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Trial Review
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Trial registered on ANZCTR
Registration number
ACTRN12616001107415
Ethics application status
Approved
Date submitted
8/08/2016
Date registered
16/08/2016
Date last updated
26/11/2018
Date data sharing statement initially provided
26/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Improving alcohol treatment outcomes: The effect of individual patient characteristics, treatment and system variables on alcohol treatment outcomes in patients attending specialist alcohol treatment service.
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Scientific title
Improving alcohol treatment outcomes: The effect of individual patient characteristics, treatment and system variables on alcohol treatment outcomes in patients attending specialist alcohol treatment service.
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Secondary ID [1]
289635
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Addiction
299426
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Alcoholism
299428
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Condition category
Condition code
Mental Health
299408
299408
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0
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Addiction
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
3
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Target follow-up type
Months
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Description of intervention(s) / exposure
Clients will be asked to complete an iPad survey at baseline while waiting for their appointment at the clinic. A telephone survey will be completed at 3 months follow up. The primary outcome measure will be the number of heavy drinking days (> 5 drinks per day) in past 14 days.
Secondary outcome measures will include the number of drinking days; total alcohol consumption; and health related quality of life. Predictor variables will include client (e.g. demographics, substance use), intervention (e.g. treatment type), and system-level variables (e.g. process of care). The relationship between predictor and outcome variables will be examined within a multilevel modelling framework.
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Intervention code [1]
295250
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Not applicable
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Comparator / control treatment
Not Applicable
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Number of heavy drinking days (>5 drinks per day) in the previous 2 week. This question is part of a survey designed specifically for this study
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Assessment method [1]
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Timepoint [1]
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Baseline and 3 months post-recruitment
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Primary outcome [2]
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Number of drinking days in the past 2 weeks. This question is part of a survey designed specifically for this study
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Assessment method [2]
298984
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Timepoint [2]
298984
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Baseline and 3 month post-recruitment
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Primary outcome [3]
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Total alcohol consumption in the previous 2 weeks. This question is part of a survey designed specifically for this study
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Assessment method [3]
298985
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Timepoint [3]
298985
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Baseline and 3 month post-recruitment
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Secondary outcome [1]
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Severity of alcohol dependence measured by Audit C
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Assessment method [1]
325818
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Timepoint [1]
325818
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3 months post-recruitment
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Secondary outcome [2]
325819
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Health-related quality of life measured by SF-8
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Assessment method [2]
325819
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Timepoint [2]
325819
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Baseline and 3 months post-recruitment
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Secondary outcome [3]
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Other drug use as measure by ATOP
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Assessment method [3]
325820
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Timepoint [3]
325820
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Baseline and 3 months post-recruitment
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Secondary outcome [4]
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Treatment provided for withdrawal measured by a client medical record audit.
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Assessment method [4]
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Timepoint [4]
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3 months post-recruitment
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Secondary outcome [5]
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Type of treatment provided for withdrawal measured by client medical record audit.
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Assessment method [5]
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Timepoint [5]
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3 months post-recruitment
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Secondary outcome [6]
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Proposed and actual length of treatment for withdrawal measured by clinical medical record audit
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Assessment method [6]
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Timepoint [6]
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3 months post-recruitment
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Secondary outcome [7]
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Characteristics of treatment episodes measured by clinical medical record audit
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Assessment method [7]
326745
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Timepoint [7]
326745
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3 months post-recruitment
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Secondary outcome [8]
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Adherence to pharmacotherapies measured by clinical medical record audit
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Assessment method [8]
326746
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Timepoint [8]
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3 months post-recruitment
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Secondary outcome [9]
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Quality of the therapeutic relationship measured by the Working Alliance Inventory in the client follow-up and staff survey.
