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Increased Documented Brief Alcohol Interventions With a Performance Measure and Electronic Decision Support

Bibliographic Data

ID9101222
AuthorsGwen T Lapham (0000-0001-6965-043X, VA Puget Sound Health Care System, corresponding author), Carol E Achtmeyer (VA Puget Sound Health Care System, corresponding author), Ellaleen C Williams (0000-0002-8210-6137, Health Services Research & Development, corresponding author), Emily C Williams, Eric J Hawkins (0000-0001-5467-1553, VA Puget Sound Health Care System, corresponding author), Daniel R Kivlahan (VA Puget Sound Health Care System, corresponding author), Karen A Bradley (0000-0003-1933-4425, VA Puget Sound Health Care System, corresponding author), Katharine A Bradley
Year2012
Volume50
Issue2
Pages179-187
Publication date2012-02-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181e35743
PMID20881876
OpenAlexW2066019849
LanguageEN
Citations received12
References cited41

BACKGROUND: Alcohol screening and brief interventions (BIs) are ranked the third highest US prevention priority, but effective methods of implementing BI into routine care have not been described. OBJECTIVES: This study evaluated the prevalence of documented BI among Veterans Affairs (VA) outpatients with alcohol misuse before, during, and after implementation of a national performance measure (PM) linked to incentives and dissemination of an electronic clinical reminder (CR) for BI. METHODS: VA outpatients were included in this study if they were randomly sampled for national medical record reviews and screened positive for alcohol misuse (Alcohol Use Disorders Identification Test-Consumption score ≥5) between July 2006 and September 2008 (N=6788). Consistent with the PM, BI was defined as documented advice to reduce or abstain from drinking plus feedback linking drinking to health. The prevalence of BI was evaluated among outpatients who screened positive for alcohol misuse during 4 successive phases of BI implementation: baseline year (n=3504), after announcement (n=753) and implementation (n=697) of the PM, and after CR dissemination (n=1834), unadjusted and adjusted for patient characteristics. RESULTS: Among patients with alcohol misuse, the adjusted prevalence of BI increased significantly over successive phases of BI implementation, from 5.5% (95% CI 4.1%-7.5%), 7.6% (5.6%-10.3%), 19.1% (15.4%-23.7%), to 29.0% (25.0%-33.4%) during the baseline year, after PM announcement, PM implementation, and CR dissemination, respectively (test for trend P<0.001). CONCLUSIONS: A national PM supported by dissemination of an electronic CR for BI was associated with meaningful increases in the prevalence of documented brief alcohol interventions

Alcohol · Alcohol consumption · Alcohol Use Disorders Identification Test · Environmental health · Family medicine · Incentive · Injury prevention · Poison control · Psychiatry · Psychological intervention · Test (biology) · Veterans Affairs · Alcohol Consumption and Health Effects · Alcoholism and Thiamine Deficiency · Internal Medicine · Medicine · Substance Abuse Treatment and Outcomes

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Unique citing works12
Citations per year0,86
Citation span2012 - 2026 (15)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 10
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