The number of experts available for the management of alcohol use disorders (AUDs) in rural and underserved areas in India is limited. In this study, a blended training programme was conducted for 26 primary care providers (PCPs) from nine districts of Bihar, in best practices for the management of AUDs. A two weeks on-site training was followed by fortnightly online tele-Extension for Community Healthcare Outcomes (ECHO) clinics for six months using the 'Hub and Spokes' ECHO model, accessible through internet-enabled smartphones. A questionnaire administered at baseline and after six months assessed changes in the PCPs compliance with principles of AUD management. Significant improvements were noted in compliance to principles in the management of AUDs based on self-report. Over the six months period 2695 individuals were screened, of whom 832 (30.8%) had an AUD Identification Test score of more than 16, indicating harmful use or dependence. The PCPs reported retaining 49.1 per cent of the cases for at least one follow up and needed to refer only 80 (3%) cases to specialists for further management. The ECHO model was found to be effective in training PCPs to provide quality healthcare. To confirm these findings, it needs to be tested in a large number of PCPs with a robust study design.


中文翻译：

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针对社区护理人员的酒精使用障碍管理，使用扩展的“社区医疗保健结果扩展”模型进行创新的虚拟指导。


印度农村和服务不足地区可用于管理酒精使用障碍（AUD）的专家人数有限。在这项研究中，针对来自比哈尔邦九个地区的26位初级保健提供者（PCP）进行了混合培训计划，其中涉及了澳元管理的最佳实践。经过为期两周的现场培训，随后每两周使用“中心辐射” ECHO模型通过社区智能手机在线访问社区医疗结果（ECHO）诊所的在线电话扩展，为期六个月。在基线和六个月后发放的调查表评估了PCP遵守AUD管理原则的变化。注意到在遵守基于自我报告的AUDs管理原则方面取得了重大改进。在六个月的时间里，筛选了2695个人，其中832（30.8％）的AUD身份认证测试得分超过16，表明使用有害或依赖。PCP报告称保留至少49.1％的病例进行至少一次随访，仅需要将80例（3％）病例转给专家进行进一步处理。人们发现，ECHO模型可有效地培训初级保健医生以提供优质的医疗保健。为了证实这些发现，需要通过强大的研究设计在大量PCP中对其进行测试。