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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedLee AK, Bobb JF, Richards JE
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
This study’s goal was to evaluate an implementation intervention to increase (1) population-based alcohol-related prevention with brief interventions and (2) treatment of alcohol use disorder (AUD) in primary care implemented with a broader program of behavioral health integration. This stepped-wedge cluster randomized trial called the Sustained Patient-Centered Alcohol-Related Care (SPARC) trial included 22 primary care practices in an integrated health system in Washington state. Participants consisted of all adult patients 18 years or older with primary care visits from January 2015 to July 2018. The study included 7 waves, with practices randomly assigned launch dates. A total of 333,596 patients visited primary care (mean age, 48 years; 193,583 [58%] female; 234,764 [70%] White individuals). The proportion of patients with brief intervention was higher during SPARC intervention than usual care periods (57 vs 11 per 10,000 patients per month). The proportion with AUD treatment engagement did not differ during intervention and usual care. However, it did increase intermediate outcomes: screening (83.2% vs 20.8%), new AUD diagnosis (33.8 vs 28.8 per 10,000), and treatment initiation (7.8 vs 6.2 per 10,000).
AHRQ-funded; HS023173.
Citation: Lee AK, Bobb JF, Richards JE .
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
JAMA Intern Med 2023 Apr;183(4):319-28. doi: 10.1001/jamainternmed.2022.7083.
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Patient-Centered Healthcare
Alexandre W, Muhammad H, Agbalajobi O
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
The purpose of this study was to investigate the relationships between medical dialogues concerning alcohol use disorder (AUD) treatment, AUD treatment engagement, and mortality rates. The retrospective cohort study encompassed all patients diagnosed with cirrhosis and AUD receiving hepatology care within a single healthcare system in 2015. Baseline data on demographics, medical history, liver disease, and AUD treatment were examined. Information on AUD treatment discussions, initiation, alcohol cessation, and the subsequent 5-year mortality rates was gathered. Out of 436 patients with alcohol-related cirrhosis, 15% received AUD treatment at baseline, with 11% undergoing behavioral therapy, 2% receiving pharmacotherapy, and 1% obtaining both. Within the first year after the initial hepatology visit, 37 patients had AUD treatment, 51 remained in treatment, and 14 discontinued. Hepatology-documented AUD treatment recommendations were provided to 30% of patients, while 26% received primary care-documented recommendations. The majority of hepatology (86%) and primary care (88%) recommendations focused on behavioral therapy. Among patients with persistent alcohol use at baseline, AUD treatment after one year was significantly and independently associated with hepatology or primary care treatment discussions, and negatively associated with Medicaid insurance. When treatment discussions occurred in both settings, high treatment rates followed. Over five years, 35% of patients died. Ongoing alcohol use, age, hepatic decompensation, and hepatocellular carcinoma significantly contributed to mortality in the final survival model. In patients with alcohol-related cirrhosis, AUD treatment discussions were documented in fewer than half of hepatology and primary care encounters; however, such discussions were significantly correlated with AUD treatment receipt.
AHRQ-funded; HS019461.
Citation: Alexandre W, Muhammad H, Agbalajobi O .
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
BMC Gastroenterol 2023 Feb 2; 23(1):29. doi: 10.1186/s12876-023-02656-z..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Clinician-Patient Communication, Communication
Singh AN, Sanchez V, Kenzie ES
Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study.
This study evaluates tailored implementation support to increase screening, brief intervention, referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) in primary care. It will explore how primary care clinics implement SBIRT and MAUD in routine practice and how practice facilitators vary implementation support across diverse clinic settings. It is anticipated that findings will inform how effectively to align implementation support to context, advance understanding of practice facilitator skill development over time, and ultimately improve detection and treatment of unhealthy alcohol use across diverse primary care clinics.
AHRQ-funded; HS027080.
Citation: Singh AN, Sanchez V, Kenzie ES .
Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study.
