A prime reason that alcohol screening of patients in primary care has been recommended is that heavy alcohol use can worsen medical conditions such as hypertension and diabetes mellitus. Unfortunately, alcohol screening in medical settings is not routine and little research is available on effective methods of facilitating the adoption and implementation of such screening by primary care providers. This project examines the effectiveness of the Practice Partner Research Network's (PPRNet) """"""""Accelerating Alcohol Screening --Translating Research into Practice (AA-TRIP)"""""""" model to improve the detection, brief intervention, treatment (including pharmacotherapy and medical management) of alcohol problems by primary care physicians. The primary objective of the project is to compare the AA-TRIP model (with 10 primary care practices throughout the United States) to a control condition (10 primary care practices) in increasing the use of the Updated 2007 NIAAA guidelines for alcohol screening, diagnosis, brief intervention, and pharmacotherapy treatment by primary care medical practices for adult patients. We hypothesize that the AA-TRIP intervention model will result in significantly more screening, intervention and treatment (including medical management and pharmacotherapy) than the control condition. In addition, we are investigating the sustained effects of AA-TRIP on NIAAA alcohol screening after training and support have been discontinued. Secondary aims of the project include the investigation of practice-level variables related to implementation and sustainability of AA-TRIP using both quantitative and qualitative research methodology. Finally, we are investigating the impact of alcohol screening and treatment on disease-specific patient outcomes (i.e., change in blood pressure in HTN patients receiving brief intervention/treatment;change in hemoglobin A1c (HgbA1c) in DM patients receiving brief intervention and or treatment). The outcome could provide the first implementation model for pharmacotherapy and medical management of alcohol use disorders in primary care. In addition, results showing a relationship between alcohol intervention and improvement of hypertension and diabetes could have far-reaching implications for routine alcohol screening and treatment of patients with these medical conditions. Finally, increased treatment of alcohol use disorders in primary care could bring needed help to the 80% of alcoholic individuals in the USA who are currently not receiving treatment. Public Health Relevance: The results of this study could provide evidence for an effective method of increasing the use of alcoholism medications and medical management in primary health care with hypertensive and diabetic patients who have alcohol use disorders. The study could also show that primary care treatment of alcohol dependence leads to better blood pressure and blood glucose control in some patients.
|Ornstein, Steven M; Miller, Peter M; Wessell, Andrea M et al. (2013) Integration and sustainability of alcohol screening, brief intervention, and pharmacotherapy in primary care settings. J Stud Alcohol Drugs 74:598-604|
|Nemeth, Lynne S; Miller, Peter M; Nietert, Paul J et al. (2013) Organizational attributes and screening and brief intervention in primary care. Addict Behav 38:2639-42|