Patient and provider factors associated with receipt and delivery of brief interventions for unhealthy alcohol use in primary care.
alcohol screening
patient and provider factors
receipt and delivery of brief interventions
unhealthy alcohol use
Journal
Alcoholism, clinical and experimental research
ISSN: 1530-0277
Titre abrégé: Alcohol Clin Exp Res
Pays: England
ID NLM: 7707242
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
06
08
2021
received:
30
03
2021
accepted:
15
08
2021
pubmed:
7
9
2021
medline:
5
3
2022
entrez:
6
9
2021
Statut:
ppublish
Résumé
Unhealthy alcohol use is a serious and costly public health problem. Alcohol screening and brief interventions are effective in reducing unhealthy alcohol consumption. However, rates of receipt and delivery of brief interventions vary significantly across healthcare settings, and relatively little is known about the associated patient and provider factors. This study examines patient and provider factors associated with the receipt of brief interventions for unhealthy alcohol use in an integrated healthcare system, based on documented brief interventions in the electronic health record. Using multilevel logistic regression models, we retrospectively analyzed 287,551 adult primary care patients (and their 2952 providers) who screened positive for unhealthy drinking between 2014 and 2017. We found lower odds of receiving a brief intervention among patients exceeding daily or weekly drinking limits (vs. exceeding both limits), females, older age groups, those with higher medical complexity, and those already diagnosed with alcohol use disorders. Patients with other unhealthy lifestyle activities (e.g., smoking, no/insufficient exercise) were more likely to receive a brief intervention. We also found that female providers and those with longer tenure in the health system were more likely to deliver brief interventions. These findings point to characteristics that can be targeted to improve universal receipt of brief intervention.
Sections du résumé
BACKGROUND
Unhealthy alcohol use is a serious and costly public health problem. Alcohol screening and brief interventions are effective in reducing unhealthy alcohol consumption. However, rates of receipt and delivery of brief interventions vary significantly across healthcare settings, and relatively little is known about the associated patient and provider factors.
METHODS
This study examines patient and provider factors associated with the receipt of brief interventions for unhealthy alcohol use in an integrated healthcare system, based on documented brief interventions in the electronic health record. Using multilevel logistic regression models, we retrospectively analyzed 287,551 adult primary care patients (and their 2952 providers) who screened positive for unhealthy drinking between 2014 and 2017.
RESULTS
We found lower odds of receiving a brief intervention among patients exceeding daily or weekly drinking limits (vs. exceeding both limits), females, older age groups, those with higher medical complexity, and those already diagnosed with alcohol use disorders. Patients with other unhealthy lifestyle activities (e.g., smoking, no/insufficient exercise) were more likely to receive a brief intervention. We also found that female providers and those with longer tenure in the health system were more likely to deliver brief interventions.
CONCLUSIONS
These findings point to characteristics that can be targeted to improve universal receipt of brief intervention.
Identifiants
pubmed: 34486124
doi: 10.1111/acer.14702
pmc: PMC8602748
mid: NIHMS1735466
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2179-2189Subventions
Organisme : NIAAA NIH HHS
ID : K24 AA025703
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA025902
Pays : United States
Informations de copyright
© 2021 by the Research Society on Alcoholism.