PLoS One 2022 Jun 28;17(6):e0269635. doi: 10.1371/journal.pone.0269635..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Care Management
Lin Y, Sharma B, Thompson HM
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
This study’s objective was to validate a machine learning approach to alcohol screening using a natural language processing (NLP) classifier developed at an independent medical center. This retrospective cohort study took place at a midwestern US tertiary-care, urban medical center that has an inpatient structured universal screening model for unhealthy substance use and an active addiction consult service. The cohort included 57,605 unplanned admissions of adult patients between October 23, 2017 and December 31, 2019 with electronic health record (EHR) documentation of manual alcohol screening. The authors examined error in manual screening and reviewed discordance between the NLP classifier and AUDIT-derived reference. The classifier demonstrated adequate sensitivity and specificity for routine clinical use as an automated screening tool for identifying at-risk patients.
AHRQ-funded; HS026385.
Citation: Lin Y, Sharma B, Thompson HM .
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
Addiction 2022 Apr;117(4):925-33. doi: 10.1111/add.15730..
Keywords: Alcohol Use, Behavioral Health, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Jonas DE, Barclay C, Grammer D
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
This paper describes a randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in primary care practices in North Carolina with 10 or fewer providers. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.
AHRQ-funded; HS027078.
Citation: Jonas DE, Barclay C, Grammer D .
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
Trials 2021 Nov 16;22(1):810. doi: 10.1186/s13063-021-05641-7..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Screening, Implementation
Tong ST, Kato EU, Nix MP
AHRQ Author: Tong ST, Kato EU, Nix, MP, Bierman, AS
Help for primary care practitioners in addressing older adult alcohol and opioid use.
Unhealthy alcohol and opioid use are growing problems among older adults who are at increased risk for harms from both alcohol and opioid use. Primary care practices can play an important role in addressing this problem, but need support in implementing evidence-based practices. This article provides help for primary care practitioners in addressing older adult alcohol and opioid use.
AHRQ-authored.
Citation: Tong ST, Kato EU, Nix MP .
Help for primary care practitioners in addressing older adult alcohol and opioid use.
Generations Journal 2020-2021 Winter;44(4)..
Keywords: Elderly, Primary Care, Alcohol Use, Opioids, Substance Abuse, Behavioral Health
Wisk LE, Magane KM, Levy S
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, the investigators sought to identify clusters of RALD and test associations with use behaviors. The investigators concluded that for YCMC, RALD were complex but endorsement of multiple general and health-related RALD was associated with less use, and health concerns are especially prevalent.
AHRQ-funded; HS022986.
Citation: Wisk LE, Magane KM, Levy S .
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
J Addict Med 2020 Jul/Aug;14(4):311-18. doi: 10.1097/adm.0000000000000603..
Keywords: Children/Adolescents, Alcohol Use, Behavioral Health, Vulnerable Populations, Substance Abuse
Ibrahim N, Alameddine M, Brennan J
New onset alcohol use disorder following bariatric surgery.
Researchers sought to characterize the patients and incidence of alcohol use disorder (AUD) following sleeve gastrectomy (SG) compared to Roux-en-Y gastric bypass (RYGB). They found that the prevalence of alcohol use disorder in patients undergoing SG and RYGB was similar pre- and postoperatively, with the majority of patients developing AUD following their second postoperative year. The authors recommended understanding the timing and incidence of AUD in order to provide appropriate counseling and treatment.
AHRQ-funded; HS023621; HS024403.
Citation: Ibrahim N, Alameddine M, Brennan J .
New onset alcohol use disorder following bariatric surgery.
Surg Endosc 2019 Aug;33(8):2521-30. doi: 10.1007/s00464-018-6545-x..
Keywords: Alcohol Use, Behavioral Health, Obesity, Obesity: Weight Management, Substance Abuse, Surgery
Kazemi DM, Borsari B, Levine MJ
Real-time demonstration of a mHealth app designed to reduce college students hazardous drinking.
