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2013 Update in addiction medicine for the generalist / A. J. GORDON ; N. BERTHOLET ; J. McNEELY ; J. L. STARRELS ; J. M. TETRAULT ; A. Y. WALLEY in Addiction Science and Clinical Practice, Vol.8, n°18 (November 2013)
Titre : 2013 Update in addiction medicine for the generalist Type de document : Périodique Auteurs : A. J. GORDON ; N. BERTHOLET ; J. McNEELY ; J. L. STARRELS ; J. M. TETRAULT ; A. Y. WALLEY Année de publication : 2013 Article en page(s) : 13 p. Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
MEDECIN GENERALISTE ; ADDICTOLOGIE ; SOINS DE PREMIER RECOURS ; ALCOOL ; PRODUIT ILLICITE ; DEPISTAGE ; INTERVENTION BREVE ; PHARMACOTHERAPIE ; EFFICACITE ; PRATIQUE PROFESSIONNELLE
Discipline : TRA Traitement et prise en charge / Treatment and care Résumé : Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for the care of patients in primary care or other generalist settings. To accomplish this aim, we selected articles in the field of addiction medicine, critically appraised and summarized the manuscripts, and highlighted their implications for generalist practice. During an initial review, we identified articles through an electronic Medline search (limited to human studies and in English) using search terms for alcohol and other drugs of abuse published from January 2010 to January 2012. After this initial review, we searched for other literature in web-based or journal resources for potential articles of interest. From the list of articles identified in these initial reviews, each of the six authors independently selected articles for more intensive review and identified the ones they found to have a potential impact on generalist practice. The identified articles were then ranked by the number of authors who selected each article. Through a consensus process over 4 meetings, the authors reached agreement on the articles with implications for practice for generalist clinicians that warranted inclusion for discussion. The authors then grouped the articles into five categories: 1) screening and brief interventions in outpatient settings, 2) identification and management of substance use among inpatients, 3) medical complications of substance use, 4) use of pharmacotherapy for addiction treatment in primary care and its complications, and 5) integration of addiction treatment and medical care. The authors discuss each selected articles' merits, limitations, conclusions, and implication to advancing addiction screening, assessment, and treatment of addiction in generalist physician practice environments. Domaine : Alcool / Alcohol ; Drogues illicites / Illicit drugs Sous-type de document : Revue de la littérature / Literature review Refs biblio. : 73 Affiliation : VA Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, PA, USA Lien : http://dx.doi.org/10.1186/1940-0640-8-18 Permalink :
in Addiction Science and Clinical Practice > Vol.8, n°18 (November 2013) . - 13 p.[article]Adolescents in primary care [Clinical review] / A. McPHERSON in British Medical Journal, Vol.330, n°7489 (26 February 2005)
Titre : Adolescents in primary care [Clinical review] Type de document : Périodique Auteurs : A. McPHERSON Année de publication : 2005 Article en page(s) : 465-467 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
ADOLESCENT ; SOINS DE PREMIER RECOURS ; PRISE EN CHARGE ; MEDECIN GENERALISTE ; RELATION THERAPEUTIQUE ; COMMUNICATION ; PRATIQUE PROFESSIONNELLE
Discipline : TRA Traitement et prise en charge / Treatment and care Résumé : Introduction:
The specific health needs of young people are often neglected by primary care as it is believed that adolescents are on the whole a healthy group who rarely present to their general practitioner (GP). "Out of sight" has been "out of mind," especially given the ever increasing pressures on primary care from other client groups.
The new GP contract in England and Wales has done nothing to mitigate this. Change is needed, however, as teenagers (a) have many health concerns, though they do not always tell their GP about them, and (b) do visit their GPs, on average two to three times a year (with about 70% of all teenagers visiting their GP in any one year). These visits provide opportunities to deal with their health concerns.
Surveys have shown that adolescents are usually happy to discuss health issues with their GP, but 40% say that they find it difficult to see their GP. Over 60% said that they would not know how to register with a GP when they left home, and 71% did not know how to register as a temporary resident. Young people identify confidentiality and access as the most important aspects of primary care for them.
