Impact of practice, provider and patient characteristics on delivering screening and brief advice for heavy drinking in primary health care secondary analyses of data from the ODHIN five country cluster randomized factorial trial

BACKGROUND: The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training. OBJECTIVES: Undertaking secondary analysis of the five-country ODHIN study, we test: the extent to which practice, provider and patient characteristics affect the likelihood of patients being screened and advised; the extent to which such characteristics moderate the impact of training in increasing screening and advice; and the extent to which training mitigates any differences due to such characteristics found at baseline. METHODS: A cluster randomized factorial trial involving 120 practices, 746 providers and 46 546 screened patients from Catalonia, England, the Netherlands, Poland, and Sweden. Practices were randomized to receive training or not to receive training. The primary outcome measures were the proportion of adult patients screened, and the proportion of screen-positive patients advised. RESULTS: Nurses tended to screen more patients than doctors (OR = 3.1; 95%CI: 1.9, 4.9). Screen-positive patients were more likely to be advised by doctors than by nurses (OR = 2.3; 95%CI: 1.4, 4.1), and more liable to be advised the higher their risk status (OR = 1.9; 95%CI: 1.3, 2.7). Training increased screening and advice giving, with its impact largely unrelated to practice, provider or patient characteristics. Training diminished the differences between doctors and nurses and between patients with low or high-risk status. CONCLUSIONS: Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised. Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552

Attitudes and delivering brief interventions for heavy drinking in primary health care: analyses from the ODHIN five country cluster randomized factorial trial

Contains fulltext : 170028.pdf (publisher's version ) (Open Access)In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers' screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity

The ODHIN assessment tool: a tool to describe the available services for the management of hazardous and harmful alcohol consumption at the country and regional level

Optimizing Delivery of Health care Interventions (ODHIN) is an ongoing European project (EC, FP7) involving research institutions from 9 European countries using the implementation of Early Identification and Brief Intervention (EIBI) programmes for Hazardous and Harmful Alcohol Consumption (HHAC) in Primary Health Care (PHC) as a case study to better understand how to translate the results of clinical research into everyday practice. The Italian National Health Service (ISS) is the project leader of the Work Package 6 assessment tool. The aim of the ODHIN assessment tool is to formalise, operationalise and test the questionnaire developed under the PHEPA project in order to produce an update instrument to assess the extent of implementation of EIBIs for HHAC throughout PHC settings. The ODHIN assessment tool has been conceived as a semi-structured questionnaire for the identification of the state of the art, gaps and areas in the country that need further work and strengthening; to monitor the adequacy of brief intervention programmes for HHAC in order to provide recommendations to improve and optimize delivery of health care interventions. It analyses 24 questions distributed across 7 key sections. Data have been collected from 9 ODHIN collaborating countries (Catalonia, Czech Republic, Italy, Poland, Portugal, Slovenia, Sweden, The Netherlands and United Kingdom) and from other 14 European countries who have agreed to share their national experience with the ODHIN partners (Belgium, Croatia, Cyprus, Estonia, Finland, Fyrom-Yugoslav Republic of Macedonia, Germany, Greece, Iceland, Ireland, Latvia, Malta, Romania, and Switzerland). Preliminary data on the state of the art of the implementation and the extent of EIBI for HHAC throughout PHC settings across 23 European participating countries will be presented. Identified areas where services require development or strengthening across the participating countries as well as examples of good practices between countries will be also discussed

Onderwijsraamwerk palliatieve zorg 2.0

Met genoegen bieden we hierbij Onderwijsraamwerk palliatieve zorg 2.0 aan. Het Onderwijsraamwerkpalliatieve zorg 2.0 beschrijft de competenties ten behoeve van de palliatieve zorgverlening voorzorgprofessionals op niveau 2 tot en met 8 volgens het Nederlands kwalificatie raamwerk zoals vastgesteld door het Nederlands kwalificatieraamwerk (NLQF). Deze bestaat uit acht niveaus en één instroomniveau. De niveaus worden vastgesteld aan de hand van beschrijvingen van wat iemand weet en kan na voltooiing van het leerproces. Deze beschrijvingen van de niveaus van kennis, vaardigheden en zelfstandigheid en verantwoordelijkheid noemen we leerresultaten.  (www.nlqf.nl

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De Gesprekswijzer bij dementie of vergeetachtigheid is ontwikkeld binnen het conslortium Ligare m.m.v. de netwerken Palliatieve zorg en dementie in regio Drenthe, IJssel-Vecht en noordoost Overijssel.Deze is ontwikkeld voor zorgverleners in de eerstelijn: namelijk huisartsen, wijkverpleegkundigen en -verzorgenden, specialisten ouderen geneeskunde en casemanagers dementie

Prostaatkanker verstoort intimiteit en seksualiteit: Maak het bespreekbaar!

Ondanks dat prostaatkanker en de behandeling hiervan grote invloed hebben op de feitelijke mogelijkheden totintimiteit, seksualiteit, de persoon als geheel en op de relatie, is dit een weinig besproken onderwerp tussen arts/oncologieverpleegkundige en donateur en partner. Toch is er bij een groot deel van de donateurs en partners welbehoefte om dit te bespreken, maar zowel artsen en verpleegkundigen als donateur en partner vinden het dikwijlseen moeilijk bespreekbaar onderwerp. In opdracht van het bestuur van de ProstaatKankerStichting zijn de donateursmet prostaatkanker en hun partners bevraagd over de invloed van de ziekte op intimiteit en seksualiteit. De ervarenknelpunten zijn in kaart gebracht evenals de wensen en ervaringen met eigen oplossingen.Er is een vragenlijststudie (open en gesloten vragen) uitgevoerd onder donateurs van de ProstaatKankerStichting en hun partners.De vragen richtten zich zowel op de periode voorafgaand aan, als na de diagnose, zodat er een vergelijking kan wordengemaakt en er cijfermatige uitspraken kunnen worden gedaan over de impact van prostaatkanker op intimiteit enseksualiteit. Ook gepubliceerd op https://www.kanker.nl/organisaties/prostaatkankerstichting/8238-rapport-prostaatkanker-verstoort-intimiteit-en-seksualiteit DOI: http://dx.doi.org/10.14261/postit/0704D79E-218C-48E3-94A28D1E6E6667F

Original Publication: N.B.: When citing this work, cite the original article.

Implementing training and support, financial reimbursement, and referral to an internetbased brief advice program to improve the early identification of hazardous and harmful alcohol consumption in primary care (ODHIN): study protocol for a cluster randomized factorial tria

Attitudes and learning through practice are key to delivering brief interventions for heavy drinking in primary health care: Analyses from the ODHIN five country cluster randomized factorial trial

In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers' screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity