McMenamin J P
N Z Med J. 1997 May 9;110(1043):173-4.
To report the outcome of intervention in 70 patients with alcohol use disorder in a general practice.
Of the 84 patients age 18-69 years identified clinically or by a screening programme with alcohol use disorder, 70 who were available for at least 2 year follow up after diagnosis were included in the study group. The clinical notes of these patients were reviewed to determine evidence of sustained achievement of abstinence or controlled drinking and factors contributing to successful change in alcohol use.
Sustained abstinence or controlled drinking was verified for 31 patients (44%) with a further 26 patients (37%) reporting reduction in alcohol use without evidence of sustained improvement. The mean interval from diagnosis to sustained improvement was 4 years. Only five patients accepted referral to specialist alcohol units. Successful change in the 31 patients achieving their drinking goal was directly related to intervention at the surgery for 9 patients.
A motivational approach with focus on the patient's perception of the issues proved relatively successful in this practice. A prolonged period of change was required to achieve drinking goals. Other factors contributing to improvement are discussed.
报告在一家普通诊所对70例酒精使用障碍患者进行干预的结果。
在通过临床诊断或筛查项目确定的84例年龄在18至69岁的酒精使用障碍患者中,70例在诊断后至少可进行2年随访的患者被纳入研究组。对这些患者的临床记录进行审查,以确定持续戒酒或控制饮酒的证据以及有助于成功改变酒精使用情况的因素。
31例患者(44%)实现了持续戒酒或控制饮酒,另有26例患者(37%)报告酒精使用量减少,但无持续改善的证据。从诊断到持续改善的平均间隔时间为4年。只有5例患者接受转介至专科酒精治疗机构。31例实现饮酒目标的患者的成功改变与9例患者在诊所接受的干预直接相关。
在本诊所,以患者对问题的认知为重点的激励方法相对成功。实现饮酒目标需要较长时间的改变。文中还讨论了其他有助于改善的因素。