Cargando…

Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey

BACKGROUND: Approximately one in six adults in the United States (U.S.) binge drinks. The U.S. Preventive Services Task Force recommends that primary care physicians screen patients for such hazardous alcohol use, and when warranted, deliver a brief intervention. OBJECTIVE: We aimed to determine pri...

Descripción completa

Detalles Bibliográficos
Autores principales: Le, Kristy Barnes, Johnson, J. Aaron, Seale, J. Paul, Woodall, Hunter, Clark, Denice C., Parish, David C., Miller, David P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441659/
https://www.ncbi.nlm.nih.gov/pubmed/25666210
http://dx.doi.org/10.1007/s11606-015-3184-y
_version_ 1782372814563573760
author Le, Kristy Barnes
Johnson, J. Aaron
Seale, J. Paul
Woodall, Hunter
Clark, Denice C.
Parish, David C.
Miller, David P.
author_facet Le, Kristy Barnes
Johnson, J. Aaron
Seale, J. Paul
Woodall, Hunter
Clark, Denice C.
Parish, David C.
Miller, David P.
author_sort Le, Kristy Barnes
collection PubMed
description BACKGROUND: Approximately one in six adults in the United States (U.S.) binge drinks. The U.S. Preventive Services Task Force recommends that primary care physicians screen patients for such hazardous alcohol use, and when warranted, deliver a brief intervention. OBJECTIVE: We aimed to determine primary care residents’ current practices, perceived barriers and confidence with conducting alcohol screening and brief interventions (SBI). DESIGN: This was a multi-site, cross-sectional survey conducted from March 2010 through December 2012. PARTICIPANTS: We invited all residents in six primary care residency programs (three internal medicine programs and three family medicine programs) to participate. Of 244 residents, 210 completed the survey (response rate 86 %). MAIN MEASURES: Our survey assessed residents’ alcohol screening practices (instruments used and frequency of screening), perceived barriers to discussing alcohol, brief intervention content, and self-rated ability to help hazardous drinkers. To determine the quality of brief interventions delivered, we examined how often residents reported including the three key recommended elements of feedback, advice, and goal-setting. KEY RESULTS: Most residents (60 %, 125/208) reported “usually” or “always” screening patients for alcohol misuse at the initial clinic visit, but few residents routinely screened patients at subsequent acute-care (17 %, 35/208) or chronic-care visits (33 %, 68/208). Only 19 % (39/210) of residents used screening instruments capable of detecting binge drinking. The most frequently reported barrier to SBI was lack of adequate training (54 %, 108/202), and only 21 % (43/208) of residents felt confident they could help at -risk drinkers. When residents did perform a brief intervention, only 24 % (49/208) “usually” or “always” included the three recommended elements. CONCLUSIONS: A minority of residents in this multi-site study appropriately screen or intervene with at-risk alcohol users. To equip residents to effectively address hazardous alcohol use, there is a critical need for educational and clinic interventions to support alcohol-related SBI.
format Online
Article
Text
id pubmed-4441659
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-44416592015-05-28 Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey Le, Kristy Barnes Johnson, J. Aaron Seale, J. Paul Woodall, Hunter Clark, Denice C. Parish, David C. Miller, David P. J Gen Intern Med Original Research BACKGROUND: Approximately one in six adults in the United States (U.S.) binge drinks. The U.S. Preventive Services Task Force recommends that primary care physicians screen patients for such hazardous alcohol use, and when warranted, deliver a brief intervention. OBJECTIVE: We aimed to determine primary care residents’ current practices, perceived barriers and confidence with conducting alcohol screening and brief interventions (SBI). DESIGN: This was a multi-site, cross-sectional survey conducted from March 2010 through December 2012. PARTICIPANTS: We invited all residents in six primary care residency programs (three internal medicine programs and three family medicine programs) to participate. Of 244 residents, 210 completed the survey (response rate 86 %). MAIN MEASURES: Our survey assessed residents’ alcohol screening practices (instruments used and frequency of screening), perceived barriers to discussing alcohol, brief intervention content, and self-rated ability to help hazardous drinkers. To determine the quality of brief interventions delivered, we examined how often residents reported including the three key recommended elements of feedback, advice, and goal-setting. KEY RESULTS: Most residents (60 %, 125/208) reported “usually” or “always” screening patients for alcohol misuse at the initial clinic visit, but few residents routinely screened patients at subsequent acute-care (17 %, 35/208) or chronic-care visits (33 %, 68/208). Only 19 % (39/210) of residents used screening instruments capable of detecting binge drinking. The most frequently reported barrier to SBI was lack of adequate training (54 %, 108/202), and only 21 % (43/208) of residents felt confident they could help at -risk drinkers. When residents did perform a brief intervention, only 24 % (49/208) “usually” or “always” included the three recommended elements. CONCLUSIONS: A minority of residents in this multi-site study appropriately screen or intervene with at-risk alcohol users. To equip residents to effectively address hazardous alcohol use, there is a critical need for educational and clinic interventions to support alcohol-related SBI. Springer US 2015-02-10 2015-06 /pmc/articles/PMC4441659/ /pubmed/25666210 http://dx.doi.org/10.1007/s11606-015-3184-y Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Research
Le, Kristy Barnes
Johnson, J. Aaron
Seale, J. Paul
Woodall, Hunter
Clark, Denice C.
Parish, David C.
Miller, David P.
Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey
title Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey
title_full Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey
title_fullStr Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey
title_full_unstemmed Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey
title_short Primary Care Residents Lack Comfort and Experience with Alcohol Screening and Brief Intervention: A Multi-Site Survey
title_sort primary care residents lack comfort and experience with alcohol screening and brief intervention: a multi-site survey
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441659/
https://www.ncbi.nlm.nih.gov/pubmed/25666210
http://dx.doi.org/10.1007/s11606-015-3184-y
work_keys_str_mv AT lekristybarnes primarycareresidentslackcomfortandexperiencewithalcoholscreeningandbriefinterventionamultisitesurvey
AT johnsonjaaron primarycareresidentslackcomfortandexperiencewithalcoholscreeningandbriefinterventionamultisitesurvey
AT sealejpaul primarycareresidentslackcomfortandexperiencewithalcoholscreeningandbriefinterventionamultisitesurvey
AT woodallhunter primarycareresidentslackcomfortandexperiencewithalcoholscreeningandbriefinterventionamultisitesurvey
AT clarkdenicec primarycareresidentslackcomfortandexperiencewithalcoholscreeningandbriefinterventionamultisitesurvey
AT parishdavidc primarycareresidentslackcomfortandexperiencewithalcoholscreeningandbriefinterventionamultisitesurvey
AT millerdavidp primarycareresidentslackcomfortandexperiencewithalcoholscreeningandbriefinterventionamultisitesurvey