“We improved our life because I cut my drinking”: Qualitative analysis of a brief intervention for people with alcohol use disorder in Ethiopian primary health care

2021 ◽  
pp. 108636
Author(s):  
Selamawit Zewdu ◽  
Charlotte Hanlon ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Solomon Teferra
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Qualitative Analysis ◽  
Brief Intervention ◽  
Alcohol Use Disorder ◽  
Primary Health

scholarly journals Managing Alcohol Use Disorder in Primary Health Care

2017 ◽  
Vol 19 (11) ◽  
Author(s):  
Peter Anderson ◽  
Amy O’Donnell ◽  
Eileen Kaner
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Primary Health

scholarly journals Evidence-based models of care for the treatment of alcohol use disorder in primary health care settings: protocol for systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Susan A. Rombouts ◽  
James Conigrave ◽  
Eva Louie ◽  
Paul Haber ◽  
Kirsten C. Morley
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Critical Appraisal ◽  
Models Of Care ◽  
Health Care Settings ◽  
Primary Health ◽  
Primary Health Care Settings

Abstract Background Alcohol use disorder (AUD) is highly prevalent and accounts globally for 1.6% of disability-adjusted life years (DALYs) among females and 6.0% of DALYs among males. Effective treatments for AUDs are available but are not commonly practiced in primary health care. Furthermore, referral to specialized care is often not successful and patients that do seek treatment are likely to have developed more severe dependence. A more cost-efficient health care model is to treat less severe AUD in a primary care setting before the onset of greater dependence severity. Few models of care for the management of AUD in primary health care have been developed and with limited implementation. This proposed systematic review will synthesize and evaluate differential models of care for the management of AUD in primary health care settings. Methods We will conduct a systematic review to synthesize studies that evaluate the effectiveness of models of care in the treatment of AUD in primary health care. A comprehensive search approach will be conducted using the following databases; MEDLINE (1946 to present), PsycINFO (1806 to present), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL) (1991 to present), and Embase (1947 to present). Reference searches of relevant reviews and articles will be conducted. Similarly, a gray literature search will be done with the help of Google and the gray matter tool which is a checklist of health-related sites organized by topic. Two researchers will independently review all titles and abstracts followed by full-text review for inclusion. The planned method of extracting data from articles and the critical appraisal will also be done in duplicate. For the critical appraisal, the Cochrane risk of bias tool 2.0 will be used. Discussion This systematic review and meta-analysis aims to guide improvement of design and implementation of evidence-based models of care for the treatment of alcohol use disorder in primary health care settings. The evidence will define which models are most promising and will guide further research. Protocol registration number PROSPERO CRD42019120293.

scholarly journals Scaling-up primary health care-based prevention and management of alcohol use disorder at the municipal level in middle-income countries in Latin America: Background and pre-protocol for a three-country quasi-experimental study

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 311 ◽  
Author(s):  
Peter Anderson ◽  
Amy O'Donnell ◽  
Eileen Kaner ◽  
Antoni Gual ◽  
Bernd Schulte ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Routine Practice ◽  
Primary Health ◽  
Implementation Period ◽  
Quasi Experimental

Background: While primary health care (PHC)-based prevention and management of alcohol use disorder (AUD) is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes to increase PHC-based screening and brief advice activity to reduce heavy drinking. However, gains have been only modest and short term at best. WHO studies have concluded that a more effective uptake could be achieved by embedding PHC activity within broader community and municipal support. Protocol: A quasi-experimental study will compare PHC-based prevention and management of AUD, operationalized by heavy drinking, in three intervention cities from Colombia, Mexico and Peru with three comparator cities from the same countries. In the implementation cities, primary health care units (PHCUs) will receive training embedded within ongoing supportive municipal action over an 18-month implementation period. In the comparator cities, practice as usual will continue at both municipal and PHCU levels. The primary outcome will be the proportion of consulting adult patients intervened with (screened and advice given to screen positives). The study is powered to detect a doubling of the outcome measure from an estimated 2.5/1,000 patients at baseline. Formal evaluation points will be at baseline, mid-point and end-point of the 18-month implementation period. We will present the ratio (plus 95% confidence interval) of the proportion of patients receiving intervention in the implementation cities with the proportions in the comparator cities. Full process evaluation will be undertaken, coupled with an analysis of potential contextual, financial and political-economy influencing factors. Discussion: This multi-country study will test the extent to which embedding PHC-based prevention and management of alcohol use disorder with supportive municipal action leads to improved scale-up of more patients with heavy drinking receiving appropriate advice and treatment.

