Related Experiment Video
Updated: Jun 11, 2025
Murine Drinking Models in the Development of Pharmacotherapies for Alcoholism: Drinking in the Dark and Two-bottle Choice
Published on: January 7, 2019
Supporting alcohol brief interventions and pharmacotherapy provision in Australian First Nations primary care:
Monika Dzidowska1,2,3, K S Kylie Lee4,5,6,7,8, James H Conigrave4,5,6
1Faculty of Medicine and Health, Discipline of Addiction Medicine, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Lev 6, King George V Building (C39), Sydney, NSW, 2006, Australia. monika.dzidowska@sydney.edu.au.
Introduction:
Primary care provides an important opportunity to detect unhealthy alcohol use and offer assistance but many barriers to this exist. In an Australian context, Aboriginal Community Controlled Health Services (ACCHS) are community-led and run health services, which provide holistic primary care to Aboriginal and Torres Strait Islander peoples. A recent cluster randomised trial conducted with ACCHS provided a service support model which showed a small but significant difference in provision of 'any treatment' for unhealthy alcohol use. However, it was not clear which treatment modalities were increased.
Aims:
To test the effect of an ACCHS support model for alcohol on: (i) delivery of verbal alcohol intervention (alcohol advice or counselling); (ii) prescription of relapse prevention pharmacotherapies.
Methods:
Intervention: 24-month, multi-faceted service support model.
Design:
cluster randomised trial; equal allocation to early-support ('treatment') and waitlist control arms.
Participants:
22 ACCHS.
Analysis:
Multilevel logistic regression to compare odds of a client receiving treatment in any two-month period as routinely recorded on practice software.
Results:
Support was associated with a significant increase in the odds of verbal alcohol intervention being recorded (OR = 7.60, [95% CI = 5.54, 10.42], p < 0.001) from a low baseline. The odds of pharmacotherapies being prescribed (OR = 1.61, [95% CI = 0.92, 2.80], p = 0.1) did not increase significantly. There was high heterogeneity in service outcomes.
Conclusions:
While a statistically significant increase in verbal alcohol intervention rates was achieved, this was not clinically significant because of the low baseline. Our data likely underestimates rates of treatment provision due to barriers documenting verbal interventions in practice software, and because different software may be used by drug and alcohol teams. The support made little impact on pharmacotherapy prescription. Changes at multiple organisational levels, including within clinical guidelines for primary care, may be needed to meaningfully improve provision of alcohol treatment in ACCHS.
Trial Registration:
ACTRN12618001892202 (retrospectively registered on 21/11/2018).
More Related Videos
05:40The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans
Published on: April 28, 2022
09:29Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
Published on: August 4, 2022
Related Concept Videos
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:21Factors Affecting Drug Response: Overview
01:26Drug Administration and Therapy Phases: Overview
The pharmaceutical phase focuses on leveraging the physicochemical properties of the drug to design and manufacture an effective product. Variants include orally administered tablets or capsules, topical creams or ointments, and parenteral-delivery solutions or emulsions.
The pharmacokinetic phase...
01:12Analysis of Population Pharmacokinetic Data
01:30Combined Effects of Drugs: Antagonism
The most common type is receptor antagonism, where one drug acts as an antagonist to block the effects of another drug by...
01:27CNS Depressants: Alcohol and Nicotine