Efectividad de programas formativos orientados al consumo de alcohol en atención primaria: revisión sistemática / Effectiveness of training programs on alcohol consumption in the Primary Care setting: Systematic review

Objetivo: Evaluar la efectividad de actividades formativas dirigidas a sanitarios de atención primaria sobre el manejo de pacientes con problemas de consumo de alcohol. Diseño: Revisión sistemática cualitativa de ensayos clínicos controlados aleatorizados. Fuentes de datos: Trip Database, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, EMBASE, CINAHL, Web of Science, Scopus, Alcohol and Alcohol Problems Science Database-ETOH y FAMILY RESOURCES DATABASE. La búsqueda se realizó en junio de 2017. Selección de estudios: Muestra final n = 3. Se incluyeron: ensayos clínicos controlados aleatorizados, indexados hasta el 30 de mayo de 2017, con objetivo evaluar la efectividad de actividades formativas orientadas a profesionales de atención primaria en el abordaje de pacientes con problemas de consumo de alcohol. Extracción de datos: Las medidas fueron expresadas en términos de efectividad de la aplicación de la actividad formativa: nivel de implementación global, cribado de consumo de alcohol, intervención de pacientes con consumo de riesgo y nivel de apoyo requerido. Resultados: Tres ensayos clínicos controlados aleatorizados, publicados desde 1999 a 2004, fueron incluidos. Tanto el cribado, como las técnicas de intervención breve, experimentaron un incremento de su aplicación en los tres estudios, tras el desarrollo de los programas formativos. Se consiguieron resultados significativos en términos de efectividad en 2 de los 3 ensayos seleccionados, tanto en la detección de consumidores de riesgo, como en la intervención breve. Conclusión: El desarrollo de programas formativos en el abordaje de pacientes con problemas de consumo de alcohol constituye una estrategia efectiva para los profesionales de atención primaria, permitiendo la implementación del cribado poblacional y de técnicas de intervención breve

Objective: To evaluate the effectiveness of training activities directed at Primary Health Care personnel on the management of patients with alcohol consumption problems. Design: A systematic review of randomised controlled trials. Data sources: Trip Database, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, EMBASE, CINAHL, Web of Science, Scopus, Alcohol and Alcohol Problems Science Database - ETOH and FAMILY RESOURCES DATABASE. The search was performed in June 2017. Study selection: The final sample was n = 3 studies. Randomised controlled trials, indexed until 30 May 2017, with the objective of assessing the effectiveness of training programs directed at Primary Care providers in the management of patients with alcohol abuse disorder were included. Data extraction: The main variables were expressed in terms of effectiveness of the training program: level of global implementation, screening of alcohol consumption, intervention in patients with a consumption risk, and level of support required. Results: Three Randomised controlled trials, published from 1999 to 2004, were included. Both screening and short intervention techniques showed an increase of its application in the three studies after the development of the three training programs. Statistical significance in terms of effectiveness was achieved in 2 of the 3 selected trials: both in detection of risk consumers, and in short intervention. Conclusion: The development of training programs in the management of patients with alcohol abuse disorder is an effective strategy for Primary Care providers, allowing the implementation of population screening, as well as the application of intervention techniques

[Effectiveness of training programs on alcohol consumption in the Primary Care setting: Systematic review]. / Efectividad de programas formativos orientados al consumo de alcohol en atención primaria: revisión sistemática.

OBJECTIVE: To evaluate the effectiveness of training activities directed at Primary Health Care personnel on the management of patients with alcohol consumption problems. DESIGN: A systematic review of randomised controlled trials. DATA SOURCES: Trip Database, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, EMBASE, CINAHL, Web of Science, Scopus, Alcohol and Alcohol Problems Science Database - ETOH and FAMILY RESOURCES DATABASE. The search was performed in June 2017. STUDY SELECTION: The final sample was n=3 studies. Randomised controlled trials, indexed until 30 May 2017, with the objective of assessing the effectiveness of training programs directed at Primary Care providers in the management of patients with alcohol abuse disorder were included. DATA EXTRACTION: The main variables were expressed in terms of effectiveness of the training program: level of global implementation, screening of alcohol consumption, intervention in patients with a consumption risk, and level of support required. RESULTS: Three Randomised controlled trials, published from 1999 to 2004, were included. Both screening and short intervention techniques showed an increase of its application in the three studies after the development of the three training programs. Statistical significance in terms of effectiveness was achieved in 2 of the 3 selected trials: both in detection of risk consumers, and in short intervention. CONCLUSION: The development of training programs in the management of patients with alcohol abuse disorder is an effective strategy for Primary Care providers, allowing the implementation of population screening, as well as the application of intervention techniques.

Measuring the quality of motivational interviewing in primary health care encounters: The development and validation of the motivational interviewing assessment scale (MIAS).

BACKGROUND: Motivational interviewing (MI) is a collaborative, goal-oriented method to help patients change behaviour. Tools that are often used to measure MI are the motivational interviewing skills code' (MISC), the 'motivational interviewing treatment integrity' (MITI) and the 'behaviour change counselling index' (BECCI). The first two instruments have not been designed to be used in primary healthcare (PHC) settings. The BECCI actually is time-consuming. The motivational interviewing assessment scale (MIAS, 'EVEM' in Spanish) was developed to measure MI in PHC encounters as an alternative to the previous instruments. OBJECTIVES: To validate MIAS as an instrument to assess the quality of MI in PHC settings. METHODS: (a) DEVELOPMENT: Sixteen experts in MI participated in the design, face and consensus validity, using a Delphi-type methodology. (b) SETTING: 27 PHC centres located in Spain. SUBJECTS: four experts in MI tested its psychometric properties with 332 video recordings coming from the Dislip-EM study (consultations provided by 37 practitioners). MEASUREMENTS: dimensionality, internal consistency, reliability (intra-class correlation coefficient-ICC), sensitivity to change and convergent validity with the BECCI scale. RESULTS: A 14-item scale was obtained after the validation process. Factor analysis: two factors explained 76.6% of the total variance. Internal consistency, α = 0.99. Reliability: intra-rater ICC = 0.96; inter-rater ICC = 0.97. Sensitivity to change: means before and after training were 23.63 versus 38.57 (P < 0.001). Spearman's coefficient between the MIAS and the BECCI scale was 0.98 (P < 0.001). CONCLUSION: The MIAS is a consistent and reliable instrument to assess the use of MI in PHC settings. [Box: see text].