None listed
Conditions
Brief summary
This project includes researching the benefits of applying a chronic disease management model to veterans with alcohol use issues. It will assess the effects of increasing self management (the Flinders model of chronic condition self management) for veterans who have alcohol related conditions compared to usual care. Alcohol use has been identified as a significant issue for the veteran community. It is reported that alcohol dependence is one of the four most common mental health disorders among veterans who have an accepted mental health disability. In addition, the level of co-morbidity between alcohol and other health problems among veterans, particularly mental health problems, is high. Methods for increasing self management and positive behaviour change in veterans with alcohol related conditions are needed. This will be a randomised control trial (50:50 randomisation) with measurement of repeated measures of quality of life in 160 patients. VV will be randomized either to Group A (Flinders group) or Group B (usual care group with a waiting list option to have the FM after nine months). a fifteen-month recruitment and intervention phase with a thirteen month follow up phase for between-group comparisons. Recruitment will be through the RGH, general practitioners in the Southern area, community health care centres, Vietnam Veterans Counselling Service (VVCS) and advertised through VV groups. Veterans will either be approached by their health professional or will volunteer themselves after hearing of the study.
Interventions
The intervention group will receive "usual care" plus The Flinders Model of Chronic Condition Self-Management, together with any/all of the interventions listed, but agreed between a health professional and the patient: Treatment options (based on the Alcohol Practice Guidelines) may include • Medical management using naltrexone (50mg tablets, orally, once per day, for an initial period of 3 months but may extend up to 9 months) or acamprosate (330mg x 2 tablets, orally, three times per day for an initial period of 3 months but may extend up to 9 months); • Self-management of alcohol problems using the web based program ‘the right mix’; www.therightmix.gov.au (duration: ongoing as needed by each individual); • Individual counselling using cognitive behaviour therapy based on motivational interviewing, cue exposure, cognitive restructuring and relapse prevention will be provided in the community through Drug and Alcohol Services SA (DASSA) and Vietnam Veterans Counselling Service (VVCS) (duration 30-90 minutes per session for as many sessions required by each individual); • Group therapy (Stanford six-week generic self-management course - 2 1/2 hours per one session per week). • “Drink Watchers: A self-monitoring approach” (duration: ongoing per individual, as needed); • Alcoholics Anonymous (duration approx 2 hours per session, once per week, for as many sessions as the Veteran requires). Each group will be offered the same treatment options during a nine month period which will be agreed between the participant, their GP and other health providers. One group will be supported in self-management techniques with the Flinders Model of self-management in the first nine months, with nine months follow-up, and the other group will be supported in self-management in the second nine months. Total intervention period 18 months.
Sponsors
Study design
Eligibility
Inclusion criteria
Must have been in the Vietnam Conflict and have an alcohol related chronic condition - Each Vietnam Veteran will need to have an Audit score (Alcohol Usage Disorders Identification Test) of 8 or above.
Exclusion criteria
Physical or mental impairment so as not to be able to give informed consent or cooperate with trial procedures.