World Health Organization Collaborative Project on Identification and Management of Alcohol-related Problems

 in Primary Health Care: Phase IV

 

Development of Country-wide Strategies for Implementing Early Identification and Brief Alcohol Intervention in Primary Health Care.

Denmark

[Customisation] [Communications] [Strategic Alliance] [Demonstration Project]

In addition to the below information there is a page contains a progress report presented at a Meeting of Phase IV Investigators in Geneva on the 24th - 27th may 2002.   

Click here to see the report: [Progress Report]:  

Final Country Chapter, January 2006

Collaborative Centre: 

Central research Unit of General Practice, Panum Institute, Blegdamsvej 3, DK-2200 Kobenhaven N, Denmark

Chief Investigators: 

Serrve Barfod, Eli Sorensen, Annelise Zachariassen, Per Vendsborg.

Geographical Area in which Implementation Strategy will be Applied:

Frederiksborg County

Starting Date: 

September 1st 1999

Completion Date: 

September 1st 2004

Project Strands and Milestones:

  • 1 Year: Planning in detail

  • 2 Year: Implementation

  • 3 Year: Implementation and follow-up

  • 4 Year: Follow up and evaluation

  • 5 Year Evaluation and report

Proposed Funding Sources: 

Health Ministry Foundation for Alcohol Studies

Local Support: 

Quality development resources

CUSTOMIZING MATERIALS AND SERVICES

Brief Intervention Package, including delivery systems:

Focus group meetings with GPs

Early Identification: 

Focus group meetings with GPs

Brief Intervention process: 

Focus group meetings with GPs

Training of Primary Health Care Staff: 

Focus group meetings with GPs to select best methods of training

Data Analysis: 

Consultant help from Central Research Unit

REFRAMING UNDERSTANDING OF ALCOHOL ISSUES:

We have chosen a scientific design as we collect qualitative and qualitative measures before and after the implementation into general practice of the method of early detection and brief intervention. The same will model will be used in the control area.

In this design we do not expect to measure any significant changes in community variables. The effects of the intervention may have a long latency (many years), e.g. hospitalisation for cirrhosis of the liver. Hence, our focus will be on health professionals only, where we might expect significant changes in behaviour.

ESTABLISHING LEAD ORGANISATIONS AND BUILDING STRATEGIC ALLIANCES

By seminars, meetings and workshop professionals from the following professionals from the following organisations will be invited to improve the alliance with general practice:

  • Public out patient alcohol clinics

  • Other institutions for treatment of people with alcohol problems

  • Departments of psychiatry

  • District psychiatry centres

  • Specialists of psychiatry with private practice

  • Municipal administration of social services

  • Municipal home nurses

DEMONSTRATION PROJECT (S)

Location:

Frederiksborg county with 250.00 inhabitants and 230 GPs

Projected Start Date: 

Sept 1 1999

Projected Completion Date: 

Sept 1 2004

Design of project:

Quasi-experimental comparison between an area with intensive implementation and an area without such measures. Before-after study in each area.

Outcome Measures:

Evaluation in general practice.

1. Quantitatively: before and after implementation

  •  Number of GPs using brief intervention vs. number of GPs contacted by the project-consultant.

  • Number of consultations were patients are asked about alcohol vs. total number of consultations

  • Number of consultations were alcohol problems  are detected vs. number of consultations were patients are asked about alcohol

  • Number of patients subject to brief intervention vs. number of patients where alcohol problems are discovered

2. Qualitatively:

  • Interviews with GPs on their routine and attitude

  • Semi-structured interviews with selected GPs on knowledge , attitudes, managements etc.

Evaluation in society:

1. Quantitatively:

  • Number of patients referred from GPs to institutions for alcohol treatment

  • Number of patients referring themselves to alcohol clinics

  • Number of alcohol-related deaths and hospitalisations.

2. Qualitatively:

  • Semi-structured interviews with selected patients

Economic Analysis:

Help will be needed from an expert in health economics.

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