Addiction Science & Clinical Practice最新文献

{"title":"Integrating an exercise program into opioid agonist therapy: a pilot study on feasibility, fitness improvements, and participation challenges.","authors":"Einar Furulund, Siv-Elin Leirvåg Carlsen, Silvia Eiken Alpers, Jørn Henrik Vold, Karl Trygve Druckrey-Fiskaaen, Tesfaye Madebo, Sindre M Dyrstad, Torgeir Gilje Lid, Lars Thore Fadnes","doi":"10.1186/s13722-025-00583-w","DOIUrl":"10.1186/s13722-025-00583-w","url":null,"abstract":"<p><strong>Background: </strong>People receiving opioid agonist therapy (OAT) face high risk of comorbidities, including cardiovascular and mental health disorders. Integrating exercise programs with OAT may reduce health disparities and improve well-being. This study explored the feasibility and preliminary effects of an integrated exercise program.</p><p><strong>Method: </strong>This multicentre, mixed-methods pilot study was conducted in Western Norway, recruiting 22 participants receiving OAT from three outpatient clinics. The six-week, group-based exercise program focused on high-intensity endurance and strength training. Changes in aerobic fitness (4-minut step test), psychological distress (10-item Hopkins Symptom Checklist, SCL-10), fatigue (3-items Fatigue Severity Scale, FSS-3), lung function (spirometry), and respiratory symptoms (modified Medical Research Council Dyspnea Scale, mMRC) were assessed, while qualitative interviews provided insights into intervention feasibility.</p><p><strong>Results: </strong>Pre- and post-test assessments indicated improvements in aerobic fitness, as measured by the 4-minute step test, with a pre-test mean of 89.4 (SD: 24.7) and a post-test mean of 103.1 (SD: 31.3) step-cycles, despite a modest attendance rate of 28%. Psychological distress, evaluated using the SCL-10, increased in score from 1.85 (SD: 0.66) to 2.03 (SD: 0.59). Fatigue also increased slightly Fss-3: 4.44 (SD:2.38) to 5.07 (SD:2.01), while respiratory symptoms using mMRC, lung capacity with FVC, and expiratory volume FEV1 remained stable. Qualitative findings were categorized into three main themes: (1) The clinic as an arena for physical activity, (2) a modest move with a substantial benefit for participants, (3) challenges and adjustments to the intervention. Participants reported that exercising in connection with the OAT clinic promoted a sense of care and support from clinicians. Many experienced increased self-confidence and social engagement, though attendance was affected by health issues, fluctuating motivation, and logistical challenges.</p><p><strong>Conclusion: </strong>This pilot study suggests that integrating structured exercise into OAT can be feasible and improve aerobic fitness. However, increased psychological distress and fatigue might indicate the need for additional support. The low attendance rate highlights engagement challenges, emphasizing the need for tailored strategies to enhance participation. Future research should focus on optimizing intervention design to improve attendance and enhance physical and psychological outcomes for individuals in OAT.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"52"},"PeriodicalIF":3.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacotherapy of psychiatric inpatients with mental and behavioral disorders caused by sedatives or hypnotics (F13): Results from an observational pharmacovigilance program between 2000 and 2017.","authors":"Philipp Pauwels, Beatrice Haack, Sermin Toto, Johanna Seifert, Renate Grohmann, Martin Heinze, Oliver Zolk, Phileas Johannes Proskynitopoulos, Michael Schneider, Timo Greiner","doi":"10.1186/s13722-025-00579-6","DOIUrl":"10.1186/s13722-025-00579-6","url":null,"abstract":"<p><strong>Background: </strong>The treatment of choice for substance use disorder (SUD) caused by sedatives, hypnotics, and anxiolytics (SHA) is to slowly taper the dose of the implicated substance to the point of abstinence, thereby minimizing withdrawal symptoms. Concomitant pharmacotherapy may be indicated to manage excessive withdrawal or rebound symptoms. This study investigated the use of psychotropic drugs for the treatment of SHA-dependent SUD patients in Germany.</p><p><strong>Methods: </strong>Data were obtained from the German Drug Safety Program in Psychiatry (\"Arzneimittelsicherheit in der Psychiatrie\"; AMSP) from 2000 to 2017. SHA SUD was classified using the 10th Edition of the International Classification of Disease (ICD-10).</p><p><strong>Results: </strong>The present study included 1,015 patients with a primary diagnosis of mental and behavioral disorders due to use of sedatives or hypnotics (F13.1-F13.9). The most common comorbid psychiatric diagnoses were additional SUDs (F1, n = 279), especially alcohol use disorder (F10; n = 124), and mood disorders (F3; n = 201). A total of 95.6% of patients received one or more psychotropic drugs, most commonly antidepressant drugs (63.1% of patients), tranquillizing drugs (55.5%), and antipsychotic drugs (46.7%). The most common combination was an antidepressant drug and a tranquillizing drug (33.0%). Overall, psychotropic drugs with sedating properties (e.g., mirtazapine, quetiapine, doxepin, and trimipramine) were preferred. An increase in use over the 17-year observation period was observed for tranquillizing drugs and, most pronounced, for antipsychotic drugs.