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Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial
Newcastle University, England; Maastricht University, Netherlands.
University of Kent, England.
Newcastle University, England.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
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2017 (English)In: Annals of family medicine (online), ISSN 1544-1709, E-ISSN 1544-1717, Vol. 15, no 4, 335-340 p.Article 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, 335-340 p.
Keyword [en]
primary health care; heavy drinking; implementation study; training and support; financial reimbursement; electronic brief intervention; practice-based research
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Nursing
Identifiers
URN: urn:nbn:se:liu:diva-139604DOI: 10.1370/afm.2051ISI: 000405400800009PubMedID: 28694269OAI: oai:DiVA.org:liu-139604DiVA: 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

Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2017-08-16

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Bendtsen, Preben
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Division of Community MedicineFaculty of Medicine and Health SciencesDepartment of Medical Specialist in Motala
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CiteExportLink to record
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Citation style
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