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Evaluation of a Service to Strengthen Primary Care Responses to Substance-misusing Patients: Welcomed, but Little Impact

NCJ Number
Drugs: Education, Prevention and Policy Volume: 9 Issue: 1 Dated: February 2002 Pages: 21-33
Paramabandhu Groves; Joan Heuston; Ian Albery; Claire Gerada; Michael Gossop; John Strang
Date Published
13 pages
This article examined the results of a training program in London offered to general health care practitioners to improve their treatment of substance-abusing patients.
The authors begin this article by noting that treating substance-abusing patients in a primary care setting is often problematic. General practitioners and their staff may lack the resources, time, and training to effectively care for these types of patients. Similarly, those who abuse illegal substances may not feel comfortable informing their general practitioner that they need help overcoming addiction for fear of being labeled a drug addict. Despite theses issues, national policies in the United Kingdom have encouraged the treatment of these patients within a primary care setting. As such, this study was part of an initiative in London to assess the current state of care in this arena and to find ways to improve treatment for drug abusing patients in their primary care setting. Thirteen primary health care practices in London and South Southwark were randomly selected to receive the Consultancy Liaison Addiction Service (CLAS) for a period of 5 months. CLAS was a general practitioner led program that incorporated practitioners and nurses with expertise in treating drug-abusing patients into the primary health care practice. The goal of the program was to teach health care workers, in particular the general practitioners, how to effectively treat drug-abusing patients. For the study, measures of the effectiveness of treatment were taken both before and after the CLAS training mission. Additionally, general practitioners and nurses were administered questionnaires to gauge their knowledge of alcohol and drug-related problems. After the CLAS program was completed, interviews were conducted with the general practitioners and nurses to ascertain the level of perceived success of the CLAS program. Results indicated that while the general practitioners made use of the CLAS training program, little change in the health care practice was noted as a result of the program. Although practitioners and nurses spoke highly of the training, the data suggested that the CLAS program had little impact on the business as usual in these practices. In conclusion, the authors wonder if the short duration of the CLAS program was at fault or that CLAS simply did not provide adequate training. Future research and training in this area is called for. Tables, references


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