</p><p><strong>Conclusion: </strong>We found high rates of non-SHA drugs among patients treated for SHA-SUD. The prevalent use of psychotropic drugs with strong sedating properties indicates a symptom-oriented treatment approach, which is often \"off-label\" but may be clinically necessary. Main limitation is the cross-sectional design of the AMSP databank. Therefore, we cannot provide any follow up data on the patient collective especially regarding outcome.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"51"},"PeriodicalIF":3.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High induction rate onto extended-release naltrexone for people with opioid use disorder: experiences from a Norwegian naturalistic study.","authors":"Jon Mordal, Farid Juya, Line Holtan, John-Kåre Vederhus, Arild Opheim, Ida H Brenna, Asle E Enger, Bente Weimand, Kristin Klemmetsby Solli, Lars Tanum","doi":"10.1186/s13722-025-00576-9","DOIUrl":"10.1186/s13722-025-00576-9","url":null,"abstract":"<p><strong>Background: </strong>For people with opioid use disorder (OUD), extended-release naltrexone (XR-NTX) is an effective antagonist treatment option. However, successful opioid tapering and abstinence is a prerequisite for XR-NTX induction and has repeatedly been reported as a major barrier to effective treatment. The aims of this study were to describe XR-NTX induction rates, reasons for incomplete induction, and extraordinary complications reported during the induction phase. We also compared sociodemographic and clinical variables among those who did and did not complete induction onto XR-NTX.</p><p><strong>Methods: </strong>This naturalistic, multicenter, and open-label Norwegian study of XR-NTX included men and women aged 18-65 who had severe OUD. Most participants were referred to inpatient medically managed opioid withdrawal and received individualized pharmacological and psychosocial treatment according to clinical assessment and national guidelines. After opioid withdrawal, the participants underwent a minimum of three opioid-free days prior to XR-NTX induction. Variables were collected through baseline assessments and a retrospective patient chart review. XR-NTX induction completers and non-completers were compared via bivariate and logistic regression analyses.</p><p><strong>Results: </strong>Of 129 participants with recent opioid use at inclusion, 106 (82%) completed XR-NTX induction. Induction was initiated in an inpatient setting for 116 participants (90%) and extraordinary complications were noted for 19 (15%) patients. Withdrawal symptoms and ambivalence were the most common reasons for non-completion, each noted in 75% of the cases. As compared with those who successfully completed induction, non-completers more often reported lifetime hepatitis (78% vs. 52%, p = 0.017), had a longer period of current substance use (mean 119 vs. 54 months, p = 0.001), and more frequently used methadone prior to study inclusion (43% vs. 8%, p < 001). In logistic regression analyses, methadone use was the only significant factor and was negatively associated with completion (odds ratio 0.20, 95% confidence interval = 0.05-0.72, p = 0.014).</p><p><strong>Conclusion: </strong>The results demonstrate the safety, efficacy and tolerability of a Norwegian opioid withdrawal and XR-NTX induction procedure. Although the present induction rate was high, our findings indicate that methadone users need special attention and tailored interventions regarding opioid withdrawal management and XR-NTX induction.</p><p><strong>Trial registration: </strong>The study is registered at clinicaltrials.gov (NCT03647774).</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"50"},"PeriodicalIF":3.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attachment styles and sense of coherence as indicators of treatment adherence and completion among individuals with substance use disorder.","authors":"Nóra Kerekes, Kourosh Bador, Carro Smedeby, Linus Hansen, Sofie Lundström, Monica Eriksson","doi":"10.1186/s13722-025-00578-7","DOIUrl":"10.1186/s13722-025-00578-7","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorder (SUD) is a growing public health concern in Sweden. Various treatments for SUD exist, with motivational treatment, cognitive behavioral therapy, and relapse prevention being the nationally recommended approaches. Attachment theory and the salutogenic theory with its core concept, sense of coherence (SOC) provides valuable insights into individuals' available personal resources and their potential for adherence to treatment. The aims of the present study were to examine attachment styles (secure, insecure-avoidant, and insecure-anxious) and SOC (overall and dimensional - comprehensibility, manageability, and meaningfulness- scores) in individuals with SUD; to explore potential correlations between these constructs ; and to assess their predictive value for treatment completion.