Fris Verder:Een verkennend onderzoek naar groepsbehandelingen voor ouderen met alcoholproblemen

Inleiding: Hoewel overmatig alcoholgebruik onder ouderen voorkomt, zijn de groepsbehandelprogramma’s niet gestandaardiseerd. In dit onderzoek staan vier programma’s voor ouderen met alcoholproblematiek centraal, met als koepelnaam Fris Verder. Het doel is een verkenning uit te voeren naar kenmerken en overeenkomsten/verschillen, mogelijkheden voor standaardisatie en evidente/werkzame elementen uit de literatuur, die we vergelijken met de kenmerken van de programma’s. Methode: We voerden een documentanalyse, interviews met professionals en een vergelijking met literatuur uit. Resultaten: Prominente overeenkomsten waren de volgende: de doelen die deelnemers en therapeuten/trainers nastreven (aanvaardbaar gebruik, waaronder abstinentie), de groepsgerichtheid van de programma’s, de programma’s waren gebaseerd op leefstijltraining/cognitieve gedragstherapie (CGT), ze werden uitgevoerd binnen de gespecialiseerde ggz door vooral verpleegkundigen, een spreiding van acht tot twaalf deelnemers, verwijzingen verliepen vooral via de eerstelijnszorg, en er was aandacht voor psycho-educatie en levensfaseproblematiek. Er waren ook verschillen: in groepsstructuur (open/gesloten), duur en theoretische uitgangspunten (leefstijltraining, CGT en/of acceptatie en toewijdingstherapie (ACT)). De volgende werkzame elementen uit de literatuur sluiten aan: geen betutteling, aandacht voor het vergroten van de individuele vaardigheden en informatieoverdracht, het beïnvloeden van sociale normen en het leveren van gepersonaliseerde feedback. Conclusie: De huidige programma’s bevatten alle effectieve elementen. Voor standaardisering wordt doorgevoerd en landelijk effectonderzoek wordt gedaan, is een evaluatie nodig om de effectiviteit van de programma’s te bepalen met alcoholgebruik als uitkomstmaat, en met aandacht voor een inventarisatie van Fris Verder in een eerdere fase in de zorgketen

Towards a new definition of the typical day in the alcohol use disorder identification test-consumption

Introduction: The standard screening instrument for alcohol problems in the current primary care, the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), contains a question about alcohol consumption "on a typical day." Since this is a term that leaves room for multiple interpretations and the differences between alcohol consumption on weekends and weekdays are not taken into account, this study examines whether the latter distinction improves the prediction validity of the screening instrument.Methods: A subgroup of 852 participants of the Dutch version of Dry January ("NoThanks") 2022 got the annual "NoThanks" survey, including questions about their alcohol consumption on weekends and weekdays, and the original ten AUDIT questions. The full AUDIT was used as golden standard. Sensitivity, specificity, and receiver operating characteristic curves were calculated for the original and different versions of the AUDIT-C.Results: Of all participants, 67 percent were hazardous drinkers (AUDIT ≥8) and 27 percent were harmful drinkers (AUDIT ≥16). For the original AUDIT-C, the cut-off score with the most balanced combination of sensitivity and specificity for hazardous drinking in men was 7 and in women was 6. For harmful drinking, this was 8 and 7, respectively. Certain versions performed equally well as the original. For harmful drinkers, the highest area under the receiver operating characteristic curve (AUROC) was 0.814 and 0.866 for the original AUDIT-C, for men and women, respectively. Only for hazardous drinking men, the AUDIT-C with weekend day (AUROC = 0.887) performed slightly better than the original.Conclusion: Distinguishing weekend- and weekday alcohol consumption in the AUDIT-C does not lead to better predictions of problematic alcohol use. However, the distinction between weekends and weekdays provides more detailed information for healthcare professionals and can be used without having to compromise too much on validity

Impeding and facilitating factors for the implementation of alcohol interventions in hospitals:A qualitative and exploratory study among Dutch healthcare professionals

BACKGROUND: Non-moderated alcohol use is more prevalent among hospitalized patients compared to the general population. However, many hospitals fail to find and intervene with people with alcohol problems. We aimed to conduct an exploration of impeding and facilitating factors experienced by healthcare professionals in implementation of alcohol interventions in Dutch general hospitals. In addition, we explored the alcohol interventions used in the selected hospitals and involved stakeholders. METHODS: Through a qualitative study, semi-structured telephone interviews were conducted with twenty healthcare professionals working in or in collaboration with six different general hospitals. RESULTS: Healthcare professionals indicated impeding and facilitating factors in the areas of motivation, knowledge and skills, patient characteristics, protocol, internal and external collaboration/support, resources, role suitability and societal support. Five different categories of approaches to identify and intervene with non-moderated alcohol use and 18 involved stakeholders from both inside and outside the hospital were found. CONCLUSIONS: Implementation of alcohol interventions for patients in Dutch general hospitals still seems to be in its infancy. Respondents emphasized the importance of one clear protocol on how to tackle alcohol problems within their hospital, repeated training on alcohol-related knowledge and skills, (clinical) “champions” that support healthcare professionals and developing and maintaining collaborations with stakeholders within and outside the hospital

Interdisciplinary collaboration in the treatment of alcohol use disorders in a general hospital department:A mixed-method study

Background !nterdisciplinary collaborations (i.e., where various disciplines work coordinated and interdependently toward shared goals) are stated to yield higher team effectiveness than multidisciplinary approaches (i.e., where various disciplines work in parallel within their professional boundaries) in somatic health care settings. Nevertheless, research is lacking on interdisciplinary approaches for alcohol use disorder (AUD) treatment of hospitalized patients as these types of approaches are still uncommon. This study aims to evaluate an innovative interdisciplinary AUD treatment initiative at a general hospital department by 1) identifying which and to what extent network partners are involved and 2) to explore how network partners experienced the interdisciplinary collaboration. Methods A mixed-method study was conducted, using 1) measures of contact frequency and closeness in a social network analysis and 2) semi-structured interviews, which were analyzed thematically. Respondents were network partners of an interdisciplinary collaboration in a general hospital department, initially recruited by the collaborations' project leader. Results The social network analysis identified 16 network partners, including a 'core' network with five central network partners from both inside and outside the hospital. The project leader played an important central role in the network and the resident gastroenterologist seemed to have a vulnerable connection within the network. Closeness between network partners was experienced regardless of frequency of contact, although this was especially true for the 'core' group that (almost) always consisted of the same network partners that were present at biweekly meetings. Interview data showed that presence of the 'core' network partners was reported crucial for an efficient collaboration. Respondents desired knowledge about the collaborations' effectiveness, and one structured protocol with working procedures, division of responsibilities and agreements on information sharing and feedback. Conclusions The design of this interdisciplinary collaboration has potential in improving the treatment of hospital patients with AUD and was evaluated positively by the involved network partners. Interdisciplinary collaborations may offer a critical solution to increase treatment rates of patients with AUD and should be adopted in hospitals on a larger scale. Research towards the effectiveness of interdisciplinary collaborations in the treatment of hospitalized patients with AUD is needed. A correction to this paper has been published: https://doi.org/10.1186/s13011-022-00492-