Cassidy, Paul

Crosland, Anne

Haining, Shona

Kaner, Eileen

Mccoll, Elaine

Mcgovern, Ruth

Newbury-birch, Dorothy

Speed, Chris

Tomson, Dave

Wilson, Graeme

Wray, Catherine

Addiction Science and Clinical Practice

English

PubMed

Health outcomes are key to patients and clinicians, but trials of alcohol brief intervention (BI) tend to focus on behavioral outcomes, while those finding positive effects on physical- or mental-health outcomes generally lack power to show robust effects. To test the feasibility of a randomized controlled trial of BI for either hypertensive or depressed primary-care patients who drink alcohol above recommended levels, records at 25 English primary-care practices were searched for adult patients with risky drinking and comorbid hypertension or depression. Eligible patients were randomized to either a hypertension or depression arm, then to a control or intervention condition. They were screened for at-risk drinking using the Alcohol Use Disorders Identification Test (AUDIT). Consenting respondents scoring &gt;7 on the AUDIT completed the Patient Health Questionnaire-9 (PHQ-9) (depression arm) or blood pressure measurement (hypertension arm) and received either BI or standard advice. At six-month follow-up, participants are again screened for alcohol use and comorbid condition. Seventeen practices (median adult patients, 7181; quartile 1, 5195, quartile 3, 8050) searched their databases. Fourteen percent of adult patients (median; quartile 1, 8.4%, quartile 3, 16.5%) drank above guidelines. Twenty percent of adult patients (median; quartile 1, 18.5%, quartile 3, 23.2%) were hypertensive, of which 5% (median; quartile 1, 3.9%, quartile 3, 5.3%) also drank heavily. Fourteen percent of adult patients had mild to moderate depression (median; quartile 1, 8.9%, quartile 3, 16.9%), of which 2% (median; quartile 1, 1.9%, quartile 3, 2.9%) also drank heavily. Of 2590 eligible patients, 633 (24%) completed the AUDIT. Thirty-five percent scored positively on the AUDIT in the hypertension arm, and 50% scored positively in the depression arm. Eighty patients were recruited to the hypertension arm, and recruitment to the depression arm is ongoing. Patients eligible for an RCT of BI for comorbid heavy drinking and hypertension or mild/moderate depression are identifiable in primary care records, though with variation among practices. Almost a quarter of these patients can be screened by mail for current alcohol use; more screen positively in the depression arm than in the hypertension arm. A trial in the hypertension arm seems most feasible

