TY - JOUR
T1 - Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the ODHIN five country cluster randomized factorial trial
AU - Anderson, Peter
AU - Bendtsen, Preben
AU - Spak, Fredrik
AU - Reynolds, Jillian
AU - Drummond, Colin
AU - Segura, Lidia
AU - Keurhorst, Myrna
AU - Palacio-Vieira, Jorge
AU - Wojnar, Marcin
AU - Parkinson, K. N. (Kathryn)
AU - Colom, Joan
AU - Kloda, Karolina
AU - Deluca, Paolo
AU - Baena, Begoña
AU - Newbury-Birch, Dorothy
AU - Wallace, Paul
AU - Heinen, Maud
AU - Wolstenholme, Amy
AU - van Steenkiste, Ben
AU - Mierzecki, Artur
AU - Okulicz-Kozaryn, Katarzyna
AU - Ronda, Gaby
AU - Kaner, Eileen
AU - Laurant, M. G. H. (Miranda)
AU - Coulton, Simon
AU - Gual, Antoni
PY - 2016/7/5
Y1 - 2016/7/5
N2 - Aim To test if training and support, financial reimbursement, and option of referring screen positive patients to an internet-based method of giving advice (eBI) can increase primary health care providers’ delivery of AUDIT-C based screening and advice to heavy drinkers.
Design Cluster randomized factorial trial with 12-week implementation and measurement period.
Setting Primary health care units (PHCU) in different locations throughout Catalonia, England, Netherlands, Poland and Sweden.
Participants 120 PHCU, 24 in each of Catalonia, England, Netherlands, Poland and Sweden.
Interventions PHCUs were randomized to one of eight groups: care as usual, training and support (TS), financial reimbursement (FR), and eBI; paired combinations of TS, FR and eBI, and all of FR, TS and eBI.
Outcome measures Measurements The primary outcome measure is was the proportion of eligible adult (age 18+ years) patients screened during a 12-week implementation period. Secondary outcome measures are were proportion of screen positive patients advised; and, proportion of consulting adult patients given an intervention (screening and advice to screen positives) during the same 12-week implementation period.
Results Findings During a 4-week baseline measurement period, 5.9 (95% CI 3.4 to 8.4) per 100 adult patients consulting per PHCU were screened for their alcohol consumption. Based on the factorial design, the ratio of the logged proportion screened during the 12-week implementation period was 1.48 (95% CI 1.13 to 1.95) in PHCU that received TS versus PHCU that did not receive TS; for FR, the ratio was2.00 (95% CI 1.56 to 2.56). The option of referral to eBI did not lead to a higher proportion of patients screened. The ratio for TS plus FR was2.34 (95% CI 1.77 to 3.10), and the ratio for TS plus FR plus eBI was1.68 (95% CI 1.11 to 2.53).
Conclusions Providing primary health care units with training, support and financial reimbursement for delivering AUDIT-C based screening and advice to heavy drinkers increases screening for alcohol consumption. Providing primary health care units with the option of referring screen positive patients to an internet-based method of giving advice does not appear to increase screening for alcohol consumption.
AB - Aim To test if training and support, financial reimbursement, and option of referring screen positive patients to an internet-based method of giving advice (eBI) can increase primary health care providers’ delivery of AUDIT-C based screening and advice to heavy drinkers.
Design Cluster randomized factorial trial with 12-week implementation and measurement period.
Setting Primary health care units (PHCU) in different locations throughout Catalonia, England, Netherlands, Poland and Sweden.
Participants 120 PHCU, 24 in each of Catalonia, England, Netherlands, Poland and Sweden.
Interventions PHCUs were randomized to one of eight groups: care as usual, training and support (TS), financial reimbursement (FR), and eBI; paired combinations of TS, FR and eBI, and all of FR, TS and eBI.
Outcome measures Measurements The primary outcome measure is was the proportion of eligible adult (age 18+ years) patients screened during a 12-week implementation period. Secondary outcome measures are were proportion of screen positive patients advised; and, proportion of consulting adult patients given an intervention (screening and advice to screen positives) during the same 12-week implementation period.
Results Findings During a 4-week baseline measurement period, 5.9 (95% CI 3.4 to 8.4) per 100 adult patients consulting per PHCU were screened for their alcohol consumption. Based on the factorial design, the ratio of the logged proportion screened during the 12-week implementation period was 1.48 (95% CI 1.13 to 1.95) in PHCU that received TS versus PHCU that did not receive TS; for FR, the ratio was2.00 (95% CI 1.56 to 2.56). The option of referral to eBI did not lead to a higher proportion of patients screened. The ratio for TS plus FR was2.34 (95% CI 1.77 to 3.10), and the ratio for TS plus FR plus eBI was1.68 (95% CI 1.11 to 2.53).
Conclusions Providing primary health care units with training, support and financial reimbursement for delivering AUDIT-C based screening and advice to heavy drinkers increases screening for alcohol consumption. Providing primary health care units with the option of referring screen positive patients to an internet-based method of giving advice does not appear to increase screening for alcohol consumption.
U2 - 10.1111/add.13476
DO - 10.1111/add.13476
M3 - Article
SN - 0965-2140
VL - 111
SP - -
JO - Addiction
JF - Addiction
IS - 11
ER -