title: ADAPTA: A pilot randomised controlled trial of an alcohol-focused intervention versus a healthy living intervention for problem drinkers identified in a general hospital setting.
abstract: OBJECTIVE
  To examine the relative feasibility, acceptability, applicability, effectiveness and explore cost-effectiveness of a healthy living focused intervention (HL) compared to an alcohol-focused intervention (AF) for problem drinkers identified in hospital.
  
  
  METHODS
  A pragmatic, randomised, controlled, open pilot trial. Feasibility and acceptability were measured by recruitment, attrition, follow-up rates and number of treatment sessions attended. Effectiveness was measured using the Alcohol Use Disorders Identification Test score at six months. Additional economic and secondary outcome measures were collected.
  
  
  RESULTS
  Eighty-six participants were randomised and 72% (n=62) were retained in full participation. Forty-one participants attended at least one treatment session (48%). A greater proportion in the HL group attended all four treatment sessions (33% vs 19%). Follow-up rates were 29% at six months and 22% at twelve months. There was no evidence of a difference in AUDIT score between treatment groups at six months. Mean cost of health care and social services, policing and the criminal justice system use decreased while EQ-5D scores indicated minor improvement in both arms. However, this pilot trial was not powered to detect differences in either measure between groups.
  
  
  CONCLUSIONS
  While no treatment effect was observed, this study demonstrated a potential to engage patients drinking at harmful or dependent levels in a healthy living intervention. However, recruitment proved challenging and follow-up rates were poor. Better ways need to be found to help these patients recognise the harms associated with their drinking and overcome the evident barriers to their engagement with specialist treatment.
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: jude.watson@york.ac.uk.
authors.forename: Judith M
authors.initials: JM
authors.lastname: Watson
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: caroline.fairhurst@york.ac.uk.
authors.forename: Caroline
authors.initials: C
authors.lastname: Fairhurst
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: jinshuo.li@york.ac.uk.
authors.forename: Jinshuo
authors.initials: J
authors.lastname: Li
authors.affiliation: Leeds Addiction Unit, 19 Springfield Mount, Leeds LS2 9NG, United Kingdom. Electronic address: gillian.tober@nhs.net.
authors.forename: Gillian
authors.initials: G
authors.lastname: Tober
authors.affiliation: Leeds Addiction Unit, 19 Springfield Mount, Leeds LS2 9NG, United Kingdom. Electronic address: helen.crosby@nhs.net.
authors.forename: Helen
authors.initials: H
authors.lastname: Crosby
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: charlie.lloyd@york.ac.uk.
authors.forename: Charlie
authors.initials: C
authors.lastname: Lloyd
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: christine.godfrey@york.ac.uk.
authors.forename: Christine
authors.initials: C
authors.lastname: Godfrey
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: noreen.mdege@york.ac.uk.
authors.forename: Noreen D
authors.initials: ND
authors.lastname: Mdege
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: veronica.dale@york.ac.uk.
authors.forename: Veronica
authors.initials: V
authors.lastname: Dale
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: paul.toner@york.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Toner
authors.affiliation: University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom. Electronic address: steve.parrott@york.ac.uk.
authors.forename: Steve
authors.initials: S
authors.lastname: Parrott
authors.affiliation: Leeds Addiction Unit, 19 Springfield Mount, Leeds LS2 9NG, United Kingdom. Electronic address: d.raistrick@nhs.net.
authors.forename: Duncan
authors.initials: D
authors.lastname: Raistrick
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy; D003362:Cost-Benefit Analysis; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D016896:Treatment Outcome
keywords: Acceptability; Alcohol-related hospital admissions; Healthy living; Problem drinkers; Randomised controlled trial; Social behaviour and network therapy