Background:
This study aimed to address the knowledge gap of the delivery of alcohol brief intervention (BI) from community pharmacies. The research aimed to design and implement an alcohol BI in community pharmacy delivered by pharmacists, and to assess its effectiveness to reduce harmful and hazardous drinking of pharmacy customers. The programme of work, reported in this thesis, comprise four related studies conducted within the first three phases of the Medical Research Council’s (MRC) framework for developing and evaluating complex healthcare interventions.
Methods:
The four studies comprised of: i) purposive sampling survey of pharmacy customers’ views of a potential alcohol BI delivered by community pharmacists to determine service utilisation; ii) assessment of pharmacists’ attitudes, knowledge and views to delivering alcohol BI and to determine if these variables were related to alcohol BI delivery; iii) focus group study to identify range of barriers and enablers experienced by low-, moderate- and high-activity pharmacists to alcohol BI delivery; iv) apply findings from subsequent phases of the study to design and deliver the first known randomised controlled trial to assess the effectiveness of pharmacy alcohol BI.
Results:
Pharmacy customers were positive about participating in alcohol BI. Pharmacist motivation evaluated using the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ), and role adequacy and work satisfaction improved among ‘active’ pharmacists. Training and support were identified as important factors influencing service delivery. At three months 326 (80% overall; 82% intervention, 78% control) participants were followed up. The difference in reduction in total Alcohol Use Disorder Identification Test (AUDIT) score (intervention minus control) was -0.57 95% CI -1.59 to 0.45, p = 0.28.
Conclusions:
A brief intervention delivered by community pharmacists appeared to have no effect in reducing hazardous or harmful alcohol consumption. Community pharmacy remains a promising setting to deliver alcohol BI, future studies could consider redesigning the alcohol BI content for a larger-scale study, extending training for pharmacy staff, and identify alternative means of targeting pharmacy customers for whom alcohol BI could be effective.
Key Points:
- Pharmacy customers were positive about participating in alcohol BI
- Training and support were identified as important factors influencing service delivery
- Community pharmacy remains a promising setting to deliver alcohol BI
- Future studies could consider redesigning the alcohol BI content for a larger-scale study, extending training for pharmacy staff, and identify alternative means of targeting pharmacy customers for whom alcohol BI could be effective.
Dhital, R., Norman, I., Whittlesea, C., Murrells, T. & McCambridge, J. (2015)
The effectiveness of brief alcohol interventions delivered by community pharmacists: randomised controlled trial.
Addiction (accepted for publication), doi: 10.1111/add.12994.
