Implementing alcohol screening and intervention in a family medicine residency clinic.
The purpose of this study was to evaluate the impact of simultaneous systems interventions and clinician training on management of hazardous and harmful drinking in a residency clinic. Systems interventions included forming a multi-disciplinary implementation team, training registration clerks to distribute health risk questionnaires using the AUDIT-C alcohol screen, and training nurses to score the AUDIT-C and administer the AUDIT to screen-positive patients. Clinicians were trained to perform brochure-based interventions on screen-positive patients. Research staff provided compliance feedback. Over 12 months, 8.0% (241/3014) of patients screened positive and 3.8% (115/3014) received brief interventions. For screen-positive patients, comparisons with baseline measurements found increased rates of alcohol assessment (50% vs. 0%, p < .0001) and intervention (48.1% vs. 9.4%, p < .0001). Clinicians intervened more often when prompted with completed AUDITs (72% vs. 23%, p < .0001). Program modifications resulted in progressive increases in numbers of patients screened. This model shows promise for use in other residency programs.
Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA 31206, USA. seale.paul@mccg.org
J Paul
JP
Seale
Sylvia
S
Shellenberger
Wanda Kaye
WK
Tillery
John
J
Boltri
Robert
R
Vogel
Barbara
B
Barton
Megan
M
McCauley
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D003376:Counseling; D003430:Cross-Sectional Studies; D003479:Curriculum; D005194:Family Practice / Q000193:education*; D005845:Georgia; D006284:Health Plan Implementation; D006801:Humans; D007396:Internship and Residency; D008403:Mass Screening; D010044:Outpatient Clinics, Hospital; D010174:Pamphlets; D015397:Program Evaluation; D011795:Surveys and Questionnaires