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.