在初级保健中解决不健康的酒精使用的实践便利:一个集群随机临床试验
Alison N Huffstetler1,2, Gabriela Villalobos1, Ben Webel1
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond.
JAMA health forum
|August 9, 2024
概括
实践便利化显著改善了初级保健中不健康酒精使用 (UAU) 的查. 这种干预增强了临床医生的信心,并导致每年超过114,000名额外的患者接受UAU查.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 不健康的酒精使用 (UAU) 是美国主要的可预防的死亡原因.
- 建议对所有成年人进行UAU的常规查,但在初级保健机构中实施不良.
研究的目的:
- 评估实践便利化在改善推的UAU查和干预与常规护理相比的有效性.
主要方法:
- 一个实践级集群随机临床试验,涉及弗吉尼亚州的76个初级保健实践.
- 干预组的实践得到了立即的实践便利化,而对照组则获得了延迟的实践便利化.
- 通过医疗记录审查和辅导员会议和采访的定性分析收集的数据.
主要成果:
- 在干预组中,UAU的查从2.1%增加到35.5%,而在对照组中增加了0.4%至1.4% (P < .001).
- 短期办公室干预在干预组增加了26.2%至62.6%,对照组增加了45.5%至55.1% (P = .008).
- 定性数据表明,临床医生在促进后对UAU进行查和干预的信心增加了.
结论:
- 实践便利化是改善UAU查和辅导在初级保健中的实施的有效策略.
- 这种干预可以显著提高对UAU的预防服务的提供,影响社区健康.
- 该研究表明,每年UAU查的数量大幅增加,达到额外的114,604名患者.
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