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Intervention to reduce excessive alcohol consumption and improve comorbidity outcomes in hypertensive or depressed primary care patients: two parallel cluster randomized feasibility trials

Wilson, Graeme, B., Wray, Catherine, Newbury-Birch, Dorothy, McColl, Elaine, Crosland, Ann, Speed, Chris, Cassidy, Paul, Tomson, Dave, Haining, Shona, Howel, Denise and Kaner, Eileen F. S. (2014) Intervention to reduce excessive alcohol consumption and improve comorbidity outcomes in hypertensive or depressed primary care patients: two parallel cluster randomized feasibility trials. Trials, 15 (235). ISSN 1745-6215

Item Type: Article

Abstract

Wilson, G. B.
Wray, C.
McGovern, R.
Newbury-Birch, D.
McColl, E.
Crosland, A.
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.

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More Information

Uncontrolled Keywords: Alcohol, Screening, Brief intervention, Comorbid, Hypertension, Depression, Primary care, Trial, Preventive, Feasibility
Depositing User: Hannah Dodd

Identifiers

Item ID: 5002
Identification Number: https://doi.org/10.1186/1745-6215-15-235
ISSN: 1745-6215
URI: http://sure.sunderland.ac.uk/id/eprint/5002
Official URL: http://www.trialsjournal.com/content/15/1/235/abst...

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Catalogue record

Date Deposited: 30 Jun 2014 08:06
Last Modified: 18 Dec 2019 15:37

Contributors

Author: Graeme, B. Wilson
Author: Catherine Wray
Author: Dorothy Newbury-Birch
Author: Elaine McColl
Author: Ann Crosland
Author: Chris Speed
Author: Paul Cassidy
Author: Dave Tomson
Author: Shona Haining
Author: Denise Howel
Author: Eileen F. S. Kaner

University Divisions

Faculty of Health Sciences and Wellbeing
Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

Subjects

Sciences > Health Sciences

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