Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study
Background: Screening, brief intervention and referral to treatment (SBIRT) programmes have resulted in generally positive outcomes in healthcare settings, particularly for problem alcohol use, yet implementation is hampered by barriers such as concerns regarding the burden on healthcare professiona...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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BMC
2021
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| Online Access: | http://hdl.handle.net/20.500.11937/85707 |
| _version_ | 1848764763240136704 |
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| author | van der Westhuizen, C. Malan, M. Naledi, T. Roelofse, M. Myers-Franchi, Bronwyn Stein, D.J. Lahri, S. Sorsdahl, K. |
| author_facet | van der Westhuizen, C. Malan, M. Naledi, T. Roelofse, M. Myers-Franchi, Bronwyn Stein, D.J. Lahri, S. Sorsdahl, K. |
| author_sort | van der Westhuizen, C. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Screening, brief intervention and referral to treatment (SBIRT) programmes have resulted in generally positive outcomes in healthcare settings, particularly for problem alcohol use, yet implementation is hampered by barriers such as concerns regarding the burden on healthcare professionals. In low-resourced settings, task-sharing approaches can reduce this burden by using non-professional healthcare workers, yet data are scarce regarding the outcomes and acceptability to patients within a SBIRT service. This study aims to evaluate patient-reported outcomes, patient acceptability, perceived benefits and recommendations for improving a task-shared SBIRT service in South African emergency centres (ECs).
Methods: This mixed methods study incorporates quantitative substance use screening and patient satisfaction data collected routinely within the service at three hospitals, and qualitative semi-structured interviews with 18 EC patient beneficiaries of the programme exploring acceptability and perceived benefits of the programme, as well as recommendations to improve the service. Approximately three months after the acute EC visit, a sub-sample of patients were followed up telephonically to assess patient-reported satisfaction and substance use outcomes.
Results: Of the 4847 patients eligible for the brief intervention, 3707 patients (76%) used alcohol as their primary substance and 794 (16%) used cannabis. At follow-up (n = 273), significant reductions in substance use frequency and severity were noted and over 95% of patients were satisfied with the service. In the semi-structured interviews, participants identified the non-judgemental caring approach of the counsellors, and the screening and psychoeducation components of the intervention as being the most valuable, motivating them to decrease substance use and make other positive lifestyle changes. Study participants made recommendations to include group sessions, market the programme in communities and extend the programme’s reach to include a broader age group and a variety of settings.
Conclusions: This task-shared SBIRT service was found to be acceptable to patients, who reported several benefits of a single SBIRT contact session delivered during an acute EC visit. These findings add to the SBIRT literature by highlighting the role of non-professional healthcare workers in delivering a low-intensity SBIRT service feasible to implement in low-resourced settings. |
| first_indexed | 2025-11-14T11:24:31Z |
| format | Journal Article |
| id | curtin-20.500.11937-85707 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:24:31Z |
| publishDate | 2021 |
| publisher | BMC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-857072021-10-15T01:23:03Z Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study van der Westhuizen, C. Malan, M. Naledi, T. Roelofse, M. Myers-Franchi, Bronwyn Stein, D.J. Lahri, S. Sorsdahl, K. Science & Technology Life Sciences & Biomedicine Substance Abuse Screening brief intervention and referral to treatment (SBIRT) Task-sharing Patient experiences Low- and middle-income countries MIDDLE-INCOME COUNTRIES MENTAL-HEALTH-CARE TREATMENT SBIRT ALCOHOL-USE BARRIERS IMPLEMENTATION FACILITATORS ACCEPTABILITY FEASIBILITY DISORDERS Background: Screening, brief intervention and referral to treatment (SBIRT) programmes have resulted in generally positive outcomes in healthcare settings, particularly for problem alcohol use, yet implementation is hampered by barriers such as concerns regarding the burden on healthcare professionals. In low-resourced settings, task-sharing approaches can reduce this burden by using non-professional healthcare workers, yet data are scarce regarding the outcomes and acceptability to patients within a SBIRT service. This study aims to evaluate patient-reported outcomes, patient acceptability, perceived benefits and recommendations for improving a task-shared SBIRT service in South African emergency centres (ECs). Methods: This mixed methods study incorporates quantitative substance use screening and patient satisfaction data collected routinely within the service at three hospitals, and qualitative semi-structured interviews with 18 EC patient beneficiaries of the programme exploring acceptability and perceived benefits of the programme, as well as recommendations to improve the service. Approximately three months after the acute EC visit, a sub-sample of patients were followed up telephonically to assess patient-reported satisfaction and substance use outcomes. Results: Of the 4847 patients eligible for the brief intervention, 3707 patients (76%) used alcohol as their primary substance and 794 (16%) used cannabis. At follow-up (n = 273), significant reductions in substance use frequency and severity were noted and over 95% of patients were satisfied with the service. In the semi-structured interviews, participants identified the non-judgemental caring approach of the counsellors, and the screening and psychoeducation components of the intervention as being the most valuable, motivating them to decrease substance use and make other positive lifestyle changes. Study participants made recommendations to include group sessions, market the programme in communities and extend the programme’s reach to include a broader age group and a variety of settings. Conclusions: This task-shared SBIRT service was found to be acceptable to patients, who reported several benefits of a single SBIRT contact session delivered during an acute EC visit. These findings add to the SBIRT literature by highlighting the role of non-professional healthcare workers in delivering a low-intensity SBIRT service feasible to implement in low-resourced settings. 2021 Journal Article http://hdl.handle.net/20.500.11937/85707 10.1186/s13722-021-00239-5 English http://creativecommons.org/licenses/by/4.0/ BMC fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Substance Abuse Screening brief intervention and referral to treatment (SBIRT) Task-sharing Patient experiences Low- and middle-income countries MIDDLE-INCOME COUNTRIES MENTAL-HEALTH-CARE TREATMENT SBIRT ALCOHOL-USE BARRIERS IMPLEMENTATION FACILITATORS ACCEPTABILITY FEASIBILITY DISORDERS van der Westhuizen, C. Malan, M. Naledi, T. Roelofse, M. Myers-Franchi, Bronwyn Stein, D.J. Lahri, S. Sorsdahl, K. Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study |
| title | Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study |
| title_full | Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study |
| title_fullStr | Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study |
| title_full_unstemmed | Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study |
| title_short | Patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in South African emergency centres: a mixed methods study |
| title_sort | patient outcomes and experience of a task-shared screening and brief intervention service for problem substance use in south african emergency centres: a mixed methods study |
| topic | Science & Technology Life Sciences & Biomedicine Substance Abuse Screening brief intervention and referral to treatment (SBIRT) Task-sharing Patient experiences Low- and middle-income countries MIDDLE-INCOME COUNTRIES MENTAL-HEALTH-CARE TREATMENT SBIRT ALCOHOL-USE BARRIERS IMPLEMENTATION FACILITATORS ACCEPTABILITY FEASIBILITY DISORDERS |
| url | http://hdl.handle.net/20.500.11937/85707 |