An alcohol-focused intervention versus a healthy living intervention for problem drinkers identified in a general hospital setting (ADAPTA): study protocol for a randomized, controlled pilot trial

Abstract

BackgroundAlcohol misuse is a major cause of premature mortality and ill health. Although there is a high prevalence of alcohol problems among patients presenting to general hospital, many of these people are not help seekers and do not engage in specialist treatment. Hospital admission is an opportunity to steer people towards specialist treatment, which can reduce health-care utilization and costs to the public sector and produce substantial individual health and social benefits. Alcohol misuse is associated with other lifestyle problems, which are amenable to intervention. It has been suggested that the development of a healthy or balanced lifestyle is potentially beneficial for reducing or abstaining from alcohol use, and relapse prevention. The aim of the study is to test whether or not the offer of a choice of health-related lifestyle interventions is more acceptable, and therefore able to engage more problem drinkers in treatment, than an alcohol-focused intervention.Methods/designThis is a pragmatic, randomized, controlled, open pilot study in a UK general hospital setting with concurrent economic evaluation and a qualitative component. Potential participants are those admitted to hospital with a diagnosis likely to be responsive to addiction interventions who score equal to or more than 16 on the Alcohol Use Disorders Identification Test (AUDIT). The main purpose of this pilot study is to evaluate the acceptability of two sorts of interventions (healthy living related versus alcohol focused) to the participants and to assess the components and processes of the design. Qualitative research will be undertaken to explore acceptability and the impact of the approach, assessment, recruitment and intervention on trial participants and non-participants. The effectiveness of the two treatments will be compared at 6 months using AUDIT scores as the primary outcome measure. There will be additional economic, qualitative and secondary outcome measurements.DiscussionDevelopment of the study was a collaboration between academics, commissioners and clinicians in general hospital and addiction services, made possible by the Collaboration in Leadership in Applied Health Research and Care (CLAHRC) program of research. CLAHRC was a necessary vehicle for overcoming the barriers to answering an important NHS question – how better to engage problem drinkers in a hospital setting.Trial registrationISRCTN47728072

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

“…Addressing Drinking Among Patients: comparing Two Approaches (ADAPTA) was a pragmatic, randomised, controlled, open pilot trial comparing a healthy living intervention with an alcohol-focused intervention for problem drinkers identified in a general hospital setting. The design has been reported in full elsewhere ( Watson et al, 2013 ). The study was granted ethical approval by the National Research Ethics Service Committee Yorkshire and The Humber—Leeds Central (Reference: 11/YH/0448).…”

“…A Hospital In-Reach Team (HIRT) from a specialist addiction service visited the wards daily to try to engage patients in treatment, using a motivational interviewing style of consultation, in the same way as usual regardless of the research conditions. Patients with an alcohol-related diagnosis or a reason for admission that suggested a possible alcohol-related diagnosis (for example: pancreatitis, hypertension) were screened to determine eligibility as described previously ( Watson et al, 2013 ), including a score of 16 or higher on the AUDIT ( Babor et al, 2001 ).…”

“…All treatment sessions were to be recorded digitally for verification of intervention fidelity. Detailed descriptions of both interventions are reported elsewhere ( Watson et al, 2013 ).…”

Online Health Check for Reducing Alcohol Intake among Employees: A Feasibility Study in Six Workplaces across England

“…Future research would benefit from comparing the online health check with an alcohol-only intervention to see which approach attracts a greater proportion of people drinking at hazardous and harmful levels. A randomised trial comparing in-person alcohol-only vs. multiple health behaviour intervention is currently underway in a UK general hospital setting [ 47 ].…”