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Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial

Anderson, Peter, Coulton, Simon, Kaner, Eileen, Bendtsen, Preben, Kloda, Karolina, Segura, Lidia, Wojnar, Marcin, Mierzecki, Artur, Deluca, Paola, Newbury-Birch, Dorothy, and others. (2017) Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial. Annals of Family Medicine, 15 (4). pp. 335-340. ISSN 1544-1709. E-ISSN 1544-1717. (doi:10.1370/afm.2051) (Access to this publication is currently restricted. You may be able to access a copy if URLs are provided)

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Abstract

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.

Item Type: Article
DOI/Identification number: 10.1370/afm.2051
Uncontrolled keywords: Primary health care; heavy drinking; implementation study; training and support; financial reimbursement; electronic brief intervention; practice-based research
Subjects: H Social Sciences
H Social Sciences > HM Sociology
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Paula Loader
Date Deposited: 24 Aug 2017 15:08 UTC
Last Modified: 29 May 2019 19:12 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/62283 (The current URI for this page, for reference purposes)
Coulton, Simon: https://orcid.org/0000-0002-7704-3274
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