Daniel R Kivlahan
Datos Biográficos
| ID | 223138 |
|---|---|
| NOMBRE | Daniel R Kivlahan |
| NOMBRES | Daniel R |
| APELLIDO | Kivlahan |
| FIRMA | KIVLAHAN D R |
| AFILIACIONES | VA Puget Sound Health Care System |
| VERIFICADO | No |
| TOTAL DE OBRAS | 14 |
| TOTAL DE CITAS | 12 |
| TOTAL COMO AUTOR | 14 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1988 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2013 |
| ÍNDICE H | 1 |
Annual Rescreening for Alcohol Misuse
BACKGROUND: Routine alcohol screening is widely recommended, and Medicare now reimburses for annual alcohol screening. Although up to 18% of patients will screen positive for alcohol misuse, the value of annual rescreening for patients who repeatedly screen negative is unknown. OBJECTIVE: To evaluate the probability of converting to a positive alcohol screen at annual rescreening among VA outpatients who previously screened negative 2-4 times. RE…
Increased Documented Brief Alcohol Interventions With a Performance Measure and Electronic Decision Support
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 ele…
Why Health Care Process Performance Measures Can Have Different Relationships to Outcomes for Patients and Hospitals
Relationships between health care process performance measures (PPMs) and outcomes can differ in magnitude and even direction for patients versus higher level units (e.g., health care facilities). Such discrepancies can arise because facility-level relationships ignore PPM–outcome relationships for patients within facilities, may have different confounders than patient-level PPM–outcome relationships, and may reflect facility effect modification …
A national survey of clinicians’ views of evidence-based therapies for PTSD and substance abuse
This study was a nationwide survey of 205 Veterans Affairs (VA) staff on their views of 11 psychotherapy models for posttraumatic stress disorder (PTSD), substance use disorder (SUD), or comorbid PTSD/SUD. For each model, staff rated four key areas: level of implementation, helpfulness overall, helpfulness for PTSD/SUD, and desire for training on it. They also provided quantitative and qualitative information on general questions related to PTSD/…
Revisiting the Cost-Effectiveness of the Combine Study for Alcohol Dependent Patients
OBJECTIVE: Most cost and cost-effectiveness studies of substance abuse treatments focus on the costs to the provider/payer. Although this perspective is important, the costs incurred by patients should also be considered when evaluating treatment. This article presents estimates of patients' costs associated with the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) alcohol treatments and evaluates the treatments' cost-effectivene…
Developing and Validating Process Measures of Health Care Quality
BACKGROUND: Health care process quality measures usually are designed by expert panels attempting to synthesize nuanced clinical evidence and subsequently operationalized using administrative data. Many quality measures are then adopted without directly validating their presumed links with outcomes. Later efforts to validate process measures often yield negative results, leaving policy makers without a defensible means of measuring quality. This …
Audit‐C as a Brief Screen for Alcohol Misuse in Primary Care
Background: The Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) questions have been previously validated as a 3‐item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT‐C's validity and optimal screening threshold(s) in other clinical populations are unknown. Methods: This cross‐sectional validation study compared screening questionnaires with standardized interviews…
Screening for Psychiatric Disorders among Adults Presenting for Substance Use Disorder Treatment
Randomized Trial of Onsite Versus Referral Primary Medical Care for Veterans in Addictions Treatment
BACKGROUND: Patients presenting for treatment of substance use disorders (SUDs) often exhibit medical comorbidities that affect functional health status and healthcare costs. Providing primary care within addictions clinics (onsite care) may improve medical and SUD treatment outcomes in this population. OBJECTIVE: The objective of this study was to compare outcomes among Veterans' Administration (VA) patients who receive medical care within the S…
Two Brief Alcohol-Screening Tests From the Alcohol Use Disorders Identification Test (Audit)
BACKGROUND: Primary care physicians need a brief alcohol questionnaire that identifies hazardous drinking and alcohol use disorders. The Alcohol Use Disorders Identification Test (AUDIT) questions 1 through 3 (AUDIT-C), and AUDIT question 3 alone are effective alcohol-screening tests in male Veterans Affairs (VA) patients, but have not been validated in women. METHODS: Female VA patients (n = 393) completed self-administered questionnaires, inclu…
Brief Intervention for Heavy-Drinking College Students
Objectives. This study examined long-term response to an individual preventive intervention for high-risk college drinkers relative to the natural history of college drinking. Methods. A single-session, individualized preventive intervention was evaluated within a randomized controlled trial with college freshmen who reported drinking heavily while in high school. An additional group randomly selected from the entire screening pool provided a nor…
Screening and brief intervention for high-risk college student drinkers
Treatment implications of comorbid psychopathology in American Indians and Alaska Natives
Addictive Behaviors
Brief Intervention for Heavy-Drinking College Students
