School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia; and Sonder Care, Edinburgh North, SA 5113, Australia.
Sonder Care, Edinburgh North, SA 5113, Australia.
Aust J Prim Health. 2024 Aug;30. doi: 10.1071/PY23231.
Background Sonder's In-Home Withdrawal Service (IHWS) has been providing a unique home-based, multidisciplinary, wraparound withdrawal option for people with low-to-moderate levels of substance dependence since September 2019. This paper provides an evaluation of the service's overall impact on reducing substance use among clients through the delivery of this innovative service model. The evaluation explores the acceptability and feasibility of the service via client, stakeholder, and staff perspectives. Methods A mixed-method design was used to evaluate the IHWS. Descriptive analysis of quantitative data was conducted using clinical assessments from client records and online feedback surveys. Qualitative data from client, staff, and stakeholder feedback surveys were analysed thematically. Results Overall, 1166 referrals were received over the lifespan of the service, and a data set of 96 clients was included in the analysis. Self-reported measures showed that most clients decreased their substance use (89%), improved their psychological health status (75%), improved their physical health (65%), improved their quality of life (69%), and improved their understanding and ability to manage their alcohol and other drugs (AOD) use (84%). Client feedback suggests the service is providing a unique option for AOD withdrawal. Stakeholders commend the service's home-based setting, multidisciplinary and person-centred approach to care, and recommended expansion of the service to increase access for clients and reduce demand on inpatient settings. Conclusions The IHWS is having a significant impact in reducing substance use and highlights the need for increased access to holistic approaches to withdrawal. This includes pre- and post-withdrawal support and the inclusion of multidisciplinary teams, and engaging lived experience practitioners. A focus on funding primary-based services is required to meet the rising costs of tertiary-based care and to better meet the needs of consumers.
自 2019 年 9 月以来，Sonder 的居家脱瘾服务（IHWS）一直为低至中度物质依赖的人提供独特的基于家庭的、多学科的、全面的脱瘾选择。本文通过提供这种创新的服务模式，评估该服务在减少客户物质使用方面的整体影响。该评估通过客户、利益相关者和员工的视角探讨了该服务的可接受性和可行性。
采用混合方法设计来评估 IHWS。使用客户记录中的临床评估和在线反馈调查对定量数据进行描述性分析。对客户、员工和利益相关者反馈调查的定性数据进行了主题分析。
在服务的整个生命周期内，共收到 1166 次转介，其中包括 96 名客户的数据。自我报告的测量结果表明，大多数客户减少了物质使用（89%）、改善了心理健康状况（75%）、改善了身体健康（65%）、提高了生活质量（69%）、提高了他们理解和管理酒精和其他药物（AOD）使用的能力（84%）。客户反馈表明，该服务为 AOD 脱瘾提供了独特的选择。利益相关者称赞该服务的家庭环境、多学科和以个人为中心的护理方法，并建议扩大服务范围，以增加客户的获得机会并减少对住院环境的需求。
IHWS 在减少物质使用方面产生了重大影响，强调需要增加获得整体脱瘾方法的机会。这包括脱瘾前后的支持以及包括多学科团队，并让有经验的从业者参与。需要关注以初级为基础的服务的资金投入，以满足三级治疗不断上升的成本，并更好地满足消费者的需求。