</p><p><strong>Methods: </strong>Clinical data were collected between 2014 and 2023 from 164 clients at a Swedish outpatient clinic for addiction who initiated the intensive, integrated treatment program. The sample comprised 109 men and 55 women, aged 18 to 72 years (M = 40.71). Data were gathered using validated self-report instruments (the Attachment Style Questionnaire and the Sense of Coherence Questionnaire). Statistical analyses included descriptive statistics, correlation analysis, and logistic regression.</p><p><strong>Results: </strong>Individuals with SUD predominantly exhibited an insecure-avoidant attachment style. The four dimensions reflecting insecure attachment (discomfort with relationships, relationships as secondary, need for approval, and preoccupation with relationships) were negatively correlated with overall SOC and its three components.  In contrast the secure attachment dimension (confidence in self and others) showed  positive association with SOC. The strongest associations were found between the manageability component of SOC and all attachment dimensions. The insecure-anxious attachment style showed the strongest association with early dropout from treatment, while higher manageability was significantly associated with  an increased likelihood of treatment completion.</p><p><strong>Conclusion: </strong>The predominance of an insecure-avoidant attachment style among clients undergoing intensive, integrated treatment for SUD underscores the importance of reinforcing a secure attachment and strengthening SOC to facilitate treatment completion. These findings highlight the need for comprehensive, integrated social and psychiatric care for individuals with SUD.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"49"},"PeriodicalIF":3.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The peers expanding engagement in stimulant harm reduction with contingency management study: a protocol paper.","authors":"Alexis Cooke, Erin Stack, Linda Peng, Ryan Cook, Bryan Hartzler, Gillian Leichtling, Christi Hildebran, Judith M Leahy, Kelsey Smith Payne, Lynn E Kunkel, Kim Hoffman, P Todd Korthuis","doi":"10.1186/s13722-025-00577-8","DOIUrl":"10.1186/s13722-025-00577-8","url":null,"abstract":"<p><strong>Background: </strong>Contingency management (CM) that is delivered by peer recovery support specialists and incentivizes harm reduction goals among people not seeking treatment for stimulant use has not been tested. The Peers Expanding Engagement in Stimulant Harm Reduction with Contingency Management (PEER-CM) study compares the effectiveness of two peer-facilitated CM interventions: (1) an experimental approach incentivizing achievement of client-identified harm reduction goals and (2) an enhanced standard of care approach incentivizing peer visit attendance.</p><p><strong>Methods: </strong>Applying a hybrid type 1 effectiveness-implementation framework and stepped-wedge design across 14 community-based peer services sites across Oregon, the PEER-CM study trains peers to conduct CM. All sites implement the standard CM approach of incentivizing peer visit attendance. Every 2 months, two sites are randomly assigned to initiate the experimental CM condition of incentives for achieving client-directed harm reduction activities. Peers monitor progress and manage incentives. In the experimental approach, peers facilitate client progress on goal-related activities (selected from a standardized list of goals) to support the primary study outcome of reducing opioid overdoses and stimulant overamping. The intended study enrollment is approximately 80 clients per site (N = 1,120). Peer specialists participate in skills-focused coaching-to-criterion coaching process to document proficient CM delivery skills. This includes a series of group coaching sessions and an individual assessment with a standardized patient, observed and rated according to core dimensions of the Contingency Management Competence Scale.</p><p><strong>Results: </strong>The primary study outcome is time until peer-reported fatal or first participant-reported non-fatal overdose or overamp (acute stimulant toxicity). Secondary outcomes include achievement of client-identified harm reduction goals and engagement in substance use disorder treatment. We will also demonstrate the feasibility of our coaching-to-criterion process by documenting peer proficiency in CM skills. Qualitative interviews with peers and their clients will explore the optimal context and implementation strategies for peer-facilitated CM.</p><p><strong>Conclusion: </strong>PEER-CM is among the first trials to test the effectiveness of peer-facilitated CM for achieving harm reduction goals and reducing overdose in non-treatment-seeking people who use stimulants. The findings will generate evidence for peer-facilitated delivery of CM and application of CM to client-identified harm reduction goals.</p><p><strong>Trial registration: </strong>This study is registered at ClinicalTrials.gov (NCT05700994).