A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes

J. Paul Seale, J Aaron Johnson, Denice Crowe Clark, Sylvia Shellenberger, Andrea T. Pusser, Jason Dhabliwala, Erika J. Sigman, Trenton Dittmer, Kristy Barnes Le, David P. Miller, Diana Clemow

Research output: Contribution to journalArticle

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Abstract

Purpose Screening and brief intervention (SBI) is a seldom-used evidence-based practice for reducing unhealthy alcohol use among primary care patients. This project assessed the effectiveness of a regional consortium's training efforts in increasing alcohol SBI. Method Investigators combined alcohol SBI residency training efforts with clinic SBI implementation processes and used chart reviews to assess impact on SBI rates in four residency clinics. Data were derived from a random sample of patient charts collected before (2010; n = 662) and after (2011; n = 656) resident training/clinic implementation. Patient charts were examined for evidence that patients were asked about alcohol use by a validated screening instrument, the screening result (positive or negative), evidence that patients received a brief intervention, prescriptions for medications to assist abstinence, and referrals to alcohol treatment. Chi-square analyses identified differences in pre-and posttraining implementation of SBI practices. Results Following program implementation, screening with validated instruments increased from 151/662 (22.8%) at baseline to 543/656 (82.8%, P <.01), and identification of unhealthy alcohol use increased from 12/662 (1.8%) to 41/656 (6.3%, P <.01). Performance of brief interventions more than doubled (10/662 [1.5%] versus 24/656 [3.7%], P <.01). There were no increases in the use of medications or referrals to treatment. Conclusions Resident training combined with clinic implementation efforts can increase the delivery of evidence-based practices such as alcohol SBI in residency clinics.

Original languageEnglish (US)
Pages (from-to)1707-1712
Number of pages6
JournalAcademic Medicine
Volume90
Issue number12
DOIs
StatePublished - Dec 1 2015

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system change
alcohol
resident
medication
evidence
patient care
random sample

ASJC Scopus subject areas

  • Education

Cite this

A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes. / Seale, J. Paul; Johnson, J Aaron; Clark, Denice Crowe; Shellenberger, Sylvia; Pusser, Andrea T.; Dhabliwala, Jason; Sigman, Erika J.; Dittmer, Trenton; Barnes Le, Kristy; Miller, David P.; Clemow, Diana.

In: Academic Medicine, Vol. 90, No. 12, 01.12.2015, p. 1707-1712.

Research output: Contribution to journalArticle

Seale, JP, Johnson, JA, Clark, DC, Shellenberger, S, Pusser, AT, Dhabliwala, J, Sigman, EJ, Dittmer, T, Barnes Le, K, Miller, DP & Clemow, D 2015, 'A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes', Academic Medicine, vol. 90, no. 12, pp. 1707-1712. https://doi.org/10.1097/ACM.0000000000000846
Seale, J. Paul ; Johnson, J Aaron ; Clark, Denice Crowe ; Shellenberger, Sylvia ; Pusser, Andrea T. ; Dhabliwala, Jason ; Sigman, Erika J. ; Dittmer, Trenton ; Barnes Le, Kristy ; Miller, David P. ; Clemow, Diana. / A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes. In: Academic Medicine. 2015 ; Vol. 90, No. 12. pp. 1707-1712.
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