Association Between Receipt of Brief Alcohol Intervention and Quality of Care among Veteran Outpatients with Unhealthy Alcohol Use

Lapham, Gwen T.; Williams, Emily C.

doi:10.1007/s11606-015-3218-5

Cited by 6 publications

(3 citation statements)

References 43 publications

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“…While this result is consistent with research indicating primary care counseling is commonly not documented in the medical record (Stange et al, 1998), the incentives to document BI in the VA were expected to promote and increase such documentation. The high prevalence of patient reported BI without corresponding documentation in the EMR could be due to patients interpreting annual alcohol screening as advice about their drinking or a halo effect whereby patients with favorable perceptions of their health care may be more likely to recall or report BI (Pbert et al, 1999b; Simonetti et al, 2015; Ward and Sanson-Fisher, 1996). In sensitivity analyses accounting for patient rating of their VA health care, patients with the most favorable ratings had higher odds of reporting BI than those with the least.…”

Section: Discussionmentioning

confidence: 99%

“…We expected that observed variability might be a result of confounding due to differences across networks in recognition of mental health and substance use disorder comorbidity (Williams et al, 2014); patient satisfaction that could create a halo effect increasing rates of reported BI (Saitz et al, 2008; Simonetti et al, 2015); and geographic differences in drinking norms, all of which could vary across networks and potentially influence whether patients report receipt of BI (Substance Abuse and Mental Health Services Administration (SAMHSA), 2011). ICD-9 CM codes were used to identify any mental health diagnosis, including affective disorders, bipolar disorder, psychosis, schizophrenia and posttraumatic stress disorder, as well as any alcohol or other substance use disorder.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients

Lapham

Rubinsky

Shortreed

et al. 2015

Drug and Alcohol Dependence

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Background Performance measures for brief alcohol interventions (BIs) are currently based on provider documentation of BI. However, provider documentation may not be a reliable measure of whether or not patients are offered clinically meaningful BIs. In particular, BI documented with clinical decision support in an electronic medical record (EMR) could appear identical irrespective of the quality of BI provided. We hypothesized that differences in how BI was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. Methods Male outpatients with unhealthy alcohol use identified by confidential satisfaction surveys (2009–2012) were assessed for whether they reported receiving BI in the past year (patient-reported BI) and whether they had BI documented in the EMR during the same period (documented BI). We evaluated and compared the prevalence of documented BI to patient-reported BI across 21 VA networks to determine whether documented BI had a variable association with patient-reported BI across the networks. Results Of 9896 eligible male outpatients with unhealthy alcohol use, 59.0% (95% CI 57.4–60.5%) reported BI (50.4–64.9% across networks) and 37.4% (95% CI 36.0–38.9%) had BI documented in the EMR (28.0–44.2% across networks). Overall, 72.9% (95% CI 70.8–75.5%) of patients with documented BI also reported BI. The association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models. Conclusions Performance measures of BI that rely on provider documentation in EMRs appear comparable to patient report for comparing care across VA networks.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients

Lapham

Rubinsky

Shortreed

et al. 2015

Drug and Alcohol Dependence

Self Cite

View full text Add to dashboard Cite

show abstract

“…The average response rate over the study period was 51% (55% in 2009, 53% in 2010, 51% in 2011, 48% in 2012). As in previous analyses, 24,26 survey weights were truncated at 500 to limit the impact of any one respondent. Unweighted and weighted percentages were used to characterize the study sample.…”

Section: Analysesmentioning

confidence: 99%