Evidence map›Paper›PMID 39342107›Full record

Trial reportBMC primary care2024

Supporting alcohol brief interventions and pharmacotherapy provision in Australian First Nations primary care: exploratory analysis of a cluster randomised trial.

Monika Dzidowska, K S Kylie Lee, James H Conigrave, Scott Wilson, Noel Hayman, Rowena Ivers, Julia Vnuk, Paul Haber, Katherine M Conigrave

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC primary care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Monika DzidowskaFaculty of Medicine and Health, Discipline of Addiction Medicine, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Lev 6, King George V Building (C39), Sydney, NSW, 2006, Australia. monika.dzidowska@sydney.edu.au.
K S Kylie LeeFaculty of Medicine and Health, Discipline of Addiction Medicine, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Lev 6, King George V Building (C39), Sydney, NSW, 2006, Australia.
James H ConigraveFaculty of Medicine and Health, Discipline of Addiction Medicine, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Lev 6, King George V Building (C39), Sydney, NSW, 2006, Australia.
Scott WilsonFaculty of Medicine and Health, Discipline of Addiction Medicine, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Lev 6, King George V Building (C39), Sydney, NSW, 2006, Australia.
Noel HaymanSouthern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), 37 Wirraway Parade Inala, Brisbane, QLD, 4077, Australia.
Rowena IversGraduate School of Medicine, The University of Wollongong, Northfields Avenue, Gwyneville, Wollongong, NSW, 2522, Australia.
Julia VnukAboriginal Health Council of South Australia, Level 8, 115 Grenfell St, Adelaide, SA, 5000, Australia.
Paul HaberFaculty of Medicine and Health, Discipline of Addiction Medicine, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Lev 6, King George V Building (C39), Sydney, NSW, 2006, Australia.
Katherine M ConigraveFaculty of Medicine and Health, Discipline of Addiction Medicine, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Lev 6, King George V Building (C39), Sydney, NSW, 2006, Australia.

Funding

Wellcome Trust 105339
6 · The paper itself

Abstract

introductionPrimary care provides an important opportunity to detect unhealthy alcohol use and offer assistance but many barriers to this exist. In an Australian context, Aboriginal Community Controlled Health Services (ACCHS) are community-led and run health services, which provide holistic primary care to Aboriginal and Torres Strait Islander peoples. A recent cluster randomised trial conducted with ACCHS provided a service support model which showed a small but significant difference in provision of 'any treatment' for unhealthy alcohol use. However, it was not clear which treatment modalities were increased.

aimsTo test the effect of an ACCHS support model for alcohol on: (i) delivery of verbal alcohol intervention (alcohol advice or counselling); (ii) prescription of relapse prevention pharmacotherapies.

methodsIntervention: 24-month, multi-faceted service support model.

designcluster randomised trial; equal allocation to early-support ('treatment') and waitlist control arms.

participants22 ACCHS. ANALYSIS: Multilevel logistic regression to compare odds of a client receiving treatment in any two-month period as routinely recorded on practice software.

resultsSupport was associated with a significant increase in the odds of verbal alcohol intervention being recorded (OR = 7.60, [95% CI = 5.54, 10.42], p < 0.001) from a low baseline. The odds of pharmacotherapies being prescribed (OR = 1.61, [95% CI = 0.92, 2.80], p = 0.1) did not increase significantly. There was high heterogeneity in service outcomes.

conclusionsWhile a statistically significant increase in verbal alcohol intervention rates was achieved, this was not clinically significant because of the low baseline. Our data likely underestimates rates of treatment provision due to barriers documenting verbal interventions in practice software, and because different software may be used by drug and alcohol teams. The support made little impact on pharmacotherapy prescription. Changes at multiple organisational levels, including within clinical guidelines for primary care, may be needed to meaningfully improve provision of alcohol treatment in ACCHS.

trial registrationACTRN12618001892202 (retrospectively registered on 21/11/2018).

Indexed as

AlcoholismHealth Services, IndigenousPrimary Health CareAdultAlcohol DeterrentsAustraliaAustralian Aboriginal and Torres Strait Islander PeoplesCluster AnalysisCounselingFemaleHumansMaleMiddle AgedSecondary PreventionAlcohol DeterrentsAboriginal community controlled health organisationAlcoholBrief interventionCounsellingPharmacotherapyPrimary careRelapse preventionTreatment

Identifiers

PMID39342107
PMCPMC11438139

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.