ADAPTA: A pilot randomised controlled trial of an alcohol-focused intervention versus a healthy living intervention for problem drinkers identified in a general hospital setting

Watson, Judith; Fairhurst, Caroline; Li, Jinshuo; Tober, Gillian; Crosby, Helen; Lloyd, Charlie; Godfrey, Christine; Mdege, Noreen Dadirai; Dale, Veronica; Toner, Paul; Parrott, Steve; Raistrick, Duncan

doi:10.1016/j.drugalcdep.2015.06.030

Cited by 10 publications

(10 citation statements)

References 34 publications

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“…The present study confirms prior studies hinting that hospitalized patients suffering from AUD may not be able or ready to consider specialized treatment for their drinking problem (11). In this study, we found that the narratives told by the six participants were strikingly alike with regard to their perspectives on alcohol use, their strivings to gain control over their alcohol use, their perceptions of health-related issues as well as relatives and relations as facilitators in obtaining what was strived for, their conceptions of alcohol treatment not being an offer for them, and their feelings towards wanting to deal with their alcohol (non)issues independently.…”

Section: Discussionsupporting

confidence: 87%

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Reasons for not seeking alcohol use disorder treatment

Tarp¹,

Sari²,

As³

2020

Preprint

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Background: In Denmark, there is a high prevalence of individuals suffering from alcohol use disorder (AUD). However, of these, only 10% seeks treatment. The aim of this study was to examine reasons not to seek treatment among people who suffer from AUD.Methods: Participants suffering from AUD were recruited among somatic as well as psychiatric in and outpatients. The study was qualitative, based on semi-structured individual participant interviews. The analysis was narrative.Results: The participant group consisted of two women and four men. Their average age was 58. The investigation indicated that the participants felt that alcohol added to their quality of life and that they enjoyed using it in social settings. Also, it seemed that there were two major groups of facilitating factors towards rehabilitation: health-related issues as well as relatives and relations. Finally, two major reasons for not seeking AUD treatment appeared: participants did not believe that it was a relevant offer for them and participants wanted to deal with their alcohol overuse issue themselves.Conclusions: In gaining an understanding of the reasons not to seek AUD treatment, we simultaneously gain an opportunity to adapt prevention campaign strategies and treatment offers to become even more inclusive towards people who may suffer from AUD but do not recognize and acknowledge a treatment need. Here, increased focus on several initiatives might contribute to a decrease of barriers to treatment-seeking and, thus, increase the proportion of people suffering from AUD who consider to and actually do seek treatment.

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Section: Discussionsupporting

confidence: 87%

“…It is well-known that hospital staff has been reluctant to systematically screen for and address risky alcohol use among patients (10). Even studies that made use of outreach visits, where therapists from the AUD clinic talked to the patients at the hospitals, did not identify a large effect on treatment-seeking (9,11).…”

Section: Introductionmentioning

confidence: 99%

Reasons for not seeking alcohol use disorder treatment

Tarp¹,

Sari²,

As³

2020

Preprint

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“…Also, it may have been due to the participation rate being lower than expected, based on participation rates in other studies conducted in the same setting. In alcohol treatment and research, it is a common challenge to recruit and maintain patients for studies, as well as for treatment [ 48 ]. Unwillingness to participate in research studies has been reported as becoming more and more common [ 36 ], especially regarding studies performed over the Internet [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Optional Videoconferencing-Based Treatment of Alcohol Use Disorders: Randomized Controlled Trial

Tarp¹,

Bojesen²,

Mejldal³

et al. 2017

JMIR Ment Health

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BackgroundTreatment of alcohol use disorders (AUDs) is characterized by an adherence rate below 50%. Clinical research has found that patient adherence enhances treatment effect; hence, health authorities, clinicians, and researchers strive to explore initiatives contributing to patients receiving treatment. Concurrently, videoconferencing-based treatment is gaining ground within other addiction and psychiatric areas.ObjectiveThe aim of this study was to test whether optional videoconferencing increases adherence to and effectiveness of AUD treatment in a randomized controlled trial (RCT). We hypothesized that the intervention would decrease premature dropout (the primary outcome), as well as increase successful treatment termination, treatment duration, and treatment outcome (secondary outcomes).MethodsWe conducted this study in the public outpatient alcohol clinic in Odense, Denmark, between September 2012 and April 2013. It was an RCT with 2 groups: treatment as usual (TAU) and treatment as usual with add-on intervention (TAU+I). The TAU+I group had the option, from session to session, to choose to receive treatment as usual via videoconferencing. Data consisted of self-reported responses to the European version of the Addiction Severity Index (EuropASI). We collected data at baseline, at follow-up at 3, 6, and 12 months, and at discharge.ResultsAmong consecutive patients attending the clinic, 128 met the inclusion criteria, and 71 of them were included at baseline. For the primary outcome, after 180 days, 2 of 32 patients (6%) in the TAU+I group and 12 of 39 patients (31%) in the TAU group had dropped out prematurely. The difference is significant (P=.008). After 365 days, 8 patients (25%) in the TAU+I group and 17 patients (44%) in the TAU group had dropped out prematurely. The difference is significant (P=.02). For the secondary outcomes, significantly more patients in the TAU+I group were still attending treatment after 1 year (P=.03). We found no significant differences between the 2 groups with regard to successful treatment termination and treatment outcome.ConclusionsThe results indicate that offering patients optional videoconferencing may prevent premature dropouts from treatment and prolong treatment courses. However, the small sample size precludes conclusions regarding the effect of the intervention, which was not detectable in the patients’ use of alcohol and severity of problems.Trial RegistrationThe Regional Health Research Ethics Committee System in Denmark: S-20110052; https://komite.regionsyddanmark.dk/wm258128 (Archived by WebCite at http://www.webcitation.org/6tTL3CO6u)

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“…24 However, whilst this is an acceptable approach, evidence on the effectiveness of multiple health behaviour change interventions for reducing alcohol intake is limited. 25,26 People are least likely to want to change their drinking when presented with alternative behaviours in the NHS health check. 27 Furthermore, when delivered in-person, health professionals may choose to prioritise other health behaviours which they feel more comfortable discussing.…”

Section: What Is Already Known On This Topicmentioning

confidence: 99%