DrugInfo seminar: Stepping out of the SHADE. The use of ehealth approaches in the management of co-morbid depression and alcohol/other drug use programs
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Similaire à DrugInfo seminar: Stepping out of the SHADE. The use of ehealth approaches in the management of co-morbid depression and alcohol/other drug use programs
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Similaire à DrugInfo seminar: Stepping out of the SHADE. The use of ehealth approaches in the management of co-morbid depression and alcohol/other drug use programs (20)
DrugInfo seminar: Stepping out of the SHADE. The use of ehealth approaches in the management of co-morbid depression and alcohol/other drug use programs
For all of the advantages of the Australian Healthcare system, like systems in other developed countries, our health system is under increasing pressure due to a shortage of trained healthcare professionals, suboptimal distribution of services and the increasing demand for care.As a result, our healthcare system is exposed to delays in accessing information and services.This leads to high levels of frustration amongst healthcare providers and clients - particularly disadvantaged groups, including those who are experiencing mental health disorders)This situation is compounded dramatically by the occurrence of comorbidity.
Australia was one of the first nations to recognise the potential and benefits of e-health, leading to a number of initiatives in the 1990s aimed at better integrating technology into practice.E-health approaches have been recommended in the newly released Guidelines on the management of co-occurring alcohol and other drug and mental health conditions (led by Kath Mills) and on the NSW Health Professional Practice Guidelines for Psychosocial Interventions in Drug and Alcohol Services.
All participants made significant improvements in their depression relative to baselineTherapist reduction = 18 points at 36/mthrel to baselineComputer = 14 pointsPCT = 11 pointsTrend towards the SHADE participants reporting significantly greater reductions in depression at 3-months (14-points) relative to the other treatment conditions (8-9 points)
This represents only those people (62%) who met criteria for hazardous alcohol use at baseline.Again, all participants made significant reductions in alcohol consumption relative to baseline. This reduction was greatest for the SHADE participants, although their baseline level of consumption was higher (although not significantly higher) to begin with.Relative to baseline, cac participants reported a 62% reduction in alcohol use at 3 years, Therapist compared to a 44% reduction for therapist cbt, PCT and in fact an increase of 18% among the pct groupSlight trend towards the SHADE participants reporting greater reductions in alcohol use relative to other conditions (especially at 3 months) – but not statistically significant, and may in fact be due to their high baseline consumption.
This represented a 25% reduction in binge drinling frequency for both cac and therapist cbt at 3 years relative to baseline, and a 3% reduction for the pct group
Relative to baseline, cac participants reported a 67% reductionin marijuana use at 3 years, compared with 44% in therapist cbt participants and 29% for the pct group.Interesting pattern of reduction over time for both PCT and SHADE – with an increase in cannabis use evident at 6-months relative to baseline.
Often, the evidence needed to encourage clinicians to support various e-health programs (SHADE included) and to adopt a proposed technology is not compelling, and in many cases is completely absent.2 dissemination trialsMental Health Service SettingEarly Psychosis Service Rob 10-week ProgramDrug and Alcohol Service SettingCounselling, Cannabis Clinic, MERITTanya Skill Modules
The failure to understand and effectively communicate the benefits of e-health has been a major impediment to the implementation of e-health in Australia and many other developed countries. But, with the right tools, sound, informed decisions can be made that are based on evidence and a clear understanding of how value can be created from e-health applications in different care settings.We hope that SHADE can go some way towards improving the current situation, if only for the important area of depression and substance use comorbidity.