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目的本研究旨在调查使用3种策略(对全科医生进行酒精筛查和简易咨询的培训和支持,以及用奖金激励全科医生提供以上两项服务)和1种方案(指导酒精筛查阳性的患者使用在线简易咨询服务)是否对全科医生使用饮酒所致疾病筛查试验和酒精摄入量检测(AUDIT-C)工具对酗酒者提供酒精筛查及咨询服务有长期效果。方法1项为期12周的整群随机试验在位于加泰罗尼亚、英国、荷兰、波兰及瑞典的120个全科诊所里开展。这些诊所被随机分为8组:对照组(提供普通诊疗服务的诊所),TS组(对全科医生进行酒精筛查和简易咨询的培训和支持的诊所),FR组(用奖金激励全科医生提供酒精筛查和简易咨询服务的诊所),eBI组(对酗酒患者提供在线简易咨询的诊所),TS+FR组(对全科医生进行酒精筛查和简易咨询的培训和支持,并用奖金激励他们对酗酒患者提供这些服务的诊所),TS+eBI组(对全科医生进行酒精筛查和简易咨询的培训和支持,并对酗酒患者提供在线简易咨询的诊所),FR+eBI组(用奖金激励全科医生提供酒精筛查和简易咨询服务,并对酗酒患者提供在线简易咨询的诊所),TS+FR+eBI组(对全科医生进行酒精筛查和简易咨询的培训和支持,并用奖金激励他们对酗酒患者提供这些服务,以及对酗酒患者提供在线简易咨询的诊所)。以开展此项试验后9个月内≥18岁接受干预(酒精筛查以及筛查结果阳性接受咨询服务)的患者数量来评估试验效果。结果对为期9个月的随访结果进行分析后发现,在TS组、TS+FR组、TS+eBI组、TS+FR+eBI组诊所里接受干预并记录在案的酗酒患者数量与在FR组、eBI组、FR+eBI组及对照组诊所里接受干预并记录在案的酗酒患者数量相比的OR为1.39[95%CI(1.03,1.88)]。接受干预的酗酒患者数量与用奖金激励全科医生给他们提供服务或者由全科医生指导酒精筛查阳性患者应用在线简易咨询无关。结论全科诊所对全科医生给予酒精筛查和简易咨询的培训和支持对9个月内接受干预服务的成年酗酒患者数量有持久的影响,尽管影响不大。
PURPOSE The purpose of this study was to investigate the use of three strategies (training and support for general practitioners for alcohol screening and simple counseling, as well as incentives for general practitioners to provide both services) and a regimen (to guide alcohol screening positive Of patients using online simple counseling services) have long-term effects on the use of alcohol-based screening tests and the Alcohol Intake Test (AUDIT-C) tool for general practitioners in providing alcohol screening and counseling to alcoholics. Method 1 A 12-week cluster randomized trial was conducted in 120 general practice clinics in Catalonia, the United Kingdom, the Netherlands, Poland and Sweden. The clinics were randomly divided into 8 groups: control group (clinics offering general care services), TS group (clinics for training and support of general practitioners for alcohol screening and counseling), FR group Doctors at clinics offering alcohol screening and simple counseling services), eBI (clinics for online simple counseling for alcoholics), the TS + FR group (training and support for general practitioners on alcohol screening and counseling, and bonuses Motivating them to provide these services to alcohol abuse patients), the TS + eBI group (training and support for general practitioners on alcohol screening and counseling, and clinics for online simple counseling for alcoholics), the FR + eBI group ( Incentive bonuses for GPs to provide alcohol screening and counseling services, and online concise counseling for alcohol abuse patients), TS + FR + eBI group (training and support for GP screening and counseling, With bonuses that motivate them to provide these services to alcoholics and clinics that provide online and simple counseling to alcoholics.) The effect of the trial was evaluated by the number of patients ≥18 years of age (alcohol screened and screening positive for counseling) within 9 months of starting the trial. Results The follow-up of 9 months showed that the number of alcohol abuse patients who were intervened in TS group, TS + FR group, TS + eBI group and TS + FR + eBI group clinic and recorded in the FR group OR of 1.39 [95% CI (1.03, 1.88)] compared with the number of alcohol abuse patients admitted to the eBI, FR + eBI, and control groups clinics. The number of alcohol abuse patients who are interviewed is not related to using incentive bonuses to motivate GPs to provide services to them or to using GPs to conduct online screening of patients who are positive for alcohol screening. Conclusion Training and support for GP screening and general counseling in GP clinics has a lasting effect on the number of adult alcohol abusers who receive intervention within 9 months, albeit with little effect.