Improving screening and brief intervention activities in primary health care: Secondary analysis of professional accuracy based on the AUDIT-C

J. Palacio-Vieira*, L. Segura, P. Anderson, A. Wolstenholme, C. Drummond, P. Bendtsen, M. Wojnar, E. Kaner, M. N. Keurhorst, B. van Steenkiste, K. Kloda, A. Mierzecki, K. Parkinson, D. Newbury-Birch, K. Okulicz-Kozaryn, P. Deluca, J. Colom, A. Gual

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Introduction and objectiveThe ODHIN trial found that training and support and financial reimbursement increased the proportion of patients that were screened and given advice for their heavy drinking in primary health care. However, the impact of these strategies on professional accuracy in delivering screening and brief advice is underresearched and is the focus of this paper. MethodFrom 120 primary health care units (24 in each jurisdiction: Catalonia, England, the Netherlands, Poland, and Sweden), 746 providers participated in the baseline and the 12-week implementation periods. Accuracy was measured in 2 ways: correctness in completing and scoring the screening instrument, AUDIT-C; the proportion of screen-negative patients given advice, and the proportion of screen-positive patients not given advice. Odds ratios of accuracy were calculated for type of profession and for intervention group: training and support, financial reimbursement, and internet-based counselling. ResultsThirty-two of 36711 questionnaires were incorrectly completed, and 65 of 29641 screen-negative patients were falsely classified. At baseline, 27% of screen-negative patients were given advice, and 22.5% screen-positive patients were not given advice. These proportions halved during the 12-week implementation period, unaffected by training. Financial reimbursement reduced the proportion of screen-positive patients not given advice (OR=0.56; 95% CI, 0.31-0.99; P<.05). ConclusionAlthough the use of AUDIT-C as a screening tool was accurate, a considerable proportion of risky drinkers did not receive advice, which was reduced with financial incentives.
Original languageEnglish
Pages (from-to)369-374
Number of pages6
JournalJournal of Evaluation in Clinical Practice
Volume24
Issue number2
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • alcohol screening
  • brief interventions
  • primary health care
  • GENERAL-POPULATION SAMPLE
  • COST-EFFECTIVENESS
  • ALCOHOL-CONSUMPTION
  • IDENTIFICATION TEST
  • AT-RISK
  • DRINKING
  • SCORES
  • DEPENDENCE
  • DRINKERS
  • MISUSE

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