</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"48"},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a hospital-based opioid stewardship program on high-risk opioid prescribing in a Canadian setting: an interrupted time series analysis.","authors":"Lianping Ti, Tamara Mihic, Arielle Beauchesne, Cameron Grant, Ingrid Frank, Nooreen Haji, Michael Legal, Stephen Shalansky, Seonaid Nolan","doi":"10.1186/s13722-025-00574-x","DOIUrl":"10.1186/s13722-025-00574-x","url":null,"abstract":"<p><strong>Background: </strong>High-risk opioid prescribing (e.g., high daily dose opioids, concurrent opioid-sedatives) is prevalent in hospitals and linked to adverse outcomes. Opioid stewardship programs (OSP) have the potential to reduce high-risk opioid prescribing through audit-and-feedback recommendations.</p><p><strong>Methods: </strong>We evaluated an audit-and-feedback based OSP implemented in January 2020 at a Vancouver, Canada tertiary care hospital using interrupted time series analysis. An electronic health record (EHR) system with computerized provider order entry (CPOE) was simultaneously operationalized. The main outcome was: any high-risk opioid prescribing (based on 10 evidence-based indicators), including high daily dose of morphine milligram equivalent (MME) prescribing (> 90MME), long opioid prescription duration (> 5 days post-admission), and concurrent opioid-sedative prescribing.</p><p><strong>Results: </strong>Between January 2018 and March 2022, 5,477 active opioid patient encounters were included. While no significant change occurred in overall high-risk opioid prescribing post-OSP (p > 0.05), a significant reduction was seen in the level of high daily dose of MME prescriptions (estimate: -0.044; 95% confidence interval [CI]: -0.082, -0.006). Conversely, the trend in long opioid duration increased (estimate: 0.006; 95%CI: 0.000, 0.011), likely due to the removal of automatic stop dates with the implementation of the EHR with CPOE. Post-OSP intervention, we initially saw an acute increase in concurrent opioid-sedative prescriptions (estimate: 0.013; 95%CI: 0.005, 0.020). A benzodiazepine ordering intervention implemented in May 2021 reversed this trend, reducing both the level (estimate: 0.874; 95%CI: 0.374, 1.375) and slope (estimate: -0.022, 95%CI: -0.034, -0.011) of concurrent prescriptions.</p><p><strong>Conclusion: </strong>The implementation of a new EHR concordant with that of the OSP may have impacted our study's results. While our research suggests the OSP reduced high-dose opioid prescribing, other indicators impacted by the EHR system did not benefit as highly from the OSP. Nevertheless, the OSP proved able to rapidly respond to unintended consequences by introducing interventions to reduce concurrent opioid and sedative prescribing.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"47"},"PeriodicalIF":3.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of the content and functionality of a just-in-time adaptive intervention for gambling problems: a mixed-methods evaluation of gambling habit hacker.","authors":"S N Rodda, S S Merkouris, C J Greenwood, A C Thomas, D I Lubman, N A Dowling","doi":"10.1186/s13722-025-00573-y","DOIUrl":"10.1186/s13722-025-00573-y","url":null,"abstract":"","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"46"},"PeriodicalIF":3.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perceptions of the use of e-cigarettes in smoking treatment programs: a qualitative analysis.","authors":"Sidney V Rojas, Kelly A Kyanko, Rachel Wisniewski, Katherine O'Connor, Rina Li, Grace Xiang, Mahathi Vojjala, Olivia Wilker, Scott E Sherman, Elizabeth R Stevens","doi":"10.1186/s13722-025-00575-w","DOIUrl":"10.1186/s13722-025-00575-w","url":null,"abstract":"<p><strong>Background: </strong>E-cigarettes may serve as a safer alternative to combustible cigarettes and may be more effective than currently available nicotine replacement therapy (NRT). Little is known about the perceptions of using e-cigarettes as part of a smoking treatment program. The objective of this study was to gain insight into patient-level factors to consider when developing smoking treatment programs that incorporate e-cigarettes.</p><p><strong>Methods: </strong>Qualitative analysis of in-depth interviews with 14 participants enrolled in the e-cigarette treatment arm of a tobacco treatment intervention pilot randomized trial comparing the impact of behavioral counseling paired with e-cigarettes or NRT on smoking outcomes. Participants were prompted to share their experiences with the products and the study overall. Transcripts were coded according to the principles of framework analysis for applied research. Codes were organized into themes using the principles of grounded theory.</p><p><strong>Results: </strong>Themes suggest that while there is an eagerness to try e-cigarettes as a new tool for smoking cessation, there is apprehension regarding what it means to \"quit\" if switching to e-cigarettes. Reflecting on the transitional purpose of e-cigarettes and potential health concerns associated with their use, many participants differentiated between the short-term goal to quit combustible cigarettes and the long-term goal to quit e-cigarettes.</p><p><strong>Conclusions: </strong>Including e-cigarettes as an option in smoking treatment regimens may be an opportunity to re-engage people who smoke who have tried and failed to quit with other forms of treatment. Participants found it challenging to establish what it means to quit cigarettes with e-cigarettes due to addiction and other health concerns. Clear guidelines are needed for integrating e-cigarettes into smoking cessation programs.