Screening, Brief Intervention, and Referral to Treatment (SBIRT): Toward a Public Health Approach to the Management of Substance Abuse

Babor, Thomas F.; McRee, Bonnie; Kassebaum, Patricia A.; Grimaldi, Paul L.; Ahmed, Kazi Matin; Bray, Jeremy

doi:10.1176/foc.9.1.foc130

Cited by 267 publications

(369 citation statements)

References 129 publications

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“…5,6 This model of care is widely known as Screening, Brief Intervention, and Referral to Treatment (SBIRT). 7 However, there is little evidence that BAIs improve outcomes or access to specialty care for individuals with moderate to severe alcohol use disorders.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Clinical Trial of Alcohol Care Management Delivered in Department of Veterans Affairs Primary Care Clinics Versus Specialty Addiction Treatment

et al. 2013

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BACKGROUND: Alcohol use disorder is one of the leading causes of disability worldwide. Despite the availability of efficacious treatments, few individuals with an alcohol use disorder are actively engaged in treatment. Available evidence suggests that primary care may play a crucial role in the identification of patients with an alcohol use disorder, delivery of interventions, and the success of treatment. OBJECTIVE: The principal aims of this study were to test the effectiveness of a primary care-based Alcohol Care Management (ACM) program for alcohol use disorder and treatment engagement in veterans. DESIGN: The design of the study was a 26-week singleblind randomized clinical trial. The study was conducted in the primary care practices at three VA medical centers. Participants were randomly assigned to treatment in ACM or standard treatment in a specialty outpatient addiction treatment program. PARTICIPANTS: One hundred and sixty-three alcoholdependent veterans were randomized. INTERVENTION: ACM focused on the use of pharmacotherapy and psychosocial support. ACM was delivered in-person or by telephone within the primary care clinic. MAIN MEASUREMENTS: Engagement in treatment and heavy alcohol consumption. KEY RESULTS: The ACM condition had a significantly higher proportion of participants engaged in treatment over the 26 weeks [OR=5.36, 95 % CI = (2.99, 9.59)]. The percentage of heavy drinking days were significantly lower in the ACM condition [OR=2.16, 95 % CI= (1.27, 3.66)], while overall abstinence did not differ between groups. CONCLUSIONS: Results demonstrate that treatment for an alcohol use disorder can be delivered effectively within primary care, leading to greater rates of engagement in treatment and greater reductions in heavy drinking.

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Section: Introductionmentioning

confidence: 99%

A Randomized Clinical Trial of Alcohol Care Management Delivered in Department of Veterans Affairs Primary Care Clinics Versus Specialty Addiction Treatment

et al. 2013

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“…Most BIs are short sessions lasting only a few minutes and may take place during one or more patient visits. Some models of SBI-called screening, brief intervention, and referral to treatment (SBIRT)-include identifying individuals at risk for alcohol dependence and referring them to formal treatment (Babor et al, 2007). SBIRT models are increasingly being used to address a variety of substance-related issues, including risky drug use and dependence.…”

Section: S Creening and Brief Intervention (Sbi) Formentioning

confidence: 99%

Costs of Alcohol Screening and Brief Intervention in Medical Settings: A Review of the Literature

Bray

Zarkin²,

Hinde³

et al. 2012

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: This article summarizes the literature on the implementation costs of alcohol screening and brief intervention (SBI) in medical settings. Method: Electronic databases were searched using SBI-and cost-related terms. Methodological approaches and cost estimates were abstracted from each study and categorized based on the cost methodology. Costs were updated to 2009 U.S. dollars. To determine a summary cost measure, we excluded outliers and computed the median of the remaining cost estimates. Results: Seventeen studies with cost estimates were identifi ed for further study. Costs ranged from $0.51 to $601.50 per screen and from $3.41 to $243.01 per brief intervention (BI). Cost estimates were lower when an activity-based cost methodology was used, in primary care settings, and when the provider was not a doctor. The median summary cost of a screen is approximately $4, and the median summary cost of a BI is approximately $48. Conclusions: Screening cost estimates had more variation than BI cost estimates. Provider type and service delivery time drive the cost variation. Interpretation of cost differences was limited by insuffi cient reporting of the cost methodology. Cost estimates presented here are similar in size to the Healthcare Common Procedure Coding System and Current Procedural Terminology reimbursement amounts, suggesting that insurance-based service reimbursement may be suffi cient to sustain alcohol SBI in practice. (J. Stud. Alcohol Drugs, 73, 911-919, 2012)

