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Implementing referral to an electronic alcohol brief advice website in primary healthcare: results from the ODHIN implementation trial
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.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-5173-5419
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-0279-5903
University of Barcelona, Spain.
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2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 6, e010271Article in journal (Refereed) Published
Abstract [en]

Objectives The objective of the present study was to explore whether the possibility of offering facilitated access to an alcohol electronic brief intervention (eBI) instead of delivering brief face-to-face advice increased the proportion of consulting adults who were screened and given brief advice. Design The study was a 12-week implementation study. Sixty primary healthcare units (PHCUs) in 5 jurisdictions (Catalonia, England, the Netherlands, Poland and Sweden) were asked to screen adults who attended the PHCU for risky drinking. Setting A total of 120 primary healthcare centres from 5 jurisdictions in Europe. Participants 746 individual providers (general practitioners, nurses or other professionals) participated in the study. Primary outcome Change in the proportion of patients screened and referred to eBI comparing a baseline 4-week preimplementation period with a 12-week implementation period. Results The possibility of referring patients to the eBI was not found to be associated with any increase in the proportion of patients screened. However, it was associated with an increase in the proportion of screen-positive patients receiving brief advice from 70% to 80% for the screen-positive sample as a whole (pamp;lt;0.05), mainly driven by a significant increase in brief intervention rates in England from 87% to 96% (pamp;lt;0.01). The study indicated that staff displayed a low level of engagement in this new technology. Staff continued to offer face-to-face advice to a larger proportion of patients (54%) than referral to eBI (38%). In addition, low engagement was seen among the referred patients; on average, 18% of the patients logged on to the website with a mean log-on rate across the different countries between 0.58% and 36.95%. Conclusions Referral to eBI takes nearly as much time as brief oral advice and might require more introduction and training before staff are comfortable with referring to eBI.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP , 2016. Vol. 6, no 6, e010271
Keyword [en]
Alcohol screening; brief intervention; referral to electronic brief advice; fidelity to intervention
National Category
Social and Clinical Pharmacy
Identifiers
URN: urn:nbn:se:liu:diva-131526DOI: 10.1136/bmjopen-2015-010271ISI: 000380237100026PubMedID: 27311902OAI: oai:DiVA.org:liu-131526DiVA: diva2:974184
Note

Funding Agencies|European Union [259268]; Netherlands Organisation for Health Research and Development (ZonMW) [200310017]; EC [Art.II.17]; NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Kings College London; NIHR Collaborations for Leadership in Applied Health Research and Care South London at Kings College Hospital NHS Foundation Trust; Polish science financial resources

Available from: 2016-09-25 Created: 2016-09-23 Last updated: 2017-11-21

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Bendtsen, PrebenMüssener, UlrikaKarlsson, Nadine
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