Gamboa Danil, Kabashi Saranda, Jørgenrud Benedicte, Lerdal Anners, Nordby Gudmund, Bogstrand Stig Tore
Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.
Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
Adv Drug Alcohol Res. 2025 Mar 5;5:14149. doi: 10.3389/adar.2025.14149. eCollection 2025.
At-risk alcohol and illicit drug use are risk factors for disease and in-hospital complications. This study investigated whether clinicians document substance use in the electronic records of acutely hospitalized internal medicine patients. Alcohol and illicit drug positive patients were identified using prospectively gathered substance use data from a study sample comprising 2,872 patients included from November 2016 to December 2017 at an internal medicine hospital in Oslo, Norway. These data were unknown to hospital staff. Whether physicians recorded quantitative substance use assessments and interventions was examined in patients with study-verified alcohol use in excess of low-risk guidelines (Alcohol Use Disorder Identification Test-4 scores [AUDIT-4] of ≥5 for women and ≥7 for men) and/or illicit drug use (one or more illicit drug detected by liquid chromatography-mass spectrometry [LC-MS] analysis). Among 548 study-verified alcohol-positive patients, physicians documented quantity and frequency (QF) of use in 43.2% (n = 237) and interventions in 22.0% (n = 121). Alcohol interventions were associated with harmful drinking (AUDIT-4 ≥9 points; adjusted odds ratio [AOR] = 4.87; 95% CI: 2.54-9.31; p < 0.001) and QF assessments (AOR = 3.66; 95% CI: 1.13-11.84; p = 0.02). Among 157 illicit-positive patients, drug use was described quantitatively in 34.4% (n = 54) and interventions in 26.0% (n = 40). The rate of quantitative alcohol and illicit drug use assessment by hospital physicians is poor, with a correspondingly low intervention rate. Important opportunities for attenuating or intervening in at-risk alcohol and illicit drug use are missed.
高危酒精和非法药物使用是导致疾病和住院并发症的风险因素。本研究调查了临床医生是否在急性住院内科患者的电子记录中记录物质使用情况。利用前瞻性收集的物质使用数据，从2016年11月至2017年12月纳入挪威奥斯陆一家内科医院的2872名患者的研究样本中识别出酒精和非法药物呈阳性的患者。医院工作人员此前并不知晓这些数据。对于经研究证实酒精使用超过低风险指南（女性酒精使用障碍识别测试-4评分[AUDIT-4]≥5分，男性≥7分）和/或非法药物使用（通过液相色谱-质谱[LC-MS]分析检测到一种或多种非法药物）的患者，检查医生是否记录了物质使用的定量评估和干预措施。在548名经研究证实酒精呈阳性的患者中，医生记录了使用量和频率（QF）的占43.2%（n = 237），记录了干预措施的占22.0%（n = 121）。酒精干预与有害饮酒（AUDIT-4≥9分；调整后的优势比[AOR]=4.87；95%置信区间：2.54-9.31；p<0.001）和QF评估（AOR = 3.66；95%置信区间：1.13-11.84；p = 0.02）相关。在157名非法药物呈阳性的患者中，34.4%（n = 54）的患者药物使用情况有定量描述，26.0%（n = 40）的患者有干预措施记录。医院医生对酒精和非法药物使用进行定量评估的比例较低，相应地干预率也较低。因此错失了减轻或干预高危酒精和非法药物使用的重要机会。
