Making a bridge between general hospital and specialised community-based treatment for alcohol use disorder—A pragmatic randomised controlled trial

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Resumé

Aim: To investigate if more patients in the intervention group attended specialized alcohol treatment compared with a treatment-as-usual group (TAU). Methods: Pragmatic randomized controlled trial where consecutive patients, admitted to somatic hospitals, filled out a lifestyle questionnaire with the Alcohol Use Disorder Identification Test (AUDIT) embedded. Patients scoring 8+ on AUDIT were included in the study. Included patients were randomized to either a Danish screening brief intervention and referral to treatment (SBIRT) called the Relay model or TAU depending on date of admission. The Relay group was offered a brief alcohol intervention by an outreach alcohol therapist. Patients scoring 16 points and above on the AUDIT test also received referral to alcohol treatment. Outcome was attendance at specialized outpatient alcohol treatment centres after discharge from hospital. Information on patients was gathered from municipal databases at 18 months follow-up. Results: A total of 3534 patients completed the questionnaire, and 609 patients (17%) scored AUDIT 8+. 48 patients were lost to follow-up, and the final sample had 561 patients. Only 33 patients (6%) attended outpatient treatment at 18-months follow-up, but significantly more patients in the Relay group sought alcohol treatment than in the TAU group (OR = 2.5 [1.2;5.2] (p = 0.017)). Number needed to treat (NNT) was 20 [95% CI 11.2;112.3]. Conclusion: The Relay intervention was associated with more patients attending specialized treatment, but further research is needed to establish if general hospitals are an excellent platform for performing SBIRT.

OriginalsprogEngelsk
TidsskriftDrug and Alcohol Dependence
Vol/bind196
Sider (fra-til)51-56
ISSN0376-8716
DOI
StatusUdgivet - 1. mar. 2019

Fingeraftryk

General Hospitals
Randomized Controlled Trials
Alcohols
Referral and Consultation
Screening
Outpatients
Numbers Needed To Treat
Databases

Citer dette

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title = "Making a bridge between general hospital and specialised community-based treatment for alcohol use disorder—A pragmatic randomised controlled trial",
abstract = "Aim: To investigate if more patients in the intervention group attended specialized alcohol treatment compared with a treatment-as-usual group (TAU). Methods: Pragmatic randomized controlled trial where consecutive patients, admitted to somatic hospitals, filled out a lifestyle questionnaire with the Alcohol Use Disorder Identification Test (AUDIT) embedded. Patients scoring 8+ on AUDIT were included in the study. Included patients were randomized to either a Danish screening brief intervention and referral to treatment (SBIRT) called the Relay model or TAU depending on date of admission. The Relay group was offered a brief alcohol intervention by an outreach alcohol therapist. Patients scoring 16 points and above on the AUDIT test also received referral to alcohol treatment. Outcome was attendance at specialized outpatient alcohol treatment centres after discharge from hospital. Information on patients was gathered from municipal databases at 18 months follow-up. Results: A total of 3534 patients completed the questionnaire, and 609 patients (17{\%}) scored AUDIT 8+. 48 patients were lost to follow-up, and the final sample had 561 patients. Only 33 patients (6{\%}) attended outpatient treatment at 18-months follow-up, but significantly more patients in the Relay group sought alcohol treatment than in the TAU group (OR = 2.5 [1.2;5.2] (p = 0.017)). Number needed to treat (NNT) was 20 [95{\%} CI 11.2;112.3]. Conclusion: The Relay intervention was associated with more patients attending specialized treatment, but further research is needed to establish if general hospitals are an excellent platform for performing SBIRT.",
keywords = "Alcohol treatment, Alcohol use disorder, Brief alcohol intervention, RCT, Referral, SBIRT",
author = "Schwarz, {Anne Sophie} and Bent Nielsen and Jes S{\o}gaard and {S{\o}gaard Nielsen}, Anette",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.drugalcdep.2018.12.017",
language = "English",
volume = "196",
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TY - JOUR

T1 - Making a bridge between general hospital and specialised community-based treatment for alcohol use disorder—A pragmatic randomised controlled trial

AU - Schwarz, Anne Sophie

AU - Nielsen, Bent

AU - Søgaard, Jes

AU - Søgaard Nielsen, Anette

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Aim: To investigate if more patients in the intervention group attended specialized alcohol treatment compared with a treatment-as-usual group (TAU). Methods: Pragmatic randomized controlled trial where consecutive patients, admitted to somatic hospitals, filled out a lifestyle questionnaire with the Alcohol Use Disorder Identification Test (AUDIT) embedded. Patients scoring 8+ on AUDIT were included in the study. Included patients were randomized to either a Danish screening brief intervention and referral to treatment (SBIRT) called the Relay model or TAU depending on date of admission. The Relay group was offered a brief alcohol intervention by an outreach alcohol therapist. Patients scoring 16 points and above on the AUDIT test also received referral to alcohol treatment. Outcome was attendance at specialized outpatient alcohol treatment centres after discharge from hospital. Information on patients was gathered from municipal databases at 18 months follow-up. Results: A total of 3534 patients completed the questionnaire, and 609 patients (17%) scored AUDIT 8+. 48 patients were lost to follow-up, and the final sample had 561 patients. Only 33 patients (6%) attended outpatient treatment at 18-months follow-up, but significantly more patients in the Relay group sought alcohol treatment than in the TAU group (OR = 2.5 [1.2;5.2] (p = 0.017)). Number needed to treat (NNT) was 20 [95% CI 11.2;112.3]. Conclusion: The Relay intervention was associated with more patients attending specialized treatment, but further research is needed to establish if general hospitals are an excellent platform for performing SBIRT.

AB - Aim: To investigate if more patients in the intervention group attended specialized alcohol treatment compared with a treatment-as-usual group (TAU). Methods: Pragmatic randomized controlled trial where consecutive patients, admitted to somatic hospitals, filled out a lifestyle questionnaire with the Alcohol Use Disorder Identification Test (AUDIT) embedded. Patients scoring 8+ on AUDIT were included in the study. Included patients were randomized to either a Danish screening brief intervention and referral to treatment (SBIRT) called the Relay model or TAU depending on date of admission. The Relay group was offered a brief alcohol intervention by an outreach alcohol therapist. Patients scoring 16 points and above on the AUDIT test also received referral to alcohol treatment. Outcome was attendance at specialized outpatient alcohol treatment centres after discharge from hospital. Information on patients was gathered from municipal databases at 18 months follow-up. Results: A total of 3534 patients completed the questionnaire, and 609 patients (17%) scored AUDIT 8+. 48 patients were lost to follow-up, and the final sample had 561 patients. Only 33 patients (6%) attended outpatient treatment at 18-months follow-up, but significantly more patients in the Relay group sought alcohol treatment than in the TAU group (OR = 2.5 [1.2;5.2] (p = 0.017)). Number needed to treat (NNT) was 20 [95% CI 11.2;112.3]. Conclusion: The Relay intervention was associated with more patients attending specialized treatment, but further research is needed to establish if general hospitals are an excellent platform for performing SBIRT.

KW - Alcohol treatment

KW - Alcohol use disorder

KW - Brief alcohol intervention

KW - RCT

KW - Referral

KW - SBIRT

U2 - 10.1016/j.drugalcdep.2018.12.017

DO - 10.1016/j.drugalcdep.2018.12.017

M3 - Journal article

VL - 196

SP - 51

EP - 56

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

SN - 0376-8716

ER -