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In the US homeland of competition and private health care, it was cooperation and coordination which led to the introduction of new medications and innovations to promote continuing care – plus the exercise of regulatory and financial muscle and the salutary experience of senior staff who placed themselves in the patient's shoes.
In 2007–08 the US state of Maine introduced a new scheme directly linking funding for outpatient treatment services to performance in terms of waiting times and retention, but financial and service delivery impacts were negligible. Were the incentives too weak, or were services already doing as well as they could?
This first major multi-modality test of a treatment engagement indicator widely used as a quality control yardstick in the USA found it was only very weakly related to patient improvement seven months after starting treatment, confirmation that simple measures of what happens during treatment struggle to capture what really makes treatment effective.
STUDY 2012 HTM file
Audit of alcohol detoxification at Leeds Addiction Unit
In a specialist hospital unit in Leeds, virtually all the alcohol dependent outpatients completed detoxification and all but a few went on to try to sustain their drinking reductions using the aversive medication disulfiram, indicative of what can be achieved in these settings.
STUDY 2012 HTM file
Alcohol screening and brief intervention in primary health care
The primary health arm of the largest alcohol screening and brief intervention study yet conducted in Britain found that the proportion of risky drinkers fell just as much after the most minimal of screening and intervention methods as after more sophisticated and longer (but still brief) alternatives.
STUDY 2012 HTM file
Alcohol screening and brief intervention in probation
The probation arm of the largest alcohol screening and brief intervention study yet conducted in Britain found that the proportion of offenders drinking at risky levels fell just as much after the most minimal of screening and intervention methods as after more sophisticated and longer (but still brief) alternatives.
From the Netherlands, the first randomised controlled trial to evaluate internet-based therapy for problem drinking via text-chat conversations with a real therapist found this improved on an automated self-help option; on average alcohol intake was cut by nearly two-thirds.
REVIEW 2012 HTM file
Computer based alcohol interventions
Worth trying but unproven for the UK and the general population and need evaluating, was the message of this review for the health service in Scotland of computer-based alcohol interventions as possible ways to extend the reach of treatment and of the national brief intervention programme.
From England’s gatekeeper to the public provision of health services, guidance for commissioners on how to organise and procure alcohol treatment and brief intervention services in an area which implement related national clinical guidance and satisfy policy requirements.
DOCUMENT 2011 HTM file
Alcohol dependence and harmful alcohol use quality standard
From the UK health service standard-setting agency, a concise statement of 13 practices which constitute high quality health care for problem drinkers and good practice in identifying and advising hazardous drinkers - standards which may be used to assess and reward providers and health service commissioning authorities.
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