TY - JOUR
KW - Adult
KW - Decision Support Systems, Clinical
KW - Humans
KW - Mass Screening/methods
KW - Primary Health Care/methods
KW - Substance-Related Disorders/diagnosis
KW - Technology
KW - HIV
KW - Unhealthy drug use
KW - brief intervention
KW - primary care
KW - Screening
KW - Substance use disorder
AU - J. McNeely
AU - M. Mazumdar
AU - N. Appleton
AU - A. M. Bunting
AU - A. Polyn
AU - S. Floyd
AU - A. Sharma
AU - D. Shelley
AU - C. M. Cleland
A1 - 
AB - Background: Screening for unhealthy drug use is now recommended for adult primary care patients, but primary care providers (PCPs) generally lack the time and knowledge required to screen and deliver an intervention during the medical visit. To address these barriers, we developed a tablet computer-based 'Substance Use Screening and Intervention Tool (SUSIT)'. Using the SUSIT, patients self-administer screening questionnaires prior to the medical visit, and results are presented to the PCP at the point of care, paired with clinical decision support (CDS) that guides them in providing a brief intervention (BI) for unhealthy drug use. Methods: PCPs and their patients with moderate-risk drug use were recruited from primary care and HIV clinics. A pre-post design compared a control 'screening only' (SO) period to an intervention 'SUSIT' period. Unique patients were enrolled in each period. In both conditions, patients completed screening and identified their drug of most concern (DOMC) before the visit, and completed a questionnaire about BI delivery by the PCP after the visit. In the SUSIT condition only, PCPs received the tablet with the patient's screening results and CDS. Multilevel models with random intercepts and patients nested within PCPs examined the effect of the SUSIT intervention on PCP delivery of BI. Results: 20 PCPs and 79 patients (42 SO, 37 SUSIT) participated. Most patients had moderate-risk marijuana use (92.4%), and selected marijuana as the DOMC (68.4%). Moderate-risk use of drugs other than marijuana included cocaine (15.2%), hallucinogens (12.7%), and sedatives (12.7%). Compared to the SO condition, patients in SUSIT had higher odds of receiving any BI for drug use, with an adjusted odds ratio of 11.59 (95% confidence interval: 3.39, 39.25), and received more elements of BI for drug use. Conclusions: The SUSIT significantly increased delivery of BI for drug use by PCPs during routine primary care encounters.
AD - Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.; Department of Public Health Policy and Management, New York University Global School of Public Health, New York, New York, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
BT - Substance abuse
C5 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
CP - 1
CY - United States
DO - 10.1080/08897077.2021.1975868
IS - 1
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - Background: Screening for unhealthy drug use is now recommended for adult primary care patients, but primary care providers (PCPs) generally lack the time and knowledge required to screen and deliver an intervention during the medical visit. To address these barriers, we developed a tablet computer-based 'Substance Use Screening and Intervention Tool (SUSIT)'. Using the SUSIT, patients self-administer screening questionnaires prior to the medical visit, and results are presented to the PCP at the point of care, paired with clinical decision support (CDS) that guides them in providing a brief intervention (BI) for unhealthy drug use. Methods: PCPs and their patients with moderate-risk drug use were recruited from primary care and HIV clinics. A pre-post design compared a control 'screening only' (SO) period to an intervention 'SUSIT' period. Unique patients were enrolled in each period. In both conditions, patients completed screening and identified their drug of most concern (DOMC) before the visit, and completed a questionnaire about BI delivery by the PCP after the visit. In the SUSIT condition only, PCPs received the tablet with the patient's screening results and CDS. Multilevel models with random intercepts and patients nested within PCPs examined the effect of the SUSIT intervention on PCP delivery of BI. Results: 20 PCPs and 79 patients (42 SO, 37 SUSIT) participated. Most patients had moderate-risk marijuana use (92.4%), and selected marijuana as the DOMC (68.4%). Moderate-risk use of drugs other than marijuana included cocaine (15.2%), hallucinogens (12.7%), and sedatives (12.7%). Compared to the SO condition, patients in SUSIT had higher odds of receiving any BI for drug use, with an adjusted odds ratio of 11.59 (95% confidence interval: 3.39, 39.25), and received more elements of BI for drug use. Conclusions: The SUSIT significantly increased delivery of BI for drug use by PCPs during routine primary care encounters.
PP - United States
PY - 2022
SN - 1547-0164; 0889-7077
SP - 564
EP - 572
EP - 
T1 - Leveraging technology to address unhealthy drug use in primary care: Effectiveness of the Substance use Screening and Intervention Tool (SUSIT)
T2 - Substance abuse
TI - Leveraging technology to address unhealthy drug use in primary care: Effectiveness of the Substance use Screening and Intervention Tool (SUSIT)
U1 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
U2 - 34586976
U3 - 10.1080/08897077.2021.1975868
VL - 43
VO - 1547-0164; 0889-7077
Y1 - 2022
ER -