Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial
Abstract Background Unhealthy alcohol use is the third leading cause of preventable death in the United States. Evidence demonstrates that screening for unhealthy alcohol use and providing persons engaged in risky drinking with brief behavioral and counseling interventions improves health outcomes,...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Family Practice |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12875-020-01147-4 |
| _version_ | 1811228342083387392 |
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| author | Alison N. Huffstetler Anton J. Kuzel Roy T. Sabo Alicia Richards E. Marshall Brooks Paulette Lail Kashiri Gabriela Villalobos Albert J. Arias Dace Svikis Beth A. Bortz Ashley Edwards John Epling Deborah J. Cohen Michael L. Parchman Jonathan Winter Patricia Wessler Timothy J. Yu Alex H. Krist |
| author_facet | Alison N. Huffstetler Anton J. Kuzel Roy T. Sabo Alicia Richards E. Marshall Brooks Paulette Lail Kashiri Gabriela Villalobos Albert J. Arias Dace Svikis Beth A. Bortz Ashley Edwards John Epling Deborah J. Cohen Michael L. Parchman Jonathan Winter Patricia Wessler Timothy J. Yu Alex H. Krist |
| author_sort | Alison N. Huffstetler |
| collection | DOAJ |
| description | Abstract Background Unhealthy alcohol use is the third leading cause of preventable death in the United States. Evidence demonstrates that screening for unhealthy alcohol use and providing persons engaged in risky drinking with brief behavioral and counseling interventions improves health outcomes, collectively termed screening and brief interventions. Medication assisted therapy (MAT) is another effective method for treatment of moderate or severe alcohol use disorder. Yet, primary care clinicians are not regularly screening for or treating unhealthy alcohol use. Methods and analysis We are initiating a clinic-level randomized controlled trial aimed to evaluate how primary care clinicians can impact unhealthy alcohol use through screening, counseling, and MAT. One hundred and 25 primary care practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN) will be engaged; each will receive practice facilitation to promote screening, counseling, and MAT either at the beginning of the trial or at a 6-month control period start date. For each practice, the intervention includes provision of a practice facilitator, learning collaboratives with three practice champions, and clinic-wide information sessions. Clinics will be enrolled for 6–12 months. After completion of the intervention, we will conduct a mixed methods analysis to identify changes in screening rates, increase in provision of brief counseling and interventions as well as MAT, and the reduction of alcohol intake for patients after practices receive practice facilitation. Discussion This study offers a systematic process for dissemination and implementation of the evidence-based practice of screening, counseling, and treatment for unhealthy alcohol use. Practices will be asked to implement a process for screening, counseling, and treatment based on their practice characteristics, patient population, and workflow. We propose practice facilitation as a robust and feasible intervention to assist in making changes within the practice. We believe that the process can be replicated and used in a broad range of clinical settings; we anticipate this will be supported by our evaluation of this approach. Trial registration ClinicalTrials.gov, ClinicalTrials.gov Identifier: NCT04248023 , Registered 5 February 2020. |
| first_indexed | 2024-04-12T09:56:17Z |
| format | Article |
| id | doaj.art-5ddcd38c27f24acf8039242c56f9d91b |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-12T09:56:17Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-5ddcd38c27f24acf8039242c56f9d91b2022-12-22T03:37:41ZengBMCBMC Family Practice1471-22962020-05-0121111110.1186/s12875-020-01147-4Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trialAlison N. Huffstetler0Anton J. Kuzel1Roy T. Sabo2Alicia Richards3E. Marshall Brooks4Paulette Lail Kashiri5Gabriela Villalobos6Albert J. Arias7Dace Svikis8Beth A. Bortz9Ashley Edwards10John Epling11Deborah J. Cohen12Michael L. Parchman13Jonathan Winter14Patricia Wessler15Timothy J. Yu16Alex H. Krist17Department of Family Medicine and Population Health, Virginia Commonwealth UniversityDepartment of Family Medicine and Population Health, Virginia Commonwealth UniversityDepartment of Biostatistics, Virginia Commonwealth UniversityDepartment of Biostatistics, Virginia Commonwealth UniversityDepartment