TY - JOUR
T1 - Promoting brief alcohol intervention by nurses in primary care
T2 - A cluster randomised controlled trial
AU - Kaner, Eileen
AU - Lock, Catherine
AU - Heather, Nick
AU - McNamee, Paul
AU - Bond, Senga
N1 - Funding Information:
The trial was funded by the Alcohol Education and Research Council and a joint Medical Research Council/Northern & Yorkshire Region Special Training Fellowship in Health Services Research which was held by Dr. Kaner. Dr. Kaner is currently supported by an NHS Primary Care Career Scientist Award. We would like to thank Lisa Tait for secretarial support, Dr. Sharon Lamont for help with follow-up visits, Nick Steen for statistical advice and Professors Martin Eccles and James Mason for comments on the manuscript. Finally we would like to thank all nurses and receptionists who were involved in this study.
PY - 2003/11
Y1 - 2003/11
N2 - This trial evaluated the clinical impact and cost-effectiveness of strategies promoting screening and brief alcohol intervention (SBI) by nurses in primary care. Randomisation was at the level of the practice and the interventions were: written guidelines (controls, n=76); outreach training (n=68); and training plus telephone-based support (n=68). After 3 months, just 39% of controls implemented the SBI programme compared to 74% of nurses in trained practices and 71% in trained and supported practices. Controls also screened fewer patients and delivered fewer brief interventions to risk drinkers than other colleagues. However, there was a trade-off between the extent and the appropriateness of brief intervention delivery with controls displaying the least errors in overall patient management. Thus cost-effectiveness ratios (cost per patient appropriately treated) were similar between the three strategies. Given the potential for anxiety due to misdirected advice about alcohol-related risk, the balance of evidence favoured the use of written guidelines to promote SBI by nurses in primary care.
AB - This trial evaluated the clinical impact and cost-effectiveness of strategies promoting screening and brief alcohol intervention (SBI) by nurses in primary care. Randomisation was at the level of the practice and the interventions were: written guidelines (controls, n=76); outreach training (n=68); and training plus telephone-based support (n=68). After 3 months, just 39% of controls implemented the SBI programme compared to 74% of nurses in trained practices and 71% in trained and supported practices. Controls also screened fewer patients and delivered fewer brief interventions to risk drinkers than other colleagues. However, there was a trade-off between the extent and the appropriateness of brief intervention delivery with controls displaying the least errors in overall patient management. Thus cost-effectiveness ratios (cost per patient appropriately treated) were similar between the three strategies. Given the potential for anxiety due to misdirected advice about alcohol-related risk, the balance of evidence favoured the use of written guidelines to promote SBI by nurses in primary care.
KW - Appropriateness of care
KW - Brief alcohol intervention
KW - Implementation
KW - Nurses
UR - http://www.scopus.com/inward/record.url?scp=0242636490&partnerID=8YFLogxK
U2 - 10.1016/S0738-3991(02)00242-2
DO - 10.1016/S0738-3991(02)00242-2
M3 - Article
C2 - 14630384
AN - SCOPUS:0242636490
SN - 0738-3991
VL - 51
SP - 277
EP - 284
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 3
ER -