Objectives. This study examined long-term response to an individual preventive intervention for high-risk college drinkers relative to the natural history of college drinking. Methods. A single-session, individualized preventive intervention was evaluated within a randomized controlled trial with college freshmen who reported drinking heavily while in high school. An additional group randomly selected from the entire screening pool provided a nor…
Addictive Behaviors
Treatment implications of comorbid psychopathology in American Indians and Alaska Natives
Screening and brief intervention for high-risk college student drinkers
Brief Intervention for Heavy-Drinking College Students
Objectives. This study examined long-term response to an individual preventive intervention for high-risk college drinkers relative to the natural history of college drinking. Methods. A single-session, individualized preventive intervention was evaluated within a randomized controlled trial with college freshmen who reported drinking heavily while in high school. An additional group randomly selected from the entire screening pool provided a nor…
Two Brief Alcohol-Screening Tests From the Alcohol Use Disorders Identification Test (Audit)
BACKGROUND: Primary care physicians need a brief alcohol questionnaire that identifies hazardous drinking and alcohol use disorders. The Alcohol Use Disorders Identification Test (AUDIT) questions 1 through 3 (AUDIT-C), and AUDIT question 3 alone are effective alcohol-screening tests in male Veterans Affairs (VA) patients, but have not been validated in women. METHODS: Female VA patients (n = 393) completed self-administered questionnaires, inclu…
Randomized Trial of Onsite Versus Referral Primary Medical Care for Veterans in Addictions Treatment
BACKGROUND: Patients presenting for treatment of substance use disorders (SUDs) often exhibit medical comorbidities that affect functional health status and healthcare costs. Providing primary care within addictions clinics (onsite care) may improve medical and SUD treatment outcomes in this population. OBJECTIVE: The objective of this study was to compare outcomes among Veterans' Administration (VA) patients who receive medical care within the S…
Audit‐C as a Brief Screen for Alcohol Misuse in Primary Care
Background: The Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) questions have been previously validated as a 3‐item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT‐C's validity and optimal screening threshold(s) in other clinical populations are unknown. Methods: This cross‐sectional validation study compared screening questionnaires with standardized interviews…
Screening for Psychiatric Disorders among Adults Presenting for Substance Use Disorder Treatment
Developing and Validating Process Measures of Health Care Quality
BACKGROUND: Health care process quality measures usually are designed by expert panels attempting to synthesize nuanced clinical evidence and subsequently operationalized using administrative data. Many quality measures are then adopted without directly validating their presumed links with outcomes. Later efforts to validate process measures often yield negative results, leaving policy makers without a defensible means of measuring quality. This …
A national survey of clinicians’ views of evidence-based therapies for PTSD and substance abuse
This study was a nationwide survey of 205 Veterans Affairs (VA) staff on their views of 11 psychotherapy models for posttraumatic stress disorder (PTSD), substance use disorder (SUD), or comorbid PTSD/SUD. For each model, staff rated four key areas: level of implementation, helpfulness overall, helpfulness for PTSD/SUD, and desire for training on it. They also provided quantitative and qualitative information on general questions related to PTSD/…
Revisiting the Cost-Effectiveness of the Combine Study for Alcohol Dependent Patients
OBJECTIVE: Most cost and cost-effectiveness studies of substance abuse treatments focus on the costs to the provider/payer. Although this perspective is important, the costs incurred by patients should also be considered when evaluating treatment. This article presents estimates of patients' costs associated with the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) alcohol treatments and evaluates the treatments' cost-effectivene…
Why Health Care Process Performance Measures Can Have Different Relationships to Outcomes for Patients and Hospitals
Relationships between health care process performance measures (PPMs) and outcomes can differ in magnitude and even direction for patients versus higher level units (e.g., health care facilities). Such discrepancies can arise because facility-level relationships ignore PPM–outcome relationships for patients within facilities, may have different confounders than patient-level PPM–outcome relationships, and may reflect facility effect modification …
Increased Documented Brief Alcohol Interventions With a Performance Measure and Electronic Decision Support
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 ele…
Annual Rescreening for Alcohol Misuse
BACKGROUND: Routine alcohol screening is widely recommended, and Medicare now reimburses for annual alcohol screening. Although up to 18% of patients will screen positive for alcohol misuse, the value of annual rescreening for patients who repeatedly screen negative is unknown. OBJECTIVE: To evaluate the probability of converting to a positive alcohol screen at annual rescreening among VA outpatients who previously screened negative 2-4 times. RE…
Medicine (10 obras) · Psychiatry (10 obras) · Substance Abuse Treatment and Outcomes (9 obras) · Environmental health (6 obras) · Family medicine (5 obras) · Internal Medicine (5 obras) · Internal Medicine (5 obras) · Psychology (5 obras) · Alcohol Consumption and Health Effects (4 obras) · Health care (4 obras)