Community Research and Development Information Service - CORDIS

FP7

ODHIN — Result In Brief

Project ID: 259268
Funded under: FP7-HEALTH
Country: Spain

Interventions for hazardous and harmful drinking

The EU has the world's highest per-capita alcohol consumption. Intervention by primary healthcare (PHC) providers could reduce alcohol-associated problems by up to 20 %.
Interventions for hazardous and harmful drinking
The EU-funded initiative ODHIN (Optimizing delivery of health care interventions) aimed to maximise the translation of clinical research results into routine practice. Researchers conducted studies on identification and brief intervention (IBI) programmes in PHC to reduce hazardous and harmful alcohol consumption (HHAC). Besides behavioural, organisational and financial aspects, the effectiveness and cost effects of IBI were evaluated.

ODHIN developed an assessment tool for IBI implementation in PHC settings to document the level of knowledge, implementation and delivery of IBI in EU. The results show that approximately 1 in every 30 patients who would benefit from advice on HHAC actually receive advice; and point to priorities for HHAC management: formal partnership/coalition/panel of experts; communication/information strategy involving compulsory training and medical education on alcohol/IBIs; national plan for prevention and research on alcohol.

Through a survey of 2345 GPs from 8 European countries, ODHIN explored the attitudes of professionals and how IBI could be increased. The resulting report highlights that PHC physicians with more training on managing alcohol problems advised a higher number of heavy drinking patients. Conversely, doctors who held a disease model rather than prevention model or those placing responsibility for drinking with the patient advised fewer heavy drinking patients.

ODHIN used a 3-step review methodology to examine how IBI for lifestyle issues can be implemented routinely in PHC. Of all strategies applied to improve delivery of preventive services in healthcare, educational, e-health and combined strategies were found to be most effective in enhancing patient health conditions and lifestyles, especially in combination. Regarding HHAC specifically, analyses showed these strategies alone had no significant impact on patients’ alcohol consumption, but did significantly improve PHC professionals’ IBI delivery. Combining strategies aimed at professionals and patients had the highest impact on IBI delivery; while organisational strategies had an additional impact when combined with others.

A multi-factorial RCT in 120 PHC units from 5 countries aimed to find out which combination of 3 incentives best increase the rate of IBI delivery: training and support, financial reimbursement to providers, or availability of an internet-based advice programme heavy drinking patients. A combination of training and support and financial reimbursement was found to treble the number of adult patients given BI in PHC.

ODHIN developed an economic model for IBI, to assess the cost outcomes of adapting IBI delivery incentives to different countries. Combining training and support and financial reimbursement was found to be highly cost effective in four of the five districts studied, leading to resource savings of approximately EUR 20 per adult over 30 years in three districts.

Related information

Keywords

Interventions, harmful drinking, alcohol, primary healthcare, identification and brief intervention
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