Primary Care Implementation Study to Scale up EIBI and Reduce Alcohol Related Negative Outcomes (PINO)

Catholic University (KU) of Leuven

Status: Unknown

Conditions: Harmful; Use, Alcohol; Hazardous; Use, Alcohol

Treatments: Behavioral: Training and support; Behavioral: Community actions

Study type: Interventional

Funder types: Other

Identifiers

NCT04398576

s63342

Details and patient eligibility

About

The aim of this implementation study is to compare the effect of tailored training and support (T&S) for general practioners with T&S and alcohol community actions and the impact it has on early identification of hazardous and harmful drinking and brief intervention.

Full description

A quasi-experimental three-arm implementation study will be undertaken in Flanders (Belgium) to assess the effects of tailored training and support to general practitioners (GPs) alone or in an area context of alcohol community actions and compared to 'support as usual' on GP's performance in terms of early identification of hazardous and harmful drinking and brief intervention.

The study will last 18 months and will take place in three cities of comparable size. In each area at least 28 GPs will be recruited.

The primary outcome will be the proportion of consulting adult patients screened for hazardous and harmful alcohol use at the end-point of an 18-month implementation period. The secondary outcomes will be the screening rate as assessed at 3, 6, 9, 12 and 15 months and the proportion of patients screening positive for hazardous and harmful alcohol use that receive a brief intervention at 3,6,9, 12, 15 and 18 months. Furthermore, the relation between GP's views and needs and practices' contexts, and EIBI performance will be explored.

Data regarding screening and brief intervention activities will be collected from the electronic health records (EHR).

Enrollment: 84 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• GP or GP trainee
• Dutch language use in practice
• Working in general practice in 3 cities of comparable size or their sub municipalities

Exclusion criteria

• No possibility of integration of e-form into the EHR-system.

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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84 participants in 3 patient groups

Support as usual

No Intervention group

Description:

There will be no interventions, only support as usual. All GPs receive an information package by post or via e-mail containing: * Belgian guidelines on the management of hazardous and harmful alcohol use * A summary card about EIBI for hazardous and harmful alcohol consumption. * Internet links to documentation of the medical association and the Flemish centre of expertise on alcohol and drugs(31). An EHR-update allows the use of an extra e-form permitting standardised introduction of screening results from the Alcohol Use Disorders Identification Test (-Consumption) (AUDIT(-C)), alcohol-related diagnoses and actions including provision of oral brief advice/intervention, referral to a digital-based system for advice and/or referral to another health care provider.

Training and support

Active Comparator group

Description:

All GPs receive an information package by post or via e-mail containing: * Belgian guidelines on the management of hazardous and harmful alcohol use * A summary card about EIBI for hazardous and harmful alcohol consumption. * Internet links to documentation of the medical association and the Flemish centre of expertise on alcohol and drugs(31). An EHR-update allows the use of an extra e-form permitting standardised introduction of screening results from the Alcohol Use Disorders Identification Test (-Consumption) (AUDIT(-C)), alcohol-related diagnoses and actions including provision of oral brief advice/intervention, referral to a digital-based system for advice and/or referral to another health care provider. There shall be tailored training and support for the general practioners. At the start of the study, this group receives two face-to-face educational trainings of two hours each. Another two face-to-face booster sessions will follow at 6 and at 12 months.

Treatment:

Behavioral: Training and support

Training and support and community actions

Active Comparator group

Description:

In this group, GPs receive the same training and support as in the second arm (training and support). There will also be embedded community-based actions within a local strategy.

Treatment:

Behavioral: Community actions

Behavioral: Training and support