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AHRQ Research Studies Date
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- (-) Alcohol Use (15)
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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 15 of 15 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
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
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
Kuhns LM, Carlino B, Greeley K
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
This study looked at rates of substance use screening and related documentation among adolescents aged 12-17 in outpatient pediatric clinics in a large academic medical center. The authors abstracted a random sample of 127 records and coded clinical notes to describe screening cases and related characteristics. They then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and identify related factors. Rates of screening by providers was 72% for each common substance and a total of 6% of patients reported substance use during screening.
AHRQ-funded; HS026385.
Citation: Kuhns LM, Carlino B, Greeley K .
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
Subst Abuse Treat Prev Policy 2020 May 25;15(1):36. doi: 10.1186/s13011-020-00276-4..
Keywords: Children/Adolescents, Substance Abuse, Screening, Ambulatory Care and Surgery, Alcohol Use, Practice Patterns, Primary Care
Huffstetler AN, Kuzel AJ, Sabo RT
Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial.
Investigators are initiating a clinic-level randomized controlled trial aimed to evaluate how primary care clinicians can impact unhealthy alcohol use through screening, counseling, and medication-assisted therapy (MAT). After completion of the intervention, researchers will conduct a mixed methods analysis to identify changes in screening rates, increase in provision of brief counseling and interventions as well as MAT, and the reduction of alcohol intake for patients after practices receive practice facilitation. They propose practice facilitation as a robust and feasible intervention to assist in making changes within the practice and believe that the process can be replicated and used in a broad range of clinical settings. They anticipate that these statements will be supported by their evaluation of this approach.
AHRQ-funded; HS027077.
Citation: Huffstetler AN, Kuzel AJ, Sabo RT .
Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial.
BMC Fam Pract 2020 May 20;21(1):93. doi: 10.1186/s12875-020-01147-4..
Keywords: Alcohol Use, Primary Care, Primary Care: Models of Care, Screening, Care Management, Prevention
Sayre M, Lapham GT, Lee AK
Routine assessment of symptoms of substance use disorders in primary care: prevalence and severity of reported symptoms.
This study looked at the prevalence and severity of DSM-5 substance use disorders (SUDs) reported by primary care (PC) patients as part of routine care. This cross-sectional study used data from 241,265 adult patients who visited one of 25 PC sites in an integrated health system in Washington state and had alcohol, cannabis, or other drug use screening documented in their electronic health records from March 2015-July 2018. A scale of Symptom Checklists (0-11) was used based on DSM-5 with 2-3 rated as mild, 4-5 moderate, and 6-11 severe. Out of those screened patients, 16,775 (5.7%) reported high-risk use of alcohol (2.4%), cannabis (3.9%), and/or other drugs (1.7%) with 65-70% completing the Symptom Checklists. Of those with high-risk alcohol use, 52.5% reported 2 or more symptoms consistent with mild-severe alcohol use disorders. Mild-severe symptoms were reported by 29.8% of patients reporting daily cannabis use, and 37.5% of patients reporting any other drug use had 2 or greater symptoms.
AHRQ-funded; HS023173.
Citation: Sayre M, Lapham GT, Lee AK .
Routine assessment of symptoms of substance use disorders in primary care: prevalence and severity of reported symptoms.
J Gen Intern Med 2020 Apr;35(4):1111-19. doi: 10.1007/s11606-020-05650-3..
Keywords: Substance Abuse, Alcohol Use, Primary Care, Diagnostic Safety and Quality
Mabry-Hernandez I, Scoulios N
AHRQ Author: Mabry-Hernandez I
Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults.
This case study concerns a 20-year-old male university student with a history of exercise-induced asthma presenting for his yearly physical. He expresses that he occasionally misses classes in the morning because he is tired.
AHRQ-authored.
Citation: Mabry-Hernandez I, Scoulios N .
Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults.
Am Fam Physician 2019 Jun 15;99(12):771-72..
Keywords: U.S. Preventive Services Task Force (USPSTF), Alcohol Use, Substance Abuse, Screening, Prevention, Primary Care, Case Study
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Glass JE, Bobb JF, Lee AL
Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial).
Implementation researchers and clinical leaders at Kaiser Permanente Washington (KPWA) partnered to design a high-quality program of evidence-based care for unhealthy alcohol use: the Sustained Patient-centered Alcohol-related Care (SPARC) program. This paper describes the cluster-randomized trial implementing SPARC.
AHRQ-funded; HS023173.
Citation: Glass JE, Bobb JF, Lee AL .
Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial).
Implement Sci 2018 Aug 6;13(1):108. doi: 10.1186/s13012-018-0795-9..
Keywords: Alcohol Use, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Bobb JF, Lee AK, Lapham GT
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). The authors describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators. They found that alcohol screening increased from 8.9 percent of patients pre-implementation to 62 percent post-implementation.
AHRQ-funded; HS023173.
Citation: Bobb JF, Lee AK, Lapham GT .
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Int J Environ Res Public Health 2017 Sep 8;14(9). doi: 10.3390/ijerph14091030.
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Keywords: Alcohol Use, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
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
Williams EC, Achtmeyer CE, Young JP
Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff.
The researchers conducted a qualitative key informant study to describe local implementation of alcohol screening and brief intervention from the perspectives of frontline adopters in VA primary care . Findings suggest that the local process of implementing alcohol screening and brief intervention may have inadequately addressed important adopter needs.
AHRQ-funded; HS022800.
Citation: Williams EC, Achtmeyer CE, Young JP .
Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff.
J Subst Abuse Treat 2016 Jan;60:27-35. doi: 10.1016/j.jsat.2015.07.011.
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Keywords: Alcohol Use, Screening, Primary Care
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)
Williams EC, Achtmeyer CE, Thomas RM
Factors underlying quality problems with alcohol screening prompted by a clinical reminder in primary care: a multi-site qualitative study.
The researchers aimed to understand factors that might contribute to low sensitivity of alcohol screening. Their qualitative study in nine clinics found that implementation of alcohol screening facilitated by a clinical reminder resulted primarily in verbal screening in which questions were not asked verbatim and were otherwise adapted.
AHRQ-funded; HS022800; HS013853.
Citation: Williams EC, Achtmeyer CE, Thomas RM .
Factors underlying quality problems with alcohol screening prompted by a clinical reminder in primary care: a multi-site qualitative study.
J Gen Intern Med 2015 Aug;30(8):1125-32. doi: 10.1007/s11606-015-3248-z..
Keywords: Alcohol Use, Screening, Primary Care, Health Information Technology (HIT)