A cascade of care for alcohol use disorder: Using 2015–2019 National Survey on Drug Use and Health data to identify gaps in past 12‐month care

Mintz, Carrie M.; Hartz, Sarah M.; Fisher, Sherri L.; Ramsey, Alex T.; Geng, Elvin; Grucza, Richard A.; Bierut, Laura J.

doi:10.1111/acer.14609

Cited by 40 publications

(50 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The low rates of documented screening contrast with BRFSS and NSDUH data indicating that around 80% of US adults report having been screened for alcohol use by a clinician in the prior 1 to 2 years 13,14 . This difference is likely due in part to the fact that the current study assesses documented screening with a validated screening questionnaire, whereas both BRFSS and NSDUH assess whether patients recall having been asked by a clinician if they drank alcohol.…”

Section: Discussionmentioning

confidence: 61%

“…The Centers for Disease Control and Prevention (CDC)'s Behavioral Risk Factor Surveillance System (BRFSS) national survey in 2017 found 81% of patients' self-reported alcohol screening 13 when asked if during a routine checkup within the prior 2 years a medical professional inquired whether they consumed alcohol. Similarly, a recent analysis of the National Survey for Drug Use and Health (NSDUH) data found 76-87% of participants reported being asked about alcohol use by a medical professional in the past year 14 . There are, however, currently relatively few studies examining clinician reports of screening for unhealthy alcohol use.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Alcohol Screening During US Primary Care Visits, 2014–2016

et al. 2022

View full text Add to dashboard Cite

Background Unhealthy alcohol use is a significant health issue for the US population. The US Preventive Services Task Force (USPSTF) recommends screening adults 18 years or older for unhealthy alcohol use during primary care visits. Objectives To evaluate alcohol screening among ambulatory visits made by US adult primary care patients and identify characteristics predictive of alcohol screening. Design A series of cross-sectional analysis of the National Ambulatory Medical Care Survey (NAMCS) data collected from 2014 to 2016 was used to examine US primary care providers’ use of alcohol screening questionnaires and delivery of counseling on alcohol use. Participants A total of 19,213 visits made by patients aged 18 years or older to a US primary care physician trained in family medicine or internal medicine. Main Measures Administration of a validated alcohol screening questionnaire and counseling/education on alcohol use. Variation in alcohol screening by patient demographic characteristics, reason for office visit, length of office visit, chronic medical conditions, evaluation by assigned primary care physician, new patient to practice, and region. Key Results Alcohol screening with a validated questionnaire occurred during 2.6% (95% Cl: 0.9%, 4.3%) of visits. Alcohol counseling, provided either by the physician or by referral, was documented in 0.8% (95% Cl: 0.3%, 1.3%) of visits. Screening was significantly more likely if patients were seen by their assigned primary care physician (adjOR 4.38 (95% Cl: 1.41, 13.61)), a new patient to the practice (adjOR 4.18 (95% Cl: 2.30, 7.79)), or had several chronic medical conditions (adjOR 3.40 (95% Cl: 1.48, 7.78)). Patients’ sex, race/ethnicity, age group, or length of appointment time was not associated with screening for unhealthy alcohol use. Conclusions Screening for unhealthy alcohol use using a validated questionnaire is uncommonly performed during US primary care visits. Interventions or incentives may be needed to increase uptake of USPSTF alcohol screening recommendations.

show abstract

Section: Discussionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Alcohol Screening During US Primary Care Visits, 2014–2016

et al. 2022

View full text Add to dashboard Cite

show abstract

“…However, only a minority received care: 11.6% reported receiving a brief intervention, roughly 5% were referred to treatment, and roughly 6% received treatment. 11 Another study found that primary care physicians underdiagnose patients with alcohol abuse as well as underregister them in medical records. 12 The study reported that of the 179 males and 82 females who met the criteria for AUD via patientreported data, only 1 of the males and none of the females were documented as such by the primary care physician.…”

Section: Underdiagnosed and Undertreatedmentioning

confidence: 99%

Destigmatizing alcohol use disorder among nurses

Rathburn

2022

Nursing

View full text Add to dashboard Cite

show abstract

“…Despite these negative consequences, and the evidence to support the benefit of AUD related treatment [ 6 , 7 ], less than 20% of individuals with AUD receive psychological/behavioural therapy with or without pharmacotherapy for relapse prevention [ 1 ]. While current statistics are lacking for Canada, a recent study in the United States found that among 21,270 adults with AUD, only 5.8% reported receiving treatment [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Clinicians’ perspectives and perceived barriers to caring for patients with alcohol use disorder and cirrhosis

Johnson

Ghosh

Daniels

et al. 2022

Addict Sci Clin Pract

View full text Add to dashboard Cite

Background Alcohol use disorder (AUD) is one of the leading etiologies for liver cirrhosis and liver transplantation. Few individuals with AUD receive guideline-based care in the form of screening, brief intervention, referral to treatment, or prescription of pharmacotherapy for relapse prevention. We interviewed clinicians across Alberta to assess the current experience and perceived barriers to managing AUD in people who have cirrhosis. The aim of this paper is to summarize these findings to inform the development of an educational intervention. Methods We used a qualitative descriptive approach to explore the experiences of clinicians who care for patients with cirrhosis and AUD in Alberta. We conducted semi-structured interviews directed by an interview guide. Interviews were recorded and transcribed verbatim. We used an inductive thematic analysis approach whereby transcripts were coded, with codes grouped into larger categories, then themes. Results Sixteen clinicians participated in this study. Many participants acknowledged that they do not use a standardized approach to screening, brief intervention, and referral to treatment. Through thematic analysis we identified four themes surrounding barriers to managing AUD in patients with cirrhosis: (i) Practicing within knowledge constraints, (ii) Navigating limited resources and system challenges, (iii) Balancing the complexity of cirrhosis and AUD, and (iv) Acknowledging the influence of provider perceptions on care. Conclusion This article presents the perspectives of clinicians who care for people who have AUD and cirrhosis. Significant barriers exist, including limited knowledge and resources, systemic challenges, and patient complexity. The information gathered will be used to develop an educational intervention that will delve deeper into these issues in order to have the greatest impact on clinicians who routinely interface with this patient population.

show abstract

A cascade of care for alcohol use disorder: Using 2015–2019 National Survey on Drug Use and Health data to identify gaps in past 12‐month care

Cited by 40 publications

References 40 publications

Alcohol Screening During US Primary Care Visits, 2014–2016

Alcohol Screening During US Primary Care Visits, 2014–2016

Destigmatizing alcohol use disorder among nurses

Clinicians’ perspectives and perceived barriers to caring for patients with alcohol use disorder and cirrhosis

Contact Info

Product

Resources

About