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%).
Comments:
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
Reference:
Babor
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.
(view
abstract)