Short summary

An increase in individuals with alcohol dependence, receiving specialized alcohol treatment, will be of major importance for society's response to alcohol problems and its consequences. A first approach would be to identify and recruit patients from general hospitals, where the proportion of inpatients with alcohol use disorders range between 16 % and 26 %.

Rationale

The target group of the present study is patients suffering from alcohol dependence admitted to a general hospital located in an urban area and a general hospital located in a rural area. The main objective of the study is to develop strategies, which increase the likelihood that patients report for outpatient alcohol treatment after discharge. It is likely that an optimization of the transfer procedure between hospital and outpatient clinic will mean that more patients will be engage in psychosocial treatment for their alcohol abuse, which will improve the prognosis, reduce re-admissions and the use of hospital beds and, thus have positive economic consequences.

The Relay Model involves the following procedures: A therapist from the local alcohol outpatient clinic comes to the participating departments at the general hospitals and informs patients of the significance of continuing an outpatient aftercare treatment. The therapist informs the patients about treatment and presents the patients with an "attendance contract". The attendance contract contains facts about the prognosis and options for attendance in the outpatient clinic. The patients are also offered an appointment. Finally, the patients are informed that they will receive two letters at two weeks intervals offering a new appointment if they do not meet in the outpatient clinic at the agreed time.

Since non-treated alcohol disorders generate billions societal costs annually for health care, social services, traffic accidents, criminal activities and lost productions, we believe the Relay Model to be either cost-neutral or cost-effective, i.e. low net costs compared to effectiveness.

Description of the cohort

The study wishes to recruit approx. 1.000 patients (650 from an urban area and 350 from a rural area). The effect of the Relay Model will be investigated in a single-blind pragmatic randomized controlled trial in which the patients are randomized into either a control group, which consists of patients referred to treatment by usual procedures, or an intervention group, which consists of patients referred to treatment by the relay model.

Data and biological material

OPEN's data manager develop electronic schemes for data entry. Data will be imported and stored in OPEN Projects.

Demographic and clinical data from the participating hospital departments, data from self report version of Alcohol Use Disorders Identification Test (AUDIT), AUDIT is composed of 10 questions divided into three domains (quantity-frequency questions, alcohol-related behaviour questions and alcohol-related consequences or harm questions. Follow-up data collected 12 months after discharge from hospital department will consist of data from: Danish Civil Registration System, The National Patient Register, The Register of Causes of Death and The National Alcohol Treatment Register.

Collaborating researchers and departments

Department of Psychiatry, Odense University Hospital/Research Unit of Psychiatry, University of Southern Denmark

• Professor, Chief Consultant and Head of Research Unit Bent Nielsen, MD, PhD
• Project Director and Assistant Professor Anette Søgaard Nielsen, PhD
• Professor Kjeld Andersen, MD, PhD

Department of Gastroenterology, Odense University Hospital/Hospital of Southern Jutland Aabenraa

Department of Neurology, Odense University Hospital/Hospital of Southern Jutland Aabenraa

Department of Orthopedics, Odense University Hospital/Hospital of Southern Jutland Aabenraa

Alcohol Treatment Center, Odense Municipal Alcohol Treatment Center, Aabenraa Municipal

Department of Biostatistics, University of Southern Denmark

• Professor Claus Ekstrøm

Faculty of Health, Aalborg University/Institute of Organization and Industrial Sociology, Copenhagen Business School

• Professor Jes Søgaard