共查询到20条相似文献,搜索用时 15 毫秒
1.
Aims To compare 5 year outcomes (general hospital and mental health morbidity and mortality) among general hospital psychiatric in‐patients randomized to receive either an alcohol reduction motivational interview (MI) or information pack (IP), and compare these to matched controls. Design We recruited 120 patients aged 18–64 years who scored ≥8 on the Alcohol Use Disorders Identification Test (AUDIT). We selected matched controls from in‐patients not recruited but who reached the same AUDIT threshold. At 5 years, follow‐up data were collected via a state‐wide hospital record system. Findings There were no significant differences between the MI and IP groups in terms of ‘survival’ to their first alcohol‐related, other general hospital or mental health admission over 5 years. Matched controls had significantly more mental health in‐patient episodes (F[1,226] 4.4, P < 0.05) and greater length of hospital stay (F[1,226] 4.8, P < 0.05) than the combined MI‐IP group. Furthermore, the MI‐IP group had longer ‘survival’ times to both first general hospital (mean 583 versus 392 days) and mental health in‐patient (mean 788 versus 580 days) events. Collapsed across groups, dependent and harmful consumers had shorter ‘survival’ times than hazardous consumers (AUDIT classifications). Conclusions Alcohol interventions have medium‐term health benefits for those with mental health and alcohol use problems. Importantly, there were no differences in outcome between the intervention groups. The low cost of providing an IP makes it attractive as an alcohol intervention. The AUDIT provided an effective means of identifying those who are at risk of subsequent alcohol‐related admissions and may benefit from intervention. 相似文献
2.
A randomized controlled trial of a brief intervention after alcohol-related facial injury 总被引:3,自引:1,他引:2
Aim To evaluate the effectiveness of a brief motivational intervention on alcohol consumption and misuse in young males with alcohol‐related face injury. Design Randomized controlled trial. Setting Oral and maxillofacial surgery out‐patient clinic in an urban teaching hospital. Participants One hundred and fifty‐one participants were randomized to motivational intervention and control conditions. Interventions Control was treatment as usual. The intervention was treatment as usual plus a one‐session brief motivational intervention administered by a nurse. Measurements Three sets of measurements were taken at baseline, 3‐month and 1‐year follow‐up. Collateral measurements were also taken at 1‐year follow‐up. Primary outcome measures were total alcohol consumption, typical weeks consumption and days abstinent in preceding 3 months. Other outcome measures included the Alcohol Use Disorders Identification Test, a short form of the Alcohol Problems Questionnaire, and a measure of satisfaction with social relationships. Results There was a significant decrease in 84‐day total alcohol consumption across the year (P < 0.006) and further, a significant effect for the motivational intervention was demonstrated (P < 0.029). This pattern was repeated for days abstinent and alcohol consumption in a typical week as well as alcohol‐related problems. There was a significantly greater reduction in the percentage of hazardous drinkers in the motivational intervention group (from 60% to 27%, P < 0.009) compared to the control group (from 54% to 51%, NS). Conclusion A proportion of young men change their alcohol consumption following alcohol‐related injury. A nurse‐led psychological intervention adds significantly to the proportion and magnitude of response. 相似文献
3.
4.
5.
6.
Aims To test motivational interviewing (MI) as a brief intervention for reducing alcohol use among needle exchange clients. Design Randomized clinical trial. Setting Needle exchange program—Providence, Rhode Island, USA. Participants Between 2/98 and 10/99, we recruited 187 AUDIT‐positive (>8) active injection drug users. Intervention Those assigned to a brief motivational intervention (MI) condition received two 1‐hour therapist sessions following assessment visits, 1 month apart, focusing on alcohol use and HIV risk‐taking. Measurements Control and MI subjects received identical research assessments at baseline, 1 and 6 months following study enrollment. At 6 months, study outcomes included days of alcohol use measured using the time‐line follow‐back method. Findings Study retention was 96.8% at 6 months. Participants reported an average of 12.0 drinking days at baseline and 8.3 at 6 months. Significant reductions in drinking days were observed in both treatment conditions. We found significant treatment × baseline drinking day interaction effects. Tests for simple main effects were significant for subjects with above median (>9) baseline drinking day frequency, but not for those with below median baseline drinking frequency. Comparisons on dichotomous outcomes provided supporting evidence of treatment efficacy; those in MI were over two times more likely than controls to report reductions of 7 days or more (P < 0.05). Conclusions This study provides the first direct evidence that brief MI can decrease alcohol use among active injection drug users with drinking problems. Heavier drinkers seem best suited for this intervention, but the optimal intensity of treatments and which components of brief intervention are most effective deserve further study. 相似文献
7.
