A multicountry controlled trial of strategies to promote dissemination and implementation of brief alcohol intervention in primary health care: findings of a World Health Organization collaborative study.

Funk, Michelle; Wutzke, Sonia; Kaner, Eileen; Anderson, Peter; Pas, Leo; McCormick, Ross; Gual, Antoni; Barfod, Sverre; Saunders, John B.

doi:10.15288/jsa.2005.66.379

Cited by 95 publications

(79 citation statements)

References 31 publications

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“…This fi nding is in line with a similar investigation concerning the Swedish primary health care, in which 77% of physicians and 89% of nurses agreed with this statement [28]. Reports on the alcohol prevention activity in primary health care have frequently highlighted the importance of knowledge and education [29][30][31]. However, studies have also demonstrated that more education and improved knowledge do not necessarily translate into expanded activity.…”

Section: Reasons For Not Addressing Alcohol Issuessupporting

confidence: 82%

Towards Increased Alcohol Intervention Activity in Swedish Occupational Health Services

Holmqvist

Hermansson²,

Nilsén³

2008

International Journal of Occupational Medicine and Environmental Health

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Objectives: To investigate the extent to which Swedish occupational physicians and nurses discuss alcohol issues with their patients, their reasons for and against addressing these issues, their amount of education in handling risky drinking, and factors that they believe could facilitate increased alcohol intervention activity in OHS. Methods: All Swedish physicians and nurses in OHS were surveyed with a postal questionnaire. The questionnaire was returned by 313 physicians (response rate 54%) and 759 nurses (response rate 69%). Results: As much as 70% of the physicians and 85% of the nurses reported that they "frequently" discussed alcohol problems with their patients. The majority of both physicians (81%) and nurses (69%) admitted participating in a maximum of a half-day training in handling risky drinking. Among the physicians, the most common reason for asking patients about their alcohol consumption was the clinical relevance (57%). Seventy-three per cent of the nurses initiated discussions about alcohol on the basis of questionnaire responses. Both the physicians (72%) and nurses (90%) said that the knowledge about counselling techniques to use when alcohol-related symptoms are evident was the most important facilitator to increased intervention activity. Conclusions: OHS professionals usually discuss alcohol-related issues with their patients. Nonetheless, they are interested in gaining further education and knowledge in this respect. The study results indicate that OHS is an important setting for alcohol prevention.

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Section: Reasons For Not Addressing Alcohol Issuessupporting

confidence: 82%

Towards Increased Alcohol Intervention Activity in Swedish Occupational Health Services

Holmqvist

Hermansson²,

Nilsén³

2008

International Journal of Occupational Medicine and Environmental Health

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“…The effect of any such contamination would be to increase the number of provider discussions in the control group, thus reducing the observed difference between groups. Indeed, 44 % of control participants reported discussing alcohol with their providers, which is higher than other reports, 37,38 and unexpectedly high considering PCPs had not been given any explicit instruction to intervene about alcohol during this study.…”

Section: Discussioncontrasting

confidence: 58%

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient–Provider Communication in Primary Care

et al. 2016

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BACKGROUND: Brief interventions for unhealthy drinking in primary care settings are efficacious, but underutilized. Efforts to improve rates of brief intervention though provider education and office systems redesign have had limited impact. Our novel brief intervention uses interactive voice response (IVR) to provide information and advice directly to unhealthy drinkers before a physician office visit, with the goals of stimulating in-office dialogue about drinking and decreasing unhealthy drinking. This automated approach is potentially scalable for wide application. OBJECTIVE: We aimed to examine the effect of a pre-visit IVR-delivered brief alcohol intervention (IVR-BI) on patient-provider discussions of alcohol during the visit. DESIGN: This was a parallel group randomized controlled trial with two treatment arms: 1) IVR-BI or 2) usual care (no IVR-BI). PARTICIPANTS: In all, 1,567 patients were recruited from eight university medical center-affiliated internal medicine and family medicine clinics. INTERVENTIONS: IVR-BI is a brief alcohol intervention delivered by automated telephone. It has four components, based on the intervention steps outlined in the National Institute of Alcohol Abuse and Alcoholism guidelines for clinicians: 1) ask about alcohol use, 2) assess for alcohol use disorders, 3) advise patient to cut down or quit drinking, and 4) follow up at subsequent visits. MAIN MEASURES: Outcomes were patient reported: patient-provider discussion of alcohol during the visit; patient initiation of the discussion; and provider's recommendation about the patient's alcohol use. KEY RESULTS: Patients randomized to IVR-BI were more likely to have reported discussing alcohol with their provider (52 % vs. 44 %, p = 0.003), bringing up the topic themselves (20 % vs. 12 %, p < 0.001), and receiving a recommendation (20 % vs. 14 %, p < 0.001). Other predictors of outcome included baseline consumption, education, age, and alcohol use disorder diagnosis. CONCLUSIONS: Providing automated brief interventions to patients prior to a primary care visit promotes discussion about unhealthy drinking and increases specific professional advice regarding changing drinking behavior.

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“…(1) Educational factors: In a multi-centre trial, training and support improved rates of SBI for problem alcohol use (Funk et al, 2005). Similarly, alcoholrelated continuing medical education impacts on a GP's diagnostic and management skills (Kaner et al, 2001).…”

Section: What Are the Enablers To Sbi For Problem Alcohol Use In Primmentioning

confidence: 99%

Commentary on ‘The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory’

Klimas

Field

Barry

et al. 2011

Drugs: Education, Prevention and Policy

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A multicountry controlled trial of strategies to promote dissemination and implementation of brief alcohol intervention in primary health care: findings of a World Health Organization collaborative study.

Cited by 95 publications

References 31 publications

Towards Increased Alcohol Intervention Activity in Swedish Occupational Health Services

Towards Increased Alcohol Intervention Activity in Swedish Occupational Health Services

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient–Provider Communication in Primary Care

Commentary on ‘The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory’

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