RT Journal Article
SR Electronic
T1 Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 335
OP 340
DO 10.1370/afm.2051
VO 15
IS 4
A1 Peter Anderson
A1 Simon Coulton
A1 Eileen Kaner
A1 Preben Bendtsen
A1 Karolina Kłoda
A1 Jillian Reynolds
A1 Lidia Segura
A1 Marcin Wojnar
A1 Artur Mierzecki
A1 Paolo Deluca
A1 Dorothy Newbury-Birch
A1 Kathryn Parkinson
A1 Katarzyna Okulicz-Kozaryn
A1 Colin Drummond
A1 Antoni Gual
YR 2017
UL http://www.annfammed.org/content/15/4/335.abstract
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.