Identification and treatment of alcohol use disorder with the 15-method – adapting the method to outpatient psychiatry

Background
Alcohol use is a large risk factor for public health with substantial health loss worldwide. One in six Danes exceeds the national recommended limits for weekly alcohol consumption. The prevalence of alcohol use disorders (AUD) among psychiatric patients in Denmark is 25% – making AUD the most dominating substance use disorder (SUD) in every psychiatric category.

The treatment gap is, however, large. Only one in eight Danes with an AUD seeks treatment. The healthcare sector has thus been viewed as an obvious platform for identifying patients with alcohol problems. However, it has proven difficult to implement efficient models for screening and treatment of AUD, largely due to barriers among the staff, such as a lack of knowledge, experience, and time.

The “15-method” is a practicable approach for meeting these challenges. The 15-method is a simple model for identifying and treating alcohol problems and has been found to be well-received by general practitioners in Danish primary care. The present study will assess whether the 15-method is a feasible method in an outpatient psychiatric setting as well.

Methods 
From March - May 2024 a qualitative feasibility study of the 15-method is conducted in a Danish outpatient psychiatric clinic, utilizing interviews and participatory design. The feasibility study consists of three phases: 1) Adjustment of the Danish version of the 15-Method for primary care into a version considered suitable for outpatient psychiatry, 2) Testing if the adapted version is feasible for clinical staff in the outpatient psychiatric hospital and how it is received by the patients, 3) An evaluation of the 15-method based on the results from phase 2 and potential final adjustments of the method.

Results
Ten staff members and 10 patients from an outpatient psychiatric hospital participate in the adaption and evaluation of the method. We will present the key elements of the adapted 15-method, focusing on the needed adjustments identified in collaboration with clinical staff and patients in the psychiatric hospital. We will also present our findings and experiences from the involvement of staff and patients; the reception of the 15-method and the assessment of the method’s feasibility.

Conclusion
The 15-method has the potential to make alcohol treatment more available for psychiatric patients. If the method proves feasible and meaningful to patients and staff in the outpatient psychiatric hospital, next step is an effectiveness study, focusing on outcomes of the 15-method when implemented in psychiatric hospitals.  

This submission was prepared in collaboration with Anders Hammarberg, Anette Søgaard Nielsen, Sven Andréasson, and Jennie Sundbye, who have submitted abstracts on related studies.

Acknowledgement: The study is funded by an unconditional grant from TrygFonden.