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准备好改变:一项通过电话提供的针对酒精、甲基苯丙胺和大麻使用问题的干预项目的初步效果

Ready2Change: Preliminary effectiveness of a telephone-delivered intervention program for alcohol, methamphetamine and cannabis use problems.

作者信息

Grigg Jasmin, Volpe Isabelle, Tyler Jonathan, Hall Kate, McPherson Belinda, Lubman Dan I, Manning Victoria

机构信息

Turning Point, Eastern Health, Melbourne, Australia.

Eastern Health Clinical School, Monash University, Melbourne, Australia.

出版信息

Drug Alcohol Rev. 2022 Feb;41(2):517-527. doi: 10.1111/dar.13363. Epub 2021 Aug 3.

Abstract

INTRODUCTION

Telehealth has considerable potential to overcome many of the barriers to accessing care for substance use problems, thereby increasing the opportunity for earlier intervention. The Ready2Change program is a multiple-session outbound telephone-delivered cognitive and behavioural intervention for mild-to-moderate substance use disorders, embedded within a long-established 24/7 alcohol and drug helpline. We sought to analyse routinely collected program data in a preliminary study to examine the effectiveness of Ready2Change in reducing substance use problem severity and psychological distress.

METHODS

A retrospective analysis of program data from December 2013 to June 2018 was performed. Analysed cases were 249 clients living in Victoria, Australia with alcohol (n = 191), methamphetamine (n = 40) or cannabis (n = 18) as their primary drug of concern. A within-subjects design was used to examine pre- and post-intervention substance use problem severity and psychological distress.

RESULTS

For alcohol cases, there was a statistically significant decrease in alcohol problem severity [AUDIT, mean difference = -12.7, 95% confidence interval (CI) -14.0, -11.5]. Statistically significant reductions in drug problem severity (DUDIT) were observed for methamphetamine (mean difference = -17.3, 95% CI -20.9, -13.7) and cannabis (mean difference = -15.9, 95% CI -22.3, -9.6) cases. All groups showed reductions in problem severity for other substances used (P < 0.05) and psychological distress (P < 0.001).

DISCUSSION AND CONCLUSIONS

Results suggest Ready2Change benefits clients with alcohol, methamphetamine and cannabis use problems, with the potential to improve treatment access for health inequity groups including those living in remote areas. These findings warrant further investigation into the effectiveness of this program.

摘要

引言

远程医疗在克服物质使用问题获得护理的诸多障碍方面具有巨大潜力,从而增加早期干预的机会。“准备好改变”项目是一项通过多阶段外拨电话提供的针对轻度至中度物质使用障碍的认知和行为干预措施,该项目嵌入了一个长期运营的全天候酒精和药物求助热线。我们试图在一项初步研究中分析常规收集的项目数据,以检验“准备好改变”项目在降低物质使用问题严重程度和心理困扰方面的有效性。

方法

对2013年12月至2018年6月期间的项目数据进行回顾性分析。分析的案例为249名居住在澳大利亚维多利亚州的客户,他们主要关注的药物分别为酒精(n = 191)、甲基苯丙胺(n = 40)或大麻(n = 18)。采用受试者内设计来检验干预前后物质使用问题的严重程度和心理困扰情况。

结果

对于酒精案例,酒精问题严重程度有统计学显著下降【酒精使用障碍识别测试(AUDIT),平均差异=-12.7,95%置信区间(CI)-14.0,-11.5】。对于甲基苯丙胺案例(平均差异=-17.3,95% CI -20.9,-13.7)和大麻案例(平均差异=-15.9,95% CI -22.2,-9.6),观察到药物问题严重程度(药物使用障碍识别测试,DUDIT)有统计学显著下降。所有组在使用的其他物质的问题严重程度(P<0.05)和心理困扰(P<0.001)方面均有所降低。

讨论与结论

结果表明,“准备好改变”项目使有酒精、甲基苯丙胺和大麻使用问题的客户受益,有可能改善包括偏远地区居民在内的健康不平等群体的治疗可及性。这些发现值得对该项目的有效性进行进一步研究。

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