Relay model for recruiting alcohol dependent patients in general hospitals - a single-blind pragmatic randomized trial

Abstract

BackgroundA large proportion of the Danish population consumes more than the officially recommended weekly amount of alcohol. Untreated alcohol use disorders lead to frequent contacts with the health care system and can be associated with considerable human and societal costs. However, only a small share of those with alcohol use disorders receives treatment. A referral model to ensure treatment for alcohol dependent patients after discharge is needed. This study evaluates the i) cost-effectiveness ii) efficacy and iii) overall impact on societal costs of the proposed referral model - The Relay Model.Method/DesignThe study is a single-blind pragmatic randomized controlled trial including patients admitted to the hospital. The study group (n = 500) will receive an intervention, and the control group (n = 500) will be referred to treatment by usual procedures. All patients complete a lifestyle questionnaire with the Alcohol Use Disorders Identification Test embedded as a case identification strategy. The primary outcome of the study will be health care expenditures 12 months after discharge. The secondary outcome will be the percentage of the target group, who 30 days after discharge, reports at the alcohol treatment clinics. In order to analyse both outcomes, difference-in-difference models will be used.DiscussionWe expect to establish evidence as to whether The Relay Model is either cost-neutral or cost-effective, compared to referral by usual procedures.Trial registrationhttps://register.clinicaltrials.gov/by identifier:RESCueH_Relay NCT02188043 Project Relay Model for Recruiting Alcohol Dependent Patients in General Hospitals (TRN Registration: 07/09/2014)

Factors influencing whether nurses talk to somatic patients about their alcohol consumption

“…When it comes to detecting overconsumption of alcohol among patients, it has been suggested that nurses could play a key role, both because they have a basic knowledge of health and diseases and because they are usually the ones who have the most contact with the patients (Groves et al, 2010;Lock, 2004). At the moment, a randomised controlled trial (RCT) called the Relay Study (Schwarz et al, 2016) is being conducted on seven somatic wards at two Danish hospitals. The purpose of the study is to investigate whether it is more efficient and cost-effective to rely on hospital staff to talk to patients about alcohol use or to have staff from outpatient alcohol treatment institutions come to the hospital and carry out brief interventions with the patients while they are hospitalised.…”

“…In the Relay Study, all inpatients (+18 years) are screened using the Alcohol Use Disorder Identification Test (AUDIT) (Babor, de la Fuente, Saunders, & Grant, 1989). If they score 8 or more in the test, they are ran- ed from the study (Schwarz et al, 2016).…”

A Predictive Machine Learning Model to Determine Alcohol Use Disorder

“…Our study population consist of patients aged 18-101 hospitalized at Odense University Hospital (OUH) in Denmark for at least 24 hours from January 2012 until June 2016. Data captured for this study is created by linking two sources, the Relay study [15][16][17] and EHRs from OUH.…”

Lifestyle factors in somatic patients with and without potential alcohol problems

“…The protocol and description of the full Relay project have been published separately (Schwarz et al 2016). Inclusion criteria were: admitted to the hospital departments in Odense or Aabenraa during the inclusion period (October 2013-June 2016), above the age of 18, hospitalized for a minimum of 24 h, residing in the uptake area of the involved alcohol treatment clinics and willing to participate in the study.…”