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Assessment method [9]
326747
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Timepoint [9]
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3 months-post recruitment for clients and once 50% of clients have been recruited from centre
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Secondary outcome [10]
326748
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Use of biological confirmation of abstinence as part of treatment measured by clients medical record audit
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Assessment method [10]
326748
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Timepoint [10]
326748
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3 months post-recruitment
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Secondary outcome [11]
326749
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Staff turn over. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [11]
326749
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Timepoint [11]
326749
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50% of clients have been recruited from centre
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Secondary outcome [12]
326750
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Staff supervision. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [12]
326750
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Timepoint [12]
326750
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50% of clients have been recruited from centre
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Secondary outcome [13]
326751
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Number and type of peripheral services. These questions are part of a survey designed specifically for this study to measure system variables
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Assessment method [13]
326751
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Timepoint [13]
326751
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50% of clients have been recruited from centre
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Secondary outcome [14]
326752
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Teaching status. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [14]
326752
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Timepoint [14]
326752
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50% of clients have been recruited from centre
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Secondary outcome [15]
326753
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Continuity of care. These questions are part of a survey designed specifically for this study to measure system variables
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Assessment method [15]
326753
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Timepoint [15]
326753
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50% of clients have been recruited from centre
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Secondary outcome [16]
326754
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Participation in clinical trials. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [16]
326754
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Timepoint [16]
326754
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50% of clients have been recruited from centre
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Secondary outcome [17]
326755
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Geographic location. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [17]
326755
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Timepoint [17]
326755
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50% of clients have been recruited from centre
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Secondary outcome [18]
326756
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Funding type. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [18]
326756
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Timepoint [18]
326756
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50% of clients have been recruited from centre
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Secondary outcome [19]
326757
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Number of clients treated per year. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [19]
326757
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Timepoint [19]
326757
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50% of clients have been recruited from centre
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Secondary outcome [20]
326758
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Organisation accreditation. This question is part of a survey designed specifically for this study to measure system variables
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Assessment method [20]
326758
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Timepoint [20]
326758
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50% of clients have been recruited from centre
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Secondary outcome [21]
326759
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Team climate. These questions are part of a survey designed specifically for this study to measure system variables
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Assessment method [21]
326759
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Timepoint [21]
326759
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50% of clients have been recruited from centre
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Secondary outcome [22]
326760
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Perceived team effectiveness. These questions are part of a survey designed specifically for this study to measure system variables
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Assessment method [22]
326760
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Timepoint [22]
326760
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50% of clients have been recruited from centre
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Secondary outcome [23]
326761
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Continuing education. These questions are part of a survey designed specifically for this study to measure system variables.
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Assessment method [23]
326761
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Timepoint [23]
326761
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50% of clients have been recruited from centre
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Secondary outcome [24]
326762
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Skills and qualifications. These questions are part of a survey designed specifically for this study to measure system variables.
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Assessment method [24]
326762
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Timepoint [24]
326762
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50% of clients have been recruited from centre
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Secondary outcome [25]
326763
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Implementation of evidence-based practice. These questions are part of a survey designed specifically for this study to measure system variables.
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Assessment method [25]
326763
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Timepoint [25]
326763
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50% of clients have been recruited from centre
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Secondary outcome [26]
326764
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Commitment to quality improvement. These questions are part of a survey designed specifically for this study to measure system variables.
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Assessment method [26]
326764
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Timepoint [26]
326764
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50% of clients have been recruited from centre
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Secondary outcome [27]
326765
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Staff performance management. These questions are part of a survey designed specifically for this study to measure system variables.
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Assessment method [27]
326765
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Timepoint [27]
326765
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50% of clients have been recruited from centre
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Secondary outcome [28]
326766
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Demographics and social functioning. These questions are part of a survey designed specifically for this study to measure client variables.
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Assessment method [28]
326766
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Timepoint [28]
326766
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3 months post-recruitment
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Eligibility
Key inclusion criteria
Clients:
(i) aged 18 years or older; (ii) presenting for new episode of treatment at the participating service; (iii) have nominated alcohol as their primary drug of concern; (iv) have used alcohol in the past 30 days; (v) have not previously been enrolled in the study in the last 6 months; and (vi) have a telephone contact number.
Staff:
All staff from participating centres will be invited to contribute to the study if they are employed in the alcohol treatment clinic and are involved in providing direct patient care.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Additionally, the study is focusing on those treatment centres community-based providing alcohol treatment to adults. Centres are ineligible if they are services that provide withdrawal only, residential rehabilitation only, detoxification services only and/or treat less than 50 clients for alcohol as primary drug of concern in 12 months (or approximately less than 75 episodes). Participants under the age of 18 have been excluded as they are unable to give informed consent. While non-English speaking groups represent an important segment within the target population, translation costs for study materials will make it cost prohibitive to include this group in the current study.
