Implementing alcohol screening and intervention

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.