Teeside University's Research Repository

M E E T I N G A B S T R A C T Open AccessCom-BI-ne: preliminary results of a feasibility trialof brief intervention to improve alcoholconsumption and comorbid outcomes inhypertensive or depressed primary care patientsRuth McGovern1*, Graeme Wilson1, Catherine Wray1, Dorothy Newbury-Birch1, Elaine McCol1, Chris Speed1,Anne Crosland2, Paul Cassidy3, Dave Tomson4, Shona Haining5, Eileen Kaner1FromInternational Network on Brief Interventions for Alcohol Problems (INEBRIA) Meeting 2011Boston, MA, USA. 21-23 September 2011Health outcomes are key to patients and clinicians, buttrials of alcohol brief intervention (BI) tend to focus onbehavioral outcomes, while those finding positive efectson physical- or mental-health outcomes generaly lackpower to show robust efects. To test the feasibility of arandomized controled trial ofBIforeitherhypertensiveor depressed primary-care patients who drink alcoholabove recommended levels,records at 25 English pri-mary-care practices were searched for adult patients withrisky drinking and comorbid hypertension or depression.Eligible patients were randomized to either a hyperten-sion or depression arm, then to a control or interventioncondition. They were screened for at-risk drinking usingthe Alcohol Use Disorders Identification Test (AUDIT).Consenting respondents scoring >7 on the AUDIT com-pleted the Patient Health Questionnaire-9 (PHQ-9)(depression arm) or blood pressure measurement (hyper-tension arm) and received either BI or standard advice.At six-month folow-up, participants are again screenedfor alcohol use and comorbid condition. Seventeen prac-tices (median adult patients, 7181; quartile 1, 5195, quar-tile 3, 8050) searched theirdatabases. Fourteen percentof adult patients (median; quartile 1, 8.4%, quartile 3,16.5%) drank above guidelines. Twenty percent of adultpatients (median; quartile 1, 18.5%, quartile 3, 23.2%)were hypertensive, of which 5% (median; quartile 1, 3.9%,quartile 3, 5.3%) also drank heavily. Fourteen percent ofadult patients had mild to moderate depression (median;quartile 1, 8.9%, quartile 3, 16.9%), of which 2% (median;quartile 1, 1.9%, quartile 3,2.9%) also drank heavily. Of2590 eligible patients, 633 (24%) completed the AUDIT.Thirty-five percent scored positively on the AUDIT inthe hypertension arm, and 50% scored positively in thedepression arm. Eighty patients were recruited to thehypertension arm, and recruitment to the depression armis ongoing. Patients eligible for an RCT of BI for comor-bid heavy drinking and hypertension or mild/moderatedepression are identifiable in primary care records,though with variation among practices. Almost a quarterof these patients can be screened by mail for currentalcohol use; more screen positively in the depression armthan in the hypertension arm. A trial in the hypertensionarm seems most feasible.Author details1Institute of Health and Society, Newcastle University, Newcastle upon Tyne,UK.2Department of Pharmacy, Health and Welbeing, University ofSunderland, Sunderland, UK.3Teams Family Practice, Gateshead, UK.4Primary Care Mental Health Education and Development Unit, Newcastleupon Tyne, UK.5Department of Research and Development, National HealthService North of Tyne, Newcastle, UK.Published: 9 October 2012doi:10.1186/1940-0640-7-S1-A65Cite this article as:McGovernet al.:Com-BI-ne: preliminary results of afeasibility trial of brief intervention to improve alcohol consumptionand comorbid outcomes in hypertensive or depressed primary carepatients.Addiction Science & Clinical Practice20127(Suppl 1):A65.1Institute of Health and Society, Newcastle University, Newcastle upon Tyne,UKFul list of author information is available at the end of the articleMcGovernet al.Addiction Science & Clinical Practice2012,7(Suppl 1):A65htp:/www.ascpjournal.org/content/7/S1/A65© 2012 McGovern et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Atribution License (htp://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.

Com-BI-ne: preliminary results of a feasibility trial of brief intervention to improve alcohol consumption and comorbid outcomes in hypertensive or depressed primary care patients

Ruth McGovern

Graeme Wilson

Catherine Wray

Dorothy Newbury-Birch

Elaine McColl

Chris Speed

Anne Crosland

Paul Cassidy

Dave Tomson

Shona Haining

Eileen Kaner

Springer - Publisher Connector

Crossref

Addiction Science & Clinical Practice

McGovern, Ruth

Newbury-Birch, Dorothy

McColl, Elaine

Crosland, Ann

Kaner, Eileen F. S.

