Patient and provider factors associated with receipt and delivery of brief interventions for unhealthy alcohol use in primary care

2021 ◽  
Author(s):  
Yun Lu ◽  
Felicia W. Chi ◽  
Sujaya Parthasarathy ◽  
Vanessa A. Palzes ◽  
Andrea H. Kline‐Simon ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Brief Interventions ◽  
Factors Associated ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Treatment of Unhealthy Alcohol Use

2019 ◽  
Author(s):  
Stephen R Holt ◽  
David A Fiellin
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Behavioral Therapy ◽  
Primary Care Providers ◽  
Similar Efficacy ◽  
Motivational Enhancement Therapy ◽  
Behavioral Strategies ◽  
Care Providers ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Unhealthy alcohol use represents the fifth leading cause of morbidity and mortality globally, and the first leading cause among persons 18 to 45 years of age. Despite the global impact of unhealthy alcohol use, the adoption of evidence-based treatments has been sluggish. Behavioral strategies for lower level drinking include the brief motivational interview, designed to be within the scope of any healthcare provider, and more specialist-driven approaches for those with alcohol use disorder (AUD) such as cognitive behavioral therapy and motivational enhancement therapy. Benzodiazepines remain the mainstay treatment for inpatient alcohol withdrawal treatment, whereas other medications have similar efficacy in managing patients in the outpatient setting with milder forms of withdrawal. For maintenance treatment of AUD, four FDA-approved medications exist, with efficacy in treating AUD, as well as several non–FDA-approved medications that have been found to be effective in promoting abstinence and reducing drinking. The use of medication to treat many patients with AUD falls within the scope of primary care providers. This review contains 6 tables and 54 references. Key Words: addiction, alcohol, counseling, drinking, pharmacotherapy, primary care, psychotherapy, relapse, treatment

scholarly journals 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

2021 ◽  
Author(s):  
Daniel E. Jonas ◽  
Colleen Barclay ◽  
Debbie Grammer ◽  
Chris Weathington ◽  
Sarah A. Birken ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Practice Facilitation ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
The Us ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background: Unhealthy alcohol use is a leading cause of preventable deaths in the US and is associated with many societal and health problems. Less than a third of people who visit primary care providers in the US are asked about or ever discuss alcohol use with a health professional. Methods/design: This study is an adaptive, 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 small-to-medium-sized primary care practices. Study participants will include primary care practices in North Carolina with 10 or fewer providers. All enrolled practices will receive a practice facilitation intervention that includes quality improvement (QI) coaching, electronic health record (EHR) support, training, and expert consultation. After 6 months, practices in the lower 50th percentile (based on performance) will be randomized to continued practice facilitation or provision of telehealth services plus ongoing facilitation for the next 6 months. Practices in the upper 50th percentile after the initial 6 months of intervention will continue to receive practice facilitation alone. The main outcome measures include the number (and %) of patients in the target population who are screened for unhealthy alcohol use, screen positive, and receive brief counseling. Additional measures include the number (and %) of patients who receive pharmacotherapy for AUD or are referred for AUD services.Discussion: A successful intervention would significantly reduce morbidity among adults from unhealthy alcohol use by increasing counseling and other treatment opportunities. 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. It will also generate scientific knowledge about whether embedded telehealth services can improve use of evidence-based screening and interventions for practices with slower uptake. 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.Trial registration: ClinicalTrials.gov NCT04317989. March 23, 2020 –registered, https://www.clinicaltrials.gov/ct2/show/NCT04317989?titles=STUN&draw=2&rank=1

Treatment of Unhealthy Alcohol Use

2019 ◽  
Author(s):  
Stephen R Holt ◽  
David A Fiellin
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Behavioral Therapy ◽  
Primary Care Providers ◽  
Similar Efficacy ◽  
Motivational Enhancement Therapy ◽  
Behavioral Strategies ◽  
Care Providers ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Unhealthy alcohol use represents the fifth leading cause of morbidity and mortality globally, and the first leading cause among persons 18 to 45 years of age. Despite the global impact of unhealthy alcohol use, the adoption of evidence-based treatments has been sluggish. Behavioral strategies for lower level drinking include the brief motivational interview, designed to be within the scope of any healthcare provider, and more specialist-driven approaches for those with alcohol use disorder (AUD) such as cognitive behavioral therapy and motivational enhancement therapy. Benzodiazepines remain the mainstay treatment for inpatient alcohol withdrawal treatment, whereas other medications have similar efficacy in managing patients in the outpatient setting with milder forms of withdrawal. For maintenance treatment of AUD, four FDA-approved medications exist, with efficacy in treating AUD, as well as several non–FDA-approved medications that have been found to be effective in promoting abstinence and reducing drinking. The use of medication to treat many patients with AUD falls within the scope of primary care providers. This review contains 6 tables and 54 references. Key Words: addiction, alcohol, counseling, drinking, pharmacotherapy, primary care, psychotherapy, relapse, treatment

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