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Study design
Purpose
Psychosocial
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
25/08/2016
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Actual
22/12/2016
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Date of last participant enrolment
Anticipated
30/04/2019
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Actual
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Date of last data collection
Anticipated
31/07/2019
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Actual
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Sample size
Target
7250
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Accrual to date
723
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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Level 1
16 Marcus Clarke Street
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Newcastle
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Address
University Drive
Callaghan NSW 2308
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Country
Australia
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Secondary sponsor category [1]
292914
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None
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Name [1]
292914
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Address [1]
292914
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Country [1]
292914
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295500
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Hunter New England Hunman Research Ethics Committe
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Ethics committee address [1]
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Lookout Road New Lambton NSW 2305 Australia
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Ethics committee country [1]
295500
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Australia
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Date submitted for ethics approval [1]
295500
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29/04/2016
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Approval date [1]
295500
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11/07/2016
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Ethics approval number [1]
295500
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16/05/18/4.07/ HREC/16/HNE/193
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Summary
Brief summary
Patient outcomes can be significantly influenced by the characteristics of the system in which health care services are delivered, independently of patient and treatment characteristics. There has been no systematic examination of the relative impact of client, treatment and systems level variables on outcomes for alcohol dependence. This study aims to determine, using a prospective cohort study, the impact of: (a) individual client characteristics; (b) type of treatment; and (c) features of the system in which treatment is provided, on alcohol treatment outcomes. Eligible treatment centres will be those that provides a facetoface specialist outpatient alcohol treatment service to adults and expect to treat at least 50 clients for alcohol as primary drug of concern in the next 12 months (or approximately 75 episodes). Fifty services across Australia will be recruited using stratified sampling. Eligible clients will be aged 18 years or older; presenting for a new episode of outpatient treatment at the service; have nominated alcohol as their primary drug of concern; have used alcohol in the last 30 days; have not previously been enrolled in the study in the last 6 months; and have a telephone contact number. Clients will be asked to complete an iPad survey at baseline while waiting for their appointment at the clinic. A telephone survey will be completed at 3 months follow up. The primary outcome measure will be the number of heavy drinking days (> 5 drinks per day) in past 14 days. Secondary outcome measures will include the number of drinking days; total alcohol consumption; and health related quality of life. Predictor variables will include client (e.g. demographics, substance use), intervention (e.g. treatment type), and system level variables (e.g. process of care). The relationship between predictor and outcome variables will be examined within a multilevel modelling framework. This is the first study internationally to examine the role of three levels of variables on treatment success. It will provide critical information for policy makers on which to base minimum service standards. Clinic Staff will be invited to participate in a web-based survey, from the Director (or delegate) of their clinic providing information about their own qualifications and skills, their role in relation to the delivery of client treatment, and their perceptions about staff attitudes, team culture and client relationship within the clinic, implementation of evidence-based practice and commitment to quality improvement. One key informant from the centre will be asked to participate in a telephone interview to obtain information number and type of staff, staff turnover, staff supervision, number and type of peripheral services, teaching status, continuity of care, participation in clinical trials, geographic location, funding type, number of clients treated per year, organisational accreditation.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Robert Sanson-Fisher
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Address
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W4 HMRI Building
University of Newcastle
University Drive
Callaghan NSW 2308
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Country
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Australia
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Phone
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+61240420713
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Megan Freund
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Address
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W4 HMRI Building
University of Newcastle
University Drive
Callaghan NSW 2308
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Country
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Australia
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Phone
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+6124040834
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Fax
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Email
67271
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[email protected]
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Contact person for scientific queries
Name
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Robert Sanson-Fisher
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Address
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W4 HMRI Building
University of Newcastle
University Drive
Callaghan NSW 2308
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Country
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Australia
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Phone
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+61240420713
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Plain language summary
No
N/A
Documents added automatically
No additional documents have been identified.
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