Effectiveness and cost-effectiveness of opportunistic screening and stepped-care interventions for older alcohol users in primary care.
AbstractObjective: To compare the clinical effectiveness and cost-effectiveness of a stepped-care intervention versus a minimal intervention for the treatment of older hazardous alcohol users in primary care. Design: A multi-centre, pragmatic RCT. Setting: Primary care general practices in England and Scotland.
HighlightsNo evidence of a difference in AUDIT score was seen between treatments at 6 months.A greater proportion in the healthy living group attended all 4 treatment sessions.Recruitment and follow up proved challenging with this non-help seeking group.Further thought needed regarding engaging problem drinkers in a hospital setting.
in fo rm a h e a lth c a re S ervice user, fa m ily and frie n d s ' view s on th e m ean in g o f a 'good o u tc o m e ' o f tre a tm e n t fo r an a d d ic tio n p ro b le m Aims: The aim of this study was to investigate the views of service users (SUs), family and friends on what constitutes a good outcome for the treatment of substance misuse problems.Methods: Six focus groups were arranged to explore and identify important elements of good outcome. Transcripts of the focus groups were analysed using thematic analysis. The content of the main theme, good outcome, was cross checked with SUs and the four authors. The main theme was analysed further into sub-themes. Findings: Participants were 24 SUs and 12 family and friend members recruited from specialist drug and alcohol services. The participants represented a broad range of treatment journey experiences in a variety of treatment modalities. A total of 20 outcome elements were elicited and categorised into seven sub-themes: abstinence, health, activities, relationships, social circumstances, self-awareness and wellbeing of family and friends. Conclusions: The focus of this study was on the ideal outcome rather than intermediate outcomes that might be valuable as individual treatment goals. Considerable weight was placed, by both SUs and their family and friends, on abstinence and ways of maintaining abstinence.
2013),"Stigma and perceptions of recovery in Scotland: a qualitative study of injecting drug users attending methadone treatment", Drugs and Alcohol Today, Vol. 13 Iss 4 pp. 244-257 http://dx.Access to this document was granted through an Emerald subscription provided by emerald-srm:448207 []
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AbstractPurpose -The purpose of this paper is to describe the development and delivery of an aftercare programme called Learning To Live Again, which was co-produced between service users and clinic staff. Design/methodology/approach -In total, 37 semi-structured interviews were conducted with 29 project stakeholders who were service users, mentors, university and clinical staff. The data were transcribed and analysed using thematic analysis. Findings -Four overarching themes were identified in the analysis of interview data as characterising the process of co-producing an aftercare programme. These were: achieving common ground, roles and responsibilities, the activities programme and the road to recovery. Interdependence of service users and clinicians was given strong emphasis. Practical implications -A number of challenges arise in co-producing an aftercare programme which is largely service user led and adds to the local recovery capital. The benefits of co-producing aftercare outweigh the difficulties and the programme can be set up within existing resources. Given the study's focus on the process of setting up and maintaining an aftercare programme, no attempt was made to evaluate the improvement in outcomes or cost-effectiveness. Originality/value -Many peer-mentor-led aftercare programmes have been set up and this paper describes stakeholders' thoughts about the challenges and benefits of co-producing an aftercare programme.
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