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

Peter Anderson*, Simon Coulton, Eileen Kaner, Preben Bendtsen, Karolina Kloda, Jillian Reynolds, Lidia Segura, Marcin Wojnar, Artur Mierzecki, Paolo Deluca, Dorothy Newbury-Birch, Kathryn Parkinson, Katarzyna Okulicz-Kozaryn, Colin Drummond, Antoni Gual

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Web of Science)

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.

Original languageEnglish
Pages (from-to)335-340
Number of pages6
JournalAnnals of Family Medicine
Volume15
Issue number4
DOIs
Publication statusPublished - 2017

Keywords

  • primary health care
  • heavy drinking
  • implementation study
  • training and support
  • financial reimbursement
  • electronic brief intervention
  • practice-based research
  • PRIMARY-HEALTH-CARE
  • ALCOHOL-CONSUMPTION
  • FACTORIAL TRIAL
  • IMPLEMENTATION
  • METAANALYSIS
  • STRATEGIES
  • MORTALITY
  • DRINKERS
  • SUPPORT

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