# Can the presence of specialized addiction staff in primary health care increase the number of alcohol-related medical consultations – A controlled intervention study

## TL;DR

Having a specialized addiction nurse in primary care may increase alcohol-related medical consultations, and educational lectures can also help boost these consultations.

## Contribution

This study evaluates the impact of a specialized addiction nurse and an educational lecture on alcohol-related consultations in primary care.

## Key findings

- The presence of a specialized addiction nurse was associated with a 33% increase in alcohol-related diagnostic codes.
- An educational lecture was linked to a 147% increase in alcohol-related diagnostic codes.
- The effect of the nurse was less certain in sensitivity analyses, and no immediate step effect was observed.

## Abstract

•Primary care is under-utilized for the management of alcohol use disorders.•Presence of an alcohol-oriented nurse may be promising in alcohol use management.•More data is needed regarding effects of alcohol-specialist staff in primary care.•A specialist lecture can increase primary care efforts in alcohol use disorders.

Primary care is under-utilized for the management of alcohol use disorders.

Presence of an alcohol-oriented nurse may be promising in alcohol use management.

More data is needed regarding effects of alcohol-specialist staff in primary care.

A specialist lecture can increase primary care efforts in alcohol use disorders.

Few individuals with alcohol use disorders receive treatment. Primary care has been suggested as an arena for early treatment for these disorders.

To evaluate whether the presence of a specialized addiction nurse can increase alcohol-related physician consultations in a primary care setting.

This controlled intervention study included one intervention and one control primary care unit in Malmö, Sweden. At the intervention unit, an addiction nurse experienced in alcohol use disorder treatment was present 20 h weekly for 12 months. At both units, an educational lecture on alcohol use disorders was given at study start. The outcome was physicians’ monthly number of alcohol-related diagnostic codes. Data were compared between intervention and control units using Poisson Regression. Eight statistical models were analyzed and Akaike information criterion was used to select the final model.

The intervention was significantly associated with an increased number of registered alcohol-related diagnostic codes (risk ratio 1.33, 95 confidence interval 1.08–1.62). However, in sensitivity analyses, such a slope effect was more uncertain and no step effect was seen. A significant association was seen between the educational lecture and an increase in the number of registered alcohol-related codes at the sites (risk ratio 2.47, 1.37–4.46).

The presence of specialized addiction staff in a primary healthcare setting might increase the number of alcohol-related physician consultations in primary care, although more research is needed. An educational lecture about alcohol use disorders could be a simple but effective intervention to increase alcohol-related physician consultations in primary care.