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Open Access Study protocol

A randomised controlled trial of extended brief intervention for alcohol dependent patients in an acute hospital setting (ADPAC)

Lynn Owens1*, Graham Butcher2, Ian Gilmore3, Ruwanthi Kolamunnage-Dona4, James Oyee4, Liz Perkins5, Tom Walley6, Paula Williamson4, Ken Wilson7 and Munir Pirmohamed1

Author Affiliations

1 The Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool (1-5 Brownlow Street) Liverpool (L69 3GL) UK

2 Department of Gastroenterology, Southport & Ormskirk NHS Trust (Town Lane) Southport (PR8 6PN) UK

3 Dept of Gastroenterology, Royal Liverpool & Broadgreen University Hospital Trust (Prescot Street) Liverpool (L7 8XP) UK

4 Department of Biostatistics, Faculty of Health & Life Sciences, University of Liverpool, (Brownlow Street) Liverpool (L69 3GS) UK

5 Department of Health and Community Care Research Unit, University of Liverpool, (Brownlow Hill) Liverpool (L69 3GB) UK

6 Department of Health Service Research, University of Liverpool (70 Pembrooke Place) Liverpool (L69 3GL) UK

7 Division of Psychiatry, Institute of Psychology Health and Society, University of Liverpool (Brownlow Street) Liverpool (L69 3GL) UK

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BMC Public Health 2011, 11:528  doi:10.1186/1471-2458-11-528

Published: 4 July 2011

Abstract

Background

Alcohol dependence affects approximately 3% of the English population, and accounts for significant medical and psychiatric morbidity. Only 5.6% of alcohol-dependent individuals ever access specialist treatment and only a small percentage ever seek treatment. As people who are alcohol dependent are more likely to have experienced health problems leading to frequent attendance at acute hospitals it would seem both sensible and practical to ensure that this setting is utilised as a major access point for treatment, and to test the effectiveness of these treatments.

Methods/Design

This is a randomised controlled trial with a primary hypothesis that extended brief interventions (EBI) delivered to alcohol-dependent patients in a hospital setting by an Alcohol Specialist Nurse (ASN) will be effective when compared to usual care in reducing overall alcohol consumption and improving on the standard measures of alcohol dependence. Consecutive patients will be screened for alcohol misuse in the Emergency Department (ED) of a district general hospital. On identification of an alcohol-related problem, following informed written consent, we aim to randomize 130 patients per group. The ASN will discharge to usual clinical care all control group patients, and plan a programme of EBI for treatment group patients. Follow-up interview will be undertaken by a researcher blinded to the intervention at 12 and 24 weeks. The primary outcome measure is level of alcohol dependence as determined by the Severity of Alcohol Dependence Questionnaire (SADQ) score. Secondary outcome measures include; Alcohol Use Disorders Identification Test (AUDIT) score, quantity and frequency of alcohol consumption, health-related quality of life measures, service utilisation, and patient experience. The trial will also allow an assessment of the cost-effectiveness of EBI in an acute hospital setting. In addition, patient experience will be assessed using qualitative methods.

Discussion

This paper presents a protocol for a RCT of EBI delivered to alcohol dependent patients by an ASN within an ED. Importantly; the trial will also seek to understand patients' perceptions and experiences of being part of a RCT and of receiving this form of intervention.

Trial registration number

ISRCTN: ISRCTN78062794