アルコール使用障害の診断と薬剤療法: レビュー

Henry R Kranzler^1,2, Michael Soyka^3,4

¹Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia.

JAMA

|September 1, 2018

まとめ

アルコール使用障害 (AUD) のための定期的なスクリーニングは推奨されていますが,あまり使われていません. ナルトレクソンなどの有効な治療法がありますが AUD患者には処方されていないのです

科学分野:

医学研究
公衆衛生
薬理学について

背景:

アルコール摂取はアメリカでは高い死亡率と罹患率を引き起こします
アルコール使用障害 (AUD) は,毎年米国の成人の14%までに影響します.
AUD の患者のうち治療を受けるのは 8% 未満で医療従事者の検査を受けるのは 6 人中 1 人だけです

研究の目的:

重度のアルコール使用とAUDのスクリーニングの重要性を強調します.
AUD治療のためのFDAが承認した薬をレビューする
有効なAUD治療の活用不足を強調するためです

主な方法:

AUDのスクリーニングと治療に関する既存の文献と臨床ガイドラインのレビュー.
AUDの薬効性と処方率の分析
現在の治療のギャップと推奨事項の議論

主要な成果:

過剰なアルコール摂取は AUD の主要な危険因子です.
4つの薬 (ディスルフィラム,ナルトキソン,アカンプロサート) はAUDに対してFDAによって承認されています.
薬は第一線治療であるにも関わらず効果がある患者の9%未満に処方されています

結論:

重度のアルコール使用のスクリーニングは,AUDの評価のために患者を特定することができます.
短期的なカウンセリングとナルトキソンのような第一線薬はAUDに推奨されます.
AUDの管理にはスクリーニングの強化と薬の処方が不可欠です

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