Características clínicas y demográficas de bebedores “por atracones” que se relacionan con una falta de eficacia de la intervención breve y el consejo médico

Gabriel Rubio, Juan A. López-Rodríguez, Pilar Zuluaga, Guillermo Ponce, Isabel Martínez-Gras, Miguel Ángel Jiménez-Arriero

Resumen


La Intervención Breve (IB) y el Consejo Médico simple (CM) son intervenciones psicoterapéuticas usadas para el tratamiento del consumo de alcohol por atracones en Atención Primaria. A pesar de la frecuencia de este patrón de abuso en Europa y en los Estados Unidos, ningún estudio ha evaluado las características de los sujetos que no responden a esas dos técnicas. Objetivo. Determinar las características demográficas y clínicas de los bebedores por atracones en los que la IB y el CM no son efectivos para la reducción del consumo perjudicial de alcohol. Métodos. Se trata de un análisis secundario de los datos obtenidos en un ensayo aleatorizado de intervención breve en alcohol con un período de seguimiento de 12 meses. Un total de 674 sujetos (89%) participaron durante todo el estudio hasta el final. La variable principal fue el cambio en el uso perjudicial de alcohol tras 12 meses de seguimiento. Resultados. Para ambos grupos de tratamiento las variables que predecían la continuidad en el consumo perjudicial tras el seguimiento eran: bajo nivel educativo, ser jóvenes, el número de cigarrillos fumados, la historia familiar de alcoholismo y la gravedad del consumo de alcohol basalmente. Conclusiones. Las características clínicas y sociodemográficas de los sujetos con un patrón de consumo de alcohol por atracones atendidos en Atención primaria influyen en el pronóstico de las Intervenciones breves y del Consejo Médico. 

 


Palabras clave


Intervención breve; Consejo médico; Atracones; Consumo perjudicial.

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Referencias


Aalto, M., & Sillanaukee, P. (2000). Compliance rate and associated factors for entering an alcohol brief intervention treatment programme. Alcohol and Alcoholism, 35, 372–376. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10906003

Ames, S. C., Pokorny, S. B., Schroeder, D. R., Tan, W., & Werch, C. E. (2014). Integrated smoking cessation and binge drinking intervention for young adults: a pilot efficacy trial. Addictive Behaviors, 39, 848–853. doi:10.1016/j.addbeh.2014.02.001

Ames, S. C., Werch, C. E., Ames, G. E., Lange, L. J., Schroeder, D. R., Hanson, A. C., & Patten, C. A. (2010). Integrated smoking cessation and binge drinking intervention for young adults: a pilot investigation. Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine, 40, 343–349. doi:10.1007/s12160-010-9222-4

Anderson, P., & Baumberg, B. (2008). Alcohol in Europe. London: Institute of Alcohol Studies.

Bertholet, N., Palfai, T., Gaume, J., Daeppen, J. B., & Saitz, R. (2014). Do brief alcohol motivational interventions work like we think they do? Alcoholism, Clinical and Experimental Research, 38, 853–859. doi:10.1111/acer.12274

Blazer, D. G., & Wu, L. T. (2009). The epidemiology of at-risk and binge drinking among middle-aged and elderly community adults: National Survey on Drug Use and Health. The American Journal of Psychiatry, 166, 1162–1169. doi:10.1176/appi.ajp.2009.09010016

Breese, G. R., Overstreet, D. H., & Knapp, D. J. (2005). Conceptual framework for the etiology of alcoholism: a “kindling”/stress hypothesis. Psychopharmacology, 178, 367–380. doi:10.1007/s00213-004-2016-2

Courtney, K. E., & Polich, J. (2009). Binge drinking in young adults: Data, definitions, and determinants. Psychological Bulletin, 135, 142–156. doi:10.1037/a0014414

Curry, S. J., Ludman, E. J., Grothaus, L. C., Donovan, D., & Kim, E. (2003). A randomized trial of a brief primary-care-based intervention for reducing at-risk drinking practices. Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 22, 156–165.

Daeppen, J.-B., Bertholet, N., Gaume, J., Fortini, C., Faouzi, M., & Gmel, G. (2011). Efficacy of brief motivational intervention in reducing binge drinking in young men: A randomized controlled trial. Drug and Alcohol Dependence, 113, 69–75. doi:10.1016/j.drugalcdep.2010.07.009

Endicott, J., Andreasen, N., & Spitzter, R. (1989). Research Diagnostic Criteria (Spanish version by Hubert M.S.). Madrid: E. Médicos, Ed.

Fleming, M. F. (2003). Brief interventions and the treatment of alcohol use disorders: current evidence. Recent Developments in Alcoholism : An Official Publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism, 16, 375–390.

Fleming, M. F., Barry, K. L., Manwell, L. B., Johnson, K., & London, R. (1997). Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices. JAMA, 277, 1039–1045. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9091691

Fleming, M. F., Manwell, L. B., Barry, K. L., Adams, W., & Stauffacher, E. A. (1999). Brief physician advice for alcohol problems in older adults: a randomized community-based trial. The Journal of Family Practice, 48, 378–384. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10334615

Grossberg, P. M. (2004). Brief physician advice for high-risk drinking among young adults. The Annals of Family Medicine, 2, 474–480. doi:10.1370/afm.122

Harrison, L. (1997). The validity of self-reported drug use in survey research: an overview and critique of research methods. NIDA Research Monograph, 167, 17–36.

