Alcohol Screening and Brief Intervention Research Programme

1
Alcohol Screening and Brief Intervention Research
Programme

• Prof Colin Drummond
• Institute of Psychiatry
• Kings College London

2
Main features

• National research consortium with expertise in
  screening and brief interventions in the alcohol
  field
• Three different settings and three different
  regions of England as different tools may be
  necessary in different settings
• Funded by DH 3.2 million,
• as part of the Alcohol Harm Reduction Strategy
  for England (2004)

3
Research Project Group

• IOP
• Prof C Drummond (CI)
• Dr P Deluca
• Ms K Perryman
• St Georges
• Dr J Myles
• Dr A Oyefeso
• Mr T Phillips
• York
• Prof M Bland
• Mr S Coulton
• Prof C Godfrey
• Mr S Parrott

• Newcastle
• Prof E Kaner (DCI)
• Prof C Day
• Dr E Gilvarry
• Dr P Cassidy
• Dr D Newbury-Birch
• Prof Nick Heather
• Imperial College and St Marys Hospital
• Dr M Crawford
• Prof R Touquet
• Alcohol Concern
• Mr D Shenker

4
Aims

• To identify the most appropriate, acceptable and
  cost-effective
• screening methods for AUD
• brief intervention techniques for AUD
• methods of implementation
• Across 3 health and social care settings
• Primary Health Care (PHC)
• Accident Emergency Departments (AED)
• Criminal Justice Services (CJS)

5
Research Programme Design

• Three cluster randomised clinical trials (PHC,
  AED, CJS)
• Each with a purpose-designed project to assess
• Identification of the most effective screening
  approach (universal vs targeted and 2/3 screening
  tools)
• Identification of the most effective and
  cost-effective intervention approach
• Barriers and facilitators to implementation
• 6 month follow-up

6
Research Programme Design (cont.)

• To recruit patients from 24 PHC practices
• 9 AEDs
• 24 CJS
• Across North East, London, and South East Regions
  
• Aim to recruit over 2,600 patients across the
  three trials
• All health and CJS staff to receive training and
  support from research team
• Staff attitudes to be assessed to identify
  acceptability of implementing screening and brief
  interventions
• Programme duration 2 years

7
PHC
8
AED
9
CJS
10
9 Clusters
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
1 AED 2/3 PHC 2/3 CJS
11
Key Stakeholders/Partners

• Government Offices (DH, HO, NOMS, regional)
• PCTs
• DAATs
• General Hospitals
• General Practitioners
• Prisons, Probation, Police

12
How will we assess implementation?

• Number screened, positives, received intervention
• Factors supporting implementation
• Factors impeding implementation
• Impact individual, service, costs and benefits
• Acceptability patient, practitioner,
  commissioner
• Sustainability

13
How will we assess effectiveness?

• Effectiveness of implementation
• Extent of screening and intervention activity
• Attitudes to SBI implementation
• Patient outcome measures
• Alcohol consumption
• Alcohol related problems
• Health related quality of life
• Health related and wider societal costs

14
Toolkit

• Screening toolkit and practical guidance for each
  setting based on optimal tool/method
  (targeted/universal)/setting combination
• Intervention tools and implementation guidance
  based on findings tailored to each setting
• Training package for professionals in each
  setting
• PIL/CIL for each setting
• Guide for commissioners of SBI services
• Resource website for providers

15
Progress

• Recruited 9 AEDs 24 PHC practices
• Ethics and RD approval
• Completed CJS pilot
• Site training in Jan 08
• Pilot study report
• Feasibility, validity of screening tools, staff
  attitudes
• Interim report 2008
• Final report 2009