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“…Louisiana FIMR began conducting PPOR in each of its nine regions and comparing results with the state overall as part of a Perinatal Needs Assessment Template. The combined findings of FIMR, PPOR, and PRAMS indicated that substance abuse during pregnancy was an important issue to address in reducing excess infant mortality, and the Screening Brief Intervention Referral and Treatment (SBIRT) model [44], an approach to screening and early intervention for substance abuse disorders, was adopted for pregnant and postpartum women.…”

Section: Maturity and Weight At Birth/maturity-and Birth Weight-specimentioning

confidence: 99%

Developing a Standard Approach to Examine Infant Mortality: Findings from the State Infant Mortality Collaborative (SIMC)

Stampfel

Kroelinger

Dudgeon

et al. 2012

Matern Child Health J

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States can improve pregnancy outcomes by using a standard approach to assess infant mortality. The State Infant Mortality Collaborative (SIMC) developed a series of analyses to describe infant mortality in states, identify contributing factors to infant death, and develop the evidence base for implementing new or modifying existing programs and policies addressing infant mortality. The SIMC was conducted between 2004 and 2006 among five states: Delaware, Hawaii, Louisiana, Missouri, and North Carolina. States used analytic strategies in an iterative process to investigate contributors to infant mortality. Analyses were conducted within three domains: data reporting (quality, reporting, definitional criteria, and timeliness), cause and timing of infant death (classification of cause and fetal, neonatal, and postneonatal timing), and maturity and weight at birth/maturity and birth weight-specific mortality. All states identified the SIMC analyses as useful for examining infant mortality trends. In each of the three domains, SIMC results were used © Springer Science+Business Media New York 2012 Correspondence to: Caroline Stampfel, cstampfel@amchp.org. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. All partners contributed to the initial design, eligibility criteria, five-state selection process, and/or ongoing scientific and technical assistance. We examine the benefits of this standard approach for assessing infant mortality by: (1) describing the SIMC process, including a comparison of five state analyses on direct contributors to infant mortality; (2) defining the strategies identified for each analysis; and (3) summarizing application of analytic findings to modify existing policies or programs. HHS Public Access DescriptionBetween 2004 and 2006, the SIMC was implemented to aid states in investigation of infant mortality through facilitated meetings with subject matter experts, review and recommendation of appropriate data sources, development of standard approaches for analyses of infant mortality causes and contributors, and interpretation of findings both consistent with the literature and useful for each participating state for programmatic and policy-making decisions.Using available infant mortality data for all 50 states and the District of Columbia, eligibility for application to the collaborative was determined using information reflecting high or increasing burden of infant mortality. The following information was used to score state Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript eligibility: (1) three types of trend analyses, (2) the states' average IMR, and (3) states' raceadjusted IMR. Of 22 states which met the minimum scoring, the top 13 were determined to be eligible for the project; eight states applied and five were selected to participate, including Delaware, Hawaii, Louisiana, Missouri, and North Carolina. Each selected s...

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Screening, Brief Intervention, and Referral to Treatment (SBIRT): Toward a Public Health Approach to the Management of Substance Abuse

Cited by 267 publications

References 129 publications

A Randomized Clinical Trial of Alcohol Care Management Delivered in Department of Veterans Affairs Primary Care Clinics Versus Specialty Addiction Treatment

A Randomized Clinical Trial of Alcohol Care Management Delivered in Department of Veterans Affairs Primary Care Clinics Versus Specialty Addiction Treatment

Costs of Alcohol Screening and Brief Intervention in Medical Settings: A Review of the Literature

Developing a Standard Approach to Examine Infant Mortality: Findings from the State Infant Mortality Collaborative (SIMC)

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