The potential cost-effectiveness of general practitioner delivered brief intervention for alcohol misuse

Evidence from rural Australia

Hector Jose Navarro, Anthony Shakeshaft, Christopher M. Doran, Dennis J. Petrie

    Research output: Contribution to journalArticle

    14 Citations (Scopus)

    Abstract

    Objective: This paper aims to model General Practitioner (GP) delivered screening and brief intervention (BI), and to identify the costs per additional risky drinker who reduces alcohol consumption to low-risk levels, relative to current practice. Method: A decision model and nine different scenarios were developed to assess outcomes and costs of GP-delivered screening and BI on the potential number of risky drinkers who reduce their alcohol consumption to low-risk levels in 10 rural communities in New South Wales, Australia. Findings: Based on evidence from current practice, approximately 19% of all risky drinkers visiting GPs annually would reduce alcohol consumption to low-risk levels, of which 0.7% would do so because of GP-delivered screening and BI. If rates of screening and BI are increased to 100%, 36% of these risky drinkers would reduce their drinking to low risk-levels. Alternatively, increments of 10% and 20% in GP-delivered screening and BI would reduce the proportion of risky drinkers by 2.1% and 4.2% respectively. The most cost-effective outcome per additional risky drinker reducing their drinking relative to current practice would be if all of these risky drinkers are screened alone with an ICER of AUD$197. Conclusion: These findings indicate that increments in rates of screening and BI delivered by GPs can result in cost-effective reductions per additional risky drinkers reducing their drinking to low-risk levels, relative to current practice. They also imply that achieving substantial reductions in the prevalence of risky drinking in a community will require strategies other than opportunistic screening and BIs by GPs. © 2011 Elsevier Ltd.
    Original languageEnglish
    Pages (from-to)1191-1198
    Number of pages8
    JournalAddictive Behaviors
    Volume36
    Issue number12
    DOIs
    Publication statusPublished - 2011

    Fingerprint

    Cost effectiveness
    General Practitioners
    Cost-Benefit Analysis
    Screening
    Alcohols
    Drinking
    Alcohol Drinking
    Costs and Cost Analysis
    South Australia
    New South Wales
    Rural Population
    Costs
    Cost reduction

    Keywords

    • Alcohol misuse
    • Brief intervention
    • Cost-effectiveness
    • General practitioner
    • Risky drinker
    • alcohol
    • adult
    • alcoholism
    • article
    • Australia
    • brief intervention
    • cost effectiveness analysis
    • female
    • general practitioner
    • human
    • major clinical study
    • male
    • medical practice
    • prevalence
    • primary medical care
    • rural area
    • rural health care
    • screening
    • Adolescent
    • Adult
    • Alcohol Drinking
    • Alcoholism
    • Cost-Benefit Analysis
    • Counseling
    • Family Practice
    • Female
    • General Practitioners
    • Humans
    • Male
    • Mass Screening
    • Middle Aged
    • Models, Theoretical
    • New South Wales
    • Risk-Taking
    • Rural Health
    • Young Adult

    Cite this

    Navarro, Hector Jose ; Shakeshaft, Anthony ; Doran, Christopher M. ; Petrie, Dennis J. / The potential cost-effectiveness of general practitioner delivered brief intervention for alcohol misuse : Evidence from rural Australia. In: Addictive Behaviors. 2011 ; Vol. 36, No. 12. pp. 1191-1198.
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    abstract = "Objective: This paper aims to model General Practitioner (GP) delivered screening and brief intervention (BI), and to identify the costs per additional risky drinker who reduces alcohol consumption to low-risk levels, relative to current practice. Method: A decision model and nine different scenarios were developed to assess outcomes and costs of GP-delivered screening and BI on the potential number of risky drinkers who reduce their alcohol consumption to low-risk levels in 10 rural communities in New South Wales, Australia. Findings: Based on evidence from current practice, approximately 19{\%} of all risky drinkers visiting GPs annually would reduce alcohol consumption to low-risk levels, of which 0.7{\%} would do so because of GP-delivered screening and BI. If rates of screening and BI are increased to 100{\%}, 36{\%} of these risky drinkers would reduce their drinking to low risk-levels. Alternatively, increments of 10{\%} and 20{\%} in GP-delivered screening and BI would reduce the proportion of risky drinkers by 2.1{\%} and 4.2{\%} respectively. The most cost-effective outcome per additional risky drinker reducing their drinking relative to current practice would be if all of these risky drinkers are screened alone with an ICER of AUD$197. Conclusion: These findings indicate that increments in rates of screening and BI delivered by GPs can result in cost-effective reductions per additional risky drinkers reducing their drinking to low-risk levels, relative to current practice. They also imply that achieving substantial reductions in the prevalence of risky drinking in a community will require strategies other than opportunistic screening and BIs by GPs. {\circledC} 2011 Elsevier Ltd.",
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    author = "Navarro, {Hector Jose} and Anthony Shakeshaft and Doran, {Christopher M.} and Petrie, {Dennis J.}",
    note = "Export Date: 21 March 2012 Source: Scopus CODEN: ADBED doi: 10.1016/j.addbeh.2011.07.023 PubMed ID: 21849233 Language of Original Document: English Correspondence Address: Navarro, H.J.; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia; email: h.navarro@unsw.edu.au Chemicals/CAS: alcohol, 64-17-5",
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    The potential cost-effectiveness of general practitioner delivered brief intervention for alcohol misuse : Evidence from rural Australia. / Navarro, Hector Jose; Shakeshaft, Anthony; Doran, Christopher M.; Petrie, Dennis J.

