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Pérula-Jiménez C, Romero-Rodríguez E, Parras-Rejano JM, de la Rubia AG, Gómez JB, de Torres LAP. Effectiveness of a training program for the management of risky alcohol use in primary care professionals based on motivational interviewing. Aten Primaria 2024; 56:102835. [PMID: 38086313 PMCID: PMC10726214 DOI: 10.1016/j.aprim.2023.102835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE To assess the effectiveness of a training program for Primary Care (PC) professionals developed to increase knowledge, attitudes, and skills for managing patients with risky alcohol use and in the motivational interview. DESIGN Multicenter, two-arm parallel, randomized, open-label controlled clinical trial. SETTING PC of the Andalusian Health Service. PARTICIPANTS The study was completed by 80 healthcare professionals from 31 PC centers. INTERVENTIONS In both experimental and control groups, a workshop on managing patients with risky alcohol consumption and the resolution of two videotaped clinical cases with standardized patients were conducted. The experimental group attended a workshop on motivational interviewing. MAIN MEASUREMENTS Knowledge about managing risky alcohol use, clinical performance in patients with this health problem, and assessment of the motivational interview. RESULTS Mean age was 39.50±13.06 - SD - (95% CI: 36.59-42.41); 71.3% (95% CI: 61.1-80.9%) were women. The average score of both groups in the knowledge questionnaire before the training program was 15.10±4.66, becoming 21.99±3.93 points after the training (95% CI: 5.70-7.92; p<0.001). The experimental group showed an average score of 18.53±13.23 before the intervention with the motivational interview and 28.33±11.86 after this intervention (p=0.002). In contrast, no significant variation was found in the score of the control group. CONCLUSIONS A training program aimed at PC professionals designed to increase knowledge on how to manage risky alcohol use and acquire communication skills in motivational interviewing is effective.
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Affiliation(s)
- Celia Pérula-Jiménez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía Hospital, University of Cordoba, Cordoba, Spain; Montoro Health Center, Andalusian Health Service, Cordoba, Spain
| | - Esperanza Romero-Rodríguez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía Hospital, University of Cordoba, Cordoba, Spain; Multiprofessional Teaching Unit of Family and Community Care of Cordoba, Spain
| | - Juan Manuel Parras-Rejano
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía Hospital, University of Cordoba, Cordoba, Spain; Sector Sur Health Center, Andalusian Health Service, Cordoba, Spain
| | - Ana González de la Rubia
- Cordoba and Guadalquivir Health District, Cordoba, Spain; General Emergencies Unit of the Regional University Hospital, Malaga, Spain
| | | | - Luis Angel Pérula de Torres
- Improvement and Evaluation Group, Program of Preventive Activities and Health Promotion (PAPPS), Semfyc, Barcelona, Spain.
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Romero-Rodríguez E, Pérula-Jiménez C, Fernández-López S, Cabello-Gracia G, Fernández-García JÁ, Pérula-de Torres LÁ, Roldán-Villalobos A, Leiva-Cepas F, Fernández-Márquez R, Parras-Rejano JM. Effectiveness of a brief motivational intervention in the management of risky alcohol use in primary care: ALCO-AP20 study protocol. Front Med (Lausanne) 2023; 9:1008832. [PMID: 36714106 PMCID: PMC9880185 DOI: 10.3389/fmed.2022.1008832] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/01/2022] [Indexed: 01/15/2023] Open
Abstract
Background Motivational interviewing (MI) could be a method for minimizing alcohol-related harm. The study aims to assess the effectiveness of a brief intervention, based on a MI, in patients with risky alcohol use attended in Primary Care (PC). Materials and methods A cluster-randomized, two-arm parallel, multicenter, open-label, controlled clinical trial. Fifty PC healthcare professionals from the province of Córdoba (Spain) will be randomized to one of the two study groups: (1) Experimental Group (EG): MI-based approach; (2) Control Group (CG): Usual care based on health advice. EG intervention: Professionals will receive a training program focused on MI, consisting of a training workshop and the use of pre- and post-workshop questionnaires to measure knowledge and skills acquired, as well as the degree of empathy, with a videotape of the health professionals with standardized patients, before and after the workshop, and subsequent training feedback. CG intervention: Workshop on the management of risky alcohol use based on health advice; participants will also complete the pre-and post-workshop questionnaires and be videotaped. Study population: Patients ≥ 14 years old with risky alcohol consumption (28 Standard Drink Units-SDU-/week in men and 17 SDU/week in women) or excessive alcohol use (≥ 6 SDU in men or ≥ 4 SDU in women, in less than 2 h). It would be necessary to include 110 subjects/group to find a difference of 20% between the percentage of patients in abstinence between EG (37%) and CG (20%), alpha error of 5%, and statistical power of 80%. Assuming a loss rate of 5% and the cluster design effect, the number of subjects to be recruited is estimated at 197/group. The follow-up period will be 12 months. The primary outcome variables will be the self-reported alcohol use level and the Alcohol Use Disorders Identification Test (AUDIT) questionnaire score. Discussion The study aims to demonstrate the effectiveness of the motivational approach in the comprehensive treatment of the patient with risky alcohol use, improving the empathy of the healthcare professionals and strengthening the healthcare professional-patient relationship to achieve the behavioral change of the patients with this problem in primary care consultations. Clinical trial registration ClinicalTrials.gov.
