TY - JOUR PY - 2017// TI - Randomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website: cost-effectiveness analysis JO - BMJ open A1 - Hunter, Rachael A1 - Wallace, Paul A1 - Struzzo, Pierluigi A1 - Vedova, Roberto Della A1 - Scafuri, Francesca A1 - Tersar, Costanza A1 - Lygidakis, Charilaos A1 - McGregor, Richard A1 - Scafato, Emanuele A1 - Freemantle, Nick SP - e014577 EP - e014577 VL - 7 IS - 11 N2 - OBJECTIVES: To evaluate the 12-month costs and quality-adjusted life years (QALYs) gained to the Italian National Health Service of facilitated access to a website for hazardous drinkers compared with a standard face-to-face brief intervention (BI).

DESIGN: Randomised 1:1 non-inferiority trial. SETTING: Practices of 58 general practitioners (GPs) in Italy. PARTICIPANTS: Of 9080 patients (>18 years old) approached to take part in the trial, 4529 (49·9%) logged on to the website and 3841 (84.8%) undertook online screening for hazardous drinking. 822 (21.4%) screened positive and 763 (19.9%) were recruited to the trial. INTERVENTIONS: Patients were randomised to receive either a face-to-face BI or access via a brochure from their GP to an alcohol reduction website (facilitated access). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome is the cost per QALY gained of facilitated access compared with face-to-face. A secondary analysis includes total costs and benefits per 100 patients, including number of hazardous drinkers prevented at 12 months.

RESULTS: The average time required for the face-to-face BI was 8 min (95% CI 7.5 min to 8.6 min). Given the maximum time taken for facilitated access of 5 min, face-to-face is an additional 3 min: equivalent to having time for another GP appointment for every three patients referred to the website. Complete case analysis adjusting for baseline the difference in QALYs for facilitated access is 0.002 QALYs per patient (95% CI -0.007 to 0.011).

CONCLUSIONS: Facilitated access to a website to reduce hazardous drinking costs less than a face-to-face BI given by a GP with no worse outcomes. The lower cost of facilitated access, particularly in regards to investment of time, may facilitate the increase in provision of BIs for hazardous drinking. TRIAL REGISTRATION NUMBER: NCT01638338;Post-results.

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Language: en

LA - en SN - 2044-6055 UR - http://dx.doi.org/10.1136/bmjopen-2016-014577 ID - ref1 ER -