Automated Screening for At-Risk Drinking in a Primary Care Office Using Interactive Voice Response

Abstract

ABSTRACT. Objective: Screening for alcohol misuse in primary care settings is strongly recommended but grossly underused. Using interactive voice response (IVR), we developed an automated screening tool (IVR Screen) for identifying alcohol misuse in outpatient primary care offi ces and evaluated its use rate and acceptability for both patients and providers. Method: Patients (N = 101) presenting to a primary care clinic for scheduled, nonemergent health care visits called the IVR Screen by using a dedicated telephone in the waiting room and answered fi ve questions about their health. Results were printed immediately for patient and provider to review during the visit. Medical assistants interviewed patients about the IVR Screen in the examination room. Results: Ninety-six percent of patients who were invited to participate in the study consented to do so. Of those, 26% met criteria for alcohol misuse. Feedback from patients and providers was positive and included constructive suggestions for revisions to the IVR Screen for future use. Conclusions: IVR-based screening for at-risk drinking was feasible and did not interfere with the provider-patient interaction. The proportion of heavy drinkers identifi ed by the IVR Screen was comparable to that of published reports of screening with written questionnaires. Implications for behavioral health screening, treatment, and clinical research are considerable because IVR-based screening assessments can be customized and targeted to different populations. Results suggest that continued development of IVR as a tool for health and alcohol screening in primary care settings is warranted. (J. Stud. Alcohol Drugs, 71, 734-738, 2010)

Interactive voice response technology for symptom monitoring and as an adjunct to the treatment of chronic pain

“…For example, studies show that subjects report higher levels of drug and alcohol abuse when using IVR as compared to live interviews [18, 37, 49, 54]. …”

HealthCall: Technology-based extension of motivational interviewing to reduce non-injection drug use in HIV primary care patients – a pilot study

“…One example is automated Interactive Voice Response (IVR), a flexible telephone-based technology that has shown promise in helping patients to manage chronic illness and medications (Kaplan, 2006; Lester et al, 2010; Oake, Jennings, van Walraven & Forster, 2009; Reid, Pipe, Quinlan & Oda, 2007). IVR has been used for alcohol screening and as an adjunct to standard care (Helzer et al, 2008; Rose et al, 2010). This strategy seemed particularly appropriate for urban HIV primary care clinics, where limited staff time and resources make extended interventions for substance abuse unfeasible (Strauss et al, 2009).…”

A scoping review to explore the suitability of interactive voice response to conduct automated performance measurement of the patient’s experience in primary care

“…The capacity to reach diverse populations through IVR technology addresses a significant limitation of the common practice-based waiting-room administration of surveys which reach only those who attend the practice, potentially creating biased samples (Green et al, 2012). Once installed IVR could have a limited burden, if any at all, on a practice and if integrated with an electronic medical record (EMR) efficiently create outreach to patients without involving practice staff (Stuart et al, 2003;Shaw and Verma, 2007;Bender et al, 2010;Rose et al, 2010b;Aharonovich et al, 2012;Willig et al, 2013). As the telephone is almost universal, IVR surveys could facilitate access to a more representative sample of the group being studied.…”

“…However, studies noted that those with hearing impairment may have difficulty participating in a phone survey and some populations may not trust reporting information to a machine (Stuart et al, 2003;Brodey et al, 2005;Goldman et al, 2008;Naylor et al, 2008;Dalal et al, 2010;Rose et al, 2010a;2010b;Graham et al, 2012;Skolarus et al, 2012). However, studies noted that those with hearing impairment may have difficulty participating in a phone survey and some populations may not trust reporting information to a machine (Stuart et al, 2003;Brodey et al, 2005;Goldman et al, 2008;Naylor et al, 2008;Dalal et al, 2010;Rose et al, 2010a;2010b;Graham et al, 2012;Skolarus et al, 2012).…”