PMID- 26200578
OWN - NLM
STAT- MEDLINE
DCOM- 20160418
LR  - 20220408
IS  - 1938-808X (Electronic)
IS  - 1040-2446 (Linking)
VI  - 90
IP  - 12
DP  - 2015 Dec
TI  - A Multisite Initiative to Increase the Use of Alcohol Screening and Brief 
      Intervention Through Resident Training and Clinic Systems Changes.
PG  - 1707-12
LID - 10.1097/ACM.0000000000000846 [doi]
AB  - PURPOSE: Screening and brief intervention (SBI) is a seldom-used evidence-based 
      practice for reducing unhealthy alcohol use among primary care patients. This 
      project assessed the effectiveness of a regional consortium's training efforts in 
      increasing alcohol SBI. METHOD: Investigators combined alcohol SBI residency 
      training efforts with clinic SBI implementation processes and used chart reviews 
      to assess impact on SBI rates in four residency clinics. Data were derived from a 
      random sample of patient charts collected before (2010; n = 662) and after (2011; 
      n = 656) resident training/clinic implementation. Patient charts were examined 
      for evidence that patients were asked about alcohol use by a validated screening 
      instrument, the screening result (positive or negative), evidence that patients 
      received a brief intervention, prescriptions for medications to assist 
      abstinence, and referrals to alcohol treatment. Chi-square analyses identified 
      differences in pre- and posttraining implementation of SBI practices. RESULTS: 
      Following program implementation, screening with validated instruments increased 
      from 151/662 (22.8%) at baseline to 543/656 (82.8%, P < .01), and identification 
      of unhealthy alcohol use increased from 12/662 (1.8%) to 41/656 (6.3%, P < .01). 
      Performance of brief interventions more than doubled (10/662 [1.5%] versus 24/656 
      [3.7%], P < .01). There were no increases in the use of medications or referrals 
      to treatment. CONCLUSIONS: Resident training combined with clinic implementation 
      efforts can increase the delivery of evidence-based practices such as alcohol SBI 
      in residency clinics.
FAU - Seale, J Paul
AU  - Seale JP
AD  - J.P. Seale is professor and director of research, Department of Family Medicine, 
      Navicent Health and Mercer University School of Medicine, Macon, Georgia. J.A. 
      Johnson is associate professor, Institute of Public and Preventive Health and 
      Department of Psychology, Georgia Regents University, Augusta, Georgia. D.C. 
      Clark is project coordinator, Department of Family Medicine, Navicent Health and 
      Mercer University School of Medicine, Macon, Georgia. S. Shellenberger is 
      professor and director of behavioral sciences, Department of Family Medicine, 
      Navicent Health and Mercer University School of Medicine, Macon, Georgia. A.T. 
      Pusser is graduate research assistant, Department of Family Medicine, Mercer 
      University School of Medicine, Macon, Georgia. J. Dhabliwala is research 
      assistant, Department of Family Medicine, Mercer University School of Medicine, 
      Macon, Georgia. E.J. Sigman is a third-year medical student, Mercer University 
      School of Medicine, Macon, Georgia. T. Dittmer is a third-year medical student, 
      Mercer University School of Medicine, Macon, Georgia. K.B. Le is assistant 
      professor, Department of Internal Medicine, Wake Forest School of Medicine, 
      Winston-Salem, North Carolina. D.P. Miller is associate professor, Department of 
      Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. 
      D. Clemow is assistant professor, AnMed Health Family Medicine Residency Program, 
      Anderson, South Carolina.
FAU - Johnson, J Aaron
AU  - Johnson JA
FAU - Clark, Denice Crowe
AU  - Clark DC
FAU - Shellenberger, Sylvia
AU  - Shellenberger S
FAU - Pusser, Andrea T
AU  - Pusser AT
FAU - Dhabliwala, Jason
AU  - Dhabliwala J
FAU - Sigman, Erika J
AU  - Sigman EJ
FAU - Dittmer, Trenton
AU  - Dittmer T
FAU - Barnes Le, Kristy
AU  - Barnes Le K
FAU - Miller, David P
AU  - Miller DP
FAU - Clemow, Diana
AU  - Clemow D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Acad Med
JT  - Academic medicine : journal of the Association of American Medical Colleges
JID - 8904605
SB  - IM
MH  - Adult
MH  - Alcoholism/*diagnosis/epidemiology
MH  - Ambulatory Care Facilities/organization & administration
MH  - Chi-Square Distribution
MH  - *Clinical Competence
MH  - Curriculum
MH  - Education, Medical, Graduate/methods
MH  - Evidence-Based Medicine
MH  - Family Practice/*education
MH  - Female
MH  - Humans
MH  - Internship and Residency/*organization & administration
MH  - Male
MH  - Mass Screening/methods
MH  - Medical History Taking/methods
MH  - Primary Health Care/methods
MH  - Program Evaluation
MH  - United States
EDAT- 2015/07/23 06:00
MHDA- 2016/04/19 06:00
CRDT- 2015/07/23 06:00
PHST- 2015/07/23 06:00 [entrez]
PHST- 2015/07/23 06:00 [pubmed]
PHST- 2016/04/19 06:00 [medline]
AID - 10.1097/ACM.0000000000000846 [doi]
PST - ppublish
SO  - Acad Med. 2015 Dec;90(12):1707-12. doi: 10.1097/ACM.0000000000000846.