Abstract

BackgroundCurrent population surveys suggest around 20% of Australians meet diagnostic criteria for an alcohol use disorder. However, only a minority seek professional help due to individual and structural barriers, such as low health literacy, stigma, geography, service operating hours and wait lists. Telephone-delivered interventions are readily accessible and ideally placed to overcome these barriers. We will conduct a randomised controlled trial (RCT) to examine the efficacy of a standalone, structured telephone-delivered intervention to reduce alcohol consumption, problem severity and related psychological distress among individuals with problem alcohol use.Methods/designThis is a single site, parallel group, two-arm superiority RCT. We will recruit 344 participants from across Australia with problem alcohol use. After completing a baseline assessment, participants will be randomly allocated to receive either the Ready2Change (R2C) intervention (n = 172, four to six sessions of structured telephone-delivered intervention, R2C self-help resource, guidelines for alcohol consumption and stress management pamphlets) or the control condition (n = 172, four phone check-ins < 5 min, guidelines for alcohol consumption and stress management pamphlets). Telephone follow-up assessments will occur at 4–6 weeks, 3 months, 6 months and 12 months post-baseline. The primary outcome is the Alcohol Use Disorders Identification Test (AUDIT) score administered at 3 months post-baseline. Secondary outcomes include change in AUDIT score (6 and 12 months post-baseline), change in number of past-month heavy drinking days, psychological distress, health and wellbeing, quality of life, client treatment evaluation and cost effectiveness.DiscussionThis study will be one of the first RCTs conducted internationally to examine the impact of a standalone, structured telephone-delivered intervention to address problem alcohol use and associated psychological morbidity. The proposed intervention is expected to contribute to the health and wellbeing of individuals who are otherwise unlikely to seek treatment through mainstream service models, to reduce the burden on specialist services and primary care providers and to provide an accessible and proportionate response, with resulting cost savings for the health system and broader community.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12618000828224. Pre-registered on 16 May 2018.

Highlights

  • Current population surveys suggest around 20% of Australians meet diagnostic criteria for an alcohol use disorder

  • This study will be one of the first randomised controlled trial (RCT) conducted internationally to examine the impact of a standalone, structured telephone-delivered intervention to address problem alcohol use and associated psychological morbidity

  • The proposed intervention is expected to contribute to the health and wellbeing of individuals who are otherwise unlikely to seek treatment through mainstream service models, to reduce the burden on specialist services and primary care providers and to provide an accessible and proportionate response, with resulting cost savings for the health system and broader community

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Summary

Introduction

Current population surveys suggest around 20% of Australians meet diagnostic criteria for an alcohol use disorder. While publicly funded treatment services are available in each state and territory, they have necessarily evolved to address the complex needs of the comparatively small minority of dependent drinkers falling at the severe end of the continuum (i.e. those with significant physical and mental health comorbidity and marked social disadvantage), often requiring expensive multi-disciplinary and inter-sectoral care. It is the substantially larger population of problem drinkers without complex medical or psychosocial needs, who are unlikely to seek treatment, who cause the greatest cost to society due to their sheer number [6].

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