F - Country Report Portugal Cristina Ribeiro - PHEPA

Portugal Strategies – Phepa project
in Primary health care
Cristina Ribeiro, , M.D.
General Directorate of Health and IDT-
National Institute of Drug Addiction
PHEPA National Project
Phepa Istambul Meeting
October 9-10, 9
2007

OVERVIEW
What was implemented
Changes ın natıonal
health servıces
-
consequences
Future Directions; DISCUSSION

Alcohol in Portugal
Evolution Alcohol Policy
Action Plan against Alcoholism
Government Resolution n.º 166/2000,
November 29th

Alcohol Portugal
Evolution Alcohol Policy
Action Plan against Alcoholism
1. Alcohol Health Promotion and Education
2. Alcohol Clinical and research issues
3. National Alcohol Network
4. Legislation and control

National Health Plan
2004 – 2010
1. National Program on Prevention of
Alcohol Related Problems
2. National Alcohol Referral Network

Changes in Portugal Strategies
Alcohol related Problems
General Directorate of of Health
Alcohol program
Plan
Implement
Evaluate
Phepa project
Alcohol
Centers
Primary heath
Care Centers

Alcohol in Portugal
New National Strategies in Alcohol Policy
3 Specialized Alcohol Centres
Are integrated in the Health System
Are involved in prevention programs
Are involved in alcohol dependent treatment
programs
Should be more articulated with PHC

Alcohol in Portugal
New National Strategies in Alcohol Policy
National Program on Prevention of
includes:
Alcohol Related Problems
National Project “Brief interventions in Primary
Health Care”

National Project “Brief interventions
in Primary Health Care”
Some national results:
Primary Health care services
11 Subregional health authorities answered to the
inquiry (61% of total)
55% have Alcohol Related Problems intervention
45% have Alcohol Related programs
55% have specific teams

National Project “Brief interventions in
Primary Health Care”
Some national results:
Primary Health care services
90% liaise with Mental Health Services
50% have Alcohol training programs
Only a very small number of PHC have research
programs

Alcohol in Portugal
New National Strategies in Alcohol Policy
Some preliminary regional results:
86% need training
77% have never participated in alcohol related
problems training
92% think that it is very important to be trained
and feel legitimicy to deal with this patients

National Project “Brief interventions in
Primary Health Care”
National Coordinator Group
Training Trainers (2 components – motivational
interviewing +BI)
Contact Regional Groups – trainers / training
program + Key elements in PHC

Alcohol in Portugal
New National Strategies in Alcohol Policy
Main goal of the training program:
Increase skills to do early identification and brief alcohol
interventions in Primary Health Care.
The training program can be delivered in two days, with a
follow-up six months later where it is possible to discuss
difficulties and the best way to solve them.

Points of Intervention
Needs Assessment of PHC in ARP
Institutional Availability
to guarantee PHC Training programs and
dissemination
Training programs and dissemination
How to transfer into practice

Phepa project in Portugal
ongoing process
an adaptive process in Primary Health Care
Integration of EIBI into daily routine requires
adequate infrastructure capacity
It also requires commitment and support from
institutions

Sustainability of SBI in PHC
Maintaining the program
Building the capacity to
continue the program

What has changed ?

Changes in Portugal Strategies
Alcohol related Problems
Changes in in Organic Law - 2007
Institute of
of
Drug Addiction
Phepa project
Changes in
in
Primary health
Care Centers
Alcohol
Centers

Addıtıonal
developments

Other developments related to
national project in ARP
There’s s now interest in pregraduate PHC
curricula at University
There’s s now interest in posgraduate internal
PHC programs
There’s s now interest on the project in groups of
tobacco intervention in PHC
There’s s now interest on the project in PHC
conferences and Institute of Drug Addiction and
alcohol national meetings

What is going on?

IMPLEMENTATION
Practice based guidelines: translated but not yet printed
Training: on process
sessions and follow-up for group of PHC professionals
Specialist support from alcohol centers
Engaging Health care providers : Discuss project,
goals, barriers, strategies
Sets Follow-up
Funding, Monitoring and Managing the programme
with Institute of drug addiction

Key points
Plan and target interventions
Monitor implementation
Evaluate outcomes
Reassess and modify interventions
Support for increased allocation of
resources and infrastructure capacity

Alcohol Related Problems
Phepa Project
Thank for your
attention!