Supporting alcohol brief interventions and pharmacotherapy provision in Australian First Nations primary care: exploratory analysis of a cluster randomised trial

被引：0

作者：

Dzidowska, Monika ^{[1
,2
,3
]}

Lee, K. S. Kylie ^{[1
,2
,3
,4
,5
]}

Conigrave, James H. ^{[1
,2
,3
]}

Wilson, Scott ^{[1
,3
,6
]}

Hayman, Noel ^{[7
,8
,9
]}

Ivers, Rowena ^{[10
,11
]}

Vnuk, Julia ^{[12
,13
]}

Haber, Paul ^{[1
,2
]}

Conigrave, Katherine M. ^{[1
,2
]}

机构：

[1] Univ Sydney, Fac Med & Hlth, NHMRC Ctr Res Excellence Indigenous Hlth & Alcohol, Discipline Addict Med, Lev 6,King George V Bldg C39, Sydney, NSW 2006, Australia

[2] Royal Prince Alfred Hosp KGV, Edith Collins Ctr Translat Res Alcohol Drugs & Tox, Drug Hlth Serv, Sydney Local Hlth Dist, 83-117 Missenden Rd, Camperdown, NSW 2050, Australia

[3] La Trobe Univ, Ctr Alcohol Policy Res, NR1, Melbourne, Vic 3086, Australia

[4] Curtin Univ, Natl Drug Res Inst, Fac Hlth Sci, 7 Parker Pl, Perth, WA 6102, Australia

[5] Burnet Inst, 85 Commercial Rd, Melbourne, Vic 3004, Australia

[6] Aboriginal Corp, Aboriginal Drug & Alcohol Council SA, 155 Holbrooks Rd, Adelaide, SA 5032, Australia

[7] Inala Indigenous Hlth Serv, Southern Queensland Ctr Excellence Aboriginal & To, Brisbane, Qld 4077, Australia

[8] Griffith Univ, Griffith Hlth Ctr G40, Sch Med, Parklands Dr, Southport, Qld 4222, Australia

[9] Univ Queensland, Sch Med, Herston Rd, Brisbane, Qld 4006, Australia

[10] Univ Wollongong, Grad Sch Med, Northfields Ave, Wollongong, NSW 2522, Australia

[11] Illawarra Aboriginal Med Serv, 150 Church St, Wollongong, NSW 2500, Australia

[12] Aboriginal Hlth Council South Australia, Level 8,115 Grenfell St, Adelaide, SA 5000, Australia

[13] Univ Adelaide, Adelaide Rural Clin Sch, Level 1,Helen Mayo North Frome Rd, Adelaide, SA 5005, Australia

来源：

BMC PRIMARY CARE | 2024年 / 25卷 / 01期

基金：

芬兰科学院; 英国医学研究理事会;

关键词：

Alcohol; Aboriginal community controlled health organisation; Pharmacotherapy; Brief intervention; Counselling; Relapse prevention; Treatment; Primary care; FACILITATORS; POPULATION; DRINKING; BARRIERS; MISUSE;

D O I：

10.1186/s12875-024-02598-9

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

IntroductionPrimary care provides an important opportunity to detect unhealthy alcohol use and offer assistance but many barriers to this exist. In an Australian context, Aboriginal Community Controlled Health Services (ACCHS) are community-led and run health services, which provide holistic primary care to Aboriginal and Torres Strait Islander peoples. A recent cluster randomised trial conducted with ACCHS provided a service support model which showed a small but significant difference in provision of 'any treatment' for unhealthy alcohol use. However, it was not clear which treatment modalities were increased. AimsTo test the effect of an ACCHS support model for alcohol on: (i) delivery of verbal alcohol intervention (alcohol advice or counselling); (ii) prescription of relapse prevention pharmacotherapies. MethodsIntervention: 24-month, multi-faceted service support model. Design: cluster randomised trial; equal allocation to early-support ('treatment') and waitlist control arms. Participants: 22 ACCHS. Analysis: Multilevel logistic regression to compare odds of a client receiving treatment in any two-month period as routinely recorded on practice software. ResultsSupport was associated with a significant increase in the odds of verbal alcohol intervention being recorded (OR = 7.60, [95% CI = 5.54, 10.42], p < 0.001) from a low baseline. The odds of pharmacotherapies being prescribed (OR = 1.61, [95% CI = 0.92, 2.80], p = 0.1) did not increase significantly. There was high heterogeneity in service outcomes. ConclusionsWhile a statistically significant increase in verbal alcohol intervention rates was achieved, this was not clinically significant because of the low baseline. Our data likely underestimates rates of treatment provision due to barriers documenting verbal interventions in practice software, and because different software may be used by drug and alcohol teams. The support made little impact on pharmacotherapy prescription. Changes at multiple organisational levels, including within clinical guidelines for primary care, may be needed to meaningfully improve provision of alcohol treatment in ACCHS. Trial registrationACTRN12618001892202 (retrospectively registered on 21/11/2018).

引用

页数：14

共 74 条

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