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Affiliation(s)
- Esperanza Romero-Rodríguez
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Multiprofessional Teaching Unit of Family and Community Care of Córdoba, Health District of Córdoba and Guadalquivir, Córdoba, Spain,Andalusian Health Service, Carlos Castilla del Pino Health Center, Córdoba, Spain,*Correspondence: Esperanza Romero-Rodríguez,
| | - Celia Pérula-Jiménez
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Andalusian Health Service, Montoro Health Center, Córdoba, Spain
| | - Sara Fernández-López
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Andalusian Health Service, Montoro Health Center, Córdoba, Spain,Andalusian Health Service, Peñarroya Health Center, Córdoba, Spain
| | | | - José Ángel Fernández-García
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Villarrubia Center, Occidente-Azahara Health Center, Córdoba, Spain
| | - Luis Ángel Pérula-de Torres
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Multiprofessional Teaching Unit of Family and Community Care of Córdoba, Health District of Córdoba and Guadalquivir, Córdoba, Spain,Luis Ángel Pérula-de Torres,
| | - Ana Roldán-Villalobos
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Andalusian Health Service, Carlos Castilla del Pino Health Center, Córdoba, Spain
| | - Fernando Leiva-Cepas
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | | | - Juan Manuel Parras-Rejano
- Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain,Andalusian Health Service, Sector Sur Health Center, Córdoba, Spain
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Romero-Rodríguez E, Pérula de Torres LÁ, Fernández García JÁ, Roldán Villalobos A, Ruiz Moral R, Parras Rejano JM. Impact of a primary care training program on the prevention and management of unhealthy alcohol use: A quasi-experimental study. PATIENT EDUCATION AND COUNSELING 2019; 102:2060-2067. [PMID: 31178165 DOI: 10.1016/j.pec.2019.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To assess the impact of a training program targeted to Primary Care (PC) professionalson the acquisition of communication skills, attitudes, and knowledge about the prevention and management of unhealthy alcohol use. METHODS A quasi-experimental, pre- and post-intervention study was performed in PC centers of Cordoba (Spain). Family doctors, residents and nurses participated in the study. The intervention was based on a motivational interviewing training program, which consisted in a workshop on learning skills, attitudes and knowledge about the alcohol management. PC providers were videotaped with a standardized patient in order to check the clinical and communication competencies acquired. A descriptive, bivariate and multivariate analysis was carried out (p < 0.05). RESULTS PC providers' communication skills and attitudes showed significant improvements in the variables studied (p < 0.001), as well as in the clinical interview evaluation parameters. CONCLUSION The present study reveals the impact of a training program targeted to PC professionals on communication skills, attitudes, and knowledge about the prevention and management of patients with unhealthy alcohol use. PRACTICE IMPLICATIONS Training activities targeted to PC providers represent a valuable strategy to improve communication skills, attitudes and knowledge of these professionals in their clinical practice.
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Affiliation(s)
- Esperanza Romero-Rodríguez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
| | - Luis Ángel Pérula de Torres
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Teaching Unit of Family and Community Medicine, Health District of Cordoba and Guadalquivir, Cordoba, Spain; Program of Preventive Activities and Health Promotion -PAPPS- (semFYC). Barcelona, Spain
| | - José Ángel Fernández García
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Villarrubia Health Center, Andalusian Health Service, Cordoba, Spain
| | - Ana Roldán Villalobos
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Teaching Unit of Family and Community Medicine, Health District of Cordoba and Guadalquivir, Cordoba, Spain; Carlos Castilla Del Pino Health Center, Andalusian Health Service, Cordoba, Spain
| | - Roger Ruiz Moral
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Francisco de Vitoria University, Madrid, Spain
| | - Juan Manuel Parras Rejano
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Villanueva del Rey Health Center, Andalusian Health Service, Cordoba, Spain
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