Effect of electronic brief intervention on uptake of specialty treatment in hospital outpatients with likely alcohol dependence: Pilot randomized trial and qualitative interviews

Natalie A Johnson; Kypros Kypri; Joanna Latter; Adrian Dunlop; Amanda  Brown; Richard Saitz; John B Saunders; John Attia; Luke Wolfenden; Christopher Doran; James McCambridge

doi:10.1016/j.drugalcdep.2017.11.016

Effect of electronic brief intervention on uptake of specialty treatment in hospital outpatients with likely alcohol dependence: Pilot randomized trial and qualitative interviews

Natalie A Johnson, Kypros Kypri, Joanna Latter, Adrian Dunlop, Amanda Brown, Richard Saitz, John B Saunders, John Attia, Luke Wolfenden, Christopher Doran, James McCambridge

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Background: A large proportion of hospital outpatients is alcohol dependent (AD) but few are engaged in treatment for their drinking. Brief intervention, designed to raise patients’ awareness of their drinking, might encourage uptake of referral to specialty treatment. We assessed the feasibility of conducting a randomized trial evaluating the effectiveness of electronic brief intervention on the uptake of specialty treatment in hospital outpatients with likely AD. Methods: This study was conducted in the outpatient department of a large public hospital in Newcastle, Australia. We randomly assigned adults who scored ≥10 on the AUDIT-C and were not currently receiving treatment for their drinking to electronic brief intervention (comprising an assessment of their drinking and personalized feedback) and referral (n=59), or to referral alone (n=64). We pre-specified two co-primary outcomes as the proportions of patients who (1) accepted and (2) attended a Drug & Alcohol outpatient clinic appointment. We interviewed 15 study participants to investigate why they had declined the appointment and what sort of help they might prefer to receive. Results: Ten patients (five in each group) accepted an appointment, and one patient (control) attended. Most interviewees’ did not see their drinking as a problem or were confident they could manage it by themselves. Those who identified a preferred source of help expressed a preference for treatment by a GP. Conclusion: Uptake of specialty treatment in hospital outpatients with likely AD was low regardless of whether they received brief intervention. Accordingly, a large randomised trial does not appear to be feasible. Registration: Australian New Zealand Clinical Trials Registry ANZCTRN 12612000919819 Keywords: alcohol dependence, outpatients, screening, brief intervention, referral, electronic

Original language	English
Journal	Drug and alcohol dependence
Early online date	2 Jan 2018
DOIs	https://doi.org/10.1016/j.drugalcdep.2017.11.016
Publication status	E-pub ahead of print - 2 Jan 2018

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10.1016/j.drugalcdep.2017.11.016

Johnson et al - HOAP extension - R2 - 25OCT2017
© 2017 Published by Elsevier B.V. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.
Accepted author manuscript, 169 KBLicence: CC BY-NC-ND

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Johnson, N. A., Kypri, K., Latter, J., Dunlop, A., Brown, A., Saitz, R., Saunders, J. B., Attia, J., Wolfenden, L., Doran, C., & McCambridge, J. (2018). Effect of electronic brief intervention on uptake of specialty treatment in hospital outpatients with likely alcohol dependence: Pilot randomized trial and qualitative interviews. Drug and alcohol dependence. Advance online publication. https://doi.org/10.1016/j.drugalcdep.2017.11.016

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title = "Effect of electronic brief intervention on uptake of specialty treatment in hospital outpatients with likely alcohol dependence: Pilot randomized trial and qualitative interviews",

abstract = "Background: A large proportion of hospital outpatients is alcohol dependent (AD) but few are engaged in treatment for their drinking. Brief intervention, designed to raise patients{\textquoteright} awareness of their drinking, might encourage uptake of referral to specialty treatment. We assessed the feasibility of conducting a randomized trial evaluating the effectiveness of electronic brief intervention on the uptake of specialty treatment in hospital outpatients with likely AD. Methods: This study was conducted in the outpatient department of a large public hospital in Newcastle, Australia. We randomly assigned adults who scored ≥10 on the AUDIT-C and were not currently receiving treatment for their drinking to electronic brief intervention (comprising an assessment of their drinking and personalized feedback) and referral (n=59), or to referral alone (n=64). We pre-specified two co-primary outcomes as the proportions of patients who (1) accepted and (2) attended a Drug & Alcohol outpatient clinic appointment. We interviewed 15 study participants to investigate why they had declined the appointment and what sort of help they might prefer to receive. Results: Ten patients (five in each group) accepted an appointment, and one patient (control) attended. Most interviewees{\textquoteright} did not see their drinking as a problem or were confident they could manage it by themselves. Those who identified a preferred source of help expressed a preference for treatment by a GP. Conclusion: Uptake of specialty treatment in hospital outpatients with likely AD was low regardless of whether they received brief intervention. Accordingly, a large randomised trial does not appear to be feasible. Registration: Australian New Zealand Clinical Trials Registry ANZCTRN 12612000919819 Keywords: alcohol dependence, outpatients, screening, brief intervention, referral, electronic ",

author = "Johnson, {Natalie A} and Kypros Kypri and Joanna Latter and Adrian Dunlop and Amanda Brown and Richard Saitz and Saunders, {John B} and John Attia and Luke Wolfenden and Christopher Doran and James McCambridge",

