Sometimes I think that when there is not a commercial interest, there is no way to implement certain activities which are beneficial and which have demonstrated their social utility.

This is the case of secondary prevention in victims of traffic accidents.

Source: Mar de Fondo

We know that near 45% of all injuries from 16 to 70 years, admitted to the hospital, alcohol, drugs of abuse and/or psychiatric drugs are present. The intake of these substances is the main risk factor for accidents and injuries.

We also know that the rate of recidivism is double in patients consumers against non-users, even some authors publishing that consumption can increase recidivism to injuries to almost 90%, which gives us an idea of the magnitude of the problem. 

There is evidence that the recidivism in these patients may decrease by almost 50% through implementation of a protocol for systematic screening of alcohol and drugs in the hospital where patients with injuries are admitted, in order to detect those capable of brief motivational intervention (IMB) during hospitalization.
The IMB is a proactive and opportunistic intervention performed, therefore, unless the patient make an express demand for therapeutic intervention. This technique uses the special susceptibility to change that gives the hospital convalescence by trauma related to consumption.

It is done by a semi-structured interview limited in time (30-45 minutes) and its objective is to promote a change in risk behavior, where it is present. However in Spain, this type of secondary prevention practically is not performed.

The reasons of zero activity in this field are multiple. There is no doubt that as a non-commercial activity could influence, because nobody promotes this activity. On the other hand there is a reluctance by healthcare professionals derived from the legal uncertainty generated by obtaining the determination of exposure to these substances, even if it is only for clinical use.

It might seem that explore the exhibition to the main risk factor for relapse in patients with trauma, it is violating more privacy than determining hemoglobin-glycosylated in the diabetic patient, although in both cases the end is secondary prevention.

We learn by hits.

Dr. Enrique Fernandez Mondéjar and Sergio Cordovilla.
President of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC)
Fundación Pública Andaluza para la Investigación Biosanitaria de Andalucía Oriental – Alejandro Otero (FIBAO)
Neorotrauma Intensive Care Unit, Hospital Virgen de las Nieves.