Feasibility and Acceptability of Screening and Brief Interventions to Address Alcohol and Other Drug Use among Patients Presenting for Emergency Services in Cape Town, South Africa

Abstract

Despite evidence from high income countries, it is not known whether screening and brief interventions (SBI) for alcohol and other drug (AOD) use are feasible to implement in low and middle income countries. This paper describes the feasibility and acceptability of a peer-led SBI for AOD-using patients presenting with injuries at emergency services in Cape Town, South Africa. Data were extracted from program records on the number of eligible patients screened and the number of program refusals. A questionnaire examined preliminary responses to the intervention for 30 patients who had completed the program and 10 emergency personnel. Peer counselors were also interviewed to identify barriers to implementation. Of the 1458 patients screened, 21% (305) met inclusion criteria, of which 74% (225) were enrolled in the intervention. Of the 30 patients interviewed, most (83%) found the program useful. Emergency personnel were supportive of the program but felt that visibility and reach could improve. Peer counselors identified the need for better integration of the program into emergency services and for additional training and support. In conclusion, with limited additional resources, peer-led SBIs for AOD use are feasible to conduct in South African emergency services and are acceptable to patients and emergency personnel.

Psychoactive substance use in a sample of community outreach participants; prevalence, correlates and ease of incorporating care

“…Given the fact that most of these participants came only for consultation for other health conditions and not specifically for substance use issues, this study has further buttressed the fact that substance use disorders are usually missed in routine community medical treatment where the health care workers don't possess the index of suspicion to identify them. As noted in some previous studies, 31,32 this study further buttress that fact that it is possible to incorporate ASSIST-linked Brief Intervention into routine community primary care. The apparent seamless incorporation of substance use screening, brief intervention and referral services was achieved during the community outreach through proper planning, training and execution by a group of psychologists and social workers who were proficient in the administration of ASSIST and ASSIST-linked Brief Intervention.…”

Screening and Brief Interventions for Alcohol and Other Drug Use Among Pregnant Women Attending Midwife Obstetric Units in Cape Town, South Africa: A Qualitative Study of the Views of Health Care Professionals

“…Whereas several studies have examined health care providers’ perceptions and views regarding the feasibility (and possible barriers) to implementing SBIRT integrated into health care services in South Africa, this study is among the first to explore the views of health care professionals working in antenatal service delivery regarding SBIRT to address alcohol and other drug use. Additionally, this study made use of the consolidated framework for implementation research, which is an overarching theory and includes important constructs from several implementation theories.…”

“…It also means that women will receive the same standard of care and treatment, regardless of which staff members they interact with. However, previous research has demonstrated the positive impact on implementation activities when peer counselors were used for screening and brief intervention and the intervention did not add to the existing workload of clinic staff …”

Adapting a blended motivational interviewing and problem-solving intervention to address risky substance use amongst South Africans

“…Currently, the South African substance abuse treatment system focuses primarily on the treatment of dependence through the delivery of drug "rehabilitation" services offered by specialist, stand-alone substance abuse service providers (Myers, Louw, & Pasche, 2010). However, feasibility studies on integrating screening and brief interventions (SBIs) into primary healthcare services (specifically emergency departments) have resulted in positive findings (Myers, Stein, Mtukushe, & Sorsdahl, 2012;Sorsdahl et al, 2013). Screening for substance use identifies whether patients' use places them and others at risk and hence warrants a brief intervention.…”