Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized TrialShow others and affiliations
2017 (English)In: Annals of Family Medicine, ISSN 1544-1709, E-ISSN 1544-1717, Vol. 15, no 4, p. 335-340Article in journal (Refereed) Published
Abstract [en]
PURPOSE We aimed to test whether 3 strategies-training and support, financial reimbursement, and an option to direct screen-positive patients to an Internet-based method of giving brief advice-have a longer-term effect on primary care clinicians delivery of screening and advice to heavy drinkers operationalized with the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) tool. METHODS We undertook a cluster randomized factorial trial with a 12-week implementation period in 120 primary health care units throughout Catalonia, England, Netherlands, Poland, and Sweden. Units were randomized to 8 groups: care as usual (control); training and support alone; financial reimbursement alone; electronic brief advice alone; paired combinations of these conditions; and all 3 combined. The primary outcome was the proportion of consulting adult patients (aged 18 years and older) receiving intervention-screening and, if screen-positive, advice-at 9 months. RESULTS Based on the factorial design, the ratio of the log of the proportion of patients given intervention at the 9-month follow-up was 1.39 (95% CI, 1.03-1.88) in units that received training and support as compared with units that did not. Neither financial reimbursement nor directing screen-positive patients to electronic brief advice led to a higher proportion of patients receiving intervention. CONCLUSIONS Training and support of primary health care units has a lasting, albeit small, impact on the proportion of adult patients given an alcohol intervention at 9 months.
Place, publisher, year, edition, pages
ANNALS FAMILY MEDICINE , 2017. Vol. 15, no 4, p. 335-340
Keywords [en]
primary health care; heavy drinking; implementation study; training and support; financial reimbursement; electronic brief intervention; practice-based research
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-139604DOI: 10.1370/afm.2051ISI: 000405400800009PubMedID: 28694269OAI: oai:DiVA.org:liu-139604DiVA, id: diva2:1133770
Note
Funding Agencies|European Unions Seventh Framework Programme for Research, Technological Development, and Demonstration [259268]; Netherlands Organisation for Health Research and Development (ZonMW, Prevention Program) [200310017]; NIHR Biomedical Research Centre for Mental Health at South London; Maudsley NHS Foundation Trust; NIHR Collaborations for Leadership in Applied Health Research and Care South London at Kings College Hospital NHS Foundation Trust; Polish science; Kings College London
2017-08-162017-08-162022-07-14