Linkage of Alcohol Abusers to Primary Care

酗酒者与初级保健的联系

• 批准号: 7253021
• 负责人: RICHARD SAITZ
• 金额: $ 8.02万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-05-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7253021
• 关键词: Linkage; Alcohol; Abusers; Primary; Care

DESCRIPTION (provided by applicant): Alcohol dependence is a chronic disease. Patients with alcohol dependence require specialty alcohol treatment, primary medical care, and management of related problems. These patients can be linked with specialty care and primary medical care, but their healthcare often remains episodic and fragmented, rather than longitudinal, comprehensive, and coordinated. As a result, adults with alcoholism often enter treatment late, and with medical, psychiatric and social consequences requiring emergency care and detoxification, rather than entering the system earlier when interventions of lower intensity but longer duration might prevent catastrophes. Chronic disease management (CDM) is a focused, longitudinal approach to the treatment of certain chronic medical illnesses proven to be more effective than routine health care. However, the effectiveness of CDM for alcohol dependence has not been tested. The objective of this proposal, the Alcohol Health Evaluation and Disease management (AHEAD) Study, is to test the effectiveness of a CDM program for alcoholism in primary care. The study will enroll 320 adults with alcohol dependence who are not in alcoholism treatment and randomize them to attend an alcoholism CDM program (the AHEAD Unit) integrated into a real-world primary care clinic or to a standard referral to link with primary care control group. All subjects will be assessed regarding alcohol diagnosis, consumption and problems, readiness to change, health-related quality of life, and medical and alcohol treatment utilization at baseline and again at 3, 6 and 12 months after enrollment; utilization data will be collected for 2 years from statewide databases. Primary outcomes are alcohol use, alcohol-related problems, emergency department visits, and hospitalizations. Additional outcomes are health-related quality of life, readiness to change, medical and psychiatric comorbidity, HIV risk behaviors, injury, and alcoholism and primary medical care treatment utilization. The hypothesis is that compared with standard care, a health services delivery intervention-- CDM for alcoholism integrated in primary care--will decrease alcohol use and related problems, and improve health care utilization patterns by decreasing hospitalizations and emergency department visits. If the AHEAD approach improves outcomes as hypothesized, the study results will support the use of a novel health services delivery strategy to better care for patients with alcoholism.

描述（由申请人提供）：酒精依赖是一种慢性疾病。酒精依赖的患者需要特殊酒精治疗，初级医疗护理以及相关问题的管理。这些患者可以与专业护理和初级医疗服务有关，但是他们的医疗保健通常仍然是偶发性和分散的，而不是纵向，全面和协调的。结果，酗酒的成年人经常迟到治疗，并且有需要急诊和排毒的医学，精神病和社会后果，而不是在强度较低但持续时间更长的持续时间的干预措施时早些时候进入系统。慢性疾病管理（CDM）是一种专注的纵向方法，用于治疗某些慢性医学疾病，这被证明比常规医疗保健更有效。但是，尚未测试CDM对酒精依赖性的有效性。该提案的目的是酒精健康评估和疾病管理（前）研究是测试CDM酒精中毒计划在初级保健中的有效性。这项研究将招募320名没有酒精中毒的成年人，他们不接受酒精中毒治疗，并将其随机参加酒精中毒CDM计划（前单位），该计划（前单位）集成到现实世界中的初级保健诊所或标准转诊中以与初级保健对照组联系。所有受试者将被评估有关酒精诊断，消费和问题，准备变化，与健康相关的生活质量以及在招生后3、6和12个月再次使用的医疗和酒精治疗利用的评估；利用数据将从全州数据库收集2年。主要结果是酒精使用，与酒精有关的问题，急诊就诊和住院治疗。其他结果是与健康相关的生活质量，愿意改变，医学和精神病合并症，艾滋病毒风险行为，伤害和酒精中毒以及初级医疗治疗治疗利用。假设是，与标准护理，医疗服务提供干预措施（用于基于初级保健的酒精中毒的CDM）相比，将减少酒精使用和相关问题，并通过减少住院和急诊就诊来改善医疗保健利用模式。如果前进方法改善了假设的结果，那么研究结果将支持使用新型的健康服务提供策略来更好地护理酒精中毒患者。