</p><p><strong>Trial registrations: </strong>ClinicalTrials.gov Identifier: NCT04465318.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"45"},"PeriodicalIF":3.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative evaluation of alcohol consumption in older patients.","authors":"Vera Guttenthaler, Maria Wittmann, Jan Menzenbach","doi":"10.1186/s13722-025-00569-8","DOIUrl":"10.1186/s13722-025-00569-8","url":null,"abstract":"<p><strong>Purpose: </strong>This sub-analysis of the PROPDESC-study (Pre-Operative Prediction of postoperative delirium by appropriate Screening-study) evaluated the alcohol consumption of older patients with two different assessment tools (single sentence question and Alcohol Use Disorder Identification Test-Consumption (AUDIT-C)) and compared the results in regards to detection, reliability, and quantification of patient´s alcohol consumption.</p><p><strong>Methods: </strong>During their anesthesiological pre-clinic visit 1084 patients older than 59 years were asked whether they consume alcohol daily and 668 of them additionally answered the AUDIT-C questionnaire.</p><p><strong>Results: </strong>According to the SSQ 11.72% of the patients consumed alcohol daily. In the AUDIT-C sub-group 25.90% reported moderate to high alcohol consumption while infrequent or very low alcohol intake was reported by 41.92%. In the subgroup 31.89% of the patients stated alcohol abstinence. About one quarter (25.13%) of patients who denied daily alcohol intake but scored positive on the AUDIT-C displayed levels of alcohol consumption ranging from moderate (11.20%) to high (13.87%) according to the AUDIT-C.</p><p><strong>Conclusion: </strong>Reliable information about alcohol consumption is related to the method of questioning. The AUDIT-C evaluates the patient´s alcohol intake precisely and identifies more older patients with possibly health- and surgery-relevant alcohol consumption levels. The validated AUDIT-C provides an objective assessment to the physician during the pre-clinic anesthesiologic consultation. Additionally, handing out a questionnaire to the patient encourages initiative and self-assessment and could also relieve both, the physician and the patient from sensing a moral evaluation of alcohol consumption.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"44"},"PeriodicalIF":3.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of implementing the 15-method in Danish general practice using the consolidated framework for implementation science.","authors":"Peter Næsborg Schøler, Jens Søndergaard, Sanne Rasmussen, Kristina Hasselbalch Volke, Per Nilsen, Anette Søgaard Nielsen","doi":"10.1186/s13722-025-00571-0","DOIUrl":"10.1186/s13722-025-00571-0","url":null,"abstract":"<p><strong>Background: </strong>Excessive alcohol consumption is a significant global health issue, often unaddressed in primary care. The 15-method, a three-step opportunistic screening and treatment tool premised on Motivational Interviewing and integrated within the Screening, Brief Intervention and Referral to Treatment framework, offers a structured approach for healthcare professionals to identify and treat alcohol-related problems. The present study aimed to assess healthcare professionals' perceptions of determinants for early-stage implementation of the 15-method in Danish general practice and to classify these determinants using the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Methods: </strong>This qualitative study involved individual interviews and group interviews with general practitioners and nurses (N = 28) from 12 general practices participating in the Identification and Treatment of Alcohol Problems in Primary Care (iTAPP) study, a stepped-wedge cluster randomized controlled trial evaluating the effectiveness of the 15-method in Danish general practice. Interviews were semi-structured, guided by the CFIR framework, and analyzed using directed content analysis. Determinants were rated for their influence on implementation.</p><p><strong>Results: </strong>Key facilitators included the 15-method's adaptability, strong evidence base, relative advantage, and compatibility with existing practices. Barriers included structural characteristics in the practices and local conditions. A central finding revealed a tension between patients' motivation and healthcare professionals' opportunities and capabilities to deliver the 15-method. Mixed determinants highlighted the complexity of implementing the 15-method across diverse practices.</p><p><strong>Conclusion: </strong>Implementing the 15-method in Danish general practice is feasible but requires addressing specific barriers and leveraging facilitators. A multifaceted implementation strategy tailored to individual practices may be necessary to address the variations in contexts and resources across different practices with an emphasis on increasing healthcare professionals' capabilities and opportunities to deliver the intervention.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"43"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}