Integration and sustainability of alcohol screening, brief intervention, and pharmacotherapy in primary care settings

J Stud Alcohol Drugs. 2013 Jul;74(4):598-604. doi: 10.15288/jsad.2013.74.598.

Abstract

Objective: 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.

Method: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Alcohol Deterrents / administration & dosage
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / prevention & control*
  • Alcohol-Related Disorders / complications
  • Alcohol-Related Disorders / drug therapy*
  • Alcohol-Related Disorders / therapy
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / therapy*
  • Humans
  • Hypertension / epidemiology
  • Hypertension / therapy*
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Practice Patterns, Physicians' / organization & administration
  • Practice Patterns, Physicians' / standards
  • Primary Health Care / methods
  • Primary Health Care / standards
  • Psychotherapy, Brief / methods
  • Quality Improvement
  • Time Factors

Substances

  • Alcohol Deterrents