Alcohol Policy UK

Findings bulletins: brief interventions implementation, improving mental health and SUD care, residential evidence & more

Recent bulletins from the Findings drug and alcohol bank:

Major trial of ways to extend brief alcohol interventions

Could combinations of three strategies – training and support, financial reimbursement, and the opportunity to refer patients to a website – effectively and cost-effectively boost delivery of brief alcohol interventions in five European countries, including England? The aim was to find the best way to narrow the gap in primary care between the number of patients who could benefit from these interventions and those who receive them. An important trial whose findings we analyse in depth, and for which we have updated our analysis of the cost-effectiveness findings.

What would better mental health and substance use care look like?

Findings bulletins: residential treatment reviewed, brief intervention implementation, domestic violence & more

Recent bulletins from the Findings drug and alcohol bank: 

Glass half full for residential/inpatient treatment of drinking problems in England

For the small cohort of people with severe and chronic drinking problems, this study found that residential and inpatient treatments were effective over half the time based on the important public health indicator of not just completing treatment successfully, but also not returning to treatment within six months. Ground-breaking and important as this is, the findings refer only to people who accessed treatment. What does this mean for those whose vulnerabilities make them eligible for intensive support but go hand-in-hand with significant barriers to treatment?

Can the disappointing roll-out of brief alcohol interventions be cost-effectively turned around?

Updated brief intervention CQUIN for 2019-20

NHS England have updated the national Commissioning for Quality and Innovation (CQUIN) for 2019–2020, which incentivises hospitals and other settings to deliver alcohol 'Identification & Brief Advice' (IBA). See here for the updated Public Health England (PHE) Health Matters guidance.

CQUINs allocate a percentage of the total value of an NHS contract with a provider for sufficient delivery of specified activity. The national CQUIN covers activities including alcohol and tobacco interventions under a prevention of ill health theme.

Findings bulletins: IBA in primary care update, MUP impact on low income groups, licensing outcomes, sexual minority harms

Recent bulletins from the Findings drug and alcohol bank: 

Review finds that brief alcohol advice in relatively normal primary care practice reduces drinking

Update of a key document forming the basis of claims that brief interventions work in ‘real-world’ settings. Combined findings from randomised trials confirm that brief advice in primary care can reduce drinking; now the issue is whether in normal practice those benefits will be realised on a grand enough scale to create public health gains.

Could low income areas experience the greatest health benefits of a minimum pricing policy?

Primary Care brief interventions 'cost effective': a future priority?

A new study has reported the levels of alcohol brief intervention in Primary Care are 'extremely low' in England and investment through training and incentives would be cost-effective. The study therefore raises questions over what has happened with efforts to implement brief interventions in Primary Care and whether they will be considered as part of the forthcoming national alcohol strategy.

Alcohol interventions and support within hospital settings: PHE & CLAHRC resources

Two new resources supporting the commissioning and delivery of alcohol interventions and support within hospital settings have been released.

Developing pathways for referring patients from secondary care to specialist alcohol treatment

The new Public Health England (PHE) resource to support the development of pathways for referral and care and for alcohol dependent patients. Given the recently initiated CQUIN to incentivise routine alcohol screening via Identification and Brief Advice (IBA), hospitals will expect to identify a proportion of dependent drinkers and should ensure they can offer the best possible referral and support.

The main sections of the resource include:

Digital interventions for reducing alcohol consumption: do they work and if so, how and why?

In this guest post, Dr Claire Garnett, a Research Associate in UCL’s Tobacco and Alcohol Research Group, discusses the findings from a recent systematic review of digital interventions for alcohol reduction.

Digital interventions are those delivered via computer technology, which includes smartphone apps, websites, computer programs, wearable devices, and telecommunications, that aim to promote behaviour change. Digital interventions for alcohol reduction have a number of advantages over the traditional face-to-face brief interventions such as: having a low cost per user, greater reach, can avoid the stigma associated with receiving help in person and are highly convenient in that they can be used as and when the individual wants. However, there is little evidence as to whether digital interventions are effective at reducing alcohol consumption.

Hopsitals gear up for brief intervention CQUIN delivery

Hospitals across England are preparing for the introduction of the ‘preventing ill health by risky behaviours – alcohol and tobacco CQUIN’, which requires alcohol and smoking brief interventions to be delivered to hospital inpatients from 1st April 2018.

Public Health England have produced a series of resources to support implementation including infographics, videos and a frontline staff briefing. Since April 2017 certain Mental Health providers have being delivering brief interventions through the Commissioning for Quality and Innovation CQUIN scheme 2017 to 2019, which PHE report 88 per cent (51/58) of eligible providers indicated they had signed up to deliver. PHE have also published two case studies including one at University Hospital Southampton where IBA is being delivered to patients by pharmacy technicians, and another at South London and Maudsley NHS Foundation Trust.

Findings bulletins: question marks over medications, single 'brief advice' impact, alcohol & families

Recent bulletins from the Findings drug and alcohol bank:

No clear role for medications in less dependent drinkers

In 2013 nalmefene was authorised for moderating drinking among patients not in need of detoxification, extending pharmacotherapy to less dependent drinkers. Though uniquely authorised for this purpose, this review found other (and probably cheaper) drugs have been just as or possibly more effective, but for none was there high quality evidence, and for some substantial safety concerns.

Can drinking be reduced in a single session?

Review finds that heavy-drinking college students respond best to single-session brief interventions that use motivational and/or personalised feedback approaches. Key question is whether the drinking reductions – which the authors acknowledge are ‘modest’ in clinical terms – would be replicated in real life (as opposed to study) settings.

IAS Alert October 2017: parental drinking, MUP, Global Alcohol Policy Conference 2017, SBI manual & more

The latest Institute of Alcohol Studies (IAS) Alcohol Alert: October 2017 is now available (here for PDF version). Read the editorial here and articles below:

• Report highlights childrens’ anxiety about parents’ drinking
• Wales introduces minimum unit price for alcohol
• GAPC2017 – Mobilising for change
• AA Ireland welcomes tougher drink-drive rules
• Most drivers want a lower drink-drive limit
• Alcohol-related deaths will go uncounted in new UK scheme
• Politicians pledge to ‘Protect the Protectors’
• Alcohol a driver of suicides in Armed Forces
• Licensing figures 2017: premises called to review – why the decline?
• Wealth gap remains among Scots drinkers
• Nurse-led service can reduce alcohol-related harm
• WHO Europe launches SBI training manual
• SHAAP launches guidance for treating ARLD