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.
Seale
J Paul
JP
Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA 31206, USA. seale.paul@mccg.org
Shellenberger
Sylvia
S
Tillery
Wanda Kaye
WK
Boltri
John
J
Vogel
Robert
R
Barton
Barbara
B
McCauley
Megan
M
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