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Johnson, NA, Kypri, K, Latter, J, Dunlop, A, Brown, A, Saitz, R, Saunders, JB, Attia, J, Wolfenden, L, Doran, C & McCambridge, J 2018, 'Effect of electronic brief intervention on uptake of specialty treatment in hospital outpatients with likely alcohol dependence: Pilot randomized trial and qualitative interviews', Drug and alcohol dependence. https://doi.org/10.1016/j.drugalcdep.2017.11.016

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T1 - Effect of electronic brief intervention on uptake of specialty treatment in hospital outpatients with likely alcohol dependence

T2 - Pilot randomized trial and qualitative interviews

AU - Johnson, Natalie A

AU - Kypri, Kypros

AU - Latter, Joanna

AU - Dunlop, Adrian

AU - Brown, Amanda

AU - Saitz, Richard

AU - Saunders, John B

AU - Attia, John

AU - Wolfenden, Luke

AU - Doran, Christopher

AU - McCambridge, James

PY - 2018/1/2

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N2 - Background: A large proportion of hospital outpatients is alcohol dependent (AD) but few are engaged in treatment for their drinking. Brief intervention, designed to raise patients’ awareness of their drinking, might encourage uptake of referral to specialty treatment. We assessed the feasibility of conducting a randomized trial evaluating the effectiveness of electronic brief intervention on the uptake of specialty treatment in hospital outpatients with likely AD. Methods: This study was conducted in the outpatient department of a large public hospital in Newcastle, Australia. We randomly assigned adults who scored ≥10 on the AUDIT-C and were not currently receiving treatment for their drinking to electronic brief intervention (comprising an assessment of their drinking and personalized feedback) and referral (n=59), or to referral alone (n=64). We pre-specified two co-primary outcomes as the proportions of patients who (1) accepted and (2) attended a Drug & Alcohol outpatient clinic appointment. We interviewed 15 study participants to investigate why they had declined the appointment and what sort of help they might prefer to receive. Results: Ten patients (five in each group) accepted an appointment, and one patient (control) attended. Most interviewees’ did not see their drinking as a problem or were confident they could manage it by themselves. Those who identified a preferred source of help expressed a preference for treatment by a GP. Conclusion: Uptake of specialty treatment in hospital outpatients with likely AD was low regardless of whether they received brief intervention. Accordingly, a large randomised trial does not appear to be feasible. Registration: Australian New Zealand Clinical Trials Registry ANZCTRN 12612000919819 Keywords: alcohol dependence, outpatients, screening, brief intervention, referral, electronic

AB - Background: A large proportion of hospital outpatients is alcohol dependent (AD) but few are engaged in treatment for their drinking. Brief intervention, designed to raise patients’ awareness of their drinking, might encourage uptake of referral to specialty treatment. We assessed the feasibility of conducting a randomized trial evaluating the effectiveness of electronic brief intervention on the uptake of specialty treatment in hospital outpatients with likely AD. Methods: This study was conducted in the outpatient department of a large public hospital in Newcastle, Australia. We randomly assigned adults who scored ≥10 on the AUDIT-C and were not currently receiving treatment for their drinking to electronic brief intervention (comprising an assessment of their drinking and personalized feedback) and referral (n=59), or to referral alone (n=64). We pre-specified two co-primary outcomes as the proportions of patients who (1) accepted and (2) attended a Drug & Alcohol outpatient clinic appointment. We interviewed 15 study participants to investigate why they had declined the appointment and what sort of help they might prefer to receive. Results: Ten patients (five in each group) accepted an appointment, and one patient (control) attended. Most interviewees’ did not see their drinking as a problem or were confident they could manage it by themselves. Those who identified a preferred source of help expressed a preference for treatment by a GP. Conclusion: Uptake of specialty treatment in hospital outpatients with likely AD was low regardless of whether they received brief intervention. Accordingly, a large randomised trial does not appear to be feasible. Registration: Australian New Zealand Clinical Trials Registry ANZCTRN 12612000919819 Keywords: alcohol dependence, outpatients, screening, brief intervention, referral, electronic

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SN - 0376-8716

JO - Drug and alcohol dependence

JF - Drug and alcohol dependence

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