Domaine : Hors addiction / No addiction Affiliation : Oxford, UK Permalink :
in British Medical Journal > Vol.330, n°7489 (26 February 2005) . - 465-467[article]Alcohol use disorders in Europe: A comparison of general population and primary health care prevalence rates / J. MANTHEY ; A. GUAL ; A. JAKUBCZYK ; L. PIEPER ; C. PROBST ; P. STRUZZO ; M. TRAPENCIERIS ; M. WOJNAR ; J. REHM in Journal of Substance Use, Vol.21, n°5 (October 2016)
Titre : Alcohol use disorders in Europe: A comparison of general population and primary health care prevalence rates Type de document : Périodique Auteurs : J. MANTHEY ; A. GUAL ; A. JAKUBCZYK ; L. PIEPER ; C. PROBST ; P. STRUZZO ; M. TRAPENCIERIS ; M. WOJNAR ; J. REHM Année de publication : 2016 Article en page(s) : 478-484 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique
EUROPE ; ITALIE ; ALLEMAGNE ; ESPAGNE ; POLOGNE ; HONGRIE ; LETTONIE
ALCOOL ; COMPARAISON ; POPULATION GENERALE ; PREVALENCE ; SOINS DE PREMIER RECOURS ; ENQUETE ; MEDECIN GENERALISTE ; MORBIDITE
Discipline : EPI Epidémiologie / Epidemiology Résumé : Aims. Alcohol use disorders (AUDs) are prevalent in Europe but occurrence in primary care and the proportion of treated cases are understudied. This study reports prevalence of AUDs and their treatment in European primary health care settings and compares them with general population estimates.
Procedure. We sampled 358 general practitioners (GPs, refusal rate: 56.4%) across six European countries (Germany, Hungary, Italy, Latvia, Poland, and Spain) who assessed 13,003 patients including providing AUD diagnoses. A subsample of 8,476 patients (refusal rate: 17.8%) was interviewed subsequently, assessing DSM-IV AUD diagnoses via the Composite International Diagnostic Interview. Final AUD diagnoses combined GP and patient interview information.
Findings. Past year AUDs were prevalent with 11.8% (95% CI: 11.2-12.5%) across all regions, which is 1.6 times the European general population AUD estimate. Of those diagnosed with AUDs, 17.7% (95% CI: 15.4-20.0%) received professional help. Compared to general population estimates, AUDs and their treatment were more prevalent in primary care settings in most countries, with disproportionally high AUD rates in Italy and Spain and unexpectedly low AUD rates in Hungary.
Conclusions. We found higher prevalence and treatment rates of AUDs in primary health care compared to general population surveys, with large variability between the observed countries.
Domaine : Alcool / Alcohol Affiliation : Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany Lien : http://dx.doi.org/10.3109/14659891.2015.1063719 Permalink :
in Journal of Substance Use > Vol.21, n°5 (October 2016) . - 478-484[article]An electronic screen for triaging adolescent substance use by risk levels / S. LEVY ; R. WEISS ; L. SHERRITT ; R. ZIEMNIK ; A. SPALDING ; S. VAN HOOK ; L. A. SHRIER in JAMA Pediatrics, Vol.168, n°9 (September 2014)
Titre : An electronic screen for triaging adolescent substance use by risk levels Type de document : Périodique Auteurs : S. LEVY ; R. WEISS ; L. SHERRITT ; R. ZIEMNIK ; A. SPALDING ; S. VAN HOOK ; L. A. SHRIER Année de publication : 2014 Article en page(s) : 822-828 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique
ADOLESCENT ; DEPISTAGE ; ORIENTATION ; ETUDE CLINIQUE ; SOINS DE PREMIER RECOURS ; VALIDITE ; TEST ; PREVALENCE
Discipline : PRO Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods Résumé : IMPORTANCE: Screening adolescents for substance use and intervening immediately can reduce the burden of addiction and substance-related morbidity. Several screening tools have been developed to identify problem substance use for adolescents, but none have been calibrated to triage adolescents into clinically relevant risk categories to guide interventions.
OBJECTIVE: To describe the psychometric properties of an electronic screen and brief assessment tool that triages adolescents into 4 actionable categories regarding their experience with nontobacco substance use.
DESIGN, SETTING, AND PARTICIPANTS: Adolescent patients (age range, 12-17 years) arriving for routine medical care at 2 outpatient primary care centers and 1 outpatient center for substance use treatment at a pediatric hospital completed an electronic screening tool from June 1, 2012, through March 31, 2013, that consisted of a question on the frequency of using 8 types of drugs in the past year (Screening to Brief Intervention). Additional questions assessed severity of any past-year substance use. Patients completed a structured diagnostic interview (Composite International Diagnostic Interview-Substance Abuse Module), yielding Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) substance use diagnoses.
