Alcohol Screening and Brief Intervention Training in Primary Care
Studies indicate alcohol screening and brief intervention (SBI) are effective in primary care settings but challenging to introduce into actual practice. In this study, researchers evaluated a 3-hour training (based on the literature and the National Institute on Alcohol Abuse and Alcoholism's Physicians' Guide to Helping Patients with Alcohol Problems) aimed at assisting implementation of SBI in primary care. Forty-four physicians and 41 clinical non-physicians (nurses, counselors, and physician assistants) from 10 practices across the United States, as well as 88 medical students, were trained. Results of pre-tests and post-tests and comparisons with 5 clinical practices that served as controls include the following:
- Knowledge regarding SBI increased significantly among all trainees.
- Confidence in screening patients increased significantly in physicians and medical students whereas confidence in conducting brief interventions increased significantly only in medical students.
- Physicians and non-physicians perceived significantly fewer obstacles to implementing brief interventions while only non-physicians perceived fewer barriers to screening.
- Trained providers reported significantly higher use of alcohol screening tests and management of patients for drinking than did untrained providers.
- The proportion of at-risk drinkers reporting (3 months after their office visit) that their providers talked to them about alcohol use was greater in the trained practices than in the untrained practices (47% versus 22%).
This training program increased provider knowledge, provider self-report of SBI, and patient report of discussions with their providers about alcohol use. These positive findings can be attributed in part to key features of the program—its systems approach and adaptability to fit within the existing practice and administrative structure of each clinical site.Kevin L. Kraemer, MD, MSc
TF, Higgins-Biddle JC, Higgins PS, et al. Training medical
providers to conduct alcohol screening and brief interventions.
Substance Abuse. 2004;25(1):17–26.