Hosmer, D., & Lemeshow, S. (2000). Applied Logistic Regression. John Wiley & Sons Ltd.

Kaner, E. F. S., Beyer, F., Dickinson, H. O., Pienaar, E., Campbell, F., Schlesinger, C., … Burnand, B. (2007). Effectiveness of brief alcohol interventions in primary care populations. The Cochrane Database of Systematic Reviews, CD004148. doi:10.1002/14651858.CD004148.pub3

Kiefer, F., Jiménez-Arriero, M. A., Klein, O., Diehl, A., & Rubio, G. (2008). Cloninger’s typology and treatment outcome in alcohol-dependent subjects during pharmacotherapy with naltrexone. Addiction Biology, 13, 124–129. doi:10.1111/j.1369-1600.2007.00073.x

Knight, J. R., Wechsler, H., Kuo, M., Seibring, M., Weitzman, E. R., & Schuckit, M. A. (2002). Alcohol abuse and dependence among U.S. college students. Journal of Studies on Alcohol, 63, 263–270.

Littlejohn, C. (n.d.). Does socio-economic status influence the acceptability of, attendance for, and outcome of, screening and brief interventions for alcohol misuse: a review. Alcohol and Alcoholism, 41, 540–545. doi:10.1093/alcalc/agl053

Monti, P. M., Colby, S. M., Barnett, N. P., Spirito, A., Rohsenow, D. J., Myers, M., … Lewander, W. (1999). Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department. Journal of Consulting and Clinical Psychology, 67, 989–994.

Murray, R. P., Istvan, J. A., Voelker, H. T., Rigdon, M. A., & Wallace, M. D. (1995). Level of involvement with alcohol and success at smoking cessation in the lung health study. Journal of Studies on Alcohol, 56, 74–82.

Naimi, T. S., Brewer, R. D., Mokdad, A., Denny, C., Serdula, M. K., & Marks, J. S. (2003). Binge drinking among US adults. JAMA, 289. doi:10.1001/jama.289.1.70

National Institute of Alcohol Abuse and Alcoholism, A. (2004). NIAAA Council Approves Definition of Binge Drinking. NIAAA Newsletter.

NIH, US Department of Health and Human Services, PHS y NIAAA. (2000). The tenth special report to the U.S. Congress on alcohol and health from the Secretary of Health and Human Services. Washington DC: U.S. Department of Health and Human Services.

Ockene, J. K., Adams, A., Hurley, T. G., Wheeler, E. V, & Hebert, J. R. (1999). Brief physician- and nurse practitioner-delivered counseling for high-risk drinkers: does it work? Archives of Internal Medicine, 159, 2198–205.

Okoro, C. A., Brewer, R. D., Naimi, T. S., Moriarty, D. G., Giles, W. H., & Mokdad, A. H. (2004). Binge drinking and health-related quality of life: do popular perceptions match reality? American Journal of Preventive Medicine, 26, 230–233. doi:10.1016/j.amepre.2003.10.022

Reiff-Hekking, S., Ockene, J. K., Hurley, T. G., & Reed, G. W. (2005). Brief physician and nurse practitioner-delivered counseling for high-risk drinking. Results at 12-month follow-up. Journal of General Internal Medicine, 20, 7–13. doi:10.1111/j.1525-1497.2005.21240.x

Rubio, G., Jiménez-Arriero, M. A., Martínez, I., Ponce, G., & Palomo, T. (2010). Efficacy of physician-delivered brief counseling intervention for binge drinkers. The American Journal of Medicine, 123, 72–78. doi:10.1016/j.amjmed.2009.08.012

Rubio, G., León, G., Pascual, F. F., & Santo-Domingo, J. (1998). Clinical significance of Cloninger’s classification in a sample of alcoholic Spanish men. Addiction, 93, 93–101.

Rubio, G., Ponce, G., Rodriguez-Jiménez, R., Jiménez-Arriero, M. a, Hoenicka, J., & Palomo, T. (2005). Clinical predictors of response to naltrexone in alcoholic patients: who benefits most from treatment with naltrexone? Alcohol and Alcoholism, 40, 227–233. doi:10.1093/alcalc/agh151

Rubio Valladolid, G., Bermejo Vicedo, J., Caballero Sánchez-Serrano, M. C., & Santo-Domingo Carrasco, J. (1998). Validation of the Alcohol Use Disorders Identification Test (AUDIT) in primary care. Revista Clínica Española, 198, 11–14.

Soler González, C., Balcells Oliveró, M., & Gual Solé, A. (2014). Alcohol related brain damage. State of the art and a call for action. Adicciones, 26, 199–207.

Stephens, D. N., Ripley, T. L., Borlikova, G., Schubert, M., Albrecht, D., Hogarth, L., & Duka, T. (2005). Repeated ethanol exposure and withdrawal impairs human fear conditioning and depresses long-term potentiation in rat amygdala and hippocampus. Biological Psychiatry, 58, 392–400. doi:10.1016/j.biopsych.2005.04.025

Town, M., Naimi, T. S., Mokdad, A. H., & Brewer, R. D. (2006). Health care access among U.S. adults who drink alcohol excessively: missed opportunities for prevention. Preventing Chronic Disease, 3, A53.

Townshend, J. M., & Duka, T. (2005). Binge drinking, cognitive performance and mood in a population of young social drinkers. Alcoholism: Clinical & Experimental Research, 29, 317–325. doi:10.1097/01.ALC.0000156453.05028.F5




DOI: https://doi.org/10.20882/adicciones.694

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