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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.
REVIEW 2015 HTM file
A comparison of the efficacy of brief interventions to reduce hazardous and harmful alcohol consumption between European and non-European countries: a systematic review and meta-analysis of randomized controlled trials
Amalgamation of results from relevant studies finds that in high-income nations brief alcohol advice to emergency or primary care patients remains effective whether trials take place in European or non-European drinking cultures and health service contexts. Impacts were however small and may not be duplicated in routine practice.
REVIEW 2015 HTM file
Prevention of addictive behaviours
Based largely on existing reviews, this report for the German Federal Centre for Health Education comprehensively assesses substance use prevention approaches. Among its many conclusions are that approaches based solely on information provision are ineffective, in contrast to the more positive evidence for lifeskills and multi-component community programmes.
US trauma centres dealing with serious and often alcohol-related injuries ought to offer an environment conducive to brief alcohol interventions, but this first multi-site trial found motivational counselling more effective than minimal advice only when combined with a follow-up ‘booster’ phone call.
From Brazilian primary care clinics a rare confirmation that a positive organisational climate featuring commitment to staff professional development and good links with the local community is associated with overcoming barriers to widely implementing screening and brief intervention programmes.
UK-focused review for Britain's National Institute for Health and Clinical Excellence of what impedes or promotes the implementation of brief alcohol interventions at the level of the organisation, the staff doing the work, and the patients targeted by the programme.
STUDY 2011 HTM file
Quality concerns with routine alcohol screening in VA clinical settings
In the US health care service for ex-military personnel, 61% of patients who screened positive when sent a postal survey did not do so when the same questions were asked by their clinics, casting doubt on the validity of the test in routine practice in a service where the emphasis was more on the quantity than the quality of screening.
Applying a systematic and comprehensive framework to map the strategies trialled in attempts to implement screening and counselling for risky drinking primary care patients gives some clues to what it has taken to achieve a high screening rate, the essential first step in the process.
STUDY 2010 HTM file
Offender alcohol interventions: minding the policy gap
Based on exhaustive consultations in the south west of England, this report diagnoses the blockages to providing adequate alcohol-related services to offenders and makes recommendations to improve commissioning, coordination and practice.
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