Impact of practice, provider and patient characteristics on delivering screening and brief advice for heavy drinking in primary healthcare: Secondary analyses of data from the ODHIN five-country cluster randomized factorial trial

Peter Anderson*, Karolina Kloda, Eileen Kaner, Jillian Reynolds, Preben Bendtsen, Myrna N. Pelgrum-Keurhorst, Lidia Segura, Marcin Wojnar, Artur Mierzecki, Paolo Deluca, Dorothy Newbury-Birch, Kathryn Parkinson, Katarzyna Okulicz-Kozaryn, Colin Drummond, Miranda G. H. Laurant, Antoni Gual

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

Abstract

Background: The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training. Objectives: Undertaking secondary analysis of the five-country ODHIN study, we test: the extent to which practice, provider and patient characteristics affect the likelihood of patients being screened and advised; the extent to which such characteristics moderate the impact of training in increasing screening and advice; and the extent to which training mitigates any differences due to such characteristics found at baseline.

Methods: A cluster randomized factorial trial involving 120 practices, 746 providers and 46 546 screened patients from Catalonia, England, the Netherlands, Poland, and Sweden. Practices were randomized to receive training or not to receive training. The primary outcome measures were the proportion of adult patients screened, and the proportion of screen-positive patients advised.

Results: Nurses tended to screen more patients than doctors (OR = 3.1; 95% CI: 1.9, 4.9). Screenpositive patients were more likely to be advised by doctors than by nurses (OR = 2.3; 95% CI: 1.4, 4.1), and more liable to be advised the higher their risk status (OR = 1.9; 95% CI: 1.3, 2.7). Training increased screening and advice giving, with its impact largely unrelated to practice, provider or patient characteristics. Training diminished the differences between doctors and nurses and between patients with low or high-risk status.

Conclusions: Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised.

Original languageEnglish
Pages (from-to)241-245
Number of pages5
JournalEuropean Journal of General Practice
Volume23
Issue number1
DOIs
Publication statusPublished - 12 Oct 2017

Keywords

  • Primary healthcare
  • heavy drinking
  • screening and advice
  • training
  • patients
  • providers
  • BRIEF ALCOHOL INTERVENTIONS

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