Transcript Lucy Dorey Presentation - FEAD (Film Exchange on Alcohol and

Journeys of Recovery following a Hospital
based Alcohol Detoxification Programme
Lucy Dorey MPhil/PhD Student
ALCOHOL
DETOXIFICATION
RECOVERY
FROM ALCOHOL
DEPENDENCE
2
Queen Alexandra Hospital (QAH)
3
Alcohol Specialist Nurse Service at QAH(ASNS)
Those who are identified as at higher risk of alcohol harm are
referred to the ASNS (4% of those screened in the hospital).
• likely to be alcohol dependent
• increased risk of alcohol related disease e.g. liver disease
• admitted younger and die younger
• more admissions and ED attendances
• 40% require detoxification
Westwood et al. submitted
4
500 patients per year who complete
detoxification follow two pathways:
Portsmouth City
Fareham, Gosport &
South Eastern Hampshire
Twelve months ASNS
Health & Recovery Focused
Outpatients appointments
One ASNS
Health & Recovery Focused
Outpatients appointment
Supported to engage
with a range of recovery
services
Referral to
Community Alcohol
& Drug Services
5
Recovery Context
Recovery is a Personal
Process of Change
6
Research Questions
• Is there a difference between the recovery outcomes for
alcohol dependent patients following the Portsmouth and
Hampshire pathways?
• What is the process of change in early recovery for this
patient group?
• What treatment and non-treatment factors are seen as
initiating, supporting and posing barriers to recovery?
7
Literature Review
• Literature Review of “post detoxification” and “Alcohol
Dependence”
• 252 Studies screened and 14 identified after critique and
exclusions - medical interventions (97), neurological
recovery (59), drug and alcohol (70)
14 Studies
1 RCT
1 Pilot
RCT
4 Quasi
Experiments
8 Cohort
Studies
No Qualitative
Studies
8
Mixed Methods Research Design
RETROSPECTIVE ANALYSIS OF
ROUTINE DATA
Data sources:
• Alcohol Specialist Nurse Service
• QAH Patient Administration
System
• Hampshire Health Record Analysis
• National Drug Treatment and
Monitoring System (aggregated)
All detoxed patients 2010-2015
Statistical analysis comparing pathways
PROSPECTIVE LONGITUDINAL STUDY
Data sources:
20 Participants Pathway A
20 Participants Pathway B
Purposive selection
Interviews and questionnaires:
1 week
3 months
6 months
12 months
Thematic analysis comparing pathways
Combined Data Analysis
9
Semi–structured interviews
• What changes have you or others noticed since our last meeting?
• What changes have you been deliberately making or attempting? Can
you give me any specific examples of when you did something
differently?
• What changes you have been considering but haven’t acted on yet?
• What or who has helped you? Anything or anyone else that helped?
• What or who have been obstacles for you? Anything or anyone else that
were obstacles?
• What does the word “recovery” mean to you?
10
Questionnaires
1. Stages of Change Readiness and Treatment Eagerness Scale
(SOCRATES)
2. Acceptance and Action Questionnaire for Substance Abuse
(AAQ –SA)
3. Values Questionnaire (VQ)
Contextual Behavioural Sciences (Hayes et al 2012)
Away from
Unwanted
Experience
Behaviour
Towards
Valued
Living
11
Mixed Methods Research Design
RETROSPECTIVE ANALYSIS OF
ROUTINE DATA
Data sources:
• Alcohol Specialist Nurse Service
• QAH Patient Administration
System
• Hampshire Health Record Analysis
• National Drug Treatment and
Monitoring System (aggregated)
All detoxed patients 2010-2015
Statistical analysis comparing pathways
PROSPECTIVE LONGITUDINAL STUDY
Data sources:
20 Participants Pathway A
20 Participants Pathway B
Purposive selection
Interviews and questionnaires:
1 week
3 months
6 months
12 months
Thematic analysis comparing pathways
Combined Data Analysis
12
Acknowledgements
This study is being supported by:
• Alcohol Research UK
• NIHR CLARHC Wessex
• Portsmouth Hospitals NHS Trust
Supervisors:
• Professor Judith Lathlean Professor of Health Research at the
University of Southampton
• Dr Greta Westwood Head of Nursing, Midwifery and AHP
Research/Clinical Academic Coordinator Portsmouth Hospitals NHS
Trust and University of Southampton
• Professor Paul Roderick Professor of Public Health within Medicine at
the University of Southampton
13