    In: Addictive Behaviors, Vol. 36, No. 12, 2011, p. 1191-1198.

    Research output: Contribution to journalArticle

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    T1 - The potential cost-effectiveness of general practitioner delivered brief intervention for alcohol misuse

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    AU - Navarro, Hector Jose

    AU - Shakeshaft, Anthony

    AU - Doran, Christopher M.

    AU - Petrie, Dennis J.

    N1 - Export Date: 21 March 2012 Source: Scopus CODEN: ADBED doi: 10.1016/j.addbeh.2011.07.023 PubMed ID: 21849233 Language of Original Document: English Correspondence Address: Navarro, H.J.; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia; email: h.navarro@unsw.edu.au Chemicals/CAS: alcohol, 64-17-5

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    Y1 - 2011

    N2 - Objective: This paper aims to model General Practitioner (GP) delivered screening and brief intervention (BI), and to identify the costs per additional risky drinker who reduces alcohol consumption to low-risk levels, relative to current practice. Method: A decision model and nine different scenarios were developed to assess outcomes and costs of GP-delivered screening and BI on the potential number of risky drinkers who reduce their alcohol consumption to low-risk levels in 10 rural communities in New South Wales, Australia. Findings: Based on evidence from current practice, approximately 19% of all risky drinkers visiting GPs annually would reduce alcohol consumption to low-risk levels, of which 0.7% would do so because of GP-delivered screening and BI. If rates of screening and BI are increased to 100%, 36% of these risky drinkers would reduce their drinking to low risk-levels. Alternatively, increments of 10% and 20% in GP-delivered screening and BI would reduce the proportion of risky drinkers by 2.1% and 4.2% respectively. The most cost-effective outcome per additional risky drinker reducing their drinking relative to current practice would be if all of these risky drinkers are screened alone with an ICER of AUD$197. Conclusion: These findings indicate that increments in rates of screening and BI delivered by GPs can result in cost-effective reductions per additional risky drinkers reducing their drinking to low-risk levels, relative to current practice. They also imply that achieving substantial reductions in the prevalence of risky drinking in a community will require strategies other than opportunistic screening and BIs by GPs. © 2011 Elsevier Ltd.

    AB - Objective: This paper aims to model General Practitioner (GP) delivered screening and brief intervention (BI), and to identify the costs per additional risky drinker who reduces alcohol consumption to low-risk levels, relative to current practice. Method: A decision model and nine different scenarios were developed to assess outcomes and costs of GP-delivered screening and BI on the potential number of risky drinkers who reduce their alcohol consumption to low-risk levels in 10 rural communities in New South Wales, Australia. Findings: Based on evidence from current practice, approximately 19% of all risky drinkers visiting GPs annually would reduce alcohol consumption to low-risk levels, of which 0.7% would do so because of GP-delivered screening and BI. If rates of screening and BI are increased to 100%, 36% of these risky drinkers would reduce their drinking to low risk-levels. Alternatively, increments of 10% and 20% in GP-delivered screening and BI would reduce the proportion of risky drinkers by 2.1% and 4.2% respectively. The most cost-effective outcome per additional risky drinker reducing their drinking relative to current practice would be if all of these risky drinkers are screened alone with an ICER of AUD$197. Conclusion: These findings indicate that increments in rates of screening and BI delivered by GPs can result in cost-effective reductions per additional risky drinkers reducing their drinking to low-risk levels, relative to current practice. They also imply that achieving substantial reductions in the prevalence of risky drinking in a community will require strategies other than opportunistic screening and BIs by GPs. © 2011 Elsevier Ltd.

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