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IN PRACTICE 2004 PDF file 418Kb
Giving the silent majority a voice
Constrained by guidelines and standards, a UK prescribing service could do little to respond to user survey feedback.
Just a few minutes with specially hired screening and intervention staff can make a difference to emergency patients' drinking, but in the real world the hospital's own staff will usually do this work. A US study tested this real-world scenario and still found (modest) drinking reductions.
This huge US study set out to test whether widespread screening and brief intervention for illegal drug use (not just heavy drinking) could be implemented in a variety of general medical settings and whether it was effective. Both tests seem to have been passed, but with some important caveats.
STUDY 2008 HTM file
Reducing alcohol harm: health services in England for alcohol misuse
Official audit of work by the Department of Health and NHS to address the health effects of alcohol misuse. Describes a system whose infrastructure is clearly inadequate compared to the size of the task, but one recently taking steps in the right direction.
Having mandated universal screening for alcohol problems, the US health system for ex military personnel here thoughtfully addresses how to measure the degree to which this led to appropriate implementation of brief interventions.
STUDY 2004 PDF file 105Kb
British GPs as effective as specialist methadone clinics
A two-year follow-up of opiate dependent patients sampled by the national English NTORS study showed that experienced or supported GPs can provide methadone maintenance treatment at least as effectively as specialist clinics.
OFFCUT 2003 PDF file 134Kb
Is your measure of success what matters to the client, or what matters to everyone else?
How a patient assesses their own well-being can be poorly related to conventional outcomes such as substance use. Using quality of life as a benchmark would often give a different impression of whether one treatment or service is better than another.
STUDY 2003 PDF file 208Kb
Ways to expand shared care for opiate addicts
Offering specialist support can transform the proportion of opiate users treated by GPs on a 'shared care' basis was the clear message of a randomised study in the north west of England.
STUDY 2003 PDF file 188Kb
Naltrexone helps heavy drinkers gain control
In Spain naltrexone helped young regular binge drinkers cut back, potentially extending its role from alcoholics seeking treatment at specialist clinics to problem drinkers identified in other settings such as primary care.
STUDY 2003 PDF file 172Kb
Injury rate cut in heavy drinking accident and emergency patients
One of the few studies to have tried alcohol interventions in the emergency department rather than after admission was also the first to find a significant reduction in later injuries, but only if the initial approach had been reinforced with a booster.
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