Why Substance Use Screening Frequency Matters in Adult Primary Care.

Grace M Drnach-Bonaventura, Debra W Moore, Georgie L Scott, Renee M Cloutier, Janice L Pringle
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Abstract

Background: Evidence-based early intervention practices, such as screening, brief intervention, and referral to treatment (SBIRT), are recommended to identify unhealthy use and provide linkages to treatment to prevent substance use disorder. However, there is a lack of screening frequency recommendations. Pennsylvania (PA) SBIRT was a five-year initiative to implement SBIRT in primary care sites. This study evaluated the effects of screening policies in PA SBIRT on changes in substance use risk category over time.

Methods: Quantitative data were obtained from seven primary care sites implementing SBIRT, with patients who were screened twice using the Drug Abuse Screening Test, US Alcohol Use Disorders Identification Test, or the Alcohol, Smoking, and Substance Involvement Screening Test and experienced any risk category change (n = 1,364). Patients were 49% male, 51% female, 81% White, and 14% Black. An intercept-only generalized estimating equation model tested whether category changes between screen one and screen two were statistically significant.

Results: The average number of months between screenings for those experiencing a risk category change was 9.01 with a range of 0 to 46 months. There was a statistically significant change between screening one and screening two (P > 0.001), with 44% undergoing a decrease in risk category and 56% undergoing an increase in risk category. Of those undergoing an increase in risk category, 91% moved from a negative/low risk category to a positive/higher risk category.

Conclusions: Results suggest that frequent screening policies may improve identification of substance use risk category changes. The results act as a catalyst to further evaluate recommended screening intervals for detecting unhealthy substance use to increase identification and patient connection.

为什么成人初级保健中的药物使用筛查频率很重要?
背景:建议采取基于证据的早期干预措施,如筛查、简单干预和转介治疗(SBIRT),以识别不健康的使用行为并提供治疗链接,从而预防药物使用障碍。然而,目前还缺乏筛查频率建议。宾夕法尼亚州(PA)SBIRT 是一项为期五年的计划,旨在基层医疗机构实施 SBIRT。本研究评估了宾夕法尼亚州 SBIRT 筛查政策对药物使用风险类别随时间变化的影响:从七个实施 SBIRT 的初级保健机构获得了定量数据,这些机构使用药物滥用筛查测试、美国酒精使用障碍鉴定测试或酒精、吸烟和药物参与筛查测试对患者进行了两次筛查,并发现患者的风险类别发生了变化(n = 1,364)。患者中男性占 49%,女性占 51%,白人占 81%,黑人占 14%。纯截距广义估计方程模型检验了第一次筛查和第二次筛查之间的类别变化是否具有统计学意义:结果:经历过风险类别变化的人在两次筛查之间的平均间隔月数为 9.01 个月,范围在 0 到 46 个月之间。第一次筛查和第二次筛查之间的变化具有统计学意义(P > 0.001),其中 44% 的人的风险类别有所下降,56% 的人的风险类别有所上升。在风险类别增加的人群中,91%的人从阴性/低风险类别转为阳性/高风险类别:结果表明,频繁筛查政策可提高对药物使用风险类别变化的识别能力。这些结果有助于进一步评估检测不健康药物使用的建议筛查时间间隔,以提高识别率并加强与患者的联系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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