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MATRIX CELL 2019 HTM file
Alcohol Treatment Matrix cell E1: Treatment systems; Screening and brief intervention
Key studies and reviews on local, regional and national systems for implementing alcohol screening and brief intervention. Context is that Britain’s National Institute for Health and Care Excellence insists commissioners and managers “must” provides the resources needed for brief intervention to become part of everyday work. Can these interventions be widely implemented, and even if they are, will they improve public health? See the rest of row 1 of the matrix for more on screening and brief interventions.
MATRIX CELL 2019 HTM file
Alcohol Treatment Matrix cell D1: Organisational functioning; Screening and brief intervention
Seminal and key studies on how organisational functioning affects screening and brief intervention. Highlights a striking illustration of the importance of organisational context emerging from the unprecedented implementation drive at the US health care system for ex-military personnel. See the rest of row 1 of the matrix for more on screening and brief interventions.
What do primary care clinicians think would help them bridge the ‘implementation gap’ in screening for risky drinking and brief advice, and extend the potential benefits to a greater proportion of the population? A European trial found the answer differed depending on distinctive national circumstances.
STUDY 2019 HTM file
Impact of the introduction and withdrawal of financial incentives on the delivery of alcohol screening and brief advice in English primary health care: an interrupted time-series analysis
The clearest impact of financial incentives to screen primary care patients in England was the plummeting screening rate after the incentives were withdrawn. If these results are applicable to England as a whole, over the following 21 months withdrawing the payments resulted in 603,719 fewer patients being screened for risky drinking and 27,439 fewer receiving brief advice.
STUDY 2016 HTM file
Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the Optimizing Delivery of Health Care Intervention (ODHIN) five-country cluster randomized factorial trial
The EU-funded ODHIN trial tested eight strategies to promote screening and brief interventions for risky drinking in primary health care units in five European countries. Results suggested that financial incentives were key but were reinforced by training and support.
Could combinations of three strategies – training and support, financial reimbursement, and the opportunity to refer patients to a website – cost-effectively boost delivery of brief interventions in European primary care? The important aim was to find the best way to narrow the ‘implementation gap’ between the number of patients who could benefit from these interventions and those who receive them.
Simulation study calculated health care cost savings and benefits for patients in England which make routine GP-based screening and brief advice for excessive drinking look an unmissable bargain, but the key assumptions derived from studies divorced from how interventions would routinely be implemented.
In these UK national prevention guidelines, experts prioritised population-wide changes like price rises and outlet restrictions which affect everyone, independent of the choices they make. But in England government prefers to target what they see as the troublesome minority, not the responsible majority.
An ambitious attempt to use research to understand the most effective and cost-effective set of policies for reducing alcohol-related harm in the English context, from taxation and price regulation to managing the drinking environment.
STUDY 2017 HTM file
Impact of financial incentives on alcohol consumption recording in primary health care among adults with schizophrenia and other psychoses: a cross-sectional and retrospective cohort study
UK study of how Quality and Outcomes Framework incentives for primary care boosted alcohol screening among patients with severe mental illness shows what could have happened had the incentives been extended across the entire primary care caseload.
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