MAIN OUTCOMES AND MEASURES: For the entire screen and the Screening to Brief Intervention, sensitivity and specificity for identifying nontobacco substance use, substance use disorders, severe substance use disorders, and tobacco dependence were calculated using the Composite International Diagnostic Interview-Substance Abuse Module as the criterion standard.
RESULTS: Of 340 patients invited to participate, 216 (63.5%) enrolled in the study. Sensitivity and specificity were 100% and 84% (95% CI, 76%-89%) for identifying nontobacco substance use, 90% (95% CI, 77%-96%) and 94% (95% CI, 89%-96%) for substance use disorders, 100% and 94% (95% CI, 90%-96%) for severe substance use disorders, and 75% (95% CI, 52%-89%) and 98% (95% CI, 95%-100%) for nicotine dependence. No significant differences were found in sensitivity or specificity between the full tool and the Screening to Brief Intervention.
CONCLUSIONS AND RELEVANCE: A single screening question assessing past-year frequency use for 8 commonly misused categories of substances appears to be a valid method for discriminating among clinically relevant risk categories of adolescent substance use.
Domaine : Plusieurs produits / Several products Refs biblio. : 36 Affiliation : Adolescent Substance Abuse Program, Boston Children's Hospital, Boston, Massachusetts, USA Lien : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270364/ Permalink :
in JAMA Pediatrics > Vol.168, n°9 (September 2014) . - 822-828[article]Behavioral counseling after screening for alcohol misuse in primary care: A systematic review and meta-analysis for the U.S. Preventive Services Task Force / D. E. JONAS ; J. C. GARBUTT ; H. R. AMICK ; J. M. BROWN ; K. A. BROWNLEY ; C. L. COUNCIL ; A. J. VIERA ; T. M. WILKINS ; C. J. SCHWARTZ ; E. M. RICHMOND ; J. YEATTS ; T. SWINSON EVANS ; S. D. WOOD ; R. P. HARRIS in Annals of Internal Medicine, Vol.157, n°9 (6 November 2012)
Titre : Behavioral counseling after screening for alcohol misuse in primary care: A systematic review and meta-analysis for the U.S. Preventive Services Task Force Type de document : Périodique Auteurs : D. E. JONAS ; J. C. GARBUTT ; H. R. AMICK ; J. M. BROWN ; K. A. BROWNLEY ; C. L. COUNCIL ; A. J. VIERA ; T. M. WILKINS ; C. J. SCHWARTZ ; E. M. RICHMOND ; J. YEATTS ; T. SWINSON EVANS ; S. D. WOOD ; R. P. HARRIS Année de publication : 2012 Article en page(s) : 645-654 Note générale : Research news: Brief counselling reduces hazardous drinking. British Medical Journal 2012;345:e6599. Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
ALCOOL ; INTERVENTION BREVE ; DEPISTAGE ; SOINS DE PREMIER RECOURS ; CONSEIL ; ADOLESCENT ; ADULTE ; INTERVENTION ; EVALUATION ; ABUS ; EFFICACITE
Résumé : Background: Alcohol misuse, which includes the full spectrum from risky drinking to alcohol dependence, is a leading cause of preventable death in the United States.
Purpose: To evaluate the benefits and harms of behavioral counseling interventions for adolescents and adults who misuse alcohol.
Data Sources: MEDLINE, EMBASE, the Cochrane Library, CINAHL, PsycINFO, International Pharmaceutical Abstracts, and reference lists of published literature (January 1985 through January 2012, limited to English-language articles).
Study Selection: Controlled trials at least 6 months' duration that enrolled persons with alcohol misuse identified by screening in primary care settings and evaluated behavioral counseling interventions.
Data Extraction: One reviewer extracted data and a second checked accuracy. Two independent reviewers assigned quality ratings and graded the strength of the evidence.
Data Synthesis: The 23 included trials generally excluded persons with alcohol dependence. The best evidence was for brief (10- to 15-minute) multicontact interventions. Among adults receiving behavioral interventions, consumption decreased by 3.6 drinks per week from baseline (weighted mean difference, 3.6 drinks/wk [95% CI, 2.4 to 4.8 drinks/wk]; 10 trials; 4332 participants), 12% fewer adults reported heavy drinking episodes (risk difference, 0.12 [CI, 0.07 to 0.16]; 7 trials; 2737 participants), and 11% more adults reported drinking less than the recommended limits (risk difference, 0.11 [CI, 0.08 to 0.13]; 9 trials; 5973 participants) over 12 months compared with control participants (moderate strength of evidence). Evidence was insufficient to draw conclusions about accidents, injuries, or alcohol-related liver problems. Trials enrolling young adults or college students showed reduced consumption and fewer heavy drinking episodes (moderate strength of evidence). Little or no evidence of harms was found.
