Intervention to reduce excessive alcohol consumption and improve comorbidity outcomes in hypertensive or depressed primary care patients: two parallel cluster randomized feasibility trials
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- 作者：Graeme B Wilson (1)
Catherine Wray (1)
Ruth McGovern (1)
Dorothy Newbury-Birch (1)
Elaine McColl (1)
Ann Crosland (2)
Chris Speed (1)
Paul Cassidy (3)
Dave Tomson (4)
Shona Haining (5)
Denise Howel (1)
Eileen FS Kaner (1)
1. Institute of Health and Society ; Newcastle University ; Baddiley Clark Building ; Richardson Road ; Newcastle upon Tyne ; NE2 4AX ; UK
2. Department of Pharmacy ; Health and Well-being ; Sunderland University ; Chester Road ; Sunderland ; SR1 3SD ; UK
3. Teams Medical Practice ; Watson Street ; Gateshead ; NE8 2PQ ; UK
4. Collingwood Health Group ; Brookland Terrace ; North Tyneside ; NE29 8EA ; UK
5. NHS North of England Commissioning Support Unit ; Goldcrest Way ; Newcastle upon Tyne ; NE15 8NY ; UK - 关键词：Alcohol ; Screening ; Brief intervention ; Comorbid ; Hypertension ; Depression ; Primary care ; Trial ; Preventive ; Feasibility
- 刊名：Trials
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：15
- 期：1
- 全文大小：1,003 KB
- 参考文献：Global health risks: Mortality and burden of disease related to selected major risks. WHO, Geneva
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- 出版者：BioMed Central
- ISSN：1745-6215
文摘
Background Many primary care patients with raised blood pressure or depression drink potentially hazardous levels of alcohol. Brief interventions (BI) to reduce alcohol consumption may improve comorbid conditions and reduce the risk of future alcohol problems. However, research has not established their effectiveness in this patient population. This study aimed to establish the feasibility of definitive trials of BI to reduce excessive drinking in primary care patients with hypertension or mild to moderate depression. Methods Thirteen general practices in North East England were randomized to the intervention or control arm of one of two parallel pilot trials. Adult patients drinking excessively and diagnosed with hypertension or mild-to-moderate depression received the Alcohol Use Disorders Identification Test (AUDIT) by postal survey. Consenting respondents scoring more than 7 on AUDIT (score range 0 to 40) received brief alcohol consumption advice plus an information leaflet (intervention) or an information leaflet alone (control) with follow-up at six months. Measurements included the numbers of patients eligible, recruited, and retained, and the AUDIT score and systolic/diastolic blood pressure of each patient or the nine-item Patient Health Questionnaire (PHQ-9) score. Acceptability was assessed via practitioner feedback and patient willingness to be screened, recruited, and retained at follow-up. Results In the hypertension trial, 1709 of 33,813 adult patients (5.1%) were eligible and were surveyed. Among the eligible patients, 468 (27.4%) returned questionnaires; 166 (9.6% of those surveyed) screened positively on AUDIT and 83 (4.8% of those surveyed) were recruited (50.0% of positive screens). Sixty-seven cases (80.7% of recruited patients) completed follow-up at six months. In the depression trial, 1,044 of 73,146 adult patients (1.4%) were eligible and surveyed. Among these eligible patients, 215 (20.6%) responded; 104 (10.0% of those surveyed) screened positively on AUDIT and 29 (2.8% of those surveyed) were recruited (27.9% of positive screens). Nineteen cases (65.5% of recruited patients) completed follow-up at six months. Conclusions Recruitment and retention rates were higher in the hypertension trial than in the depression trial. A full brief intervention trial appears feasible for primary care patients with hypertension who drink excessively. High AUDIT scores in the depression trial suggest the importance of alcohol intervention in this group. However, future work may require alternative screening and measurement procedures. Trial registration Current Controlled Trials ISRCTN89156543; registered 21 October 2013.