的圣保罗医院于 2014 年改组为大型跨学科成瘾医学咨询服务（AMCS）之后，AMCS 的咨询请求数量增加了 228%，其中超过一半的请求来自急诊科。大约三分之二的咨询请求是关于阿片类药物或兴奋剂的使用。
