None listed
Conditions
Brief summary
Patient outcomes can be significantly influenced by the characteristics of the system in which health care services are delivered, independently of patient and treatment characteristics. There has been no systematic examination of the relative impact of client, treatment and systems level variables on outcomes for alcohol dependence. This study aims to determine, using a prospective cohort study, the impact of: (a) individual client characteristics; (b) type of treatment; and (c) features of the system in which treatment is provided, on alcohol treatment outcomes. Eligible treatment centres will be those that provides a facetoface specialist outpatient alcohol treatment service to adults and expect to treat at least 50 clients for alcohol as primary drug of concern in the next 12 months (or approximately 75 episodes). Fifty services across Australia will be recruited using stratified sampling. Eligible clients will be aged 18 years or older; presenting for a new episode of outpatient treatment at the service; have nominated alcohol as their primary drug of concern; have used alcohol in the last 30 days; have not previously been enrolled in the study in the last 6 months; and have a telephone contact number. Clients will be asked to complete an iPad survey at baseline while waiting for their appointment at the clinic. A telephone survey will be completed at 3 months follow up. The primary outcome measure will be the number of heavy drinking days (> 5 drinks per day) in past 14 days. Secondary outcome measures will include the number of drinking days; total alcohol consumption; and health related quality of life. Predictor variables will include client (e.g. demographics, substance use), intervention (e.g. treatment type), and system level variables (e.g. process of care). The relationship between predictor and outcome variables will be examined within a multilevel modelling framework. This is the first study internationally to examine the role of three levels of variables on treatment success. It will provide critical information for policy makers on which to base minimum service standards. Clinic Staff will be invited to participate in a web-based survey, from the Director (or delegate) of their clinic providing information about their own qualifications and skills, their role in relation to the delivery of client treatment, and their perceptions about staff attitudes, team culture and client relationship within the clinic, implementation of evidence-based practice and commitment to quality improvement. One key informant from the centre will be asked to participate in a telephone interview to obtain information number and type of staff, staff turnover, staff supervision, number and type of peripheral services, teaching status, continuity of care, participation in clinical trials, geographic location, funding type, number of clients treated per year, organisational accreditation.
Interventions
Clients will be asked to complete an iPad survey at baseline while waiting for their appointment at the clinic. A telephone survey will be completed at 3 months follow up. The primary outcome measure will be the number of heavy drinking days (> 5 drinks per day) in past 14 days.
Secondary outcome measures will include the number of drinking days; total alcohol consumption; and health related quality of life. Predictor variables will include client (e.g. demographics, substance use), interventio
Clients will be asked to complete an iPad survey at baseline while waiting for their appointment at the clinic. A telephone survey will be completed at 3 months follow up. The primary outcome measure will be the number of heavy drinking days (> 5 drinks per day) in past 14 days. Secondary outcome measures will include the number of drinking days; total alcohol consumption; and health related quality of life. Predictor variables will include client (e.g. demographics, substance use), intervention (e.g. treatment type), and system-level variables (e.g. process of care). The relationship between predictor and outcome variables will be examined within a multilevel modelling framework.
Sponsors
The University of Newcastle
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Clients: (i) aged 18 years or older; (ii) presenting for new episode of treatment at the participating service; (iii) have nominated alcohol as their primary drug of concern; (iv) have used alcohol in the past 30 days; (v) have not previously been enrolled in the study in the last 6 months; and (vi) have a telephone contact number. Staff: All staff from participating centres will be invited to contribute to the study if they are employed in the alcohol treatment clinic and are involved in providing direct patient care.
Exclusion criteria
Additionally, the study is focusing on those treatment centres community-based providing alcohol treatment to adults. Centres are ineligible if they are services that provide withdrawal only, residential rehabilitation only, detoxification services only and/or treat less than 50 clients for alcohol as primary drug of concern in 12 months (or approximately less than 75 episodes). Participants under the age of 18 have been excluded as they are unable to give informed consent. While non-English speaking groups represent an important segment within the target population, translation costs for study materials will make it cost prohibitive to include this group in the current study.
Outcome results
None listed