Extrait

Background and study aims Harmful alcohol consumption is a major public health problem, and is the third leading cause of disability in Europe. The Department of Health estimates that alcohol costs the NHS in England £3.5 billion each year, 80% of which through inpatient and emergency care costs. Alcohol-related hospital admissions have doubled in the last eight years to over 1.2m per annum in England, a quarter (304,000) of which were for conditions wholly attributable to alcohol. Reducing alcohol related admissions is therefore a key public health target in England. An intervention called assertive outreach treatment (AOT) has been developed to target the patients who have the most frequent alcohol related hospital admissions. AOT emphasises active engagement over an extended period and has several features, including rapid access to services, a small caseload, a high ratio of community to office-based appointments, assertive engagement (e.g. with multiple attempts) and a shared care approach, with care coordinators working within a multidisciplinary team that meets frequently. The aim of this study is to assess the effectiveness and cost effectiveness of AOT plus care as usual (CAU) compared with CAU alone for patients who have frequent alcohol related admissions. Who can participate? Adults with alcohol dependence who have been admitted to hospital at least 3 times in the last 12 months, with at least one admission attributable to alcohol. What does the study involve? Participants are randomly allocated to one of two groups. Those in the first group receive care as usual. Those in the second group receive assertive outreach treatment plus care as usual. This involves receiving support from the assertive outreach team, in the form of regular contact with the care co-ordinator over 12 months. The appointments take place in the participant’s preferred location (home, local neighbourhood or at the service). Participants in both groups complete a number of questionnaires at the start of the study and then again after 6 and 12 months to assess alcohol consumption. What are the possible benefits and risks of participating? Participants may experience health benefits if the treatment helps them to cut down their alcohol consumption. There is a small risk that some participants may feel uncomfortable filling in the study questionnaires. Where is the study run from? 1. King's College Hospital (UK) 2. South London and Maudsley NHS Trust (UK) 3. Guy's Hospital (UK) 4. St Thomas' Hospital (UK) When is the study starting and how long is it expected to run for? January 2013 to December 2018 Who is funding the study? 1. National Institute for Health Research (UK) 2. Guy’s and St Thomas’ Charity and National Institute for Health Research (UK) Who is the main contact? Professor Colin Drummond [email protected]

Critère d'inclusion

• Specialty: Mental Health, Primary sub-specialty: Addictions - alcohol; UKCRC code/ Disease: Mental Health/ Unspecified mental disorder

Liens

• isrctn