Evidence map›Paper›PMID 32171278›Full record

ArticleBMC public health2020

Assertive outreach treatment versus care as usual for the treatment of high-need, high-cost alcohol related frequent attenders: study protocol for a randomised controlled trial.

R Blackwood, A Wolstenholme, A Kimergård, S Fincham-Campbell, Z Khadjesari, S Coulton, S Byford, P Deluca, S Jennings, E Currell and 5 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

R BlackwoodNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. rosalind.blackwood@kcl.ac.uk.ORCID http://orcid.org/0000-0002-9284-0810
A WolstenholmeNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
A KimergårdNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
S Fincham-CampbellNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Z KhadjesariNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
S CoultonUniversity of Kent, Kent, Canterbury, UK.
S ByfordKing's Health Economics, Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK.
P DelucaNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
S JenningsNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
E CurrellNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
J DunneNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
J O'TooleNIHR Collaborations for Leadership in Applied Health Research and Care South London, London, UK.
J WinningtonSouth London and the Maudsley NHS Foundation Trust, London, UK.
E FinchSouth London and the Maudsley NHS Foundation Trust, London, UK.
C DrummondNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
King's College London · GBSouth London and Maudsley NHS Foundation Trust · GBNational Institute for Health Research · GBUniversity of Kent · GB

Funding

Department of Health 13/86/03Department of Health RP-PG-0609-10162Guys and St Thomas' Charity MAJ140701Medical Research Council G0701681Medical Research Council G0701818Medical Research Council MR/N00616X/1
6 · The paper itself

Abstract

backgroundAlcohol-related hospital admissions have doubled in the last ten years to > 1.2 m per year in England. High-need, high-cost (HNHC) alcohol-related frequent attenders (ARFA) are a relatively small subgroup of patients, having multiple admissions or attendances from alcohol during a short time period. This trial aims to test the effectiveness of an assertive outreach treatment (AOT) approach in improving clinical outcomes for ARFA, and reducing resource use in the acute setting.

methodsOne hundred and sixty ARFA patients will be recruited and following baseline assessment, randomly assigned to AOT plus care as usual (CAU) or CAU alone in equal numbers. Baseline assessment includes alcohol consumption and related problems, physical and mental health comorbidity and health and social care service use in the previous 6 months using standard validated tools, plus a measure of resource use. Follow-up assessments at 6 and 12 months after randomization includes the same tools as baseline plus standard measure of patient satisfaction. Outcomes for CAU + AOT and CAU at 6 and 12 months will be compared, controlling for pre-specified baseline measures. Primary outcome will be percentage of days abstinent at 12 months. Secondary outcomes include emergency department (ED) attendance, number and length of hospital admissions, alcohol consumption, alcohol-related problems, other health service use, mental and physical comorbidity 6 and 12 months post intervention. Health economic analysis will estimate the economic impact of AOT from health, social care and societal perspectives and explore cost-effectiveness in terms of quality adjusted life years and alcohol consumption at 12-month follow-up. DISCUSSION: AOT models piloted with alcohol dependent patients have demonstrated significant reductions in alcohol consumption and use of unplanned National Health Service (NHS) care, with increased engagement with alcohol treatment services, compared with patients receiving CAU. While AOT interventions are costlier per case than current standard care in the UK, the rationale for targeting HNHC ARFAs is because of their disproportionate contribution to overall alcohol burden on the NHS. No previous studies have evaluated the clinical and cost-effectiveness of AOT for HNHC ARFAs: this randomized controlled trial (RCT) targeting ARFAs across five South London NHS Trusts is the first.

trial registrationInternational standard randomized controlled trial number (ISRCTN) registry: ISRCTN67000214, retrospectively registered 26/11/2016.

Indexed as

Alcohol-Related DisordersFacilities and Services UtilizationAdultAlcohol DrinkingCost-Benefit AnalysisEmergency Service, HospitalFemaleHospitalizationHumansLondonMaleRandomized Controlled Trials as TopicState MedicineTreatment OutcomeAlcoholAssertive outreach treatmentDependenceFrequent attendersHigh need high costMultimorbidityRandomized controlled trial

Identifiers

PMID32171278
PMCPMC7071678
OpenAlexW3011221358

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.