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基于动机性访谈的干预措施对降低西班牙初级保健患者危险饮酒行为的有效性:一项对照临床试验。

Effectiveness of a Motivational Interviewing-Based Intervention in Decreasing Risky Alcohol Use in Primary Care Patients in Spain: A Controlled Clinical Trial.

作者信息

Pérula-Jiménez Celia, Romero-Rodríguez Esperanza, Fernández-García José Angel, Parras-Rejano Juan Manuel, Carmona-Casado Ana Belén, Rich-Ruiz Manuel, González-De la Rubia Ana, Baleato-Gomez Juan

机构信息

Pedro Abad Health Center, UGC Montoro, Andalusian Health Service, 14630 Cordoba, Spain.

Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Cordoba, Spain.

出版信息

Healthcare (Basel). 2024 Oct 2;12(19):1970. doi: 10.3390/healthcare12191970.

Abstract

OBJECTIVE

Our study aimed to evaluate the effectiveness of an intervention based on Motivational Interviewing (MI) performed by healthcare professionals in Primary Care (PC) patients with risky alcohol use through a multicenter, two-arm parallel, cluster-randomized, open-label controlled clinical trial.

METHODS

PC professionals were randomized into two groups: an Experimental Group (EG) and a Control Group (CG). The study was carried out in PC centers of the Andalusian Health Service, located in Cordoba, Spain. An MI-based approach was implemented with patients recruited in the EG, while health advice was provided to those included in the CG. The follow-up period was 12 months, with five visits scheduled. The consumption of standard drinking units per week was quantified, and risky alcohol use was estimated using the Alcohol Use Disorders Identification Test (AUDIT). An intention-to-treat statistical analysis was performed. Relative risk (RR), absolute risk reduction (ARR) and the number of subjects needed to treat (NNT) were used to estimate the intervention effect size.

RESULTS

A total of 268 patients were included, 148 in the EG and 120 in the CG. Considering the quantification of risky alcohol use, the ARR at 12 months after baseline visit was 16.46% (95% CI: 5.37-27.99), with an NNT of 6 (95% CI: 4-19). According to the AUDIT, the ARR at 12 months was 13.15% (95% CI: 2.73-24.24%), and the NNT was 8 (95% CI: 4-37).

CONCLUSIONS

We concluded that MI is more effective than the usual health advice in decreasing risky alcohol use in patients treated in PC.

摘要

目的

我们的研究旨在通过一项多中心、双臂平行、整群随机、开放标签的对照临床试验,评估初级保健(PC)机构中由医疗保健专业人员对有危险饮酒行为的患者实施的基于动机性访谈(MI)的干预措施的有效性。

方法

PC专业人员被随机分为两组:实验组(EG)和对照组(CG)。该研究在位于西班牙科尔多瓦的安达卢西亚卫生服务中心的PC机构中进行。对招募到EG组的患者实施基于MI的方法,而对CG组的患者提供健康建议。随访期为12个月,安排了五次就诊。对每周标准饮酒单位的消费量进行量化,并使用酒精使用障碍识别测试(AUDIT)评估危险饮酒情况。进行意向性治疗统计分析。使用相对风险(RR)、绝对风险降低率(ARR)和需要治疗的受试者数量(NNT)来估计干预效果大小。

结果

共纳入268例患者,其中EG组148例,CG组120例。考虑到危险饮酒情况的量化,基线访视后12个月的ARR为16.46%(95%CI:5.37 - 27.99),NNT为6(95%CI:4 - 19)。根据AUDIT,12个月时的ARR为13.15%(95%CI:2.73 - 24.24%),NNT为8(95%CI:4 - 37)。

结论

我们得出结论,在降低PC机构治疗的患者的危险饮酒行为方面,MI比常规健康建议更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b82a/11477329/4b1f7135a3eb/healthcare-12-01970-g001.jpg

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