Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
Prev Med. 2024 Aug;185:108038. doi: 10.1016/j.ypmed.2024.108038. Epub 2024 Jun 8.
Despite increasing prevalence of substance use disorders (SUD), few patients are diagnosed and treated in primary care settings. This study evaluated changes in knowledge, confidence, and intention to implement screening and brief intervention (SBI) and SUD treatment after clinicians participated in an asynchronous online education course.
A self-selected sample of primary care clinicians in Texas participated in online SBI and SUD education March 2021-July 2023. Baseline and post-training surveys evaluated changes in knowledge, confidence, and intent to implement SBI and SUD treatment. Changes were compared using paired t-tests. Multivariable linear regression examined factors potentially associated with confidence and intention to implement changes. Clinician feedback regarding the course was included.
Of 613 respondents, 50.9% were practicing family medicine clinicians. Knowledge of adolescent screening tools increased from 21.9% to 75.7% (p < 0.001). Knowledge about the number of drinks that define excessive drinking among non-pregnant women increased from 24.5% at baseline to 64.9% (p < 0.001). Clinicians reported lowest confidence in providing opioid use disorder pharmacotherapy, which improved after program participation. Intent to implement SBI and medication for alcohol, nicotine and opioid use disorders increased (p < 0.001) after training. No factors were associated with change in confidence or intention to implement in multivariable models (p > 0.05). Satisfaction was high and nearly 60% reported intention to change their clinical practice because of the program.
Knowledge, confidence, and intent to implement SBI and SUD treatment increased after completing the online course. Clinician satisfaction was high and demonstrated improved intention to implement SBI and SUD treatment.
尽管物质使用障碍（SUD）的患病率不断上升，但在初级保健环境中，只有少数患者得到诊断和治疗。本研究评估了临床医生参加异步在线教育课程后，在知识、信心和实施筛查和简短干预（SBI）以及 SUD 治疗的意愿方面的变化。
德克萨斯州的一组自我选择的初级保健临床医生参加了 2021 年 3 月至 2023 年 7 月的在线 SBI 和 SUD 教育。基线和培训后调查评估了在知识、信心和实施 SBI 和 SUD 治疗的意愿方面的变化。使用配对 t 检验比较变化。多变量线性回归分析了与信心和实施变化意愿相关的潜在因素。课程的临床医生反馈也包括在内。
在 613 名受访者中，50.9%是从事家庭医学临床医生。青少年筛查工具的知识从 21.9%增加到 75.7%（p<0.001）。关于非孕妇中定义过量饮酒的饮料数量的知识从基线时的 24.5%增加到 64.9%（p<0.001）。临床医生报告说，他们对提供阿片类药物使用障碍药物治疗的信心最低，而在参与该项目后，这种信心得到了提高。实施 SBI 和治疗酒精、尼古丁和阿片类药物使用障碍的意愿增加（p<0.001）。在多变量模型中，没有因素与信心或实施意愿的变化相关（p>0.05）。满意度很高，近 60%的人表示因为该项目而打算改变他们的临床实践。
完成在线课程后，SBI 和 SUD 治疗的知识、信心和实施意愿都有所增加。临床医生满意度很高，并表现出改善实施 SBI 和 SUD 治疗的意愿。