The authors developed a smartphone application (SmarTrek) that targets college students and aims to reduce risky alcohol use. They found that the majority of participants agreed that SmarTrek was easy to use and that the information provided was useful and had a positive effect on decreasing their drinking.
AHRQ-funded; HS023875.
Citation: Kazemi DM, Borsari B, Levine MJ .
Real-time demonstration of a mHealth app designed to reduce college students hazardous drinking.
Psychol Serv 2019 May;16(2):255-59. doi: 10.1037/ser0000310..
Keywords: Alcohol Use, Behavioral Health, Lifestyle Changes, Health Information Technology (HIT), Substance Abuse, Telehealth, Young Adults
Cochran G, Field C, DiClemente C
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
The purpose of this study was to identify differential improvement in alcohol use among injured patients following brief intervention. Increases in both clinical trials for days abstinent were reported by classes characterized by multiple risks and minimal risks. Decreases in volume consumed for both studies were also reported by classes characterized by multiple risks and minimal risks.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, DiClemente C .
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
Behav Med 2016;42(1):29-38. doi: 10.1080/08964289.2014.951305.
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Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Treatments
Chavez LJ, Williams EC, Lapham GT
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
The researchers examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. They found that among patients with alcohol misuse, the adjusted prevalence of alcohol-related advice increased from 40.4% in 2007 to 55.5% in 2011. Rates of alcohol-related advice increased significantly each year except the last.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Williams EC, Lapham GT .
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
J Stud Alcohol Drugs 2016 May;77(3):500-8.
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Keywords: Alcohol Use, Behavioral Health, Primary Care, Substance Abuse
Liu L, Strawderman RL, Johnson BA
Analyzing repeated measures semi-continuous data, with application to an alcohol dependence study.
The authors reviewed and considered three extensions of two-part random effects models. They compared the performance through applications to daily drinking records in a secondary data analysis from a randomized controlled trial of topiramate for alcohol dependence treatment. They found that all three models provide a significantly better fit than the log-normal model, and there exists strong evidence for heteroscedasticity.
AHRQ-funded; HS020263.
Citation: Liu L, Strawderman RL, Johnson BA .
Analyzing repeated measures semi-continuous data, with application to an alcohol dependence study.
Stat Methods Med Res 2016 Feb;25(1):133-52. doi: 10.1177/0962280212443324.
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Keywords: Alcohol Use, Behavioral Health, Substance Abuse
Ludman EJ, Curry SJ
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
This study, Options Regarding Consumption of Alcohol (ORCA), was designed to test whether a primary care-based intervention would reduce alcohol misuse among patients who screened positive for risky or hazardous drinking. This paper assesses the study features using the Pragmatic-Explanatory Continuum Indicator Summary Model domains. As a randomized trial, the study included some explanatory features (e.g., standardized follow-up surveys administered by study personnel); however, several aspects of the study were highly pragmatic.
AHRQ-funded; 290201000004I.
Citation: Ludman EJ, Curry SJ .
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S194-9. doi: 10.1016/j.amepre.2015.05.016.
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Keywords: Alcohol Use, Behavioral Health, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Okuda M, Olfson M, Wang S
Correlates of intimate partner violence perpetration: results from a National Epidemiologic Survey.
This study presents data on the association of intimate partner violence (IPV) perpetration and rates of psychiatric disorders, and other correlates. It finds that being younger, having an alcohol use disorder, a personality disorder, low levels of social support, and low income were associated with perpetration. Across a wide range of factors, IPV victimization itself had the strongest association with perpetration.
AHRQ-funded; HS021112.
Citation: Okuda M, Olfson M, Wang S .
Correlates of intimate partner violence perpetration: results from a National Epidemiologic Survey.
J Trauma Stress 2015 Feb;28(1):49-56. doi: 10.1002/jts.21986..
Keywords: Domestic Violence, Alcohol Use, Behavioral Health, Social Determinants of Health