PT  - JOURNAL ARTICLE
AU  - Anderson, Peter
AU  - Coulton, Simon
AU  - Kaner, Eileen
AU  - Bendtsen, Preben
AU  - Kłoda, Karolina
AU  - Reynolds, Jillian
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  - Gual, Antoni
TI  - Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial
AID  - 10.1370/afm.2051
DP  - 2017 Jul 01
TA  - The Annals of Family Medicine
PG  - 335--340
VI  - 15
IP  - 4
4099  - http://www.annfammed.org/content/15/4/335.short
4100  - http://www.annfammed.org/content/15/4/335.full
SO  - Ann Fam Med2017 Jul 01; 15
AB  - 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.