Christine Timko1,2, Kathleen M Grant3,4, Xiaotong Han5,6, Lance Brendan Young7, Michael A Cucciare5,6. 1. Department of Veterans Affairs Health Care System, Center for Innovation to Implementation, Palo Alto, CA, USA. 2. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. 3. Mental Health and Behavioral Science Department, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA. 4. Pulmonary Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA. 5. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA. 6. Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, USA. 7. Department of Preventive & Community Dentistry, The University of Iowa, Iowa City, USA.
Abstract
AIMS: To test the effectiveness of an intervention, Al-Anon Intensive Referral (AIR), to facilitate participation in Al-Anon Family Groups (Al-Anon). DESIGN, SETTING AND PARTICIPANTS: Multi-site, randomized controlled trial of AIR versus usual care (UC), with follow-up assessments at 3, 6 and 12 months. The 12-month follow-up rate was 74%. Residential alcohol use disorder (AUD) treatment programs in three US locations. Concerned others (COs) of patients in treatment for AUD. COs were mainly women (77%) who were patients' spouses (33%) or parents (25%). INTERVENTION AND COMPARATOR: AIR (n = 128) consisted of four sessions over 3 months with an Al-Anon coach. UC (n = 151) was the treatment program's offer of educational sessions for COs. MEASUREMENTS: Primary outcome: COs' self-reports of any Al-Anon attendance (yes or no) at 3 months. SECONDARY OUTCOMES: number of Al-Anon meetings and the CO-patient relationship (stressors, resources). Potential predictors of outcomes examined in generalized linear mixed models were their baseline value, time, CO-patient relationship type (marital or non-marital), treatment program and condition. FINDINGS: There was no effect of condition for the primary outcome (28% in AIR, 21% in UC; Bayes factor = 1.86). Relationship stressors at follow-ups were more severe for COs in a marital relationship with the patient than for COs in a non-marital relationship [β = 2.19, 95% confidence interval (CI) = 1.07, 3.32]. For CO-patient relationship resources at follow-ups, the main effect for condition was significant (β = 1.33, 95% CI = 0.04, 2.61). COs assigned to the AIR condition had more resources than COs who were in the UC condition. CONCLUSIONS: Relative to usual care, Al-Anon Intensive Referral was not associated with increases in participation of concerned others in Al-Anon, but was associated with more resources in the concerned other-patient relationship.
AIMS: To test the effectiveness of an intervention, Al-Anon Intensive Referral (AIR), to facilitate participation in Al-Anon Family Groups (Al-Anon). DESIGN, SETTING AND PARTICIPANTS: Multi-site, randomized controlled trial of AIR versus usual care (UC), with follow-up assessments at 3, 6 and 12 months. The 12-month follow-up rate was 74%. Residential alcohol use disorder (AUD) treatment programs in three US locations. Concerned others (COs) of patients in treatment for AUD. COs were mainly women (77%) who were patients' spouses (33%) or parents (25%). INTERVENTION AND COMPARATOR: AIR (n = 128) consisted of four sessions over 3 months with an Al-Anon coach. UC (n = 151) was the treatment program's offer of educational sessions for COs. MEASUREMENTS: Primary outcome: COs' self-reports of any Al-Anon attendance (yes or no) at 3 months. SECONDARY OUTCOMES: number of Al-Anon meetings and the CO-patient relationship (stressors, resources). Potential predictors of outcomes examined in generalized linear mixed models were their baseline value, time, CO-patient relationship type (marital or non-marital), treatment program and condition. FINDINGS: There was no effect of condition for the primary outcome (28% in AIR, 21% in UC; Bayes factor = 1.86). Relationship stressors at follow-ups were more severe for COs in a marital relationship with the patient than for COs in a non-marital relationship [β = 2.19, 95% confidence interval (CI) = 1.07, 3.32]. For CO-patient relationship resources at follow-ups, the main effect for condition was significant (β = 1.33, 95% CI = 0.04, 2.61). COs assigned to the AIR condition had more resources than COs who were in the UC condition. CONCLUSIONS: Relative to usual care, Al-Anon Intensive Referral was not associated with increases in participation of concerned others in Al-Anon, but was associated with more resources in the concerned other-patient relationship.
Authors: Charles J Holahan; Penny L Brennan; Kathleen K Schutte; Carole K Holahan; J Gregory Hixon; Rudolf H Moos Journal: Alcohol Clin Exp Res Date: 2018-02-27 Impact factor: 3.455