Commentary on ‘<i>The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory’</i>

Klimas, Jan; Field, Catherine Anne; Barry, Joseph; Bury, Gerard; Keenan, Eamon; Lyons, Suzi; Smyth, Bobby P; Cullen, William R.

doi:10.3109/09687637.2011.577462

Cited by 12 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…46 –48 The effectiveness of brief interventions for alcohol consumption is well recognized. 18,49,50 In 2011, A Cochrane review found brief interventions for heavy alcohol users to be beneficial in the short term. 51 Therefore, screening for alcohol misuse is recommended in HIV-infected individuals, and is especially important for HIV/HCV co-infected patients.…”

Section: Discussionmentioning

confidence: 99%

Use of the Alcohol Use Disorders Identification Test (AUDIT) to determine the prevalence of alcohol misuse among HIV-infected individuals

et al. 2013

View full text Add to dashboard Cite

The aim of the paper is to evaluate alcohol misuse among an inner city adult HIV clinic population with AUDIT (Alcohol Use Disorders Identification Test). A cross-sectional HIV outpatient clinic analysis between 28 February 2011 and 11 March 2011 was carried out. AUDIT, demographic and clinical data were collected. Univariate analysis was performed to look for the associations between variables. Backward stepwise multivariate analyses were performed on significant variables from the univariate analysis to assess for predictors of alcohol dependence. In total, 111 patients were included (60% uptake of clinic attendees); 66% were men and 26% were hepatitis C virus (HCV) co-infected. The median AUDIT score was 5 (within normal range). Thirty-four 'AUDIT positive' cases were identified: five (4.5%) indicated consumption of hazardous levels of alcohol; 21 (19%) indicated harmful levels of alcohol; and eight (7%) were likely alcohol dependent. Younger age (<40 years old) was significantly associated with AUDIT positivity (P = 0.006). On multivariate analysis younger age (P = 0.045, odds ratio 13.8) and lower level of education (P = 0.006, odds ratio 6.7) were predictive of scores indicative of alcohol dependence (AUDIT ≥20). In conclusion, younger age and lower educational levels were associated with scores consistent with alcohol dependence. AUDIT was well tolerated and easy to administer in this outpatient HIV clinic population.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of the Alcohol Use Disorders Identification Test (AUDIT) to determine the prevalence of alcohol misuse among HIV-infected individuals

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Patients with opioid use disorders have specific health needs and risk behaviors (O'Toole et al 2008; Klimas et al 2012). Alcohol use is common.…”

Section: Introductionmentioning

confidence: 99%

Alcohol Screening among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program

Klimas

Muench

Wiest

et al. 2015

Journal of Psychoactive Drugs

Self Cite

View full text Add to dashboard Cite

Problem alcohol use is associated with adverse health and economic outcomes, especially among people in opioid agonist treatment. Screening, brief intervention and referral to treatment (SBIRT) are effective in reducing alcohol use; however, issues involved in SBIRT implementation among opioid agonist patients are unknown. To assess identification and treatment of alcohol use disorders, we reviewed clinical records of opioid agonist patients screened for an alcohol use disorder in a primary care clinic (n =208) and in an opioid treatment program (n = 204) over a two year period. In the primary care clinic, 193 (93%) buprenorphine patients completed an annual alcohol screening and six (3%) had elevated AUDIT scores. Among the patients treated in the opioid treatment program, an alcohol abuse or dependence diagnosis was recorded for 54 (27%) methadone patients. Practitioner focus groups were completed in the primary care (n = 4 physicians) and the opioid treatment program (n = 11 counsellors) to assess experience with and attitudes towards screening opioid agonist patients for alcohol use disorders. Focus groups suggested organizational, structural, provider, patient and community variables hindered or fostered alcohol screening. Alcohol screening is feasible among opioid agonist patients. Effective implementation, however, requires physician training and systematic changes in workflow.

show abstract

“…Patients’ views on this matter can not only deepen our understanding of the barriers or enablers to screening and brief intervention, but can also help us to develop interventions that are specific to their needs [23]. Patients views are particularly important as they may be at odds with those of healthcare professionals, for example which healthcare professional is best placed to address the issue [24] and whether GPs are sufficiently confident to address problem alcohol use [25].…”

Section: Introductionmentioning

confidence: 99%

Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment

et al. 2013

Self Cite

View full text Add to dashboard Cite

BackgroundProblem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients’ experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care.MethodsThis qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland’s Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer.ResultsWe identified three overarching themes relevant to the purpose of this paper: (1) patients’ experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment.ConclusionsProblem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic detailing and practice visits, should be explored.

show abstract

Commentary on ‘The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory’

Cited by 12 publications

References 22 publications

Use of the Alcohol Use Disorders Identification Test (AUDIT) to determine the prevalence of alcohol misuse among HIV-infected individuals

Use of the Alcohol Use Disorders Identification Test (AUDIT) to determine the prevalence of alcohol misuse among HIV-infected individuals

Alcohol Screening among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program

Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment

Contact Info

Product

Resources

About