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Can routine data help evaluate the implementation of brief alcohol intervention in primary health care? A mixed-methods investigation of the use of routinely collected information to evaluate the delivery of screening and brief interventions (sbis) for alcohol

Lookup NU author(s): Dr Amy O'DonnellORCiD, Dr Katie Haighton, Dr David Chappel, Professor Eileen KanerORCiD

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Abstract

Background: UK health policy has sought to encourage alcohol screening and brief intervention (SBI) delivery in primary care, including via the introduction of pay-for-performance (P4P) schemes in 2008. In order to measure the impact of such policies, a range of data exist, including General Practitioner (GP) Read codes which record all clinical activity. Research question: Can routinely recorded Read code data help evaluate the implementation of alcohol SBI in primary healthcare?Method: Sequential mixed methods design: descriptive statistical analysis of alcohol Read code data by systematically interrogating 16 GP practice IT systems in North East England; followed by 10 in-depth GP interviews to explore factors influencing recording behaviourResults: 287 alcohol-related Read codes existed, however only 40 (13.9%) were used between 2007-11, generally relating to the recording of a patient’s alcohol consumption status, BI delivery and screening tool administration (57.6%, 34.9% and 7.2% respectively of all codes used 2007-11). Further, many of the 287 available Read codes related to relatively rare alcohol conditions (52.2%) or duplicate/outmoded terminology (31%). Use of formal screening tools was rare pre-2008, but rates increased steadily after this point. In 2010-11 practices with higher SBI recording rates were typically signed up to P4P schemes (e.g. screening rates ranged from 3.73% (CI: 3.65-3.89) in P4P practices to 0.05% (CI: 0.03-0.08) in non-P4P practices (p <0.00)). However, GP interviews suggested that nurse-led SBI was most likely to be coded and delivered consistently, whilst GP delivery of SBI was more ad hoc, with a strong reliance on weekly alcohol consumption measures rather than validated screening tools to assess risk.Conclusions: Whilst routine data may detect more successfully embedded screening activity in primary care post-2008, measuring SBI delivery remains challenging, particularly for GPs.


Publication metadata

Author(s): O'Donnell A, Haighton K, Chappel D, Shevills C, Kaner E

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: 36th Annual Scientific Meeting of the Research Society on Alcoholism

Year of Conference: 2013

Publisher: Research Society on Alcoholism

URL: http://www.rsoa.org/2013meet-indexAbs.htm


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