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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.
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.
European and US studies show that methadone patients stick with therapy for hepatitis C disease and do as well as other patients, bolstering the case for drug services to encourage clients to consider diagnostic testing and therapy.
Comprehensive and thoughtful review of the UK-relevant literature warns that services which impose rigid and unrealistic expectations of abstinence or independent living on homeless addicts would deny treatment and housing to vulnerable adults with complex needs.
Comprehensive Australian review garners the lessons from across health promotion and medical care on how best to improve practice by introducing research-based innovations, and evaluates their applicability to substance misuse.
STUDY 2008 HTM file
Does following research-derived practice guidelines improve opiate-dependent patients’ outcomes under everyday practice conditions? Results of the Multisite Opiate Substitution Treatment study
In everyday practice at methadone maintenance clinics and with the full range of patients, does implementing clinical guidelines lead to better outcomes for patients? Two sets of US clinics selected for high versus low adherence to guidelines provided evidence that the recommended high doses and intensive psychosocial services really do make the intended difference.
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.
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.
STUDY 2006 PDF file 171Kb
Matching resources to needs is key to achieving 'wrap-around' care objectives
Linking treatment intake assessments to a computerised guide to local welfare and medical services transformed the assessments from redundant paperwork into a practical route to the reintegration services being advocated in Britain – and treatment completion rates doubled.
Interventions delivered by nurses did lead to a reduction in excessive drinking in their patients, but there seemed to be no advantage of a structured brief intervention over standard advice.
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