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Improving the deliv...
Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the Optimizing Delivery of Health Care Intervention (ODHIN) five-country cluster randomized factorial trial
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- Anderson, P. (author)
- Newcastle University, England; Maastricht University, Netherlands
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- Bendtsen, Preben (author)
- Linköpings universitet,Avdelningen för samhällsmedicin,Medicinska fakulteten,Region Östergötland, Medicinska specialistkliniken
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- Spak, Fredrik, 1948 (author)
- Gothenburg University,Göteborgs universitet,Enheten för socialmedicin,Social Medicine unit,University of Gothenburg, Sweden
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- Reynolds, J. (author)
- Hospital Clin Barcelona, Spain
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- Drummond, C. (author)
- Kings Coll London, England; South London and Maudsley NHS Fdn Trust, England
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- Segura, L. (author)
- Govt Catalonia, Spain
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- Keurhorst, M. N. (author)
- Radboud University of Nijmegen, Netherlands
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- Palacio-Vieira, J. (author)
- Govt Catalonia, Spain
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- Wojnar, M. (author)
- Medical University of Warsaw, Poland
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- Parkinson, K. (author)
- Newcastle University, England
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- Colom, J. (author)
- Govt Catalonia, Spain
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- Kłoda, K. (author)
- Pomeranian Medical University, Poland
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- Deluca, P. (author)
- Kings Coll London, England
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- Baena, B. (author)
- Govt Catalonia, Spain
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- Newbury-Birch, D. (author)
- Newcastle University, England
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- Wallace, P. (author)
- UCL, England
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- Heinen, M. (author)
- Radboud University of Nijmegen, Netherlands; HAN University of Appl Science, Netherlands
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- Wolstenholme, A. (author)
- Kings Coll London, England
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- van Steenkiste, B. (author)
- Maastricht University, Netherlands
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- Mierzecki, A. (author)
- Pomeranian Medical University, Poland
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- Okulicz-Kozaryn, K. (author)
- State Agency Prevent Alcohol Related Problems, Poland
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- Ronda, G. (author)
- Maastricht University, Netherlands
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- Kaner, E. (author)
- Newcastle University, England
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Laurant, M. G. H. (author)
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- Coulton, S. (author)
- University of Kent, England
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- Gual, T. (author)
- Hospital Clin Barcelona, Spain
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(creator_code:org_t)
- 2016-07-25
- 2016
- English.
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In: Addiction. - : Wiley. - 1360-0443 .- 0965-2140. ; 111:11, s. 1935-1945
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Abstract
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- Aim: To test if training and support, financial reimbursement and option of referring screen-positive patients to an internet-based method of giving advice (eBI) can increase primary health-care providers' delivery of Alcohol Use Disorders Identification Test (AUDIT)-C-based screening and advice to heavy drinkers. Design: Cluster randomized factorial trial with 12-week implementation and measurement period. Setting: Primary health-care units (PHCU) in different locations throughout Catalonia, England, the Netherlands, Poland and Sweden. Participants: A total of 120 PHCU, 24 in each of Catalonia, England, the Netherlands, Poland and Sweden. Interventions: PHCUs were randomized to one of eight groups: care as usual, training and support (TS), financial reimbursement (FR) and eBI; paired combinations of TS, FR and eBI, and all of FR, TS and eBI. Measurements: The primary outcome measure was the proportion of eligible adult (age 18+ years) patients screened during a 12-week implementation period. Secondary outcome measures were proportion of screen-positive patients advised; and proportion of consulting adult patients given an intervention (screening and advice to screen-positives) during the same 12-week implementation period. Findings: During a 4-week baseline measurement period, the proportion of consulting adult patients who were screened for their alcohol consumption was 0.059 per PHCU (95% CI 0.034 to 0.084). Based on the factorial design, the ratio of the logged proportion screened during the 12-week implementation period was 1.48 (95% CI=1.13–1.95) in PHCU that received TS versus PHCU that did not receive TS; for FR, the ratio was 2.00 (95% CI=1.56–2.56). The option of referral to eBI did not lead to a higher proportion of patients screened. The ratio for TS plus FR was 2.34 (95% CI=1.77–3.10), and the ratio for TS plus FR plus eBI was1.68 (95% CI=1.11–2.53). Conclusions: Providing primary health-care units with training, support and financial reimbursement for delivering Alcohol Use Disorders Identification Test-C-based screening and advice to heavy drinkers increases screening for alcohol consumption. Providing primary health-care units with the option of referring screen-positive patients to an internet-based method of giving advice does not appear to increase screening for alcohol consumption. © 2016 Society for the Study of Addiction
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Beroendelära (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Substance Abuse (hsv//eng)
Keyword
- Brief interventions
- financial reimbursement
- heavy drinking
- implementation
- ODHIN
- primary health care
- training and support
- Brief interventions; financial reimbursement; heavy drinking; implementation; ODHIN; primary health care; training and support
Publication and Content Type
- ref (subject category)
- art (subject category)
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Addiction
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Anderson, P.
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Bendtsen, Preben
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Spak, Fredrik, 1 ...
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Reynolds, J.
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Drummond, C.
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Segura, L.
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Keurhorst, M. N.
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Palacio-Vieira, ...
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Wojnar, M.
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Parkinson, K.
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Colom, J.
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Kłoda, K.
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Deluca, P.
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Baena, B.
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Newbury-Birch, D ...
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Wallace, P.
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Heinen, M.
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Wolstenholme, A.
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van Steenkiste, ...
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Mierzecki, A.
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Okulicz-Kozaryn, ...
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Ronda, G.
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Kaner, E.
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Laurant, M. G. H ...
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Coulton, S.
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Gual, T.
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Addiction
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University of Gothenburg
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Linköping University