F - Country Report Portugal Cristina Ribeiro - PHEPA
F - Country Report Portugal Cristina Ribeiro - PHEPA
F - Country Report Portugal Cristina Ribeiro - PHEPA
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<strong>Portugal</strong> Strategies – Phepa project<br />
in Primary health care<br />
<strong>Cristina</strong> <strong>Ribeiro</strong>, , M.D.<br />
General Directorate of Health and IDT-<br />
National Institute of Drug Addiction<br />
<strong>PHEPA</strong> National Project<br />
Phepa Istambul Meeting<br />
October 9-10, 9<br />
2007
OVERVIEW<br />
What was implemented<br />
Changes ın natıonal<br />
health servıces<br />
-<br />
consequences<br />
Future Directions; DISCUSSION
Alcohol in <strong>Portugal</strong><br />
Evolution Alcohol Policy<br />
Action Plan against Alcoholism<br />
Government Resolution n.º 166/2000,<br />
November 29th
Alcohol <strong>Portugal</strong><br />
Evolution Alcohol Policy<br />
Action Plan against Alcoholism<br />
1. Alcohol Health Promotion and Education<br />
2. Alcohol Clinical and research issues<br />
3. National Alcohol Network<br />
4. Legislation and control
National Health Plan<br />
2004 – 2010<br />
1. National Program on Prevention of<br />
Alcohol Related Problems<br />
2. National Alcohol Referral Network
Changes in <strong>Portugal</strong> Strategies<br />
Alcohol related Problems<br />
General Directorate of of Health<br />
Alcohol program<br />
Plan<br />
Implement<br />
Evaluate<br />
Phepa project<br />
Alcohol<br />
Centers<br />
Primary heath<br />
Care Centers
Alcohol in <strong>Portugal</strong><br />
New National Strategies in Alcohol Policy<br />
3 Specialized Alcohol Centres<br />
Are integrated in the Health System<br />
Are involved in prevention programs<br />
Are involved in alcohol dependent treatment<br />
programs<br />
Should be more articulated with PHC
Alcohol in <strong>Portugal</strong><br />
New National Strategies in Alcohol Policy<br />
National Program on Prevention of<br />
includes:<br />
Alcohol Related Problems<br />
National Project “Brief interventions in Primary<br />
Health Care”
National Project “Brief interventions<br />
in Primary Health Care”<br />
Some national results:<br />
Primary Health care services<br />
11 Subregional health authorities answered to the<br />
inquiry (61% of total)<br />
55% have Alcohol Related Problems intervention<br />
45% have Alcohol Related programs<br />
55% have specific teams
National Project “Brief interventions in<br />
Primary Health Care”<br />
Some national results:<br />
Primary Health care services<br />
90% liaise with Mental Health Services<br />
50% have Alcohol training programs<br />
Only a very small number of PHC have research<br />
programs
Alcohol in <strong>Portugal</strong><br />
New National Strategies in Alcohol Policy<br />
Some preliminary regional results:<br />
86% need training<br />
77% have never participated in alcohol related<br />
problems training<br />
92% think that it is very important to be trained<br />
and feel legitimicy to deal with this patients
National Project “Brief interventions in<br />
Primary Health Care”<br />
National Coordinator Group<br />
Training Trainers (2 components – motivational<br />
interviewing +BI)<br />
Contact Regional Groups – trainers / training<br />
program + Key elements in PHC
Alcohol in <strong>Portugal</strong><br />
New National Strategies in Alcohol Policy<br />
Main goal of the training program:<br />
Increase skills to do early identification and brief alcohol<br />
interventions in Primary Health Care.<br />
The training program can be delivered in two days, with a<br />
follow-up six months later where it is possible to discuss<br />
difficulties and the best way to solve them.
Points of Intervention<br />
Needs Assessment of PHC in ARP<br />
Institutional Availability<br />
to guarantee PHC Training programs and<br />
dissemination<br />
Training programs and dissemination<br />
How to transfer into practice
Phepa project in <strong>Portugal</strong><br />
ongoing process<br />
an adaptive process in Primary Health Care<br />
Integration of EIBI into daily routine requires<br />
adequate infrastructure capacity<br />
It also requires commitment and support from<br />
institutions
Sustainability of SBI in PHC<br />
Maintaining the program<br />
Building the capacity to<br />
continue the program
What has changed ?
Changes in <strong>Portugal</strong> Strategies<br />
Alcohol related Problems<br />
Changes in in Organic Law - 2007<br />
Institute of<br />
of<br />
Drug Addiction<br />
Phepa project<br />
Changes in<br />
in<br />
Primary health<br />
Care Centers<br />
Alcohol<br />
Centers
Addıtıonal<br />
developments
Other developments related to<br />
national project in ARP<br />
There’s s now interest in pregraduate PHC<br />
curricula at University<br />
There’s s now interest in posgraduate internal<br />
PHC programs<br />
There’s s now interest on the project in groups of<br />
tobacco intervention in PHC<br />
There’s s now interest on the project in PHC<br />
conferences and Institute of Drug Addiction and<br />
alcohol national meetings
What is going on?
IMPLEMENTATION<br />
Practice based guidelines: translated but not yet printed<br />
Training: on process<br />
sessions and follow-up for group of PHC professionals<br />
Specialist support from alcohol centers<br />
Engaging Health care providers : Discuss project,<br />
goals, barriers, strategies<br />
Sets Follow-up<br />
Funding, Monitoring and Managing the programme<br />
with Institute of drug addiction
Key points<br />
Plan and target interventions<br />
Monitor implementation<br />
Evaluate outcomes<br />
Reassess and modify interventions<br />
Support for increased allocation of<br />
resources and infrastructure capacity
Alcohol Related Problems<br />
Phepa Project<br />
Thank for your<br />
attention!