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The European Journal of Public Health Advance Access originally published online on December 26, 2008
The European Journal of Public Health 2009 19(1):16-18; doi:10.1093/eurpub/ckn093
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© The Author 2008. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Alcohol, Tobacco and Drugs

Integration of alcohol use disorders identification and management in the tuberculosis programme in Tomsk Oblast, Russia

Trini A. Mathew1, Sergey A. Yanov2, Rais Mazitov3, Sergey P. Mishustin4, Aivar K. Strelis4,5, Galina V. Yanova2, Vera T. Golubchikova4, Dmitry V. Taran3, Alex Golubkov6, Alan L. Shields7,8,9, Shelly F. Greenfield7,9, Sonya S. Shin6,10 and on behalf of the Tomsk Tuberculosis Alcohol Working Group*

1 Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS 39216, USA
2 Tomsk Oblast Clinical Tuberculosis Hospital, Tomsk, Russian Federation
3 Partners In Health Russia, Moscow, Russian Federation
4 Tomsk Oblast Tuberculosis Services, Tomsk, Russian Federation
5 Siberian State Medical University, Tomsk, Russian Federation
6 Partners In Health, Boston, MA 02199, USA
7 Harvard Medical School, Boston, MA 02115, USA
8 Department of Psychology, East Tennessee State University, Johnson City, TN 37614, USA
9 Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, MA 02478, USA
10 Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA 02115, USA

Correspondence: Trini A. Mathew, MD, MPH, Division of Infectious Diseases, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA, tel: +601 984 5560, fax: +601 815 4015, e-mail: tmathew{at}medicine.umsmed.edu

Received April 15, 2008 , accepted September 19, 2008

Alcohol use disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. We developed a multidisciplinary model to manage AUDs among TB patients in Tomsk, Russia. First, we assessed current standards of care through stakeholder meetings and ethnographic work. The Alcohol Use Disorders Identification Test (AUDIT) was incorporated into routine assessment of all patients starting TB treatment. We established treatment algorithms based on AUDIT scores. We then hired specialists and addressed licensing requirements to provide on-site addictions care. Our experience offers a successful model in the management of co-occurring AUDs among patients with chronic medical problems.

Keywords: alcohol use disorders, tuberculosis, Alcohol Use Disorders Identification Test, Russia, systems integration, Siberia

*Tomsk Tuberculosis Alcohol Working Group includes: Viktoria Livchits, Svetlana Y. Grinchenko, Alexander S. Leschev, Svetlana A. Okhrimenko, Viktor V. Provotorov, Tatiana A. Kudryatseva, Irina A. Kalchenko, Hilary Connery, Megan Murray


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