of Family Medicine and Population Health, Virginia Commonwealth UniversityDepartment of Family Medicine and Population Health, Virginia Commonwealth UniversityDepartment of Family Medicine and Population Health, Virginia Commonwealth UniversityDepartment of Psychiatry, Virginia Commonwealth UniversityDepartment of Psychology, Virginia Commonwealth UniversityVirginia Center for Health InnovationVirginia Center for Health InnovationDepartment of Family and Community Medicine, Virginia Tech Carilion School of MedicineDepartment of Family Medicine, Oregon Health & Science UniversityMacColl Center, Kaiser Permanente of Washington Health Research InstituteShenandoah Valley Family Practice Residency, Virginia Commonwealth UniversityRiverside Family Medicine Residency, Virginia Commonwealth UniversitySt. Francis Family Medicine Residency, Virginia Commonwealth UniversityDepartment of Family Medicine and Population Health, Virginia Commonwealth UniversityAbstract Background Unhealthy alcohol use is the third leading cause of preventable death in the United States. Evidence demonstrates that screening for unhealthy alcohol use and providing persons engaged in risky drinking with brief behavioral and counseling interventions improves health outcomes, collectively termed screening and brief interventions. Medication assisted therapy (MAT) is another effective method for treatment of moderate or severe alcohol use disorder. Yet, primary care clinicians are not regularly screening for or treating unhealthy alcohol use. Methods and analysis We are initiating a clinic-level randomized controlled trial aimed to evaluate how primary care clinicians can impact unhealthy alcohol use through screening, counseling, and MAT. One hundred and 25 primary care practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN) will be engaged; each will receive practice facilitation to promote screening, counseling, and MAT either at the beginning of the trial or at a 6-month control period start date. For each practice, the intervention includes provision of a practice facilitator, learning collaboratives with three practice champions, and clinic-wide information sessions. Clinics will be enrolled for 6–12 months. After completion of the intervention, we will conduct a mixed methods analysis to identify changes in screening rates, increase in provision of brief counseling and interventions as well as MAT, and the reduction of alcohol intake for patients after practices receive practice facilitation. Discussion This study offers a systematic process for dissemination and implementation of the evidence-based practice of screening, counseling, and treatment for unhealthy alcohol use. Practices will be asked to implement a process for screening, counseling, and treatment based on their practice characteristics, patient population, and workflow. We propose practice facilitation as a robust and feasible intervention to assist in making changes within the practice. We believe that the process can be replicated and used in a broad range of clinical settings; we anticipate this will be supported by our evaluation of this approach. Trial registration ClinicalTrials.gov, ClinicalTrials.gov Identifier: NCT04248023 , Registered 5 February 2020.http://link.springer.com/article/10.1186/s12875-020-01147-4Unhealthy alcohol usePreventive careRisk reductionPrimary careSBIRT |
| spellingShingle | Alison N. Huffstetler Anton J. Kuzel Roy T. Sabo Alicia Richards E. Marshall Brooks Paulette Lail Kashiri Gabriela Villalobos Albert J. Arias Dace Svikis Beth A. Bortz Ashley Edwards John Epling Deborah J. Cohen Michael L. Parchman Jonathan Winter Patricia Wessler Timothy J. Yu Alex H. Krist Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial BMC Family Practice Unhealthy alcohol use Preventive care Risk reduction Primary care SBIRT |
| title | Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial |
| title_full | Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial |
| title_fullStr | Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial |
| title_full_unstemmed | Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial |
| title_short | Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial |
| title_sort | practice facilitation to promote evidence based screening and management of unhealthy alcohol use in primary care a practice level randomized controlled trial |
| topic | Unhealthy alcohol use Preventive care Risk reduction Primary care SBIRT |
| url | http://link.springer.com/article/10.1186/s12875-020-01147-4 |
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