Implementation of a clinical pathway may improve alcohol treatment outcome.
This article describes the design, implementation, and evaluation of a clinical pathway system in a two-cohort quasi-experimental study before and after implementation, controlling for confounders. The main outcome measures were retention in care and sensible alcohol use (defined as abstinent or drinking no more than 21 standard drinks per week). Patients with harmful alcohol use or dependence as their primary problem who were seeking psychosocial treatment at one of four alcohol clinics in Denmark participated in the study. After implementation of the clinical pathway system, which incorporated a structured intake, a referral and independent follow-up system, checklists, audit, and feedback, there was no change in length of stay, but significantly more patients had a good clinical outcome (stopped or moderated their consumption) at the end of treatment (OR = 1.9; 1.2-3.1). The study documents the feasibility of using a clinical pathway framework, incorporating a local monitoring system, checklists, audit, and feedback to enhance treatment quality and improve outcomes for alcohol use disorders.
Department of Psychiatry, Odense University Hospital, DK-5000, Odense C, Denmark. ansnielsen@health.sdu.dk.|Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, DK-5000, Odense C, Denmark. ansnielsen@health.sdu.dk.
Anette Søgaard
AS
Nielsen
Department of Psychiatry, Odense University Hospital, DK-5000, Odense C, Denmark. Bent.Nielsen@rsyd.dk.|Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, DK-5000, Odense C, Denmark. Bent.Nielsen@rsyd.dk.
Bent
B
Nielsen
D000328:Adult; D019973:Alcohol-Related Disorders / Q000523:psychology / Q000628:therapy*; D003266:Continuity of Patient Care / Q000458:organization & administration; D019091:Critical Pathways / Q000458:organization & administration* / Q000592:standards; D003718:Denmark; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration; D017410:Practice Guidelines as Topic