Nancy P. Barnett Timothy R. Apodaca Molly Magill Suzanne M. Colby Chad Gwaltney Damaris J. Rohsenow Peter M. Monti 《Addiction (Abingdon, England)》2010,105(3):452-465
Objective To evaluate moderators and mediators of brief alcohol interventions conducted in the emergency department. Methods Patients (18–24 years; n = 172) in an emergency department received a motivational interview with personalized feedback (MI) or feedback only (FO), with 1‐ and 3‐month booster sessions and 6‐ and 12‐month follow‐ups. Gender, alcohol status/severity group [ALC+ only, Alcohol Use Disorders Identification Test (AUDIT+) only, ALC+/AUDIT+], attribution of alcohol in the medical event, aversiveness of the event, perceived seriousness of the event and baseline readiness to change alcohol use were evaluated as moderators of intervention efficacy. Readiness to change also was evaluated as a mediator of intervention efficacy, as were perceived risks/benefits of alcohol use, self‐efficacy and alcohol treatment seeking. Results Alcohol status, attribution and readiness moderated intervention effects such that patients who had not been drinking prior to their medical event, those who had low or medium attribution for alcohol in the event and those who had low or medium readiness to change showed lower alcohol use 12 months after receiving MI compared to FO. In the AUDIT+ only group those who received MI showed lower rates of alcohol‐related injury at follow‐up than those who received FO. Patients who had been drinking prior to their precipitating event did not show different outcomes in the two interventions, regardless of AUDIT status. Gender did not moderate intervention efficacy and no significant mediation was found. Conclusions Findings may help practitioners target patients for whom brief interventions will be most effective. More research is needed to understand how brief interventions transmit their effects. 相似文献
8.
9.
10.
11.
12.
Internet‐based brief intervention for young men with unhealthy alcohol use: a randomized controlled trial in a general population sample
下载免费PDF全文
![点击此处可从《Addiction (Abingdon, England)》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Nicolas Bertholet John A. Cunningham Mohamed Faouzi Jacques Gaume Gerhard Gmel Bernard Burnand Jean‐Bernard Daeppen 《Addiction (Abingdon, England)》2015,110(11):1735-1743
13.
14.
The long-term effectiveness of brief interventions for unsafe alcohol consumption: a 10-year follow-up 总被引:4,自引:3,他引:4
Aims To examine the long‐term impact of brief and early interventions for hazardous and harmful alcohol consumption. Design A 9‐month and 10‐year follow‐up of subjects recruited into a randomized controlled trial of a range of alcohol‐related brief interventions. Setting General practices, the outpatient or acute care services of a major city hospital, and a privately run health screening programmeme. Participants The cohort of 554 (non‐dependent) hazardous and harmful drinkers recruited into the Australian arm of the Phase II World Health Organization collaborative project on identification and treatment of persons with harmful alcohol consumption. Intervention The effectiveness of three forms of intervention, ranging from 5 to 60 minutes in duration, were compared with a no‐treatment control condition. Measurements Included drinking behaviour and biological markers of alcohol use. In addition, at 10 years subjects were asked about symptoms of diagnosable alcohol use disorders and their experience of alcohol‐related psychological, social and physical harm. Mortality was also assessed. Findings Results provide further evidence for the short‐term effectiveness of alcohol‐related brief interventions. In comparison to controls, subjects offered intervention: (1) report significantly lower consumption; and (2) less unsafe drinking at 9‐month follow‐up. The intensity of intervention was not related to the amount of change in drinking behaviour. Analysis at 10 years failed to find any differences in outcomes between intervention and control groups in median consumption, mean reduction in consumption from baseline to follow‐up, mortality and ICD‐10 diagnoses of alcohol dependence or harmful alcohol use. Conclusions This study failed to find evidence that brief advice and counselling without regular follow‐up and reinforcement can sustain significant long‐term reductions in drinking behaviour at 10‐year follow‐up. 相似文献
15.
Nicolas Bertholet Mohamed Faouzi Gerhard Gmel Jacques Gaume Jean‐Bernard Daeppen 《Addiction (Abingdon, England)》2010,105(12):2106-2112
Aim To investigate whether different sequences of ‘change talk’ utterances within a brief motivational intervention (BMI) are associated with drinking outcomes. Design Speech content analysis of recorded BMI. Setting BMI delivered in an emergency department for at‐risk drinking. Participants Ninety‐seven subjects who received a BMI. Measurements Ninety‐seven BMI were coded in duplicate by two psychologists with the Motivational Interviewing Skill Code (MISC), a Hidden Markov Model was used to identify three different patient states reflecting attitudes regarding changing their drinking behaviour within a BMI: towards change, away from change and non‐determined. Adjusted regression models were used to predict drinking at 12 months' follow‐up using patient attitudes regarding changing drinking at the beginning, during the intervention and at the end. Findings The dynamic process at place within a BMI was marked mainly by stability: at each point during the intervention, staying in the same attitude was far more likely than transitioning from one attitude to another. When subjects did change from one attitude to another, they were more likely to move from an ‘away from change’ to a ‘towards change’ state. At 12 months, subjects with an attitude towards change at the end of the BMI drank significantly less (13.1 drinks per week) than subjects with an attitude away from change, independent of their attitude at the beginning of the intervention. Conclusions Transition in ‘change talk’ between ‘away from change’ and ‘towards change’ appears to be rare in brief motivational intervention for excessive alcohol consumption. Moreover, change talk ‘towards change’ at the end of the intervention is associated with improved outcomes at follow‐up, independently of the type of change talk at the beginning of the intervention, suggesting that it is important to end a BMI session with a positive attitude towards change by the client. 相似文献
16.
