Pathways to Comorbidity Care program in Australian drug and alcohol services

Comorbid mental health and substance use disorders are common among patients in drug and alcohol outpatient services, leading to increased complexity of problems and reduced quality of life. 

Treatment of comorbidity is challenging due to a lack of training among clinicians in accurately identifying and treating these conditions. Integrated care is hindered by barriers within organisations and limited funding for comorbidity management. 

In Australia, these challenges are exacerbated by geographical factors, including higher prevalence of alcohol use disorders and suicide rates in nonmetropolitan areas, poorer treatment outcomes in regional towns, and limited access to services and skilled professionals in rural locations. 

The Pathways to Comorbidity Care package was developed to address these barriers and has shown effectiveness in improving comorbidity management.

A research paper, Geographical variation in implementation of the Pathways to Comorbidity Care program in Australian drug and alcohol services uses the Consolidated Framework for Implementation Research (CFIR) to evaluate variations in implementation outcomes across geographically diverse services. The CFIR guided the development of self-report measures and semi-structured interviews evaluating implementation of the Pathways to Comorbidity Care training, and disparities in implementation barriers and facilitators were determined.

Findings revealed that regional clinicians encountered more barriers to implementation compared with metropolitan clinicians, particularly regarding ongoing and effective communication with local clinical teams about how to incorporate the approach into routine practices.  These findings highlight the importance of understanding the specific needs of local settings and adapting the intervention accordingly to each service. 

The paper is available in the June 2023 issue of JBI Evidence Implementation

Geographical variation in implementation of the Pathways to Comorbidity Care program in Australian drug and alcohol services

Louie, Eva; Giannopoulos, Vicki; Uribe, Gabriela; Wood, Katie; Teesson, Maree; Childs, Steven; Baillie, Andrew; Haber, Paul S; Morley, Kirsten C2
JBI Evidence Implementation 21(2):p 186-193, June 2023. | DOI: 10.1097/XEB.0000000000000344