Home > Psychosocial interventions for problem alcohol use in primary care settings (PINTA): baseline feasibility data.

Klimas, Jan and Heninan, Anne Marie and McCombe, Geoff and Swan, Davina and Anderson, Rolande and Bury, Gerard and Dunne, Colum and Keenan, Eamon and Saunders, Jean and Williams Shorter, Gillian and Smyth, Bobby P and Cullen, Walter (2015) Psychosocial interventions for problem alcohol use in primary care settings (PINTA): baseline feasibility data. Journal of Dual Diagnosis , 11 , (2) , pp. 97-106.


Objective: Many individuals receiving methadone maintenance receive their treatment through their primary care provider. As many also drink alcohol excessively, there is a need to address alcohol use to improve health outcomes for these individuals. We examined problem alcohol use and its treatment among people attending primary care for methadone maintenance treatment, using baseline data from a feasibility study of an evidence-based complex intervention to improve care.

 

Methods: Data on addiction care processes were collected by (1) reviewing clinical records (n = 129) of people who attended 16 general practices for methadone maintenance treatment and (2) administering structured questionnaires to both patients (n = 106) and general practitioners (GPs) (n = 15).

 

Results: Clinical records indicated that 24 patients (19%) were screened for problem alcohol use in the 12 months prior to data collection, with problem alcohol use identified in 14 (58% of those screened, 11% of the full sample). Of those who had positive screening results for problem alcohol use, five received a brief intervention by a GP and none were referred to specialist treatment. Scores on the Alcohol Use Disorders Identification Test (AUDIT) revealed the prevalence of hazardous, harmful, and dependent drinking to be 25% (n = 26), 6% (n = 6), and 16% (n = 17), respectively. The intraclass correlation coefficient (ICC) for the proportion of patients with negative AUDITs was 0.038 (SE = 0.01). The ICCs for screening, brief intervention, and/or referral to treatment (SBIRT) were 0.16 (SE = 0.014), −0.06 (SE = 0.017), and 0.22 (SE = 0.026), respectively. Only 12 (11.3%) AUDIT questionnaires concurred with corresponding clinical records that a patient had any/no problem alcohol use. Regular use of primary care was evident, as 25% had visited their GP more than 12 times during the past 3 months.

 

Conclusions: Comparing clinical records with patients’ experience of SBIRT can shed light on the process of care. Alcohol screening in people who attend primary care for substance use treatment is not routinely conducted. Interventions that enhance the care of problem alcohol use among this high-risk group are a priority.

Item Type:Article
Date:2015
Page Range:pp. 97-106
Publisher:Taylor & Francis
Volume:11
Number:2
EndNote:View
Related URLs:
Subjects:B Substances > Alcohol
B Substances > Opioids (opiates)
G Health and disease > Substance use disorder > Alcohol use
HJ Treatment method > Psychosocial treatment method
J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for substance use
J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)
T Demographic characteristics > Doctor
VA Geographic area > Europe > Ireland

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