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Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care
Alcohol use is a major cause of disability and death worldwide. To improve prevention and treatment addressing unhealthy alcohol use, experts recommend that alcohol-related care be integrated into primary care (PC). However, few healthcare systems do so. To address this gap, implementation researche...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615567/ https://www.ncbi.nlm.nih.gov/pubmed/28885557 http://dx.doi.org/10.3390/ijerph14091030 |
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author | Bobb, Jennifer F. Lee, Amy K. Lapham, Gwen T. Oliver, Malia Ludman, Evette Achtmeyer, Carol Parrish, Rebecca Caldeiro, Ryan M. Lozano, Paula Richards, Julie E. Bradley, Katharine A. |
author_facet | Bobb, Jennifer F. Lee, Amy K. Lapham, Gwen T. Oliver, Malia Ludman, Evette Achtmeyer, Carol Parrish, Rebecca Caldeiro, Ryan M. Lozano, Paula Richards, Julie E. Bradley, Katharine A. |
author_sort | Bobb, Jennifer F. |
collection | PubMed |
description | Alcohol use is a major cause of disability and death worldwide. To improve prevention and treatment addressing unhealthy alcohol use, experts recommend that alcohol-related care be integrated into primary care (PC). However, few healthcare systems do so. To address this gap, implementation researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). Here, we describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators. Across the three sites (N = 74,225 PC patients), alcohol screening increased from 8.9% of patients pre-implementation to 62% post-implementation (p < 0.0001), with a corresponding increase in assessment for alcohol use disorders (AUD) from 1.2 to 75 patients per 10,000 seen (p < 0.0001). Increases were sustained over a year later, with screening at 84.5% and an assessment rate of 81 patients per 10,000 seen across all sites. In addition, there was a 50% increase in the number of new AUD diagnoses (p = 0.0002), and a non-statistically significant 54% increase in treatment within 14 days of new diagnoses (p = 0.083). The pilot informed an ongoing stepped-wedge trial in the remaining 22 PC sites. |
format | Online Article Text |
id | pubmed-5615567 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-56155672017-09-30 Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care Bobb, Jennifer F. Lee, Amy K. Lapham, Gwen T. Oliver, Malia Ludman, Evette Achtmeyer, Carol Parrish, Rebecca Caldeiro, Ryan M. Lozano, Paula Richards, Julie E. Bradley, Katharine A. Int J Environ Res Public Health Article Alcohol use is a major cause of disability and death worldwide. To improve prevention and treatment addressing unhealthy alcohol use, experts recommend that alcohol-related care be integrated into primary care (PC). However, few healthcare systems do so. To address this gap, implementation researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). Here, we describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators. Across the three sites (N = 74,225 PC patients), alcohol screening increased from 8.9% of patients pre-implementation to 62% post-implementation (p < 0.0001), with a corresponding increase in assessment for alcohol use disorders (AUD) from 1.2 to 75 patients per 10,000 seen (p < 0.0001). Increases were sustained over a year later, with screening at 84.5% and an assessment rate of 81 patients per 10,000 seen across all sites. In addition, there was a 50% increase in the number of new AUD diagnoses (p = 0.0002), and a non-statistically significant 54% increase in treatment within 14 days of new diagnoses (p = 0.083). The pilot informed an ongoing stepped-wedge trial in the remaining 22 PC sites. MDPI 2017-09-08 2017-09 /pmc/articles/PMC5615567/ /pubmed/28885557 http://dx.doi.org/10.3390/ijerph14091030 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Bobb, Jennifer F. Lee, Amy K. Lapham, Gwen T. Oliver, Malia Ludman, Evette Achtmeyer, Carol Parrish, Rebecca Caldeiro, Ryan M. Lozano, Paula Richards, Julie E. Bradley, Katharine A. Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care |
title | Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care |
title_full | Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care |
title_fullStr | Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care |
title_full_unstemmed | Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care |
title_short | Evaluation of a Pilot Implementation to Integrate Alcohol-Related Care within Primary Care |
title_sort | evaluation of a pilot implementation to integrate alcohol-related care within primary care |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615567/ https://www.ncbi.nlm.nih.gov/pubmed/28885557 http://dx.doi.org/10.3390/ijerph14091030 |
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