@article{ref1,
title="Cost-effectiveness of strategies to improve delivery of brief interventions for heavy drinking in primary care: results from the ODHIN trial",
journal="European journal of public health",
year="2019",
author="Angus, Colin and Li, Jinshuo and Romero-Rodriguez, Esperanza and Anderson, Peter and Parrott, Steve and Brennan, Alan",
volume="29",
number="2",
pages="219-225",
abstract="BACKGROUND: Screening and brief interventions (SBIs) for heavy drinking are an effective and cost-effective approach to reducing alcohol-related harm, yet delivery rates remain low. This study uses trial data to estimate the cost-effectiveness of alternative strategies to increase SBI delivery. <br><br>METHODS: Data from a large cluster-randomized trial were combined with the Sheffield Alcohol Policy Model, a policy appraisal tool, to estimate the cost-effectiveness of eight strategies to increase SBI delivery in primary care in England, Poland and the Netherlands: care as usual (control), training and support (TS), financial reimbursement (FR), referral of patients to an online brief intervention (eBI) and all combinations of TS, FR and eBI. cost-effectiveness was assessed from a healthcare perspective by comparing health benefits (measured in Quality-Adjusted Life Years) with total implementation costs and downstream healthcare savings for each strategy over a 30-year horizon and calculating Incremental cost-effectiveness ratios (ICERs). <br><br>RESULTS: All trialled strategies were cost-effective compared to control. TS combined with FR was the most cost-effective approach in England (more effective and less costly than control) and Poland (ICER €4632 vs. next-best strategy). This combination is not cost-effective in the Netherlands, where TS alone is the most cost-effective approach (ICER €3386 vs. next-best strategy). <br><br>CONCLUSIONS: Structured TS, financial incentives and access to online interventions are all estimated to be cost-effective methods of improving delivery of alcohol brief interventions. TS and FR together may be the most cost-effective approach, however this is sensitive to country characteristics and alternative BI effect assumptions. TRIAL REGISTRATION: ClinicalTrials.gov trial identifier: NCT01501552.<p /> <p>Language: en</p>",
language="en",
issn="1101-1262",
doi="10.1093/eurpub/cky181",
url="http://dx.doi.org/10.1093/eurpub/cky181"
}