Commentary on Nilsen <i>et al</i>. (2011): The importance of asking patients—the potential value of patient report of brief interventions

Bradley, Katharine A.; Johnson, Maxine; Williams, Emily C.

doi:10.1111/j.1360-0443.2011.03587.x

Cited by 15 publications

(15 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, given that alcohol screening is inexpensive, brief, and acceptable to most patients, screening 17 patients to identify 1 patient who converted to a positive screen a year after a single negative screen will most likely be acceptable in many healthcare systems. This may be particularly true of systems, like the VA, which have implemented support systems for evidence-based follow-up for screen positive patients (Bradley et al, 2011a;Lapham et al, 2012). Future research will need to evaluate the probability of converting to a positive screen after multiple negative alcohol screens.…”

Section: Discussionmentioning

confidence: 93%

Probability and Predictors of Patients Converting from Negative to Positive Screens for Alcohol Misuse

Lapham

Rubinsky

Heagerty

et al. 2013

Alcohol Clin Exp Res

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 93%

Probability and Predictors of Patients Converting from Negative to Positive Screens for Alcohol Misuse

Lapham

Rubinsky

Heagerty

et al. 2013

Alcohol Clin Exp Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…These findings highlight the need for evaluations in later stages of implementation. Although rates of brief intervention at the time of this study were only 28%, national rates of brief intervention reached 77% in 2010 [61], which may have resulted in a more even distribution of brief intervention across facilities and patient subpopulations.…”

Section: Discussionmentioning

confidence: 99%

An early evaluation of implementation of brief intervention for unhealthy alcohol use in the US Veterans Health Administration

et al. 2014

Self Cite

View full text Add to dashboard Cite

Aims The US Veterans Health Administration [Veterans Affairs (VA)] used performance measures and electronic clinical reminders to implement brief intervention for unhealthy alcohol use. We evaluated whether documented brief intervention was associated with subsequent changes in drinking during early implementation. Design Observational, retrospective cohort study using secondary clinical and administrative data. Setting Thirty VA facilities. Participants Outpatients who screened positive for unhealthy alcohol use [Alcohol Use Disorders Identification Test Consumption (AUDIT-C ≥ 5)] in the 6 months after the brief intervention performance measure (n = 22 214) and had follow-up screening 9–15 months later (n = 6210; 28%). Measurements Multi-level logistic regression estimated the adjusted prevalence of resolution of unhealthy alcohol use (follow-up AUDIT-C <5 with ≥2 point reduction) for patients with and without documented brief intervention (documented advice to reduce or abstain from drinking). Findings Among 6210 patients with follow-up alcohol screening, 1751 (28%) had brief intervention and 2922 (47%) resolved unhealthy alcohol use at follow-up. Patients with documented brief intervention were older and more likely to have other substance use disorders, mental health conditions, poor health and more severe unhealthy alcohol use than those without (P-values < 0.05). Adjusted prevalences of resolution were 47% [95% confidence interval (CI) = 42–52%] and 48% (95% CI = 42–54%) for patients with and without documented brief intervention, respectively (P = 0.50). Conclusions During early implementation of brief intervention in the US Veterans Health Administration, documented brief intervention was not associated with subsequent changes in drinking among outpatients with unhealthy alcohol use and repeat alcohol screening.

show abstract

“…Previous research has identified low sensitivity of clinical screening for identifying alcohol misuse in the VA compared with AUDIT-Cs on SHEP surveys (Bradley et al, 2011a), and local qualitative research suggests that this may occur because of nonstandardized verbal administration of alcohol screening by triage staff (Williams et al, 2015). Therefore, it could be that many of the patients in our study sample who screened positive on SHEP did not screen positive during a past-year VA outpatient visit and that their VA provider was not prompted to offer brief interventions.…”

Section: Discussionmentioning

confidence: 99%

Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions

Chavez

Williams

Lapham

et al. 2016

J. Stud. Alcohol Drugs

Self Cite

View full text Add to dashboard Cite

ABSTRACT. Objective: Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. Method: This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP;-2011 who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C 5) was estimated for each year. Results: Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. Conclusions: The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation. (J. Stud. Alcohol Drugs, 77, 500-508, 2016)

show abstract

Commentary on Nilsen et al. (2011): The importance of asking patients—the potential value of patient report of brief interventions

Cited by 15 publications

References 16 publications

Probability and Predictors of Patients Converting from Negative to Positive Screens for Alcohol Misuse

Probability and Predictors of Patients Converting from Negative to Positive Screens for Alcohol Misuse

An early evaluation of implementation of brief intervention for unhealthy alcohol use in the US Veterans Health Administration

Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions

Contact Info

Product

Resources

About