Integration and Sustainability of Alcohol Screening, Brief Intervention, and Pharmacotherapy in Primary Care Settings

Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina.
Journal of studies on alcohol and drugs (Impact Factor: 2.76). 07/2013; 74(4):598-604. DOI: 10.15288/jsad.2013.74.598
Source: PubMed


At-risk drinking and alcohol use disorders are common in primary care and may adversely affect the treatment of patients with diabetes and/or hypertension. The purpose of this article is to report the impact of dissemination of a practice-based quality improvement approach (Practice Partner Research Network-Translating Research into Practice [PPRNet-TRIP]) on alcohol screening, brief intervention for at-risk drinking and alcohol use disorders, and medications for alcohol use disorders in primary care practices.

Nineteen primary care practices from 15 states representing 26,005 patients with diabetes and/or hypertension participated in a group-randomized trial (early intervention vs. delayed intervention). The 12-month intervention consisted of practice site visits for academic detailing and participatory planning and network meetings for "best practice" dissemination.

At the end of Phase 1, eligible patients in early-intervention practices were significantly more likely than patients in delayed-intervention practices to have been screened (odds ratio [OR] = 3.30, 95% CI [1.15, 9.50]) and more likely to have been provided a brief intervention (OR = 6.58, 95% CI [1.69, 25.7]. At the end of Phase 2, patients in delayed-intervention practices were more likely than at the end of Phase 1 to have been screened (OR = 5.18, 95% CI [4.65, 5.76]) and provided a brief intervention (OR = 1.80, 95% CI [1.31, 2.47]). Early-intervention practices maintained their screening and brief intervention performance during Phase 2. Medication for alcohol use disorders was prescribed infrequently.

PPRNet-TRIP is effective in improving and maintaining improvement in alcohol screening and brief intervention for patients with diabetes and/or hypertension in primary care settings.

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    • "The US Preventive Task Force recommends screening all patients for alcohol misuse and addressing hazardous or harmful use through a brief intervention [10]. Screening instruments and evaluation protocols are important initial tools needed in addressing alcohol use/dependence and drug abuse [2] [3] [11] [12]. Screening instruments such as the AUDIT, ASSIST, CAGE questionnaire, or other validated tool can be utilized to determine hazardous or harmful alcohol use, as well as identifying drug abuse and opioid dependence to help inform the primary care provider in determining the level of care and treatment setting for the patient [13– 15]. "
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