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ProACTIVE – Programme of research for Alcohol Care Teams

Summary

Alcohol-related hospital admissions continue to rise, with estimates that 10% of patients admitted to acute hospitals may be alcohol dependent (AD). Yet, there remains considerable variation in provision of Alcohol Care Teams (ACTs) in England, and a limited evidence base for understanding their clinical effectiveness. This three-year programme of research commissioned by the National Institute for Health Research (HS&DR) will examine the clinical and cost effectiveness of ACTs to inform the future commissioning of these services.

The ProACTIVE team is a consortium of public collaborators and experienced researchers drawn from the universities of Hull, Southampton, Keele, Kent, Sheffield, Newcastle, King’s College London and South London and the Maudsley NHS Foundation Trust. The ProACTIVE research programme is a multi-disciplinary, integrated, mixed-methods study designed to evaluate the impact of ACTs at macro (policy), meso (health system) and micro (patient) level. It will categorise models of ACT, define the components which best support the identification, and cost-effective management of hospitalised adults with AD.

Work packages

WP1. Defining Alcohol Care Teams

• WP1a: Comprehensive national survey of hospital-based alcohol provision in England
• WP1b: Define the range of components of care, and agree a taxonomy for ACT interventions – Delphi study
• WP1c: Explore the reliability and linkage of nationally available data

WP2: Examining the impact of Alcohol Care Teams

• WP2a: quasi-experimental naturalistic effectiveness study of three ‘optimal’ ACTs and three ‘minimal’/no ACT sites, following-up patients for six months (using propensity score matching to identify a matched control group)
• WP2b: Re-admission rates, length of stay, etc. will be assessed by an interrupted time series analysis using nationally available data
• WP2c: cost-effectiveness of ACT at both meso and micro levels

WP3: A qualitative evaluation of ACTs, using an organisational ethnographic case study design enabling development of 4 case studies by triangulation of:

• multiple data sources (documentary analysis, observation, interviews)
• perspectives (decision-makers, clinical staff, patients)

WP4: Data integration, dissemination and recommendations for future policy and practice using the ‘Context and Implementation of Complex Interventions’ framework, and co-production with stakeholders to generate guiding principles, and toolkit for best practice for ACTs

What we plan to do

• Determine the spectrum of characteristics and care needs of patients who may benefit from ACTs
• Identify the components and resource implications of clinical- and cost-effective models of ACTs across England, which best support the identification, and management of hospitalised adults with alcohol dependence
• Work with Stakeholders to co-produce and ensure rapid dissemination of outputs to inform macro and meso level policy decisions, clinical best practice, and future research priorities

Privacy Notices

WP1 (study 1) Privacy Notice
WP1 (study 2) Privacy Notice
WP2a Privacy Notice
WP2b Privacy Notice
WP3b Privacy Notice