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Implementing referral to an electronic alcohol brief advice website in primary healthcare: results from the ODHIN implementation trial
  1. Preben Bendtsen1,
  2. Ulrika Müssener2,
  3. Nadine Karlsson2,
  4. Hugo López-Pelayo3,
  5. Jorge Palacio-Vieira4,
  6. Joan Colom4,
  7. Antoni Gual3,
  8. Jillian Reynolds3,
  9. Paul Wallace5,
  10. Lidia Segura4,
  11. Peter Anderson6,7
  1. 1Department of Medical Specialist and Department of Medical and Health Sciences, Linköping University, Motala, Sweden
  2. 2Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  3. 3Grup Addiccions Clínic (GRA-GRE), Hospital Clínic de Barcelona, IDIBAPS, RTA, University of Barcelona, Barcelona, Spain
  4. 4Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
  5. 5Department of Primary Care and Population Health, University College London, London, UK
  6. 6Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
  7. 7Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
  1. Correspondence to Dr Preben Bendtsen; preben.bendtsen{at}


Objectives The objective of the present study was to explore whether the possibility of offering facilitated access to an alcohol electronic brief intervention (eBI) instead of delivering brief face-to-face advice increased the proportion of consulting adults who were screened and given brief advice.

Design The study was a 12-week implementation study. Sixty primary healthcare units (PHCUs) in 5 jurisdictions (Catalonia, England, the Netherlands, Poland and Sweden) were asked to screen adults who attended the PHCU for risky drinking.

Setting A total of 120 primary healthcare centres from 5 jurisdictions in Europe.

Participants 746 individual providers (general practitioners, nurses or other professionals) participated in the study.

Primary outcome Change in the proportion of patients screened and referred to eBI comparing a baseline 4-week preimplementation period with a 12-week implementation period.

Results The possibility of referring patients to the eBI was not found to be associated with any increase in the proportion of patients screened. However, it was associated with an increase in the proportion of screen-positive patients receiving brief advice from 70% to 80% for the screen-positive sample as a whole (p<0.05), mainly driven by a significant increase in brief intervention rates in England from 87% to 96% (p<0.01). The study indicated that staff displayed a low level of engagement in this new technology. Staff continued to offer face-to-face advice to a larger proportion of patients (54%) than referral to eBI (38%). In addition, low engagement was seen among the referred patients; on average, 18% of the patients logged on to the website with a mean log-on rate across the different countries between 0.58% and 36.95%.

Conclusions Referral to eBI takes nearly as much time as brief oral advice and might require more introduction and training before staff are comfortable with referring to eBI.

Trial registration number NCT01501552; Post-results.

  • Alcohol screening
  • brief intervention
  • referral to electronic brief advice
  • fidelity to intervention

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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