Using the chronic care model to improve treatment of alcohol use disorders in primary care settings.
OBJECTIVE
Alcohol use disorders (AUDs) are serious and often chronic medical conditions that present a significant public health concern. The Chronic Care Model (CCM), originally designed to improve care for patients with chronic conditions, is also applicable to a broad range of individuals with AUDs. In this article, we describe the CCM and discuss ways it can be adapted in primary care settings to improve care for AUDs.


METHODS
We review the evidence for considering the spectrum of AUDs as a chronic disease and discuss how the CCM might guide the reorganization of care to improve the delivery of effective interventions in primary care settings. We also solicited specific advice and feedback from an expert panel by means of a listserv.


RESULTS
The CCM is a heuristic model that offers an approach to increase the ability of PCPs to identify, treat and effectively manage AUDs. Research suggests the model works well for a variety of chronic illnesses and across a number of different organizational settings. Implementation of the model in the case of AUDs has the potential to improve their care.


CONCLUSIONS
Given the potentially chronic and relapsing nature of AUDs, it is important for the alcohol treatment community to be aware of the current research on improving care for chronic illnesses and to consider how the CCM might be adapted to improve care for AUDs. Further work is needed on developing tools, self-management support resources and training strategies before the CCM can be evaluated in real world settings.
Watkins
Katherine
K
RAND, 1700 Main Street, Santa Monica, California 90407-2138, USA. Katherine_Watkins@rand.org
Pincus
Harold Alan
HA
Tanielian
Terri L
TL
Lloyd
Jacqueline
J
D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002908:Chronic Disease; D003661:Decision Support Techniques; D017408:Guidelines as Topic; D006304:Health Status; D006801:Humans; D008403:Mass Screening; D011320:Primary Health Care