title: Raising achievement: educating physicians to address effects of at-risk drinking on common diseases.
abstract: BACKGROUND
  Despite a high prevalence, internists rarely screen for at-risk drinking. A contributing factor is likely to be physicians' limited understanding of the negative effects that at-risk drinking can have on common clinical conditions managed on a daily basis.
  
  
  OBJECTIVE
  To develop and conduct a pre-post pilot evaluation of a web-based educational programme to educate and support physicians to assess alcohol use in patients with sleep disorders, depression and hypertension.
  
  
  METHODS
  An expert panel developed a programme that addressed: 1) screening for alcohol use; 2) evidence on effect of alcohol on hypertension, sleep disorders and depression; 3) brief interventions for at-risk drinking with patient education materials; and 4) codes for payment of brief alcohol interventions. From an internist network, 17 physicians were recruited for a pilot test of the web-based educational programme. All participants were surveyed at baseline and at an end point three months after the intervention about attitudes, knowledge and beliefs about at-risk drinkers and effects of alcohol on hypertension, sleep disorders and depression.
  
  
  RESULTS
  Among the 17 study physicians: 1) most believed that at-risk drinking affected their ability to treat hypertension, sleep disorders and depression (77% at baseline and 65% at end point); 2) nearly all were aware that at-risk drinking affects hypertension, sleep disorders and depression (94% at baseline and 94% at end point); and 3) 94% rated the educational programme positively at the end point. Frustration with managing at-risk alcohol use decreased (from 71% at baseline to 53% at end point) and study physicians' self-reported screening for at-risk drinking increased for new patients (from 47% at baseline to 71% at end point) and established patients (from 35% at baseline to 47% at end point).
  
  
  CONCLUSIONS
  This pilot of a web-based educational programme for internists was well received by study physicians. The programme increased screening for at-risk drinking while reducing frustration in dealing with this condition. Future work needs to evaluate this highly accessible programme in diverse practices and assess patient-related outcomes.
authors.affiliation: American College of Physicians, Department of Clinical Policy, Philadelphia, PA 19106, USA. mgannon@acponline.org
authors.forename: Meghan A
authors.initials: MA
authors.lastname: Gannon
authors.forename: Amir
authors.initials: A
authors.lastname: Qaseem
authors.forename: Vincenza
authors.initials: V
authors.lastname: Snow
authors.forename: Barbara
authors.initials: B
authors.lastname: Turner
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D015897:Comorbidity; D003194:Computer-Assisted Instruction; D003863:Depression / Q000453:epidemiology; D004502:Education, Medical, Continuing / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007388:Internal Medicine / Q000193:education*; D020407:Internet; D008403:Mass Screening / Q000592:standards* / Q000706:statistics & numerical data; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology