Assessing the relationship between medical residents' perceived barriers to SBIRT implementation and their documentation of SBIRT in clinical practice

Agley, Jon; Gassman, Ruth A.; Vannerson, Julie; Crabb, David W.

doi:10.1016/j.puhe.2014.05.011

Cited by 13 publications

(19 citation statements)

References 7 publications

(7 reference statements)

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“…Additionally, other EHR tools such as automated reminders increased the number of patients screened at our program practices. The EHR needs to clearly flag or highlight positive screens to ensure that brief interventions are delivered [ 37 ]. Attention must be paid to the EHR integration during the planning phase, however, or lost revenue and poor outcome documentation can sink a program before it becomes established.…”

Section: Screening In Primary Care Projectmentioning

confidence: 99%

Implementing SBIRT (Screening, Brief Intervention and Referral to Treatment) in primary care: lessons learned from a multi-practice evaluation portfolio

et al. 2017

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BackgroundScreening, Brief Intervention and Referral to Treatment (SBIRT) is a public health framework approach used to identify and deliver services to those at risk for substance-use disorders, depression, and other mental health conditions. Primary care is the first entry to the healthcare system for many patients, and SBIRT offers potential to identify these patients early and assist in their treatment. There is a need for pragmatic “best practices” for implementing SBIRT in primary care offices geared toward frontline providers and office staff.MethodsTen primary care practices were awarded small community grants to implement an SBIRT program in their location. Each practice chose the conditions for which they would screen, the screening tools, and how they would provide brief intervention and referral to treatment within their setting. An evaluation team communicated with each practice throughout the process, collecting quantitative and qualitative data regarding facilitators and barriers to SBIRT success. Using the editing method, the qualitative data were analyzed and key strategies for success are detailed for implementing SBIRT in primary care.ResultsThe SBIRT program practices included primary care offices, federally qualified health centers, school-based health centers, and a safety-net emergency department. Conditions screened for included alcohol abuse, drug abuse, depression, anxiety, child safety, and tobacco use. Across practices, 49,964 patients were eligible for screening and 36,394 pre-screens and 21,635 full screens were completed. From the qualitative data, eight best practices for primary care SBIRT are described: Have a practice champion; Utilize an interprofessional team; Define and communicate the details of each SBIRT step; Develop relationships with referral partners; Institute ongoing SBIRT training; Align SBIRT with the primary care office flow; Consider using a pre-screening instrument, when available; and Integrate SBIRT into the electronic health record.Conclusions and implicationsSBIRT is an effective tool that can empower primary care providers to identify and treat patients with substance use and mental health problems before costly symptoms emerge. Using the pragmatic best practices we describe, primary care providers may improve their ability to successfully create, implement, and sustain SBIRT in their practices.

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Section: Screening In Primary Care Projectmentioning

confidence: 99%

Implementing SBIRT (Screening, Brief Intervention and Referral to Treatment) in primary care: lessons learned from a multi-practice evaluation portfolio

et al. 2017

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“…Despite their efficacy, little progress has been made in the broad implementation of evidence‐based interventions into clinical practice (Gardiner et al., ; McKnight‐Eily et al., ; Roberts et al., ). This is often because providers lack time and resources to effectively screen for and intervene on alcohol and illicit drug use behaviors among women of childbearing age (Agley et al., ; Friedmann et al., ; Nygaard and Aasland, ). In addition, traditional intervention modalities have limited capacity to reach populations who might not otherwise receive care (Griffiths et al., ; Roberts et al., ).…”

mentioning

confidence: 99%

The Efficacy of Technology‐Based Interventions for Alcohol and Illicit Drug Use Among Women of Childbearing Age: A Systematic Review and Meta‐Analysis

Hai

Hammock

Velasquez

2019

Alcoholism Clin & Exp Res

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Background: Alcohol and illicit drug use is prevalent among women of childbearing age and may lead to higher risk for substance-exposed pregnancy and related health consequences for both women and their offspring. Technology-based interventions (TBIs) are increasingly used to prevent or reduce substance use among women of childbearing age. The efficacy of these approaches, however, is unclear. This review critically reviewed existing research evidence from randomized controlled trials (RCTs) on the efficacy of TBIs in preventing and reducing alcohol and illicit drug use among childbearing-aged women.Methods: Seven electronic databases were searched to identify eligible studies. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analyses.Results: Fifteen RCTs including 3,488 participants were included in the systematic review. Metaanalysis results based on 13 RCTs suggest that TBIs were efficacious relative to control conditions in preventing and reducing substance use among women of childbearing age (d = 0.19, 95% CI = 0.02, 0.35). Preliminary moderator analysis results suggest that the efficacy of TBIs might not vary by participant age, race/ethnicity, the type of technology used, or whether a virtual health assistant was used. TBIs' efficacy in terms of specific substance use types (alcohol use and illicit drug use) or control types (inactive control and active controls) was inconclusive, due to the limited number of studies in each category.Conclusions: This systematic review and meta-analysis found evidence of TBIs' efficacy in reducing alcohol and illicit drug use among women of childbearing age. Implications for future research and practice are discussed.

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“…Women's health providers have much room for improvement in using screening and brief intervention methods, possibly due to misplaced concerns about damaging the patient-doctor relationship. 18,19 In contrast to these concerns, the primary results of the current survey study show that women are open to talking about drinking and related risks to their health with women's health providers. Moreover, they see discussing drinking and its related risks as part of their practitioner's job and report that they would respond honestly to provider inquiries about drinking and related risk behaviors.…”

Section: Discussionmentioning

confidence: 74%

“…18 While a range of factors are cited by physicians as barriers to implementation, many express concerns about time, their own abilities to effectively intervene, or that patients may be offended and SBIRT services will damage rapport or interfere with the patient-doctor relationship. 19 This is also true in qualitative analyses of barriers where providers indicate concern about inducing shame when discussing stigmatized behavior. 20 There are no published reports of an SBIRT strategy to reduce risky drinking and risk for AEP in women's health settings.…”

Section: Introductionmentioning

confidence: 99%

Missed Opportunities: Screening and Brief Intervention for Risky Alcohol Use in Women's Health Settings

Hettema

Cockrell

Russo

et al. 2015

Journal of Women's Health

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Assessing the relationship between medical residents' perceived barriers to SBIRT implementation and their documentation of SBIRT in clinical practice

Cited by 13 publications

References 7 publications

Implementing SBIRT (Screening, Brief Intervention and Referral to Treatment) in primary care: lessons learned from a multi-practice evaluation portfolio

Implementing SBIRT (Screening, Brief Intervention and Referral to Treatment) in primary care: lessons learned from a multi-practice evaluation portfolio

The Efficacy of Technology‐Based Interventions for Alcohol and Illicit Drug Use Among Women of Childbearing Age: A Systematic Review and Meta‐Analysis

Missed Opportunities: Screening and Brief Intervention for Risky Alcohol Use in Women's Health Settings

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