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Brief Interventions: An evidence - based approach

Brief Interventions: An evidence - based approach. 6 th October 2010. Presenters: Su Mably & Mererid Bowley. Outline. What are Brief Interventions? Evidence base–alcohol and smoking cessation Discussion how we embed Brief Intervention within healthcare setting?.

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Brief Interventions: An evidence - based approach

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  1. Brief Interventions: An evidence - based approach 6th October 2010 Brief Interventions - An evidence–based approach Presenters: Su Mably & Mererid Bowley

  2. Outline • What are Brief Interventions? • Evidence base–alcohol and smoking cessation • Discussion how we embed Brief Intervention within healthcare setting? Brief Interventions - An evidence–based approach

  3. Brief Interventions - Alcohol • What is an alcohol Brief Intervention? • Involves a screening questionnaire • FRAMES • Who can deliver? • Strong evidence base- NICE/ Cochrane- primary care/ hazardous drinkers Brief Interventions - An evidence–based approach

  4. A short, evidence-based, structured conversation about alcohol consumption with a client to motivate and support the individual to think about and/or plan a change in their drinking behaviour in order to reduce their consumption. 5-10 mins Effective for those identified as hazardous drinkers Brief Intervention- Alcohol Brief Interventions - An evidence–based approach

  5. Brief Interventions - Alcohol • What is an alcohol Brief Intervention? • Involves a screening questionnaire • FRAMES • Who can deliver? • Strong evidence base- NICE/ Cochrane- primary care/ hazardous drinkers Brief Interventions - An evidence–based approach

  6. Brief Interventions – other settings • Alcohol- A & E; secondary care; pharmacy; criminal justice system; sexual health; youth work Brief Interventions - An evidence–based approach

  7. Brief Interventions – Smoking Cessation • Brief Intervention for smoking cessation: - what is it? - 3 A’s - Evidence base Brief Interventions - An evidence–based approach

  8. Brief intervention for smoking cessation • Nice guidelines: - 5-10 minutes - simple opportunistic advice to stop - an assessment of the client’s commitment to quit - an offer of pharmacotherapy and/or behavioural support - provision of self-help material and referral to more intensive support Brief Interventions - An evidence–based approach

  9. 3 A’s Ask - Does the client currently smoke? Advise - Of the benefits of stopping smoking / risks to health Act -Support clients; refer to services How to deliver? Brief Interventions - An evidence–based approach

  10. % abstinent at 6 months or longer Willpower alone 2 - 3% Willpower plus: Self-help materials 4% Brief advice from Physician 5% NRT 6-9% Smokers’ clinic 10% Smokers’ clinic & NRT 20% (Parrot et al, Thorax 1998) Effectiveness Brief Interventions - An evidence–based approach

  11. All smokers ~70% want to stop ~2–3% of all smokers succeed in stopping each year ~30% try each year The Power of Addiction Bridgewood et al. (1998) Brief Interventions - An evidence–based approach

  12. Approach • Two-pronged approach: - Brief intervention - Intensive behavioural support Brief Interventions - An evidence–based approach

  13. Cost effectiveness Potential savings to the NHS: • Pre operative £0.2 – £2.3 million • Support to staff to stop £0.6 - £1.2 million • GP brief intervention support: - cost £11 per person more than usual care - medical treatment for smoking related conditions costs est. £17,000 per life year gained Brief Interventions - An evidence–based approach

  14. Discussion • How do we embed brief intervention in health service? - consistent, systematic implementation capable of audit • How do we influence healthcare staff to deliver B.I.? • Healthcare staff as ambassadors for health? • Interaction between local and national teams in promotion B.I.? Brief Interventions - An evidence–based approach

  15. Prevention & Promotion work stream • NHS Wales five year Plan • High impact areas to realise financial savings • Smoking cessation & alcohol brief interventions • Project working groups Brief Interventions - An evidence–based approach

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