TY - JOUR
KW - Aged
KW - Alcohol Drinking/psychology
KW - Alcoholism/diagnosis/psychology/therapy
KW - Cohort Studies
KW - Directive Counseling/methods/standards
KW - Electronic Mail/standards
KW - Hospitals, Veterans/standards
KW - Humans
KW - Male
KW - Middle Aged
KW - Primary Health Care/methods/standards
KW - Questionnaires
KW - Reminder Systems/standards
KW - Time Factors
KW - Treatment Outcome
AU - E. C. Williams
AU - C. E. Achtmeyer
AU - D. R. Kivlahan
AU - D. Greenberg
AU - J. O. Merrill
AU - T. M. Wickizer
AU - T. D. Koepsell
AU - P. J. Heagerty
AU - K. A. Bradley
A1 - 
AB - OBJECTIVE: Brief intervention for patients with unhealthy alcohol use is a prevention priority in the United States, but most eligible patients do not receive it. This study evaluated an electronic alcohol-counseling clinical reminder at a single Veterans Affairs general medicine clinic. METHOD: The systems-level intervention evaluated in this study consisted of making the clinical reminder, which facilitated medical record documentation of brief intervention among patients who screened positive for unhealthy alcohol use, available to providers on one (of two) randomly selected hallways. Secondary electronic data were extracted for all patients who visited the clinic (October 1, 2002, to September 30, 2005). The proportion of patients with clinical-reminder use was evaluated among patients who screened positive for unhealthy drinking and were assigned to intervention hallway providers ("descriptive cohort"). Adjusted logistic regression evaluated the association between the intervention and resolution of unhealthy drinking at follow-up among all screen-positive patients who completed a second Alcohol Use Disorders Identification Test Consumption questionnaire 18 months or longer after the first ("outcomes cohort"). RESULTS: Eligible patients (N= 22,863) included 10,392 controls and 12,471 in the intervention group. Fifteen percent (398 of 2,640) of descriptive cohort patients with unhealthy drinking had clinical-reminder use, which varied by severity (14% [n = 302 of 2,165] with mild/moderate and 20% [n = 96 of 475] with severe unhealthy drinking,p = .001). Only 39% (156 of 398) of patients with clinical-reminder use had documented brief intervention; advice to abstain was most common. Access to the clinical reminder was not significantly associated with resolution of unhealthy drinking in 1,358 patients in the outcomes cohort. CONCLUSIONS: Availability of a clinical reminder to facilitate brief intervention did not, alone, result in substantial use of the clinical reminder. More active implementation efforts may be needed to get brief interventions onto the agenda of busy primary care providers.
BT - Journal of studies on alcohol and drugs
C5 - HIT & Telehealth
CP - 5
CY - United States
IS - 5
JF - Journal of studies on alcohol and drugs
N2 - OBJECTIVE: Brief intervention for patients with unhealthy alcohol use is a prevention priority in the United States, but most eligible patients do not receive it. This study evaluated an electronic alcohol-counseling clinical reminder at a single Veterans Affairs general medicine clinic. METHOD: The systems-level intervention evaluated in this study consisted of making the clinical reminder, which facilitated medical record documentation of brief intervention among patients who screened positive for unhealthy alcohol use, available to providers on one (of two) randomly selected hallways. Secondary electronic data were extracted for all patients who visited the clinic (October 1, 2002, to September 30, 2005). The proportion of patients with clinical-reminder use was evaluated among patients who screened positive for unhealthy drinking and were assigned to intervention hallway providers ("descriptive cohort"). Adjusted logistic regression evaluated the association between the intervention and resolution of unhealthy drinking at follow-up among all screen-positive patients who completed a second Alcohol Use Disorders Identification Test Consumption questionnaire 18 months or longer after the first ("outcomes cohort"). RESULTS: Eligible patients (N= 22,863) included 10,392 controls and 12,471 in the intervention group. Fifteen percent (398 of 2,640) of descriptive cohort patients with unhealthy drinking had clinical-reminder use, which varied by severity (14% [n = 302 of 2,165] with mild/moderate and 20% [n = 96 of 475] with severe unhealthy drinking,p = .001). Only 39% (156 of 398) of patients with clinical-reminder use had documented brief intervention; advice to abstain was most common. Access to the clinical reminder was not significantly associated with resolution of unhealthy drinking in 1,358 patients in the outcomes cohort. CONCLUSIONS: Availability of a clinical reminder to facilitate brief intervention did not, alone, result in substantial use of the clinical reminder. More active implementation efforts may be needed to get brief interventions onto the agenda of busy primary care providers.
PP - United States
PY - 2010
SN - 1938-4114; 1937-1888
SP - 720
EP - 725
EP - 
T1 - Evaluation of an electronic clinical reminder to facilitate brief alcohol-counseling interventions in primary care
T2 - Journal of studies on alcohol and drugs
TI - Evaluation of an electronic clinical reminder to facilitate brief alcohol-counseling interventions in primary care
U1 - HIT & Telehealth
U2 - 20731977
VL - 71
VO - 1938-4114; 1937-1888
Y1 - 2010
ER -