Referral to Treatment After Positive Screens for Unhealthy Drug Use in an Outpatient Veterans Administration Setting
Open accessAbstract
Objectives: To measure the rates and predictors of clinician recommendation for follow-up after a positive screen for unhealthy drug use, in a context of mandatory routine screening. To measure response to clinician recommendations and identification of new drug use diagnoses. Methods: Data are from a Veterans Health Administration (VHA) medical center that introduced mandatory routine screening for unhealthy drug use in outpatient primary care and mental health settings, using a validated single question. This study analyzed VHA electronic health records data for patients who screened positive for unhealthy drug use (n = 570) and estimated logistic regression models to identify the predictors of receiving a recommendation for any follow-up and for specialty substance use disorder (SUD) treatment. Bivariate tests were used for other analyses. Results: Among patients who screened positive for unhealthy drug use, 66% received no recommendation to return to primary care or another setting from the screening clinician. Further, among the 23% of patients who received a recommendation to visit specialty SUD treatment, only 25% completed the visit within 60 days. Six percent of all positive screens both received a referral to specialty SUD treatment and acted upon it. Conclusions: In the context of mandatory drug use screening using a single item, rates of clinician action and patient receipt of care appeared low. Improved follow-up will require health systems to provide more supports for clinicians and patients at each of the stages from positive screen to attending the follow-up appointment.
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- Authors
- Hodgkin, D., Gao, W., Larson, M. J., Drebing, C. E., Merrick, E. L., Pugatch, M., Horgan, C. M., Zolotusky, G., Petry, N. M., & Saitz, R.
- Affiliations
- Boston University (US)
- National Museum of the Philippines (PH)
- Corresponding author
- Hodgkin, Dominic
- ORCID
- Venue
- Journal of Addiction Medicine
- Published
- 2019-09-17
- Volume
- 14
- Issue
- 3
- Pages
- 236-243
- ISSN
- 1932-0620 (ISSN-L)
- 1935-3227
- PMC
- PMC7075731
- OpenAlex
- W2978535358
- Cited by
- 4
- References
- 27
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Addiction Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs (I50 RX001873)
- National Institute on Drug Abuse (R01DA033402, R21DA032039, P30DA035772)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- substance use screening, substance use disorders, referral to treatment, follow-up care, mandatory screening, Veterans Affairs health care, outpatient primary care, mental health services, clinician recommendations, treatment completion, veterans
- MeSH terms
- Veterans Health Services, Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Outpatients, Referral and Consultation, United States, Veterans, Substance-Related Disorders, Young Adult
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