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Breve intervención para el uso problemático de drogas en entornos de atención primaria de red de seguridad: un ensayo
Peter Roy-Byrne1, Kristin Bumgardner1, Antoinette Krupski1
1Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle.
JAMA
|August 7, 2014
Resumen
Una breve intervención no redujo el uso problemático de drogas en los pacientes de la red de seguridad clínica. Este estudio sugiere precaución al adoptar este enfoque para el uso de drogas en entornos de atención primaria.
Área de la Ciencia:
- Salud Pública La salud pública.
- Medicina de la adicción Medicina de la adicción
- Investigación de la atención primaria de la salud.
Sus antecedentes:
- El consumo problemático de drogas prevalece en las poblaciones desfavorecidas que reciben atención en entornos de red de seguridad.
- Las intervenciones breves son efectivas para el consumo de alcohol, pero su impacto en el consumo de drogas se entiende menos.
Objetivo del estudio:
- Evaluar la efectividad de una intervención breve en comparación con la atención habitual mejorada para reducir el uso problemático de drogas.
Principales métodos:
- Se realizó un ensayo clínico aleatorizado en 7 clínicas de atención primaria con red de seguridad.
- 868 pacientes con problemas de consumo de drogas fueron asignados al azar para recibir una breve intervención o una atención habitual mejorada.
- Los resultados se evaluaron al inicio y a los 3, 6, 9 y 12 meses utilizando el uso de drogas autoinformado y el Índice de Gravedad de Adicción-Lite (ASI).
Principales resultados:
- No se encontraron diferencias significativas en los días autoinformados de uso problemático de drogas o puntuaciones compuestas de uso de drogas ASI entre la intervención breve y los grupos de atención habitual mejorada a los 3 o 12 meses.
- Los resultados secundarios, incluidas las admisiones al tratamiento y otras puntuaciones compuestas de ASI, tampoco mostraron diferencias significativas entre los grupos.
Conclusiones:
- Una sola intervención breve con un intento de refuerzo telefónico fue ineficaz para reducir el uso problemático de drogas en pacientes dentro de entornos de atención primaria de redes de seguridad.
- Los hallazgos indican la necesidad de precaución con respecto a la implementación generalizada de esta breve intervención para el uso de drogas en la atención primaria.
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