Category: Evidence based treatment

Helping agonist patients with alcohol problems: A NEW guide for primary care staff

What should doctors do differently when screening for alcohol use and delivering brief interventions for agonist patients in primary care? General principles remain the same like for other people, but:
  1. the screening and treatment processes should be more systematic and proactive in all problem drug users, especially in those with concurrent chronic illnesses or psychiatric co-morbidity,
  2. lower thresholds should be applied for both identification and intervention of problem alcohol use and referral to specialist services,
  3. special skills and specialist supervision is required if managing persistent/dependent alcohol use in primary care.

What agonist patients think about alcohol #SBIRT? A new paper out now

What do patients attending family physicians for methadone treatment think of screening and brief interventions for alcohol problems? Except for being screened at the intake, few recalled routine screening or treatment, and felt that primary care staff should be more proactive when addressing excessive drinking.
Check out our new qualitative study (www.biomedcentral.com/1471-2296/14/98/abstract)

Cochrane conference in Ireland: Making an impact? (#cochraneevidence)

Another conference’s over. This one is among my favourites because it’s about Cochrane collaboration. It attracted around 70 delegates who came to Queens university in Belfast this year.

Lots of interesting discussions with colleagues, e.g. how do you define an expert? or What’s an ideal composition of an expert panel or a committee? It would seem that senior academics, professors or directors are the right experts, but truth may not be so straightforward. Some of these senior people may be simply too busy or think they know it all. Inclusion of junior staff, post-docs, nurses or systematic review authors on expert panels is better because they lack the weaknesses mentioned earlier. What more, they may be the most hard working group in the academia or research in general. Because of that, hey are likely to be dedicated members of expert panels.

A whole different discussion was going on between the conference delegates on Twitter:

Hearing and talking about my/ fellow reviewers’ experiences of doing SRs made me think about what was special different about my own experience or review:

  • it was my first review
  • I’ve applied a truly systematic approach, which received praise from my quality advisor (see previous blog post)
  • it was real quick
  • I had multiple presentations and non-peer reviewed articles about the review
  • I worked for 2 universities
  • I’ve used EPPI-reviewer software, unlike many of my fellow colleagues
  • I’ve used a lot of support from our health information specialists
  • it was done within a unique Health Research Board of Ireland (HRB) fellowships scheme
  • I couldn’t have done it without a strong support from my co-authors and the Cochrane Drugs and Alcohol review group (CDAG)

So, what impact had this year’s Cochrane in Ireland conference on me? It helped me to regain my research identity again.
…and the sky in Belfast was grey, yet again.
A copy of my cochrane review can be accessed here:

Why Empirically Supported Psychosocial Treatments Are Important for Drug Users? New research project

UL researchers have been awarded €300,000 by Ireland’s Health Research Board to develop and evaluate psychosocial interventions for drug and alcohol users in primary care. Psychosocial interventions are described as aimed at reducing consumption behaviour or alcohol-related problems by using psychological approaches

UL Researchers Undertake Study to Evaluate Impact of Psychology Based Treatments for Drugs Users

Principal Investigator and Professor of General Practice at UL, Walter Cullen, explains: “The focus of this study is to evaluate the impact of psychology based treatments as opposed to the approach of medicating patients dealing with drug and alcohol addiction. There is a significant knowledge gap in this area internationally and we hope this study will help practitioners in Ireland assist their patients to deal with this issue.”
 
Led by Dr Jan Klimas Post-doctoral Researcher at the Centre for Interventions in Inflammation, Infection & Immunity (4i) (http://www.4i.ie) hosted by University of Limerick’s Graduate Entry Medical School, the study involves collaborators from a wide range of disciplines and agencies as well as international experts from the UK, USA and Australia.
 
The study, entitled ‘‘Are Psychosocial Interventions Effective for Problem Alcohol Use among Problem Drug Users’ (the PINTA study) will involve over 20 practices in the Midwest and Eastern regions.
 
The Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, UL brings together a multidisciplinary team of researchers focused on developing studies that impact health outcomes.
 
Director of the Centre, Professor Colum Dunne, complimented the team that successfully competed for this funding, adding “this study builds on previous work, also funded by the HRB, that qualitatively explored patients’ and practitioners’ experiences of problem drug and alcohol use. In a recent Cochrane review we identified gaps in the currently available scientific evidence relating to effectiveness treatments for problem alcohol use. This new study will add considerably to that field of practice.”
Read more here …