Scaling up prevention and management of alcohol-use-disorders and co-morbid depression in Latin America

A number of meta-analyses and systematic reviews have demonstrated the impact and cost-effectiveness of primary health care (PHC)–based measurement and advice programmes in reducing heavy drinking. Despite this, few governments have implemented such programmes countrywide owing to lack of motivation, time, or adequate training and support materials among other reasons.

The award

Funded by the European Commission, the SCALA study aims to test the implementation of primary health care (PHC)-based programmes, embedded in a community and municipal setting, for the measurement, management, and prevention of Alcohol Use Disorders (AUD) and co-morbid depression in Colombia, Mexico, and Peru.

The SCALA project is led by Professor Peter Anderson, (Maastricht University, Netherlands) and Dr EvaJané-Llopis (ESADE Business School,Spain). The study team combines expertise from Netherlands, Peru, Colombia, Germany, Mexico, Spain, and the UK.

Key outcomes

Findings so far demonstrate a clear impact of training. Centres whose providers received training measured the alcohol consumption of a nearly ten times higher proportion of patients than centres whose providers had not received training.

• The study has delivered pre-implementation training to 309 providers and booster training to 177 PHC providers.

• Over the course of the study, it is estimated that 30,000 new patients will be measured for their alcohol consumption

• 1,500 newly identified heavy drinkers will be advised and treated

• And over 500 new patients will be identified and treated for co-morbid depression.

Next steps

As the project draws to a close, the study team is looking at ensuring the sustainability of the implemented programmes. The Ministries of Health in Colombia, Mexico, and Peru are very interested in building on the study and scaling it up. The engagement with PAHO is expected to facilitate wider scale-up within and outside the three study countries.

The study team plans to produce a validated framework and strategy with guidance on implementation and scale-up as well as guidance on approaches for use in pandemics, including tele-medicine approaches. This should be a key tool for more widespread adoption and implementation of PCH-based programmes for prevention of AUD and co-morbid depression.

Full case study: Scaling up prevention and management of alcohol use disorders and co morbid depression in Latin America