Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the ODHIN five country cluster randomized factorial trial

Peter Anderson, Preben Bendtsen, Fredrik Spak, Jillian Reynolds, Colin Drummond, Lidia Segura, Myrna Keurhorst, Jorge Palacio-Vieira, Marcin Wojnar, K. N. (Kathryn) Parkinson, Joan Colom, Karolina Kloda, Paolo Deluca, Begoña Baena, Dorothy Newbury-Birch, Paul Wallace, Maud Heinen, Amy Wolstenholme, Ben van Steenkiste, Artur Mierzecki & 6 others Katarzyna Okulicz-Kozaryn, Gaby Ronda, Eileen Kaner, M. G. H. (Miranda) Laurant, Simon Coulton, Antoni Gual

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Abstract

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.
Original languageEnglish
Pages (from-to)-
JournalAddiction
Volume111
Issue number11
DOIs
Publication statusPublished - 5 Jul 2016

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Training Support
Drinking
Primary Health Care
Alcohol Drinking
Outcome Assessment (Health Care)
Poland
Sweden
England
Internet
Netherlands
Health Personnel
Referral and Consultation
Delivery of Health Care

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Anderson, Peter ; Bendtsen, Preben ; Spak, Fredrik ; Reynolds, Jillian ; Drummond, Colin ; Segura, Lidia ; Keurhorst, Myrna ; Palacio-Vieira, Jorge ; Wojnar, Marcin ; Parkinson, K. N. (Kathryn) ; Colom, Joan ; Kloda, Karolina ; Deluca, Paolo ; Baena, Begoña ; Newbury-Birch, Dorothy ; Wallace, Paul ; Heinen, Maud ; Wolstenholme, Amy ; van Steenkiste, Ben ; Mierzecki, Artur ; Okulicz-Kozaryn, Katarzyna ; Ronda, Gaby ; Kaner, Eileen ; Laurant, M. G. H. (Miranda) ; Coulton, Simon ; Gual, Antoni. / Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the ODHIN five country cluster randomized factorial trial. In: Addiction. 2016 ; Vol. 111, No. 11. pp. -.
@article{32e93eb4799443a8af512666c21573f7,
title = "Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the ODHIN five country cluster randomized factorial trial",
abstract = "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.",
author = "Peter Anderson and Preben Bendtsen and Fredrik Spak and Jillian Reynolds and Colin Drummond and Lidia Segura and Myrna Keurhorst and Jorge Palacio-Vieira and Marcin Wojnar and Parkinson, {K. N. (Kathryn)} and Joan Colom and Karolina Kloda and Paolo Deluca and Bego{\~n}a Baena and Dorothy Newbury-Birch and Paul Wallace and Maud Heinen and Amy Wolstenholme and {van Steenkiste}, Ben and Artur Mierzecki and Katarzyna Okulicz-Kozaryn and Gaby Ronda and Eileen Kaner and Laurant, {M. G. H. (Miranda)} and Simon Coulton and Antoni Gual",
year = "2016",
month = "7",
day = "5",
doi = "10.1111/add.13476",
language = "English",
volume = "111",
pages = "--",
journal = "Addiction",
issn = "0965-2140",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "11",

}

Anderson, P, Bendtsen, P, Spak, F, Reynolds, J, Drummond, C, Segura, L, Keurhorst, M, Palacio-Vieira, J, Wojnar, M, Parkinson, KNK, Colom, J, Kloda, K, Deluca, P, Baena, B, Newbury-Birch, D, Wallace, P, Heinen, M, Wolstenholme, A, van Steenkiste, B, Mierzecki, A, Okulicz-Kozaryn, K, Ronda, G, Kaner, E, Laurant, MGHM, Coulton, S & Gual, A 2016, 'Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the ODHIN five country cluster randomized factorial trial', Addiction, vol. 111, no. 11, pp. -. https://doi.org/10.1111/add.13476

Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the ODHIN five country cluster randomized factorial trial. / Anderson, Peter; Bendtsen, Preben; Spak, Fredrik; Reynolds, Jillian; Drummond, Colin; Segura, Lidia; Keurhorst, Myrna; Palacio-Vieira, Jorge; Wojnar, Marcin; Parkinson, K. N. (Kathryn); Colom, Joan; Kloda, Karolina; Deluca, Paolo; Baena, Begoña; Newbury-Birch, Dorothy; Wallace, Paul; Heinen, Maud; Wolstenholme, Amy; van Steenkiste, Ben; Mierzecki, Artur; Okulicz-Kozaryn, Katarzyna; Ronda, Gaby; Kaner, Eileen; Laurant, M. G. H. (Miranda); Coulton, Simon; Gual, Antoni.

In: Addiction, Vol. 111, No. 11, 05.07.2016, p. -.

Research output: Contribution to journalArticleResearchpeer-review

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

VL - 111

SP - -

JO - Addiction

JF - Addiction

SN - 0965-2140

IS - 11

ER -