Screening, brief intervention and referral of emergency department patients with unhealthy drug use: efficacious or not?

D’Onofrio, Gail; Bernstein, Steven

doi:10.1136/eb-2014-102037

Cited by 8 publications

(7 citation statements)

References 2 publications

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“…Although FQHCs only serve about 6% of the total US population, they are responsible for nearly 15% of uninsured patients and nearly 30% of those who use some form of public insurance [34][35][36]. With recent work noting the low efficacy of SBIRT alone on linking individuals in primary care settings to SUD treatment [11,37,38], our results provide evidence on the feasibility of adding RMC-PC to SBIRT procedures and relative effectiveness of doing so by approximately doubling the rates of treatment linkage and days of treatment.…”

Section: Discussionmentioning

confidence: 99%

Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings

et al. 2022

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Background and Aims Recovery management checkups (RMC) have established efficacy for linking patients to substance use disorder (SUD) treatment. This study tested whether using RMC in combination with screening, brief intervention, and referral to treatment (SBIRT), versus SBIRT alone, can improve linkage of primary care patients referred to SUD treatment. Design A randomized controlled trial of SBIRT as usual (n = 132) versus SBIRT plus recovery management checkups for primary care (RMC‐PC) (n = 134) with follow‐up assessments at 3 months post‐baseline. Setting Four federally qualified health centers in the United States serving low‐income populations. Participants Primary care patients (n = 266, 64% male, 80% Black, mean age, 48.3 [range, 19–53]) who were referred to SUD treatment after SBIRT. Interventions SBIRT alone (control condition) compared with SBIRT + RMC‐PC (experimental condition). Measurement The primary outcome was any days of SUD treatment in the past 3 months. Key secondary outcomes were days of SUD treatment overall and by level of care, days of alcohol and other drug (AOD) abstinence, and days of using specific substances, all based on self‐report. Findings At 3‐month follow‐up, those assigned to SBIRT + RMC‐PC (n = 134) had higher odds of receiving any SUD treatment (46% vs 20%; adjusted odds ratio = 4.50 [2.49, 8.48]) compared with SBIRT only, including higher rates of entering residential and intensive outpatient treatment. They also reported more days of treatment (14.45, vs 7.13; d = +0.26), more days abstinent (41.3 vs 31.9; d = +0.22), and fewer days of using alcohol (27.14, vs 36.31; d = −0.25) and cannabis (19.49, vs 28.6; d = −0.20). Conclusions Recovery management checkups in combination with screening, brief intervention, and referral to treatment are an effective strategy for improving linkage of primary care patients in need to substance use disorder treatment over 3 months.

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Section: Discussionmentioning

confidence: 99%

Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings

et al. 2022

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“…Furthermore, the evidence for the effectiveness of brief intervention itself for drug use is not conclusive. 49 Mdege et al systematically reviewed 22 studies and concluded that a single intervention had no effect, but multiple interventions might be beneficial for those with alcohol use disorders. 50 Use of medication-assisted treatment with drugs, shown to be efficacious in reducing drinking, has not been studied in this setting.…”

Section: Discussionmentioning

confidence: 99%

An Initial Assessment of the Utility of Validated Alcohol and Drug Screening Tools in Predicting 30-Day Readmission to Adult General Medicine Wards

et al. 2018

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Previous studies have identified drug and alcohol use as risk factors for readmission using claims data, but not by using substance use screening scores. This preliminary study tested the hypothesis that prevalence of 30-day readmission would be higher among patients screening positive on the 10-item Alcohol Use Disorders Identification Test (AUDIT-10) or the 10-item Drug Abuse Screening Test (DAST-10) tools at intake than among the general patient population. Social workers screened 4708 adult inpatients using prescreening questions followed by the AUDIT-10 and/or DAST-10. Patients with positive screens were followed for readmissions within 30 days of discharge. A positive screening score on the AUDIT-10 or DAST-10 instrument at intake was associated with higher risk of readmission to the general medicine wards within 30 days; this relationship appears complex and subject to mediation. Post hoc chart review found that the majority of readmissions among patients with positive screens were not immediately attributable to substance use. Further study is needed to verify these preliminary findings.

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“…Several intervention models have been developed that provide overdose survivors with information and referrals to treatment; these include partnerships between public safety and public health providers, clinical or peer outreach, or communitybased drop-in programs (Formica et al, 2018). Another approach has focused on screening patients in hospital emergency departments (ED) or inpatient settings for OUD and initiating use of medications, such as Suboxone, with referrals provided to community-based MAT providers (D'Onofrio & Bernstein, 2015;D'Onofrio, O'Connor, Pantalon, et al, 2015;Lee, Liebschutz, Anderson, & Stein, 2017;Liebschutz, Crooks, Herman, & Stein, 2014;Shanahan, Beers, Alford, Brigandi, & Samet, 2010).…”

Section: Efforts To Engage Individuals Into Services Following Opioidmentioning

confidence: 99%

Findings from the recovery initiation and management after overdose (RIMO) pilot study experiment

Scott

Dennis

Grella

et al. 2020

Journal of Substance Abuse Treatment

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This pilot study evaluated the feasibility of the Recovery Initiation and Management after Overdose (RIMO) intervention to link individuals to medication-assisted treatment (MAT) following an opioid overdose. The study team worked with the Chicago Fire Department to train Emergency Medical Service (EMS) teams to request permission from individuals after an opioid overdose reversal to release their contact information; individuals were subsequently contacted by the study team for participation. A mixed-methods study design comprised: (1) an experimental pilot study that examined participation at each stage of the intervention and compared the odds of treatment received for individuals who were randomly assigned to either the RIMO intervention (n = 16) or a passive referral control (n = 17); and (2) a focus group that was subsequently conducted with participants in the RIMO group to obtain their feedback on the intervention components. Quantitative data was collected on participant characteristics at study intake and treatment received was based on self-report at a 30-day follow-up. The RIMO group had higher odds of receiving any treatment for opioid use (OR = 7.94) and any MAT (OR = 20.2), and received significantly more days of opioid treatment (Ms=15.2 vs. 3.4) and more days of MAT in the 30 days post-randomization (Ms=11.2 vs. 0.76), relative to the control group (all p < .05). Qualitative data illustrated that participants valued the assertive outreach, engagement, and persistent follow-up components of RIMO, which differed from their prior experiences. The pilot study suggests that the RIMO intervention is able to address the challenges of linking and engaging individuals into MAT after an opioid overdose.

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Screening, brief intervention and referral of emergency department patients with unhealthy drug use: efficacious or not?

Cited by 8 publications

References 2 publications

Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings

Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings

An Initial Assessment of the Utility of Validated Alcohol and Drug Screening Tools in Predicting 30-Day Readmission to Adult General Medicine Wards

Findings from the recovery initiation and management after overdose (RIMO) pilot study experiment

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