Treating alcohol problems: a study of programme effectiveness and cost effectiveness according to length and delivery of treatment.

Abstract

To compare effectiveness and cost-effectiveness of a 5-week inpatient and a two week in- and day-patient regime. Pre-post assessment of consecutive treatment referrals with follow-up at 6 and 12 months. In a sequential study design, 112 patients underwent a 5-week residential programme while a subsequent 100 patients underwent a 2-week in- and day-patient programme. To investigate the effect of changing programme delivery, patient groups from before and after the programme changes were compared. Addiction treatment unit in an independent hospital. One hundred and thirty-six males and 76 female patients with an ICD-10 diagnosis of Alcohol Dependence Syndrome. Self-report (Comprehensive Drinkers Profile: Follow-Up Drinkers Profile: SADQ), collateral report (Collateral Interview Form) and blood test (MCV & GGT) data were used to categorize patients into abstinent, non-problem drinker, drinking but improved and unimproved groups. Percentage of days abstinent, intensity of drinking, length of time in treatment, treatment cost and use of aftercare were also measured. Abstinence or non-problem drinking was achieved by 55.6% of all patients at 1 year. Change in programme delivery did not affect outcome but treatment costs and mean length of stay for the revised programme were significantly reduced. A two week in- and day-patient treatment was more cost effective than a 5-week inpatient treatment. Design limitations make these conclusions tentative pending a randomized controlled trial.