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全科医生在预防急诊酒精筛查和简短干预管理酒精相关问题后的再入院方面的关键作用。

Critical Role of General Practitioners in Preventing Readmission Following Emergency Department Alcohol Screening and Brief Intervention Management of Alcohol-Related Problems.

机构信息

Fiona Stanley Hospital, Murdoch, Western Australia, Australia.

South Metropolitan Health Service, Murdoch, Western Australia, Australia.

出版信息

J Prim Care Community Health. 2021 Jan-Dec;12:21501327211027437. doi: 10.1177/21501327211027437.

Abstract

INTRODUCTION/OBJECTIVES: Alcohol screening and brief intervention (ASBI) strategies are useful in general practice (GP) but their effectiveness in the emergency department (ED) is unclear. We evaluated the effect of ED-based ASBI on re-admissions.

METHODS

453 ED subjects exceeding the threshold score on the three-item Alcohol Use Disorders Identification Test-Consumption (females 3+: males 4+) were randomized. We conducted telephone follow-up at 1 and 3 months and recorded hospital events 6 months pre- and post-enrolment.

RESULTS

Median weekly alcohol use was 20 standard drinks (interquartile range (IQR) 9-45) on enrolment. After 3 months, 247 (55%) were able to be re-interviewed. Median alcohol use was 10 drinks (IQR 4-26). Six months later, subjects receiving ED-ASBI without GP follow-up had significantly greater risk of re-admission compared with those having GP follow-up (OR 1.68, 95%CI 1.06-2.65;  = .028).

CONCLUSIONS

ASBI reduces the likelihood of ED re-presentation only in subjects who have GP follow-up. The study has been registered as a clinical trial (Australian and New Zealand Clinical Trial Registry ACTRN12617001254381).

摘要

简介/目的:酒精筛查和简短干预(ASBI)策略在全科医学中很有用,但在急诊科(ED)中的有效性尚不清楚。我们评估了基于 ED 的 ASBI 对再入院的影响。

方法

453 名 ED 受试者在三项目酒精使用障碍识别测试-消耗(女性 3+:男性 4+)中超过阈值评分被随机分组。我们在 1 个月和 3 个月进行电话随访,并记录 6 个月前和入组后的医院事件。

结果

入组时每周酒精使用量中位数为 20 标准饮料(四分位距(IQR)9-45)。3 个月后,有 247 人(55%)可以重新接受采访。酒精使用量中位数为 10 饮料(IQR 4-26)。6 个月后,未接受 GP 随访的 ED-ASBI 组与接受 GP 随访的组相比,再入院的风险显著增加(OR 1.68,95%CI 1.06-2.65; = .028)。

结论

ASBI 仅在接受 GP 随访的受试者中降低 ED 再次出现的可能性。该研究已作为临床试验注册(澳大利亚和新西兰临床试验注册 ACTRN12617001254381)。

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