Limitations: Results may be biased to the null because the behavior of control participants could have been affected by alcohol misuse assessments. In addition, evidence is probably inapplicable to persons with alcohol dependence and selective reporting may have occurred.
Conclusion: Behavioral counseling interventions improve behavioral outcomes for adults with risky drinking.
Primary Funding Source: Agency for Healthcare Research and Quality.
Domaine : Alcool / Alcohol Sous-type de document : Méta-analyse / Meta-analysis ; Revue de la littérature / Literature review Refs biblio. : 89 Affiliation : University of North Carolina at Chapel Hill, Department of Medicine, Chapel Hill, NC, USA Lien : http://annals.org/article.aspx?articleid=1361859 Permalink :
in Annals of Internal Medicine > Vol.157, n°9 (6 November 2012) . - 645-654[article]Brief intervention for problem drug use in safety-net primary care settings: A randomized clinical trial / P. P. ROY-BYRNE ; K. BUMGARDNER ; A. KRUPSKI ; C. DUNN ; R. RIES ; D. M. DONOVAN ; I. I. WEST ; C. MAYNARD ; D. C. ATKINS ; M. C. GRAVES ; J. M. JOESCH ; G. A. ZARKIN in Journal of the American Medical Association, Vol.312, n°5 (August 6, 2014)PermalinkClinical survey assessing the appropriate management of individuals with acute recreational drug toxicity at a large outdoor festival event / J. R. H. ARCHER ; P. O. BEAUMONT ; D. MAY ; P. I. DARGAN ; D. M. WOOD in Journal of Substance Use, Vol.17, n°4 (August 2012)PermalinkCollaborative care for opioid and alcohol use disorders in primary care: The SUMMIT randomized clinical trial / K. E. WATKINS ; A. J. OBER ; K. LAMP ; M. LIND ; C. SETODJI ; K. C. OSILLA ; S. B. HUNTER ; C. M. MCCULLOUGH ; K. BECKER ; P. O. IYIEWUARE ; A. DIAMANT ; K. HEINZERLING ; H. A. PINCUS in JAMA Internal Medicine, Online first 28/08/2017 (2017)PermalinkA comparison of the efficacy of brief interventions to reduce hazardous and harmful alcohol consumption between European and non-European countries: a systematic review and meta-analysis of randomized controlled trials / C. ELZERBI ; K. DONOGHUE ; C. DRUMMOND in Addiction, Vol.110, n°7 (July 2015)PermalinkEffectiveness of brief alcohol interventions in primary care populations [Review] / E. F. S. KANER ; F. R. BEYER ; C. MUIRHEAD ; F. CAMPBELL ; E. D. PIENAAR ; N. BERTHOLET ; J. B. DAEPPEN ; J. B. SAUNDERS ; B. BURNAND in Cochrane Database of Systematic Reviews, n°2 (2018)PermalinkEffectiveness of brief alcohol interventions in primary care populations (Review) / E. F. S. KANER in Cochrane Database of Systematic Reviews, n°2 (2007)PermalinkEffectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial / E. KANER ; M. BLAND ; P. CASSIDY ; S. COULTON ; V. DALE ; P. DELUCA ; E. GILVARRY ; C. GODFREY ; N. HEATHER ; J. MYLES ; D. NEWBURY-BIRCH ; A. OYEFESO ; S. PARROTT ; K. A. PERRYMAN ; T. PHILLIPS ; J. SHEPHERD ; C. DRUMMOND in British Medical Journal, Vol.346, n°7892 (26 January 2013)PermalinkGuidelines for recognising, assessing and treating alcohol and cannabis abuse in primary care / National Health CommitteePermalinkHeavy episodic drinking in Europe: a cross section study in primary care in six European countries / I. NAZARETH ; C. WALKER ; A. RIDOLFI ; A. ALUOJA ; J. BELLON ; M. GEERLINGS ; I. SVAB ; M. XAVIER ; M. KING in Alcohol and Alcoholism, Vol.46, n°5 (September-October 2011)PermalinkImplementation of a "learner-driven" curriculum: An Screening, Brief Intervention, and Referral to Treatment (SBIRT) interdisciplinary primary care model / M. R. STANTON ; W. L. ATHERTON ; P. J. TORIELLO ; J. L. HODGSON in Substance Abuse, Vol.33, n°3 (2012)Permalink