TY - JOUR
T1 - Impact of practice, provider and patient characteristics on delivering screening and brief advice for heavy drinking in primary healthcare
T2 - Secondary analyses of data from the ODHIN five-country cluster randomized factorial trial
AU - Anderson, Peter
AU - Kloda, Karolina
AU - Kaner, Eileen
AU - Reynolds, Jillian
AU - Bendtsen, Preben
AU - Pelgrum-Keurhorst, Myrna N.
AU - Segura, Lidia
AU - Wojnar, Marcin
AU - Mierzecki, Artur
AU - Deluca, Paolo
AU - Newbury-Birch, Dorothy
AU - Parkinson, Kathryn
AU - Okulicz-Kozaryn, Katarzyna
AU - Drummond, Colin
AU - Laurant, Miranda G. H.
AU - Gual, Antoni
PY - 2017/10/12
Y1 - 2017/10/12
N2 - 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.
AB - 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.
KW - Primary healthcare
KW - heavy drinking
KW - screening and advice
KW - training
KW - patients
KW - providers
KW - BRIEF ALCOHOL INTERVENTIONS
U2 - 10.1080/13814788.2017.1374365
DO - 10.1080/13814788.2017.1374365
M3 - Article
C2 - 29022763
SN - 1381-4788
VL - 23
SP - 241
EP - 245
JO - European Journal of General Practice
JF - European Journal of General Practice
IS - 1
ER -