Identification and treatment of AUD with the 15-method – Evaluating effectiveness of the method in Danish primary care
The 15-method is a targeted screening and treatment approach for alcohol problems in primary care. The 15-method used in primary care has proven as effective as specialized treatment for mild to moderate alcohol dependence in Sweden for treatment seeking patients. A feasibility study of the method in Danish primary care indicated that it could work in the Danish primary healthcare with few adjustments to improve its contextual fit. Whether implementation of the 15-method will lead to increased focus on alcohol in primary healthcare, i.e. if the targeted screening component of the method functions as intended, and whether the method will impact on the patients’ alcohol intake is yet to be seen and is the objective of the study “Identification and Treatment of Alcohol Problems in Primary Care (iTAPP-study).
Design: The iTAPP study is a stepped wedge cluster randomized controlled trial, involved 21 primary health care practices (clinics). It involves a three-month baseline phase with no clinics being exposed to training in the Thereafter, three times with three months in between, a cluster of 6-7 clinics will be randomized receiving training in the 15-method. When all three clusters have become trained clusters, a concluding follow-up phase is set for three months. The total duration of the trail is thus 19 months. Throughout the trial period, the implementation of the method in the practices will be followed and evaluated.
Data: A questionnaire will be sent to patients >18 years affiliated to the participating clinics practices four times during the study period by means of e-boks, collecting data on lifestyle in general and on alcohol use in particular. Healthcare professionals in the participating general practices will register any event of alcohol related conversations in their patient filing system by a predefined code of text during the whole period under study. Data on prescriptions on pharmacological treatment for alcohol use disorder will be collected from the Danish National Prescription Registry. Focus groups interviews with staff will be performed to assess implementation of the method.
Preliminary results: A total of twenty clinics are enrolled in the study, involving approximately 60.000 patients. At present, three of the four clusters have been trained in the method, and the last cluster will be trained in March. Two surveys among the patients attached to the practices has been performed, with response rates of 30.1 % (baseline) and 31.4% (after five months). The next surveys will be performed in February and August 2024.
Conclusion: The project is an ongoing large-scale stepped wedge cluster randomized controlled study of the 15-method in primary care. We aim to present preliminary results from the project at the conference.
This submission was prepared together with J. Sundbye, A. Hammarberg, S. Andréasson, and K. Volke, who have submitted related abstracts on the 15-method.
Acknowledgement: The study is funded by Trygfonden.