Edinburgh Research Explorer

     Edinburgh Research Explorer                                      Com-BI-ne: preliminary results of a feasibility trial of briefintervention to improve alcohol consumption and comorbidoutcomes in hypertensive or depressed primary care patientsCitation for published version:McGovern, R, Wilson, G, Wray, C, Newbury-Birch, D, McColl, E, Speed, C, Crosland, A, Cassidy, P,Tomson, D, Haining, S & Kaner, EFS 2012, 'Com-BI-ne: preliminary results of a feasibility trial of briefintervention to improve alcohol consumption and comorbid outcomes in hypertensive or depressed primarycare patients' Addiction Science & Clinical Practice, vol 7, no. Supplement 1.Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher final version (usually the publisher pdf)Published In:Addiction Science & Clinical PracticePublisher Rights Statement:© McGovern, R., Wilson, G., Wray, C., Newbury-Birch, D., McColl, E., Speed, C., ... Kaner, E. F. S. (2012).Com-BI-ne: preliminary results of a feasibility trial of brief intervention to improve alcohol consumption andcomorbid outcomes in hypertensive or depressed primary care patients. Addiction Science & Clinical Practice,7(Supplement 1).General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 20. Feb. 2015MEETING ABSTRACT Open AccessCom-BI-ne: preliminary results of a feasibility trialof brief intervention to improve alcoholconsumption and comorbid outcomes inhypertensive or depressed primary care patientsRuth McGovern1*, Graeme Wilson1, Catherine Wray1, Dorothy Newbury-Birch1, Elaine McColl1, Chris Speed1,Anne Crosland2, Paul Cassidy3, Dave Tomson4, Shona Haining5, Eileen Kaner1From International Network on Brief Interventions for Alcohol Problems (INEBRIA) Meeting 2011Boston, MA, USA. 21-23 September 2011Health outcomes are key to patients and clinicians, buttrials of alcohol brief intervention (BI) tend to focus onbehavioral outcomes, while those finding positive effectson physical- or mental-health outcomes generally lackpower to show robust effects. To test the feasibility of arandomized controlled trial of BI for either hypertensiveor depressed primary-care patients who drink alcoholabove recommended levels, records at 25 English pri-mary-care practices were searched for adult patients withrisky drinking and comorbid hypertension or depression.Eligible patients were randomized to either a hyperten-sion or depression arm, then to a control or interventioncondition. They were screened for at-risk drinking usingthe Alcohol Use Disorders Identification Test (AUDIT).Consenting respondents scoring >7 on the AUDIT com-pleted the Patient Health Questionnaire-9 (PHQ-9)(depression arm) or blood pressure measurement (hyper-tension arm) and received either BI or standard advice.At six-month follow-up, participants are again screenedfor alcohol use and comorbid condition. Seventeen prac-tices (median adult patients, 7181; quartile 1, 5195, quar-tile 3, 8050) searched their databases. Fourteen percentof adult patients (median; quartile 1, 8.4%, quartile 3,16.5%) drank above guidelines. Twenty percent of adultpatients (median; quartile 1, 18.5%, quartile 3, 23.2%)were hypertensive, of which 5% (median; quartile 1, 3.9%,quartile 3, 5.3%) also drank heavily. Fourteen percent ofadult patients had mild to moderate depression (median;quartile 1, 8.9%, quartile 3, 16.9%), of which 2% (median;quartile 1, 1.9%, quartile 3, 2.9%) also drank heavily. Of2590 eligible patients, 633 (24%) completed the AUDIT.Thirty-five percent scored positively on the AUDIT inthe hypertension arm, and 50% scored positively in thedepression arm. Eighty patients were recruited to thehypertension arm, and recruitment to the depression armis ongoing. Patients eligible for an RCT of BI for comor-bid heavy drinking and hypertension or mild/moderatedepression are identifiable in primary care records,though with variation among practices. Almost a quarterof these patients can be screened by mail for currentalcohol use; more screen positively in the depression armthan in the hypertension arm. A trial in the hypertensionarm seems most feasible.Author details1Institute of Health and Society, Newcastle University, Newcastle upon Tyne,UK. 2Department of Pharmacy, Health and Wellbeing, University ofSunderland, Sunderland, UK. 3Teams Family Practice, Gateshead, UK.4Primary Care Mental Health Education and Development Unit, Newcastleupon Tyne, UK. 5Department of Research and Development, National HealthService North of Tyne, Newcastle, UK.Published: 9 October 2012doi:10.1186/1940-0640-7-S1-A65Cite this article as: McGovern et al.: Com-BI-ne: preliminary results of afeasibility trial of brief intervention to improve alcohol consumptionand comorbid outcomes in hypertensive or depressed primary carepatients. Addiction Science & Clinical Practice 2012 7(Suppl 1):A65.1Institute of Health and Society, Newcastle University, Newcastle upon Tyne,UKFull list of author information is available at the end of the articleMcGovern et al. Addiction Science & Clinical Practice 2012, 7(Suppl 1):A65http://www.ascpjournal.org/content/7/S1/A65© 2012 McGovern et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.

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Com-BI-ne: preliminary results of a feasibility trial of brief intervention to improve alcohol consumption and comorbid outcomes in hypertensive or depressed primary care patients

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