在初级保健中药物使用的查和简短干预:ASPIRE随机临床试验
Richard Saitz1, Tibor P A Palfai2, Debbie M Cheng3
1Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts2Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston.
JAMA
|August 7, 2014
概括
在初级保健中对不健康药物使用的查和简短干预没有显示出有效性. 这些发现并不支持广泛实施药物使用查和干预计划.
科学领域:
- 公共卫生 公共卫生
- 临床干预 临床干预
- 药物使用障碍 药物使用障碍
背景情况:
- 美国已经投资于对非法药物使用和处方药滥用进行查和短期干预.
- 在不健康的酒精使用中有效的证据与缺乏药物使用的证据形成鲜明对比,阻止其作为初级保健中的普遍预防服务的推.
研究的目的:
- 测试两种针对不健康药物使用的简短咨询干预措施的有效性:简短协商面试 (BNI) 和动机面试 (MOTIV) 的调整.
- 为了比较BNI和MOTIV的疗效,而不是对初级保健患者的短暂干预.
主要方法:
- 一项涉及528名成年初级保健患者的3组随机试验,通过查确定了药物使用.
- 干预包括由健康教育工作者进行的10-15分钟的BNI和由辅导员进行的30-45分钟的MOTIV会话.
- 主要结局是过去30天内使用药物的日数,用验证的日历方法在6个月后进行评估.
主要成果:
- 在基线,参与者最常报告大麻 (63%),可卡因 (19%) 或阿片类药物 (17%) 作为主要药物.
- 在6个月后,在没有短期干预组 (12天) 和BNI (11天) 或MOTIV (12天) 组之间,主要药物使用日数的平均数量没有显著差异.
- 二次结果,包括其他药物使用措施,药物使用严重程度和后果,也没有显示出任何干预措施的显著影响.
结论:
- 简短干预策略 (BNI和MOTIV) 在通过查发现的初级保健患者中没有有效减少不健康的药物使用.
- 这些发现不支持在初级保健机构广泛实施非法药物使用和处方药滥用查和短期干预.
相关概念视频
Preventive Healthcare Services
2.3K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
2.3K
Primary Healthcare Services
2.9K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
2.9K
Community Based Intervention
615
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
615
Acute Coronary Syndrome IV: Interprofessional Care
519
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
519
Drug Discovery: Overview
10.3K
Drug discovery is a multifaceted process involving extensive screening, testing, and optimization of lead compounds to identify potential new drugs for therapeutic use. It combines several approaches, including screening large numbers of natural products, chemical modification of known active molecules, identification of new drug targets, and rational design based on biological mechanisms and drug-receptor structure. These approaches are carried out in both academic research laboratories and...
10.3K
Drug Abuse and Addiction: Pharmacological Phenomena
1.6K
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
1.6K