scholarly journals Scaling-up primary health care-based prevention and management of alcohol use disorder at the municipal level in middle-income countries in Latin America: Background and pre-protocol for a three-country quasi-experimental study

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 311 ◽  
Author(s):  
Peter Anderson ◽  
Amy O'Donnell ◽  
Eileen Kaner ◽  
Antoni Gual ◽  
Bernd Schulte ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Routine Practice ◽  
Primary Health ◽  
Implementation Period ◽  
Quasi Experimental

Background: While primary health care (PHC)-based prevention and management of alcohol use disorder (AUD) is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes to increase PHC-based screening and brief advice activity to reduce heavy drinking. However, gains have been only modest and short term at best. WHO studies have concluded that a more effective uptake could be achieved by embedding PHC activity within broader community and municipal support. Protocol: A quasi-experimental study will compare PHC-based prevention and management of AUD, operationalized by heavy drinking, in three intervention cities from Colombia, Mexico and Peru with three comparator cities from the same countries. In the implementation cities, primary health care units (PHCUs) will receive training embedded within ongoing supportive municipal action over an 18-month implementation period. In the comparator cities, practice as usual will continue at both municipal and PHCU levels. The primary outcome will be the proportion of consulting adult patients intervened with (screened and advice given to screen positives). The study is powered to detect a doubling of the outcome measure from an estimated 2.5/1,000 patients at baseline. Formal evaluation points will be at baseline, mid-point and end-point of the 18-month implementation period. We will present the ratio (plus 95% confidence interval) of the proportion of patients receiving intervention in the implementation cities with the proportions in the comparator cities. Full process evaluation will be undertaken, coupled with an analysis of potential contextual, financial and political-economy influencing factors. Discussion: This multi-country study will test the extent to which embedding PHC-based prevention and management of alcohol use disorder with supportive municipal action leads to improved scale-up of more patients with heavy drinking receiving appropriate advice and treatment.

Connecting patients to services: Screening, brief intervention and referral to treatment in primary health care

2014 ◽  
Vol 21 (5) ◽  
pp. 370-379 ◽  
Author(s):  
Jon Agley ◽  
Russell McIntire ◽  
Mallori DeSalle ◽  
David Tidd ◽  
Jim Wolf ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Brief Intervention ◽  
Primary Health

scholarly journals A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care

2020 ◽  
Author(s):  
Carrie M. Mintz ◽  
Sarah M. Hartz ◽  
Sherri L. Fisher ◽  
Alex T. Ramsey ◽  
Elvin H. Geng ◽  
...  
Keyword(s):  
Health Care ◽  
Alcohol Use ◽  
Drug Use ◽  
Brief Intervention ◽  
Alcohol Use Disorder ◽  
Alcohol Misuse ◽  
Health Data ◽  
Health Care Settings ◽  
The Past ◽  
Cascade Of Care

ABSTRACTBackgroundAlthough effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care between diagnosis and treatment for persons with AUD.MethodsUsing 2015-2018 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) prevalence of adults with AUD; 2) proportion of adults who utilized health care in the past 12 months; 3) were screened about alcohol use; 4) received a brief intervention about alcohol misuse; 5) received information about treatment for alcohol misuse; and 6) proportion of persons with AUD who received treatment. Analyses were stratified by AUD severity.ResultsOf the 171,766 persons included in the sample, weighted prevalence of AUD was 7.9% (95% CI 7.7-8.0%). Persons with AUD utilized health care settings at similar rates as those without AUD. Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but the percent who received the subsequent steps of care decreased substantially. For those with severe AUD, 83.5% (CI: 78.3%-88.7%) utilized health care in the past 12 months, 73.5% (CI: 68.1%-78.9%) were screened for alcohol use, 22.7% (CI: 19.4%-26.0%) received a brief intervention, 12.4% (CI: 10%-14.7%) received information about treatment, and 20.5% (CI: 18%-23.1%) were treated for AUD. The greatest decrease in the care continuum occurred from screening to brief intervention and referral to treatment. More persons with severe AUD received treatment than were referred, indicating other pathways to treatment outside of the healthcare system.ConclusionsPersons with AUD utilize health care at high rates and are frequently screened about alcohol use, but few receive treatment. Health care settings-particularly primary care settings-represent a prime opportunity to implement pharmacologic treatment for AUD to improve outcomes in this high-risk population.

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