改善酒精使用障碍出院随访需行为支持与护理协调
Improving AUD Follow-Up Care Requires Coordination
一项发表于《内科学年鉴》的系统综述显示,针对酒精使用障碍住院患者出院后随访,最有效的方式是结合行为支持与护理协调。在评估的21项干预中,8项报告随访改善;15项随机对照试验中仅4项在1至3个月内随访率有统计学显著提升,且均包含护理协调。研究者指出,因干预异质性高、偏倚风险及评估标准不一,尚难得出更确定结论。
正文 · 原文
The most effective approaches for post-discharge follow-up of hospitalized adults with alcohol use disorder (AUD) combine behavioral support and care coordination, according to a systematic review published in Annals of Internal Medicine.
Why It’s Relevant
AUD affects one in 10 U.S. adults, with hospitalizations for AUD becoming increasingly prevalent. While ongoing outpatient care is critical for treatment success, fewer than half of patients receive timely follow-up care post-hospitalization.
By the Numbers
- Most of the 21 follow-up interventions assessed included multiple components, particularly behavioral therapy (76%), care coordination (76%), and social support (33%). Only 14% of interventions included medication management.
- Overall, eight out of 21 interventions reported improved outpatient follow-up after hospitalization for AUD
- Of the 15 interventions tested in a randomized controlled trial, just four showed statistically significant improvements in follow-up over one to three months (23% to 30% increase) when compared with usual care (n=3) or brief advice along with 12-step referral (n=1).
- All four successful interventions involved care coordination (such as discharge planning or having a dedicated transition specialist), while three of the four had behavioral components (such as motivational interviewing and/or patient education) and two involved social support.
What’s More
The researchers found wide variations and imprecision in assessment criteria and screening tools for AUD. For example, nine studies included participants with unhealthy alcohol use (but not AUD) or a non-alcohol substance use disorder.
The Other Side
The findings may not generalize to medically managed withdrawal facilities because there were no studies that occurred in these settings, the researchers noted. The researchers were unable to draw more definitive conclusions due to the heterogeneity and complexity of the interventions and the risk of bias.
Takeaway Message
“Further research is urgently needed to identify effective components of interventions to improve posthospitalization follow-up for patients with AUD,” the researchers wrote.
Related Information
Source
Eden Y. Bernstein, et al. Interventions to improve outpatient follow-up for hospitalized patients with alcohol use disorder. Annals of Internal Medicine. Published September 8, 2026. doi:10.7326/ANNALS-26-01312
(Image: Getty Images/iStock/SolStock)
来源:美国精神医学学会 · Psychiatric News · alert.psychnews.org