Holloway AS Watson HE Arthur AJ Starr G McFadyen AK McIntosh J 《Addiction (Abingdon, England)》2007,102(11):1762-1770
AIMS: (i) To evaluate the effect of receiving one of two brief interventions in reducing alcohol consumption among general hospital patients compared with usual care. (ii) To assess whether a brief intervention of self-efficacy enhancement was superior to a self-help booklet in reducing alcohol consumption. DESIGN: A three-arm cluster randomized controlled trial. SETTING: Seven general medical, six general surgical, one dermatology and two otolaryngology wards of a large teaching hospital covering a large urban and rural area. PARTICIPANTS: A total of 215 of 789 in-patients aged 18-75 years, who screened positive for alcohol consumption in excess of national recommended limits according to a 7-day retrospective drinking diary. INTERVENTIONS: Participants were allocated to receive one of three interventions: (i) face-to-face self-efficacy enhancement; (ii) a self-help booklet; or (iii) usual care. MEASUREMENTS: The primary outcome measure was change in reported alcohol consumption at 6-month follow-up as measured by a 7-day retrospective drinking diary. Secondary outcomes were change in: number of alcohol drinking days in last week; the maximum units of alcohol consumed on any one day in last week; and Drinking Refusal Self-efficacy Expectancy Questionnaire score. FINDINGS: Compared to the usual care group the self-efficacy enhancement group (-10.1 units 95% CI -16.1 to -4.1) and the self-help booklet group (-10.0 units 95% CI -16.0 to -3.9) had greater reductions in self-reported weekly alcohol consumption. There was no evidence that self-efficacy enhancement was superior to the self-help booklet (P = 0.96). CONCLUSIONS: Brief interventions delivered in hospital offer simple means of helping heavy drinkers to reduce their alcohol consumption. 相似文献
17.
A randomized controlled trial of a brief intervention for alcohol and drugs linked to the Alcohol,Smoking and Substance Involvement Screening Test (ASSIST) in primary health care in Chile
下载免费PDF全文
![点击此处可从《Addiction (Abingdon, England)》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Fernando Poblete Nicolas A. Barticevic Maria Soledad Zuzulich Rodrigo Portilla Alvaro Castillo‐Carniglia Jaime C. Sapag Luis Villarroel Brena F. Sena Magdalena Galarce 《Addiction (Abingdon, England)》2017,112(8):1462-1469
18.
19.
20.
Rose HL Miller PM Nemeth LS Jenkins RG Nietert PJ Wessell AM Ornstein S 《Addiction (Abingdon, England)》2008,103(8):1271-1280
Aims To determine the effect of an intervention to improve alcohol screening and brief counseling for hypertensive patients in primary care. Design Two‐year randomized, controlled trial. Setting/participants Twenty‐one primary care practices across the United States with a common electronic medical record. Intervention To promote alcohol screening and brief counseling. Intervention practices received site visits from study personnel and were invited to annual network meetings to review the progress of the project and share improvement strategies. Measurements Main outcome measures included rates of documented alcohol screening in hypertensive patients and brief counseling administered in those diagnosed with high‐risk drinking, alcohol abuse or alcohol dependence. Secondary outcomes included change in blood pressure among patients with these diagnoses. Findings Hypertensive patients in intervention practices were significantly more likely to have been screened after 2 years than hypertensive patients in control practices [64.5% versus 23.5%; adjusted odds ratio (OR) = 8.1; 95% confidence interval (CI) 1.7–38.2; P < 0.0087]. Patients in intervention practices diagnosed with high‐risk drinking, alcohol abuse or alcohol dependence were more likely than those in control practices to have had alcohol counseling documented (50.5% versus 29.6%; adjusted OR = 5.5, 95% CI 1.3–23.3). Systolic (adjusted mean decline = 4.2 mmHg, P = 0.036) and diastolic (adjusted mean decline = 3.3 mmHg, P = 0.006) blood pressure decreased significantly among hypertensive patients receiving alcohol counseling. Conclusions Primary care practices receiving an alcohol‐focused intervention over 2 years improved rates of alcohol screening for their hypertensive population. Implementation of alcohol counseling for high‐risk drinking, alcohol abuse or alcohol dependence also improved and led to changes in patient blood pressures. 相似文献