Cribado de problemas de alcohol e intervención breve en los servicios de urgencias: una oportunidad para la prevención Screening for alcohol problems and Brief Intervention in the Emergency Department: Opportunity for Prevention

Autores/as

  • Cheryl J. Cherpitel Alcohol Research Group, Berkeley, CA, USA.
  • Alicia Rodríguez Martos Public Health Agency, Barcelona, Spain. Enviar correspondencia a: Alicia Rodríguez-Martos. Pl. Lesseps, 1. 08023-Barcelona.

DOI:

https://doi.org/10.20882/adicciones.367

Palabras clave:

alcohol, cribado, intervención breve, servicio de urgencias alcohol, screening, brief intervention, emergency department

Resumen

Se ha comprobado una fuerte asociación entre consumo de alcohol y lesiones. Dos recientes estudios internacionales han analizado la implicación del alcohol en las lesiones, teniendo en cuenta variables contextuales. Los pacientes con alcoholemia positiva o que informaron haber consumido alcohol antes de la lesión tenían mayor probabilidad de ser admitidos en urgencias por lesiones que los pacientes no traumáticos, y las pautas perjudiciales de consumo predecían, a nivel individual, el riesgo relacionado con el alcohol y la probabilidad de atribuir la lesión al consumo de dicha sustancia. Los servicios de urgencias (SU) están en una posición privilegiada para identificar e intervenir sobre individuos con consumo de riesgo o que ya han desarrollado problemas relacionados con el alcohol, pues se encuentran en un “momento receptivo” tras el evento impactante. Se han analizado diferentes instrumentos de cribado para la identificación de los problemas de alcohol en los pacientes que acuden a urgencias. Se propone la utilización del cuestionario RAPS4-QF (Rapid Alcohol Problems Screen, 4 ítems + 2 preguntas de cantidad-frecuencia) por su óptimo rendimiento en el marco de los SU. Diversos estudios han puesto de manifiesto el buen resultado de la intervención breve entre estos pacientes, con una reducción del consumo no siempre significativa frente al grupo control, y una reducción significativa de los problemas relacionados con el alcohol (por ejemplo, nuevas lesiones e ingresos hospitalarios), comparada con el grupo control. Sin embargo, identificación precoz e intervención breve siguen siendo una asignatura pendiente en los SU de todo el mundo.
Alcohol is one of the most important risk factors for disease and disability, with a strong association found between alcohol and injury. Two recent international studies have analysed the involvement of alcohol in injuries, taking into account contextual variables. Blood alcohol level (BAL) positive patients and those reporting drinking before the injury were more likely to be admitted to the emergency department (ED) with an injury compared to a non-injury problem, and detrimental patterns of drinking predicted the individual’s alcohol-related risk and the likelihood of attributing the injury to alcohol. Emergency departments are in a privileged position to identify and intervene with patients who are at risk or have developed problems because of their drinking, for these patient find themselves in a teachable moment after the critical event. Different screening instruments have been investigated for identifying alcohol use disorders in emergency department patients. The RAPS4-QF (Rapid Alcohol Problems Screen, 4 items + 2 quantity frequency items) is proposed for its optimal performance at the ED setting. A number of studies have shown good results of brief intervention among these patients. Most studies show a significant reduction in the consumption of alcohol, although not always significant compared with control patients, and a significant reduction in alcohol-related problems (e.g. new injuries and hospital admissions) compared with controls. Nevertheless, early identification and brief intervention are still a pending subject in emergency departments throughout the world.

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Publicado

2005-09-01

Número

Vol. 17 Núm. 3 (2005)

Sección

Editorial