Abrahamsson Tove, Magnusdottir Ester, Berge Jonas, Lundvall Åsa, Öjehagen Agneta, Håkansson Anders
Lund University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund, Sweden.
Region Skåne, Center of Primary Care, Malmö, Sweden.
Addict Behav Rep. 2024 Jan 4;19:100526. doi: 10.1016/j.abrep.2024.100526. eCollection 2024 Jun.
Few individuals with alcohol use disorders receive treatment. Primary care has been suggested as an arena for early treatment for these disorders.
To evaluate whether the presence of a specialized addiction nurse can increase alcohol-related physician consultations in a primary care setting.
This controlled intervention study included one intervention and one control primary care unit in Malmö, Sweden. At the intervention unit, an addiction nurse experienced in alcohol use disorder treatment was present 20 h weekly for 12 months. At both units, an educational lecture on alcohol use disorders was given at study start. The outcome was physicians' monthly number of alcohol-related diagnostic codes. Data were compared between intervention and control units using Poisson Regression. Eight statistical models were analyzed and Akaike information criterion was used to select the final model.
The intervention was significantly associated with an increased number of registered alcohol-related diagnostic codes (risk ratio 1.33, 95 confidence interval 1.08-1.62). However, in sensitivity analyses, such a slope effect was more uncertain and no step effect was seen. A significant association was seen between the educational lecture and an increase in the number of registered alcohol-related codes at the sites (risk ratio 2.47, 1.37-4.46).
The presence of specialized addiction staff in a primary healthcare setting might increase the number of alcohol-related physician consultations in primary care, although more research is needed. An educational lecture about alcohol use disorders could be a simple but effective intervention to increase alcohol-related physician consultations in primary care.
很少有酒精使用障碍患者接受治疗。初级保健被认为是对这些疾病进行早期治疗的场所。
评估在初级保健环境中配备专业成瘾护士是否能增加与酒精相关的医生会诊次数。
这项对照干预研究纳入了瑞典马尔默的一个干预初级保健单元和一个对照初级保健单元。在干预单元，一名有酒精使用障碍治疗经验的成瘾护士每周工作20小时，为期12个月。在两个单元，研究开始时都举办了一场关于酒精使用障碍的教育讲座。结果指标是医生每月与酒精相关的诊断编码数量。使用泊松回归对干预单元和对照单元的数据进行比较。分析了八个统计模型，并使用赤池信息准则选择最终模型。
干预与登记的与酒精相关的诊断编码数量增加显著相关（风险比1.33，95%置信区间1.08 - 1.62）。然而，在敏感性分析中，这种斜率效应更不确定，且未观察到阶跃效应。在各站点，教育讲座与登记的与酒精相关的编码数量增加之间存在显著关联（风险比2.47，1.37 - 4.46）。
在初级卫生保健环境中配备专业成瘾工作人员可能会增加初级保健中与酒精相关的医生会诊次数，尽管还需要更多研究。关于酒精使用障碍的教育讲座可能是一种简单而有效的干预措施，可增加初级保健中与酒精相关的医生会诊次数。