Références
Am J Lifestyle Med. 2011 May;5(3):
pubmed: 24358034
JAMA. 1997 Apr 2;277(13):1039-45
pubmed: 9091691
BMJ. 2003 Sep 6;327(7414):536-42
pubmed: 12958114
Clin Geriatr Med. 2018 Feb;34(1):1-10
pubmed: 29129209
Fam Pract. 2004 Jun;21(3):270-5
pubmed: 15128688
J Clin Epidemiol. 1992 Jun;45(6):613-9
pubmed: 1607900
BMJ Open. 2020 Aug 30;10(8):e035212
pubmed: 32868351
Int J Environ Res Public Health. 2016 May 24;13(6):
pubmed: 27231920
Arch Intern Med. 2005 May 9;165(9):986-95
pubmed: 15883236
Alcohol Clin Exp Res. 2020 Dec;44(12):2536-2544
pubmed: 33151592
JAMA Netw Open. 2020 May 1;3(5):e204687
pubmed: 32401315
Int J Addict. 1989 Jan;24(1):19-28
pubmed: 2759762
Alcohol Clin Exp Res. 2021 Jun;45(6):1276-1286
pubmed: 33993541
Addiction. 2017 Feb;112 Suppl 2:73-81
pubmed: 28074567
Psychiatr Serv. 2009 May;60(5):663-70
pubmed: 19411355
Front Psychiatry. 2014 Sep 01;5:114
pubmed: 25225487
Subst Abus. 2007;28(3):7-30
pubmed: 18077300
Alcohol Clin Exp Res. 2020 Dec;44(12):2386-2400
pubmed: 33119905
Alcohol Clin Exp Res. 2020 Dec;44(12):2545-2554
pubmed: 33067802
Arch Intern Med. 2003 Nov 10;163(20):2511-7
pubmed: 14609789
Ann Intern Med. 2004 Apr 6;140(7):557-68
pubmed: 15068985
J Subst Abuse Treat. 2020 Dec;119:108078
pubmed: 32736926
Am J Manag Care. 2019 Dec 1;25(12):e358-e365
pubmed: 31860229
J Subst Use. 2019;24(1):41-46
pubmed: 30559602
Indian J Med Res. 2013 Oct;138(4):439-42
pubmed: 24434250
JAMA. 2002 Aug 14;288(6):756-64
pubmed: 12169083
Drug Alcohol Rev. 2009 May;28(3):301-23
pubmed: 19489992
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Addict Sci Clin Pract. 2017 Dec 07;12(1):33
pubmed: 29212532
Cochrane Database Syst Rev. 2018 Feb 24;2:CD004148
pubmed: 29476653
Drug Alcohol Rev. 2010 Nov;29(6):631-40
pubmed: 20973848
Lancet. 2018 Apr 14;391(10129):1513-1523
pubmed: 29676281
Am J Psychiatry. 2010 Aug;167(8):969-76
pubmed: 20439391
J Safety Res. 2020 Sep;74:125-131
pubmed: 32951773
J Fam Issues. 2018 Jan;39(1):3-27
pubmed: 29307947
JAMA. 2001 Oct 10;286(14):1715-23
pubmed: 11594896
J Stud Alcohol Drugs. 2020 Jul;81(4):436-445
pubmed: 32800079
Drug Alcohol Depend. 2020 Aug 1;213:108128
pubmed: 32603975
JAMA Psychiatry. 2017 Sep 1;74(9):911-923
pubmed: 28793133
Addiction. 2000 May;95(5):677-86
pubmed: 10885042
J Am Geriatr Soc. 2006 May;54(5):757-62
pubmed: 16696740
Prev Chronic Dis. 2017 Nov 30;14:E123
pubmed: 29191260
MMWR Morb Mortal Wkly Rep. 2020 Mar 13;69(10):265-270
pubmed: 32163383
BMJ. 2020 Dec 3;371:m4691
pubmed: 33272963
Drug Alcohol Depend. 2007 Jan 5;86(1):1-21
pubmed: 16759822
Alcohol Res. 2016;38(1):115-20
pubmed: 27159818
Acad Med. 2020 Dec;95(12S Addressing Harmful Bias and Eliminating Discrimination in He):S33-S43
pubmed: 32889925
Addict Sci Clin Pract. 2015 Nov 19;10:26
pubmed: 26585638
Br J Gen Pract. 2001 Oct;51(471):822-7
pubmed: 11677706
Alcohol Clin Exp Res. 2012 Sep;36(9):1614-22
pubmed: 22404130
Am J Prev Med. 2015 Nov;49(5):e73-e79
pubmed: 26477807
J Urban Health. 2006 Nov;83(6):1041-62
pubmed: 17031568