Psychosocial interventions for problem alcohol use in primary care settings (PINTA): Baseline feasibility data

Jan Klimas, Anne Marie Henihan, Geoff McCombe, Davina Swan, Rolande Anderson, Gerard Bury, Colum Dunne, Eamon Keenan, Jean Saunders, Gillian Williams Shorter, Bobby P. Smyth, Walter Cullen

    Research output: Contribution to journalReview article

    5 Citations (Scopus)

    Abstract

    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.

    LanguageEnglish
    Pages97-106
    Number of pages10
    JournalJournal of Dual Diagnosis
    Volume11
    Issue number2
    DOIs
    Publication statusE-pub ahead of print - 18 May 2015

    Fingerprint

    Primary Health Care
    Alcohols
    Methadone
    General Practitioners
    Therapeutics
    Referral and Consultation
    Feasibility Studies
    General Practice
    Drinking
    Health

    Keywords

    • Agonist treatment
    • Alcohol
    • Family medicine
    • Implementation
    • Methadone
    • Opioids
    • SBIRT

    Cite this

    Klimas, J., Marie Henihan, A., McCombe, G., Swan, D., Anderson, R., Bury, G., ... Cullen, W. (2015). Psychosocial interventions for problem alcohol use in primary care settings (PINTA): Baseline feasibility data. Journal of Dual Diagnosis, 11(2), 97-106. https://doi.org/10.1080/15504263.2015.1027630
    Klimas, Jan ; Marie Henihan, Anne ; McCombe, Geoff ; Swan, Davina ; Anderson, Rolande ; Bury, Gerard ; Dunne, Colum ; Keenan, Eamon ; Saunders, Jean ; Shorter, Gillian Williams ; Smyth, Bobby P. ; Cullen, Walter. / Psychosocial interventions for problem alcohol use in primary care settings (PINTA) : Baseline feasibility data. In: Journal of Dual Diagnosis. 2015 ; Vol. 11, No. 2. pp. 97-106.
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    abstract = "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.",
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    author = "Jan Klimas and {Marie Henihan}, Anne and Geoff McCombe and Davina Swan and Rolande Anderson and Gerard Bury and Colum Dunne and Eamon Keenan and Jean Saunders and Shorter, {Gillian Williams} and Smyth, {Bobby P.} and Walter Cullen",
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    Klimas, J, Marie Henihan, A, McCombe, G, Swan, D, Anderson, R, Bury, G, Dunne, C, Keenan, E, Saunders, J, Shorter, GW, Smyth, BP & Cullen, W 2015, 'Psychosocial interventions for problem alcohol use in primary care settings (PINTA): Baseline feasibility data', Journal of Dual Diagnosis, vol. 11, no. 2, pp. 97-106. https://doi.org/10.1080/15504263.2015.1027630

    Psychosocial interventions for problem alcohol use in primary care settings (PINTA) : Baseline feasibility data. / Klimas, Jan; Marie Henihan, Anne; McCombe, Geoff; Swan, Davina; Anderson, Rolande; Bury, Gerard; Dunne, Colum; Keenan, Eamon; Saunders, Jean; Shorter, Gillian Williams; Smyth, Bobby P.; Cullen, Walter.

    In: Journal of Dual Diagnosis, Vol. 11, No. 2, 18.05.2015, p. 97-106.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - Psychosocial interventions for problem alcohol use in primary care settings (PINTA)

    T2 - Journal of Dual Diagnosis

    AU - Klimas, Jan

    AU - Marie Henihan, Anne

    AU - McCombe, Geoff

    AU - Swan, Davina

    AU - Anderson, Rolande

    AU - Bury, Gerard

    AU - Dunne, Colum

    AU - Keenan, Eamon

    AU - Saunders, Jean

    AU - Shorter, Gillian Williams

    AU - Smyth, Bobby P.

    AU - Cullen, Walter

    PY - 2015/5/18

    Y1 - 2015/5/18

    N2 - 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.

    AB - 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.

    KW - Agonist treatment

    KW - Alcohol

    KW - Family medicine

    KW - Implementation

    KW - Methadone

    KW - Opioids

    KW - SBIRT

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    DO - 10.1080/15504263.2015.1027630

    M3 - Review article

    VL - 11

    SP - 97

    EP - 106

    JO - Journal of Dual Diagnosis

    JF - Journal of Dual Diagnosis

    SN - 1550-4263

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