Short summary

The purpose of this study is to determine whether patient self-matching (as compared with treatment, as usual, by expert matching) improves satisfaction, retention and outcome for patients being treated for alcohol problems. Four hundred consecutive patients starting treatment at the alcohol outpatient clinic in Odense will be enrolled. At baseline, patients will be randomized to either choosing his or hers own treatment among four options, or being assigned to one of the options by means of algorithm and expert opinion. The treatment options available are; family therapy, cognitive behavioural therapy, contract therapy or supportive therapy. Patients will be re-interviewed 6 months after initiation of treatment.

Rationale

The purpose of this study is to determine whether increased patient involvement improves satisfaction, retention and outcome for patients being treated for alcohol problems. There are at least two good reasons for offering patients a choice, when the goal is a change in their behaviour. The first is that patients are likely to know what treatment works best for them. Secondly, being allowed to choose between options may increase compliance in treatment. In a randomized controlled trial, this study will compare the efficacy of patient self-matching versus treatment-as-usual expert matching.

Description of the cohort

All patients entering the alcohol outpatient clinic i Odense with a wish to start treatment for alcohol problems are offered to participate in the study if they meet all of the below inclusion criteria:

1. Fulfilling DSM-IV criteria for alcohol abuse or dependence

2. Aged between 18 and 60 years

3. Native Danish speaking

4. Having no severe psychosis or cognitive impairment

5. Accepting to participate in the study

A total of 400 consecutive patients will be enrolled in the study.

Data and biological material

Interview data from all participating patients will be collected at baseline and 6 months follow up. The primary assessment instrument for collecting the data will be the Time Line Follow Back. Other instruments will also be administered at intake to provide standardized measures of alcohol problems and quality of life:

• Addiction Severity Index (ASI)
• Time Line Follow Back (TLFB)
• Short Form 36 (SF36)

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
• Clinical Associate Professor Kjeld Andersen, MD, PhD

Alcohol Treatment Center, Odense Municipal Department of Biostatistics, University of Southern Denmark

• Professor Claus Ekstrøm

University of New Mexico, US

• Professor William R. Miller