Abstract
BackgroundIdentifying and treating problem alcohol use among people who also use illicit drugs is a challenge. Primary care is well placed to address this challenge but there are several barriers which may prevent this occurring. The objective of this study was to determine if a complex intervention designed to support screening and brief intervention for problem alcohol use among people receiving opioid agonist treatment is feasible and acceptable to healthcare providers and their patients in a primary care setting.MethodsA randomised, controlled, pre-and-post design measured feasibility and acceptability of alcohol screening based on recruitment and retention rates among patients and practices. Efficacy was measured by screening and brief intervention rates and the proportion of patients with problem alcohol use.ResultsOf 149 practices that were invited, 19 (12.8 %) agreed to participate. At follow up, 13 (81.3 %) practices with 81 (62.8 %) patients were retained. Alcohol screening rates in the intervention group were higher at follow up than in the control group (53 % versus 26 %) as were brief intervention rates (47 % versus 19 %). Four (18 %) people reduced their problem drinking (measured by AUDIT-C), compared to two (7 %) in the control group.ConclusionsAlcohol screening among people receiving opioid agonist treatment in primary care seems feasible. A definitive trial is needed. Such a trial would require over sampling and greater support for participating practices to allow for challenges in recruitment of patients and practices.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0548-2) contains supplementary material, which is available to authorized users.
Highlights
Identifying and treating problem alcohol use among people who use illicit drugs is a challenge
The integration of complex interventions which can increase the uptake of screening and brief intervention in primary care is a priority to address problem alcohol use among patients attending primary care for opioid agonist treatment
An educational intervention was subsequently developed to enable General practitioner (GP) to deliver brief interventions for problem alcohol use among people receiving opioid agonist treatment and its possible feasibility, acceptability and usefulness in practice was demonstrated in a pilot study [18]
Summary
Identifying and treating problem alcohol use among people who use illicit drugs is a challenge. The objective of this study was to determine if a complex intervention designed to support screening and brief intervention for problem alcohol use among people receiving opioid agonist treatment is feasible and acceptable to healthcare providers and their patients in a primary care setting. The ability to incorporate such interventions into practice may be challenged through workload, lack of time, knowledge or skills [12] This is especially the case for problem alcohol use among people receiving opioid agonist treatment. An educational intervention was subsequently developed to enable GPs to deliver brief interventions for problem alcohol use among people receiving opioid agonist treatment and its possible feasibility, acceptability and usefulness in practice was demonstrated in a pilot study [18]. The PINTA (Psychosocial INTerventions for problem Alcohol use) project has further developed a complex intervention (which includes this educational intervention) to enhance screening and brief intervention
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