دورية أكاديمية
Assertive community treatment for high-utilizing alcohol misuse patients: a before-and-after cohort study protocol.
| العنوان: | Assertive community treatment for high-utilizing alcohol misuse patients: a before-and-after cohort study protocol. |
|---|---|
| المؤلفون: | Wu J; Health Services Research Centre, SingHealth, Outram, Singapore. gmswuj@nus.edu.sg.; Health Services and Systems Research, Duke-NUS Medical School, Outram, Singapore. gmswuj@nus.edu.sg.; Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, Singapore. gmswuj@nus.edu.sg., Siddiqui FJ; Pre-hospital and Emergency Research Centre, Duke-NUS Medical School, Outram, Singapore., Mak CCM; National Addictions Management Service, Institute of Mental Health, Buangkok, Singapore., Chua ISY; Department of Emergency Medicine, Singapore General Hospital, Outram, Singapore., Thangayah JR; Department of Emergency Medicine, Singapore General Hospital, Outram, Singapore., Tan EXX; Department of Emergency Medicine, Ng Teng Fong General Hospital, Jurong East, Singapore, Singapore., Seet HY; Acute and Emergency Care Centre, Khoo Teck Puat Hospital, Yishun, Singapore., Rao AK; Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, Singapore.; Acute and Emergency Care Centre, Khoo Teck Puat Hospital, Yishun, Singapore., Tan HY; Acute and Emergency Care Centre, Khoo Teck Puat Hospital, Yishun, Singapore., Mohamed A; Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore., Hartman M; Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, Singapore.; Department of Surgery, National University Hospital, Kent Ridge, Singapore.; Saw Swee Hock School of Public Health, National University of Singapore, Kent Ridge, Singapore., Leong BS; Department of Emergency Medicine, National University Hospital, Kent Ridge, Singapore., Ong MEH; Health Services and Systems Research, Duke-NUS Medical School, Outram, Singapore.; Department of Emergency Medicine, Singapore General Hospital, Outram, Singapore.; Unit for Pre-hospital Emergency Care, Ministry of Health, Outram, Singapore., Mao DR; Acute and Emergency Care Centre, Khoo Teck Puat Hospital, Yishun, Singapore. |
| المصدر: | BMC health services research [BMC Health Serv Res] 2024 Feb 28; Vol. 24 (1), pp. 256. Date of Electronic Publication: 2024 Feb 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Alcoholism*/therapy , Community Mental Health Services* , Emergency Medical Services* , Alcohol-Related Disorders*, Humans ; Cohort Studies ; Prospective Studies ; Emergency Service, Hospital |
| مستخلص: | Background: The challenge posed by Alcohol-Related Frequent Attenders (ARFAs) in Emergency Departments (EDs) is growing in Singapore, marked by limited engagement with conventional addiction treatment pathways. Recognizing this gap, this study aims to explore the potential benefits of Assertive Community Treatment (ACT) - an innovative, community-centered, harm-reduction strategy-in mitigating the frequency of ED visits, curbing Emergency Medical Services (EMS) calls, and uplifting health outcomes across a quartet of Singaporean healthcare institutions. Methods: Employing a prospective before-and-after cohort design, this investigation targeted ARFAs aged 21 years and above, fluent in English or Mandarin. Eligibility was determined by a history of at least five ED visits in the preceding year, with no fewer than two due to alcohol-related issues. The study contrasted health outcomes of patients integrated into the ACT care model versus their experiences under the exclusive provision of standard emergency care across Hospitals A, B, C and D. Following participants for half a year post-initial assessment, the evaluation metrics encompassed socio-demographic factors, ED, and EMS engagement frequencies, along with validated health assessment tools, namely Christo Inventory for Substance-misuse Services (CISS) scores, University of California, Los Angeles (UCLA) Loneliness scores, and Centre for Epidemiologic Studies Depression Scale Revised (CESD-R-10) scores. Discussion: Confronted with intricate socio-economic and medical challenges, the ARFA cohort often grapples with heightened vulnerabilities in relation to alcohol misuse. Pioneering the exploration of ACT's efficacy with ARFAs in a Singaporean context, our research is anchored in a patient-centered approach, designed to comprehensively address these multifaceted clinical profiles. While challenges, like potential high attrition rates and sporadic data collection, are anticipated, the model's prospective contribution towards enhancing patient well-being and driving healthcare efficiencies in Singapore is substantial. Our findings have the potential to reshape healthcare strategies and policy recommendations. Trial Registration: ClinicalTrials.gov, NCT04447079. Initiated on 25 June 2020. (© 2024. The Author(s).) |
| References: | Med J Aust. 2006 Jun 19;184(12):602-6. (PMID: 16803437) Acad Emerg Med. 2015 Sep;22(9):1025-33. (PMID: 26284824) PLoS One. 2015 Apr 13;10(4):e0123660. (PMID: 25874866) Clin Psychol Rev. 2013 Dec;33(8):1010-24. (PMID: 24029221) Ann Emerg Med. 2010 Jul;56(1):42-8. (PMID: 20346540) Eur J Emerg Med. 2010 Dec;17(6):332-6. (PMID: 20038842) BMC Public Health. 2020 Mar 14;20(1):332. (PMID: 32171278) J Public Health Med. 1990 Feb;12(1):39-44. (PMID: 2390308) Emerg Med J. 2007 Jun;24(6):398-401. (PMID: 17513534) Front Health Serv. 2022 Nov 04;2:1029455. (PMID: 36925838) Emerg Med J. 2009 Feb;26(2):103-5. (PMID: 19164618) Prehosp Emerg Care. 2019 Mar-Apr;23(2):215-224. (PMID: 30118627) |
| معلومات مُعتمدة: | MH 6:13/13-12 Ministry of Health -Singapore; MH 6:13/13-12 Ministry of Home Affairs - Singapore |
| فهرسة مساهمة: | Keywords: Alcohol-related frequent attenders; Assertive community treatment; Emergency department utilization; Healthcare resource optimization; Singapore |
| سلسلة جزيئية: | ClinicalTrials.gov NCT04447079 |
| تواريخ الأحداث: | Date Created: 20240228 Date Completed: 20240301 Latest Revision: 20240302 |
| رمز التحديث: | 20240302 |
| مُعرف محوري في PubMed: | PMC10900701 |
| DOI: | 10.1186/s12913-023-10516-5 |
| PMID: | 38419049 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1472-6963 |
|---|---|
| DOI: | 10.1186/s12913-023-10516-5 |