Community psychiatric nurse aftercare for alcoholics: a five‐year follow‐up study

Abstract

The aim of this study was to determine if community psychiatric nurse (CPN) aftercare for 1 year improved the 5-year outcome in patients following inpatient treatment for alcohol dependence. A 5-year follow-up study, observer blind, with non-random allocation of subjects to aftercare by CPN for 1 year or standard outpatient care, was used. Subjects had all received inpatient treatment for 6 weeks in a rural alcohol treatment unit. Subjects were traced and assessed in the community 5 years after the index admission. The participants consisted of 127 white male alcoholics. All were first admissions, who had been selected for inpatient treatment and who completed a 6-week inpatient stay. Seventy-three subjects received intensive aftercare by CPN for 1 year, 54 subjects received standard outpatient appointments not due to random allocation but because no CPN was available. Data were collected by semi-structured interview at entry to the trial, namely background epidemiological information, details of drinking history, previous hospital admission, educational, employment and criminal information. At 5-year follow-up, data on drinking status, use of other drugs, hospital admissions, criminal behaviour and gambling, attendance at self-help groups, relationships and employment were collected. Thirty-six per cent of the CPN aftercare group was completely abstinent during the 5 years after treatment compared to 6% of the standard aftercare group (p < 0.001). Subjects receiving CPN aftercare were less likely to report blackouts (p < 0.05) or gambling (p < 0.05). They were more likely to attend hospital meetings (p < 0.0001). CPN aftercare is an effective way of maximizing the effects of inpatient treatment. The effects endured for 5 years after treatment.

Assertive Community Treatment for alcohol dependence (ACTAD): study protocol for a randomised controlled trial

“…In terms of alcohol consumption a proportional difference between the groups of 30% would be considered a clinically important difference. This equates to an effect size difference of 0.70 similar to the effect sizes found in Patterson et al study [38] and the Cochrane meta-analysis of ACT [19]. As a pilot study we have employed an alpha of 0.2 and power of 80%, a sample of 35 in each group followed-up at 12 months would allow us to detect an effect size of the order of 0.5, a more conservative estimate of effect than seen in similar studies.…”

Continuing care research: What we have learned and where we are going

“…Even in studies that produced significant treatment effects, variability of response is still evident in the effective intervention. For example, rates of abstinence in effective interventions within specific follow-up periods ranged from 75% (McKay et al, 2005) to 36% (Patterson et al, 1997). Rates of favorable outcomes on other measures tended to be higher (e.g., linkage to continuing care services, no readmissions to treatment, and so forth).…”

“…Patterson, MacPherson, and Brady (1997) conducted a study that tested the effect of a continuing care protocol that consisted of home visits provided by a psychiatric nurse over a one-year period. The participants were alcohol dependent men, who had completed a six-week inpatient program in a rural area.…”

Effectiveness of Continuing Care Interventions for Substance Abusers

“…Positive results were found in the following four studies. Home visits by a nurse over a 12-month period produced better alcohol abstinence rates and fewer blackouts than a minimal control condition over a 5-year follow-up period (Patterson, MacPherson, and Brady 1997). In this study, however, all nursing visits were provided by one individual, which means that treatment and provider effects were confounded.…”