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Improvement of access to treatment for people with alcohol- and drug-related problems [IATPAD] [2005322] - Project
General objectives

The present project is targeting the issue of access to treatment for people with alcohol- and drug-related problems. Problems of substance-related disorders, when not properly dealt with, produce dramatic costs to all societies in terms of lost productivity, transmission of infectious diseases such as HIV/AIDS, hepatitis C and B, family and social disorder, crime, excessive utilization of health care and, of course, decrease quality of life of the individual and of the entire EU community. The general objectives of the project are to decrease the above mentioned costs for the society and for the individual caused by delaying of or even preventing people with alcohol- and drug-related problems from treatment entry. It is the improvement of access to treatment for people with alcohol- and drug-related problems, as also suggested by research evidence, which has the potential to contribute to the achievement of strategic objectives such as decreasing the incidence of HIV, hepatitis C and B and other infectious diseases, reducing the prevalence of substance use and substance demand, reducing the incidence of substance use related health damage, reducing drug related crime, reducing excessive utilization of health care, increasing productivity and decreasing substance use related absenteeism and unemployment, increasing the level of security for the society, reducing the burden of distress for the family caused by substance use problems, reducing disease, injury, disability and premature death caused by substance use, reducing highrisk behaviours, including unsafe sex, especially among youth.

Strategic relevance and contribution to the public health programme

The present project is in accordance with the Public Health Programme and the Work Plan 2005 priorities. The priorities 3.1.3. and 3.1.2. are to support key Community strategies on addictive substances which give the priority on treatment and reinsertion activities and aim to promote best practice as to improving availability of prevention and harm reduction services, and improvement of accessibility of services for drug and alcohol users. In compliance with this, the aim of the project is to explore and describe the health care systems in 8 European countries with respect to potential barriers of access to substance related disorder treatment, and on the basis of this, to provide recommendations on improvement of access to such treatment. This will enhance the opportunity to decrease negative impacts of alcohol and illicit psychoactive substances consumption on individuals and on society in the EU and accessing countries. A thorough overview of attitudes of health care personnel towards people with substance-related health problems, which might be an important problem hindering access to treatment in the respective partner countries, and perceived treatment system related barriers, will be obtained through surveys among health care personnel. Treatment of substance-related mental disorders serves as one of HIV/AIDS preventive measures. The project aims at identifying addiction treatment access barriers and providing recommendation on good practice in the field, thus addressing the priority 3.2.3. of the Work plan 2005. In accordance with 3.3.1 of the Work plan for 2005, the project focuses on developing targeted public health response strategies to address vulnerable groups, including access to and quality of health and social services, through transnational meetings, reports, Booklet (D9) and Publication (D11), which will present project findings and conclusions. The main output of the project will be provision of possible suggestions of good practice models and recommendations on innovative approaches to ease access to treatment.

Methods and means

In the first phase of the project in months one through nine, exploration and description of the current situation regarding health care systems with respect to potential barriers of access to addiction treatment for alcohol and/or drug using clients on the national level will be conducted. This will be done by means of analysis of relevant health care policy documents of the respective country. This could be supplemented by phone or face-to-face interviews with providers of specialised health care for alcohol and/or drug users, and by other methods where necessary. The collected data will be analysed by qualitative methods, summarised into national overviews and will serve as a material for hypotheses generation and fine-tuning of the proposed methods for the second phase of the project. Appropriateness of the method: since exploring a new field, qualitative methods are generally best for hypothesis generation. In the second phase of the project, the hypotheses about barriers to treatment entry connected with attitudes towards clients with substance-related problems and system barriers hindering their access to addiction treatment will be tested. A representative sample of the key health-care personnel exactly determined in the first phase of the project will be driven and data will be collected by questionnaire methods. Although the standard methodology will be exactly defined during the second Transnational Work Meeting, additional methods can be used on country levels where necessary. Data analysis will be conducted on national as well as international level, with the use of descriptive, as well as multivariate statistics. Appropriateness of the method: questionnaire method is the most cost-effective method for necessary data collection for the intended data analyses. Qualitative methods like focus groups and/or interviews will be used to explore patients` point of view of the barriers that were hindering their access to appropriate treatment. Appropriateness of the method: to explore a brand new point of view and to generate hypothesis for further research and projects, we find focus groups and interviews with patients the most appropriate methods.

Expected outcomes period

Results to be achieved Work package 1: Coordination of the project This work package is linked to co-ordination of work and subsequent achievement of all 5 specific objectives. Its goals are to ensure synergy between partners, common time schedule, comparability and synthesis of their work. This will be done through a unique informatics platform created within the project period. Work package 2: Dissemination of the results This work package is directly linked to dissemination of the project itself, as well as of the results of specific objectives 1 through 5. The objective is to r each all target groups that work in the field or have the possibility to contribute to change in the current situation regarding substance use treatment entry. Work package 3: Evaluation of the project This package will evaluate achievement of specific objectives 1 through 5, as well as of extra outputs. It will also provide evaluation of project coordination. Work package 4: Country overviews of access to treatment barriers This WP is linked to specific objective number 1: detection of barriers hindering access to substance use treatment for people with substance use problems through qualitative analysis of the treatment systems in partner countries. Work package 5: Survey among health care professionals and clients This WP is linked to specific objectives 2 and 3: Measurement of health care personnel attitudes towards substance users by a survey in primary and specialised health care, and Analysis of the impact of (a) health care personnel attitude towards clients with substance use problems and (b) system barriers on treatment accessibility with the use of multivariate statistical methods and qualitative approaches. Work package 6: Publications production The objective of this work package is to produce the Publication. It refers to all other specific objectives, since it will contain a description of all methodologies and outputs of the project. Work package 7: Transnational Work Meetings 1 – 5 (TWM 1–5) This WP refers to specific objectives 1 through 5 for it provides the possibility to agree on comparative approach to the problem that will be necessary in all parts of the project conduction to come to a findings comparable between the partner countries, and to the possibility of development of recommendations of innovative approaches in facilitation of positive attitudes of health care personnel towards such clients and aspects of health care system that promote easy access to treatment.

Start date: 11/11/2006
End date: 11/11/2009
Duration: 36 month(s)
Current status: Finalised
Programme title: First Programme of Community action in the field of public health (2003-2008)
EC Contribution: € 678 000,00