Methadone-Maintained (MM) clients who engage in excessive alcohol use are at high risk for HIV and Hepatitis B virus (HBV) infection. Nurse-led Hepatitis Health Promotion (HHP) may be one strategy to decrease alcohol use in this population.
To evaluate the impact of nurse-led HHP, delivered by nurses compared to Motivational Interviewing (MI), delivered by trained therapists in group sessions or one-on-one on reduction of alcohol use.
A three-arm randomized, controlled trial, conducted with 256 MM adults attending one of five MM outpatient clinics in the Los Angeles area. Within each site, moderate-to-heavy alcohol-using MM participants were randomized into one of three conditions: 1) nurse-led hepatitis health promotion group sessions (n=87); 2) MI delivered in group sessions (MI-group; n=90), or 3) MI delivered one-on-one sessions (MI-single, n=79).
Self-reported alcohol use was reduced from a median of 90 drinks/month at baseline to 60 drinks/month at six month follow-up. A Wilcoxon sign-rank test indicated a significant reduction in alcohol use in the total sample (p < .05). In multiple logistic regression analysis controlling for alcohol consumption at baseline and other covariates, no differences by condition were found.
As compared to two programs delivered by MI specialists, a culturally-sensitive and easy to implement nurse-led HHP program produced similar reductions in alcohol use over six months. Employing nurse-led programs may allow cost savings for treatment programs as well as a greater integration of alcohol reduction counseling along with a more comprehensive focus on general health-related issues than previously conducted.
Keywords: Alcohol use, Methadone Maintained, Motivational Interviewing, nurse-led hepatitis health promotion