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在一项针对临床护理中 HIV 患者计算机化简短干预的实施研究中,酒精摄入量下降。

Decreased Alcohol Consumption in an Implementation Study of Computerized Brief Intervention among HIV Patients in Clinical Care.

机构信息

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N Broadway, Suite 115, Baltimore, MD, 21205, USA.

Department of Psychiatry and Behavioral Neurobiology, University of Alabama At Birmingham, Birmingham, AL, USA.

出版信息

AIDS Behav. 2021 Dec;25(12):4074-4084. doi: 10.1007/s10461-021-03295-9. Epub 2021 May 16.


DOI:10.1007/s10461-021-03295-9
PMID:33993353
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8594281/
Abstract

This prospective, nonrandomized implementation study evaluated a computerized brief intervention (CBI) for persons with HIV (PWH) and heavy/hazardous alcohol use. CBI was integrated into two HIV primary care clinics. Eligible patients were engaged in care, ≥ 18 years old, English speaking, endorsed heavy/hazardous alcohol use on the Alcohol Use Disorders Identification Test-C (AUDIT-C). Two 20-min computerized sessions using cognitive behavioral techniques were delivered by a 3-D avatar on touch screen tablets. Of 816 eligible AUDIT-C scores, 537 (66%) resulted in CBI invitation, 226 (42%) of invited patients enrolled, and 176 (78%) of enrolled patients watched at least one session. CBI enrollment was associated with a significant average reduction of 9.1 drinks/week (95% CI - 14.5, - 3.6) 4-12 months post-enrollment. Among those who participated in one or both sessions, average reduction in drinks/week was 11.7 drinks/week (95% CI - 18.8, - 4.6). There was corresponding improvement in AUDIT-C scores. Overall patients reported high levels of intervention satisfaction, particularly among older and Black patients. These promising results point to a practical intervention for alcohol reduction in this vulnerable patient population with elevated rates of heavy/hazardous drinking. Future research should examine strategies to increase initial engagement, strengthen intervention effects to increase the number of patients who achieve non-hazardous drinking, and examine the duration of therapeutic effects.

摘要

本前瞻性、非随机实施研究评估了一种针对艾滋病毒感染者(PWH)和重度/危险饮酒者的计算机化简短干预(CBI)。CBI 整合到两家 HIV 初级保健诊所中。符合条件的患者正在接受治疗,年龄≥18 岁,英语流利,在酒精使用障碍识别测试-C(AUDIT-C)上表示重度/危险饮酒。使用认知行为技术,通过 3D 头像在触摸屏平板电脑上进行两次 20 分钟的计算机化会话。在 816 份符合条件的 AUDIT-C 评分中,有 537 份(66%)导致 CBI 邀请,226 份(42%)受邀患者入组,176 份(78%)入组患者观看了至少一次会话。CBI 入组与入组后 4-12 个月平均每周饮酒量减少 9.1 份(95%CI-14.5,-3.6)显著相关。在参加了一次或两次会话的患者中,每周饮酒量平均减少 11.7 份(95%CI-18.8,-4.6)。AUDIT-C 评分也相应改善。总体而言,患者对干预措施的满意度较高,尤其是年龄较大和黑人患者。这些有希望的结果表明,对于饮酒量较高的这一脆弱患者群体,CBI 是一种实用的减少饮酒量的干预措施。未来的研究应探讨增加初始参与度的策略,加强干预效果,以增加达到非危险饮酒的患者数量,并检查治疗效果的持续时间。

相似文献

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Decreased Alcohol Consumption in an Implementation Study of Computerized Brief Intervention among HIV Patients in Clinical Care.

AIDS Behav. 2021-12

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[7]
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引用本文的文献

[1]
Alcohol use and the longitudinal HIV care continuum for people with HIV who enrolled in care between 2011 and 2019.

Ann Epidemiol. 2023-9

[2]
Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol.

Contemp Clin Trials Commun. 2023-3-24

[3]
Project BETTER: A Family-Centered, Technology-Delivered Intervention for Pregnant People with Opioid Use Disorder.

Children (Basel). 2023-2-11

[4]
Characterizing Unhealthy Alcohol Use Patterns and Their Association with Alcohol Use Reduction and Alcohol Use Disorder During Follow-Up in HIV Care.

AIDS Behav. 2023-5

[5]
Interventions for Integrating Behavioral Health Services Into HIV Clinical Care: A Narrative Review.

Open Forum Infect Dis. 2022-7-26

[6]
Acceptability, Adaptability, and Feasibility of a Novel Computer-Based Virtual Counselor-Delivered Alcohol Intervention: Focus Group and In-depth Interview Study Among Adults With HIV or Tuberculosis in Indian Clinical Settings.

JMIR Form Res. 2022-5-27

[7]
HealthCall: A randomized trial assessing a smartphone enhancement of brief interventions to reduce heavy drinking in HIV care.

J Subst Abuse Treat. 2022-7

本文引用的文献

[1]
Changing Patterns of Alcohol Use and Probability of Unsuppressed Viral Load Among Treated Patients with HIV Engaged in Routine Care in the United States.

AIDS Behav. 2021-4

[2]
Effectiveness of naltrexone treatment for alcohol use disorders in HIV: a systematic review.

Subst Abuse Treat Prev Policy. 2020-3-18

[3]
World Health Organization risk drinking level reductions are associated with improved functioning and are sustained among patients with mild, moderate and severe alcohol dependence in clinical trials in the United States and United Kingdom.

Addiction. 2020-9

[4]
Alcohol use disorders.

Lancet. 2019-8-31

[5]
RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review.

Front Public Health. 2019-3-29

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Alcohol Clin Exp Res. 2019-5

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Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials.

PLoS Med. 2018-12-18

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Alcohol Use Patterns and Subsequent Sexual Behaviors Among Women, Men who have Sex with Men and Men who have Sex with Women Engaged in Routine HIV Care in the United States.

AIDS Behav. 2019-6

[9]
Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement.

JAMA. 2018-11-13

[10]
Missingness in the Setting of Competing Risks: from missing values to missing potential outcomes.

Curr Epidemiol Rep. 2018-6

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